Growth hormone (GH) replacement therapy in GH-deficient adults should be initiated with a low dose, independent of body weight or body surface area. Measurements of serum insulin-like growth factor I (IGF-I) concentrations, as well as clinical examinations aimed at detecting signs of fluid excess, are important as safety markers to avoid overtreatment with GH. At present, there is no optimal marker for the long-term efficacy of GH replacement therapy. The long-term maintenance dose of GH should, therefore, be titrated in each individual based on the clinical response, with the aim of normalizing body hydration, other measurements of body composition, quality of life and well-being, and biochemical indices such as serum IGF-I concentration.
Copyright 2001 S. Karger AG, Basel