Answer: D. All of the above. Low IGF-I levels can be indicative of AGHD provided a patient does not have a blunted response to growth hormone as a result of increased oral estrogen such as seen in cases of a liver disease, poorly controlled diabetes, and during administration of oral estrogen therapy.
4. Provocative testing for AGHD is optional if a patient has one or more deficiencies present in pituitary axes.
Endocrine Society, Molitch ME, Clemmons DR, et al. Evaluation and treatment of adult growth hormone deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1587-1609.