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A decrease in the level of growth hormone in adults may result in:
• weakened heart muscle contraction and heart rate
- increased arterial plaque and blood pressure
- elevated lipids or fats in the blood:
- cholesterol
- low density lipoproteins (LDL)
- triglycerides
- decreased exercise capacity due to decreased cardiac output
- decreased energy due to decreased metabolic rate
- abnormal body composition:
- increased abdominal obesity (waist to hip ratio)
- decreased bone density due to decreased synthesis of bone
- increase in fractures and osteoporosis
- decreased muscle strength and muscle size
- decreased lean body mass
- increased fat mass
- low blood sugar:
- weakness or tiredness
- headaches
- poor concentration or memory
Physical Symptoms
- lack of energy or fatigue
- decreased sexual desire
- muscle weakness
- sleep problems
- weight gain
Psychological Symptoms
- shyness
- withdrawal from others
- nervousness or anxiety
- problem with sleep quality
- decreased social contact
- sadness or depression
- feelings of hopelessness
Adult Growth Hormone Deficiency (AGHD) is a condition in adults caused by the low or lack of secretion of somatotropin by the anterior pituitary gland. Somatotropin is another name for growth hormone. Hormones are chemical messages produced by special cells in glands and other organs of the body. A syndrome is a set of signs and symptoms that occur together and result from the same cause.
A single measurement of growth hormone levels is rarely useful, since growth hormone concentration is normally low most of the day and is released in pulses, not a steady secretion. Therefore, a lack of response to standard growth hormone stimulation tests is required for accurate diagnosis. The diagnosis of AGHD also requires a prior history of any childhood growth hormone deficiency or a history of organic pituitary disease. After a review of all criteria, an adult endocrinologist will make the diagnosis.
Growth Hormone Replacement Therapy (GHRT) is recombinant (biosynthetic) human growth hormone (rhGH). The goals of GHRT are to restore to as great an extent as possible, normal body function, including energy, metabolism and body composition. The importance of growth hormone in adults was recognized in the late 1990s.
The pituitary gland, known as the "master gland," produces several hormones that control the functions of other glands. It is located in the middle of the skull below the part of the brain called the hypothalamus. The pituitary gland secretes its hormones in response to a chemical message from the hypothalamus, the part of the brain to which it is connected. The pituitary gland has two distinct parts: the anterior (front) lobe and the posterior (rear) lobe. The anterior lobe produces six major hormones: one for the production of breast milk, two for reproduction, one for thyroid function, one for adrenal function, and one is somatotropin, which influences growth and metabolism (chemical and physical processes to maintain life). The hypothalamus stimulates the hormone release from the anterior pituitary; these hormones then act elsewhere in the body. When the pituitary gland is removed or destroyed, hormone secretion is lost. When one or more hormones are lost, this is known as hypopituitarism; when the pituitary gland is completely removed or destroyed and all hormone secretion is lost, this is referred to as panhypopituitarism.
Signs and symptoms of hypopituitarism depend on the specific hormones that are lacking. The amount of somatotropin (growth hormone) produced and secreted normally goes down with age. The decrease of somatotropin in children results in failure to grow; with a decrease of somatotropin in adults, the symptoms are subtle but measurable. Growth hormone (somatotropin) is often the first hormone to be lost or reduced in pituitary and hypothalamic disorders.
| Causes of Hypopituitarism |
Location of the hypothalamus and pituitary gland |
Congenital or acquired |
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| Inflammation |
| Surgery |
| Radiation |
| Autoimmune disease |
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Having adult GHD can mean you experience several different symptoms, many of which directly affect your mood and emotions. This is thought to occur because growth hormone (GH) plays an important part in managing psychological feelings besides helping childhood growth and other physical processes to occur. The most commonly reported symptoms reported by people with AGHD are listed above. Not everyone with AGHD experiences all these conditions; but if you do, there are effective therapies and treatments available to you.
You should feel comfortable talking to your primary physician and an endocrologist about any of signs and symptoms of AGHD you experience to determine whether evaluation is appropriate. In addition, AGHD persons who have depression or anxiety may benefit from psychotropic medication, or from a type of counseling called cognitive-behavior therapy in which the individual learns to change their feelings by reorganizing and reframing their dysfunctional thoughts. Support groups are also helpful to many people. Combinations of these therapies have been shown to work most effectively.
American Psychological Association
(800) 368-5777
American Psychiatric Association
(800) 245-3333
Contributions made by:
Lorraine Sosnowski, BSN, CRNI
Ann Arbor, MI
Brian Stabler, Ph.D.
UNC Chapel Hill, Chapel Hill, NC
Michael O. Thorner, M.B., D.Sc.
UVA Health Sciences Center, Charlottesville, VA
Reviewed by the HGF Education Committee
Copyright © 1998 Human Growth Foundation
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