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Diagnosis of growth hormone deficiency in adulthood

The diagnosis of GH deficiency, either in children or in adults, can be a cumbersome task (1, 2). For someone unfamiliar with the field, it might seem a strange assertion, considering the amount of new knowledge and the insight arising from worldwide research on GH regulation. When dealing with patients grouped by aetiology, the task is easier and the GH provocative tests are clear-cut. But, clinicians do not deal with groups and we must make individual diagnoses and treatments, and this is where the problem resides. When studying a patient with suspected GH deficiency, there are two categories in which it is easy to classify him, i.e. healthy or with clear-cut GH deficiency, categories in which biochemical tests match clinical suspicion very well. There is a third and larger category, however, in which neither clinical data nor biochemical tests are of definitive help, and one becomes aware that most of