Abstract
GHD in adulthood associated with hypothalamicpituitary dysfunction is now widely accepted as a distinct clinical syndrome, and is linked to a substantial number of metabolic abnormalities, many of which can be ameliorated with GH replacement therapy. However, despite the growing body of evidence on the benefits of GH therapy, there is still considerable variability in the US in the clinical practice of GH replacement for adults with GHD. Early studies utilized GH doses based on body weight or body surface area derived from pediatric experience. Although these studies reported beneficial effects of GH replacement, dose-related side effects such as arthralgia and peripheral edema were frequently observed. Growth hormone should only be prescribed for adults with a history of hypothalamic-pituitary disease and biochemically proven GHD, while the unapproved use of GH for nonmedical conditions such as sports and aging is strongly discouraged. Responsiveness to GH therapy is determined by many variables such as age, sex, adiposity, and concomitant medications.