Growth Hormone In Adults

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Onset of GH Deficiency

Determining the Onset of Growth Hormone Deficiency
Onset	Childhood	Adulthood
Height	Short stature Dwarf	Normal height, but beginning to hunch over (up to severe Kyphosis)
General	Major physical impact (dwarf) Less severe emotional impact	Major emotional impact Physical impact is less severe (premature aging)
Face, eyebrows, nose, jaw bones, chin, hands, feet	Small Thin	Normal-sized But thinning and sagging
Quality of life	Moderately impaired	Severely impaired
Muscles, Bones	Thin and small	Atrophy
Sex organs	Sexual immaturity Small genitals: micro-phallus, micro-clitoris	Sexual maturity Normal sized genitals, but atrophying
Body Hair	Sexual immaturity Less body hair, the pattern is prepubescent or pubescent	Sexual maturity Diffuse thinning of body hair, but adult hair pattern

Complaints of GH Deficiency

Complaints suggestive of Adult Growth Hormone Deficiency
MENTAL COMPLAINTS
Stress		Poor stress tolerance; may collapse from minor stress
Quality of life		Poor quality of life, feels unwell
Self-esteem		Low self-esteem Lack of self-confidence
Mood		Lack of inner peace Chronic anxiety, without any reason Tendency to be depressed
Efficacy		Great difficulty in performing multiple tasks Feeling powerless Lack of concentration
Social behavior		Lack of self-control Excessive emotional reactions, sharp verbal retorts Dramatizing, outbursts of panic and anxiety Tendency to social isolation Impaired social status (lower professional position, lower income, poor social integration, often without partner, living still with parents)
PHYSICAL COMPLAINTS
Feet	Sore feet after long walks (caused by collapsed arches)
Health	Poor health
Physical appearance	Degradation of Physical appearance Muscle and skin: thinning, loosening and weakness Obesity
Energy/vitality	Exhaustion with poor or no recovery Difficulty in recovering when not having slept enough Feeling of rapidly aging, feeling of profound physical degradation
Temperature	Cold intolerance
Sex (men)	Erectile dysfunction: lack of volume and persistence of erections
Sleep	Light sleep Excessive need for sleep-9 hours or more
Food	Poor appetite for meat (because of the low anabolic state that decreases the appetite for protein)

Physical Signs of GH Deficiency

Physical Signs suggestive of Adult Growth Hormone Deficiency
Hair	Sparse thin hair	Body	Prematurely aged body
Face	Droopy eyelids		Obese body
	Sagging cheeks		Normal-sized, sexual aging or atrophying body (adulthood-onset GH deficiency)
	Thin lips
	Thin nose with the tip pointing downward		Small sexually immature body (childhood-onset)
	Thin jaw bones
Neck	Loose skin folds under the chin	Trunk	Small difference between maximal expiratory
Shoulders	Small or smaller shoulders		and inspiratory circumference of the chest
	Thin muscles
Arms	Droopy triceps	Abdomen	A fat, droopy abdomen
Hands	Thin muscles		Stretch marks on the abdomen
	Thin fingers (atrophic	Back	Kyphosis (hunchback)
	metacarpal bones)		hyperlordosis (increased lumbar curve)
	Prolonged skin folds after		Increased subscapular skin fold
	pinching the skin at the back		Sagging back muscles that look
	of the hand		like drapery folds
	Nails with striae	Thighs	Sagging inner thighs
	(longitudinal lines)		Fatty “cushions” (fat deposits)
	Atrophied palm and		above the knees
	hypothenar eminence
	(reduced muscle tone at the	Feet	Reduced foot arch or flat feet
	palm of the hands,		Muscular atrophy of foot sole
	esp. just beneath the thumb
	and under the little finger)