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Low GH with high IGF-1?

Discussion in 'Female Health & HRT' started by Mally, Jan 29, 2015.

  1. Mally

    Mally New Member

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    Hi,
    I'm new here and posting for the first time.

    I have had slightly over range IGF-1 levels for over 5 years now however every doctor I've ever seen has thought I also have a growth hormone deficiency.

    I did the Rhein urine test and it came back at 5.1 (.5-8).

    So my questions are these:
    1. If my IGF-1 is over range, shouldn't my urinary GH also be at the top of the range?

    2. Is there something else besides GH that stimulates IGF-1?

    As a bit of history, I also have adrenal insufficiency and have early menopause so am on BHRT. I also have a primary immunodeficiency and infuse Hizentra.

    Thanks for any insight you may be able to offer on why IGF-1 might be high and if that urine result excludes a growth hormone deficiency.

    Mally
     
  2. Mally

    Mally New Member

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    I found this which may help explain my results. I have high ACTH due adrenal insufficiency despite steroid replacement. I still wonder if it would be safe to try low dose GH replacement. Any thoughts from anyone?

    Thanks!

    Thus, IGF-I seems to be produced as a constituent in ACTH cells, possibly indicating its particular importance in stress response. Generally, IGF-I from the endocrine cells may regulate synthesis and/or release of hormones in an autocrine/paracrine manner as well as prevent apoptosis and stimulate proliferation. Production of IGF-I in GH cells may depend on the physiological status, most likely the serum IGF-I level. IGF-I released from GH cells may suppress GH synthesis and/or release by an autocrine feedback mechanism in addition to the endocrine route.

    Eur J Neurosci. 2007 Jan;25(1):191-200.
    Insulin-like growth factor I (IGF-I) and its receptor (IGF-1R) in the rat anterior pituitary.
     
  3. JanSz

    JanSz Well-Known Member

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    At least one of the problems is how one does the testing.
    I have book written by dr Tierry Hertoghe.
    He discusses and underlines good and bad testing for HGH, Growth hormones.

    Chemoluminoessence=bad way of testing.
    RIA, Radio-Immuno-Assay=this is the way to go.

    Using LabCorp, use this test:
    ----------------------------------------------
    Growth Assessment Test Group X (Growth Hormone, IGF-I, IGF-II, IGFBP-3)
    Test Code 500901 ... CPT Code 83003, 84305, 83519, 83519
    -----------------------------------------------
    On above test one want to have (naturally or via supplementation), =

    IGF-1=300-350
    IGFBP3=3000


    .
     
  4. Mally

    Mally New Member

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    I had the Esoterix testing, Growth Hormone Assessment.

    My results are:

    IGF-1 (BL) 207 ng/mL
    IGFBP-3 2.7 mg/L

    So these are actually low compared to your optimal ranges above, @JanSz.

    It seems odd that my always high IGF-1 is now deficient. Is this type of reversal common when changing the type of assay?

    I was thinking of trying a growth hormone releaser first to improve GH levels. Does anyone have any experience with sublingual Sermorelin?

    Thank you!
     
  5. JanSz

    JanSz Well-Known Member

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    Esoterix have good and bad tests.
    You want RIA.

    //
     
  6. Mally

    Mally New Member

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    This is the RIA, Growth Hormone Panel X.
     
  7. JanSz

    JanSz Well-Known Member

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    This is Female Health & HRT forum.
    Sorry, I posted ranges for man

    IGF-1=300-350
    IGFBP3=3000
    ===================

    For females dr Hertoghe wants IGF-1(220-300) you are basically there.

    specially that other doc I have seen, who follows dr Hertoghe,
    added clarifier to dr Hertoghes statement (that makes sense to me).

    he added a ratio (IGF-1)/(IGFBP3)

    ideal from Hertoghe
    IGF-1(220-300)
    IGFBP3(3000)

    (IGF-1)/(IGFBP3)=220/3000=0.0733
    (IGF-1)/(IGFBP3)=300/3000=0.1
    you
    (IGF-1)/(IGFBP3)=207/2700=0.0767



    //
     
    Last edited: Apr 12, 2015
  8. JanSz

    JanSz Well-Known Member

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    Just to clarify further,
    The proposed values are for average weight and height people.

    Large and tall people have a higher optimal GH
    short, thin people have a lover optimal GH
    page 58
    //
     
  9. Mally

    Mally New Member

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    So I guess that brings me back to my original question...is it possible to have a GH deficiency in the face of seemingly "normal" IGF-1? For example, if my high ACTH due to Addison's is causing my IGF-1 to be higher than it should be per the article I posted above.

    Is there any way to suss that out short of a stim test?

    And what are the risks involved in trying the releasers as I mentioned to see if they improved symptoms?
     
  10. JanSz

    JanSz Well-Known Member

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    is it possible to have a GH deficiency in the face of seemingly "normal" IGF-1?
    -----------
    I do not have a good answer to this question.
    Dr Hertoghe have two chapters in his book.
    One is about GH the other about IGF-1.
    He lists variety of tests with explanation that they may help insurance companies to make their decisions about payments.

    For treatment he uses IGF-1 and IGFBP3 obtained via RIA method.
    He lists also GH obtained via 24hr urine test, but give it low value.

    So, since he does not trust GH tests, he assumes that when one achieve good IGF-1 and IGFBP3 tests that implies good GH value.

    /////
    Since your IGF-1 and IGFBP3 appear to be in good standing,
    I assume that you have good GH.

    ///
     

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