IGF-1

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Onset of IGF- 1 Deficiency

Determining the Onset of IGF- 1 Deficiency
IGF- 1 Deficiency		IGF- 1/ Growth hormone deficiency
ONSET	Prenatal	Childhood	Adulthood
General	Greatest physical impact: Small dwarf, Underdeveloped features Emotional impact of intermediate degree	Major Physical impact (dwarf) Less severe emotional impact	Physical impact is less severe: Premature aging Major emotional impact
Height	Very small dwarf Very short stature	Dwarf Short stature	Normal height Bowed Back+++
Face	Very small face Underdeveloped nose, jaws, chin, ears	Small Face Thin	Normal –sized Atrophy chin, nose, Jaws, ears,
Hands, feet	Very small hands and feet	Small hands and feet	Atrophying hands and feet
Muscles, Bones	Thinner and smaller than in childhood deficiency	Thin and small muscles- bones	Atrophied muscles-bones
Sex Organs	Sexual immaturity Very small genitals: micro-phallus, micro-clitoris	Sexual immaturity Small genitals: Micro-phallus, micro-clitoris	Sexual maturity Normal sized genitals, but atrophying
Quality of life	Considerably impaired	Moderately impaired	Severely impaired

Complaints of IGF- 1 Deficiency

Complaints suggestive of IGF- 1 Deficiency
MENTAL		PHYSICAL
Life	Poor quality of life, feels unwell	Health	General poor health
Mood	Lack of inner peace Chronic anxiety without clear reason Tendency to be depressed	Physical appearance	Degradation of physical appearance Thinner, loose skin Muscle atrophy, become droopy and weaker Obesity
Self-esteem	Low Self-esteem Lack of Self-confidence	Feet	Sore feet after long walks ( caused by collapsed foot arches)
Efficacy	Great difficulty in performing multiple tasks Feeling powerless Lack of concentration	Energy/ Vitality	Exhaustion with poor or no recovery Difficulty in recovering when not having not slept enough Feeling of rapidly aging, feeling of profound physical degradation
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, still living with parents	Temperature	Cold intolerance
Social behavior		Sex (Men)	Erectile dysfunction: lack of volume and persistence of erections
Stress	Poor stress tolerance, may collapse in minor stress situations	Sleep	Light sleep Excessive need for sleep 9 hours or more
Diet	Ambivalent appetite for sweets and sugar (in some it is excessive, in others low)	Food	Poor appetite fro meat ( because of the low anabolic state that lowers the appetite for protein)

Physical Signs of IGF- 1 Deficiency

Physical Signs suggestive of IGF- 1 Deficiency
Hair	Sparse, thin hair	Body	Childhood-onset IGF- 1 deficit: Small, sexually immature body Adulthood-onset IGF- 1 deficit: Prematurely aged appearance Normal-sized, sexually regressing appearance body Both types of IGF- 1 deficit: Obesity (more in adult type)
Face	Prenatal/early childhood IGF- deficit: Small chin, jaws, nose, Adulthood-onset Signs of IGF- 1 deficiency Thinner eyebrows Droopy eyelids Thin nose with the tip pointing downward Thin lips Thin jaw bones Sagging cheeks	Body
Face		Trunk	Superficial breathing: small difference between maximal expiratory and inspiratory circumference of the chest
Neck	Loose skin folds under the chin	Abdomen	A fat, droopy abdomen Stretch marks on the abdomen
Shoulders	Small or smaller shoulders Thin muscles	Back	Kyhphosis ( hunchback) Hyperiordosis (excess lumbar curve) Increased subscapular skin fold Sagging back muscles
Arms	Poorly developed/ droopy triceps	Thighs	Sagging inner thihs Fatty “cushions” (fat deposits) above the knees
Hands	Prenatal/early childhood IGF-deficit: Small hands Short, thin fingers Adulthood-onset IGF- 1 deficit: Normal- sized hands, but with thinner muscles Thinner fingers (atrophic metacarpal bones) Prolonged skin folds after pinching the skin at the back of the hand Nails with longitudinal lines Atrophied palm ( low muscle tone)	Feet	Prenatal/early childhood IGF- deficit: Small feet with short, thin toes Flat feet Adulthood-onset IGF- 1 deficit: Reduced foot arch Muscular atrophy of foot sole