Growth hormone (GH) testing measures the level of human growth hormone in the blood. GH is a hormone made in the pituitary gland in the brain. Your doctor may order one of the following tests if you have symptoms that suggest a GH abnormality:
There are many factors that can interfere with GH testing. Stress, exercise, certain medications, and blood glucose levels can all cause GH levels to rise and fall. For this reason, GH tests are often done with other hormones, like insulin-like growth factor-1 ( IGF-1).
Suppression tests are ordered:
GH stimulation tests are ordered:
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There are no major complications associated with this procedure.
To prepare for the procedure:
The injection site will be cleaned. An elastic tie will be placed around the upper arm. A needle will be inserted into the vein. The blood will be collected in a vial. Once the vials are full, the needle will be removed from the skin. Pressure will be put on the puncture site.
A blood sample will be taken between 6 am and 8 am. You will be asked to drink a water and glucose (sugar) solution. The glucose should make the GH level in the blood lower. Two more blood samples are taken within 1-2 hours after you have consumed the solution. In each blood sample, the GH level will be measured. IGF-1 levels may also be measured since they do not vary so much.
Blood samples will be drawn 5 times at different intervals. A first sample for blood glucose, cortisol, and growth hormone will be taken between 6 am and 8 am. Then, insulin will be given through the IV. The insulin should make the blood glucose level go down, which should make the GH level go up. Blood samples will be collected at 30, 60, 90, and 120 minutes for glucose, cortisol, and growth hormone.
If the blood sugar has not dropped to a certain level after 45 minutes, a repeat dose of insulin will be given. The blood sample will be collected 75 minutes and 150 minutes later. If the blood sugar levels fall too low, a high dose of sugar will be given by IV, followed by a sugar infusion.
An insulin tolerance test may not be available in all areas.
The blood sample will be drawn 5 times at different intervals. The first sample will be taken between 6 am and 8 am. Arginine or GH-releasing peptide will be given through the IV for 30 minutes. Once the arginine or GH-releasing peptide has been administered, GH-releasing hormone will be given by IV. This should stimulate the pituitary to release GH. The last four blood samples will be drawn every 30 minutes following both infusions.
Note: GHRH is not currently available commercially in the US.
You will be able to leave after the test is done.
The procedure often takes at least 3 hours.
There may be some minor discomfort when the needle is inserted in the skin and during the infusions. A doctor will supervise the insulin tolerance, as insulin can cause a very low blood sugar level in the blood.
Your doctor will discuss the results of the test. You may need further testing or treatment.
After the test, call your doctor for:
If you think you have an emergency, call for emergency medical services right away.
Healthy Children—American Academy of Pediatrics
Hormone Health Network—Endocrine Society
About Kids Health—The Hospital for Sick Children
Caring for Kids—Canadian Paediatric Society
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Growth hormone deficiency in children. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T908510/Growth-hormone-deficiency-in-children. Updated July 17, 2017. Accessed December 15, 2017.
Growth hormone deficiency in children. Endocrine Society Hormone Health Network website. Available at: http://www.hormone.org/questions-and-answers/2011/growth-hormone-deficiency-in-children. Accessed December 15, 2017.
Growth hormone test (arginine/clonidine stimulation test).Cincinnati Children's website. Available at: https://www.cincinnatichildrens.org/health/g/growth-hormone. Updated January 1, 2017. Accessed December 15, 2017.
Ho KK. H Deficiency Consensus Workshop Participants: Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: a statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of endocrinology, Japan Endocrine Society, and Endocrine Society of Australia. Eur J Endocrinol. 2007;157(6):695-700.
Last reviewed December 2017 by EBSCO Medical Review Board Marcie L. Sidman, MD Last Updated: 12/15/2017