Thread by @lissabauer

It's always a pleasure to hear Dr. Biller speak about pituitary topics. Today is on GHD. Bottom line is that there are many barriers to dx & tx esp in those who had dx as kids and are now adults but treatment can come w/ a lot of benefit #AACE2021 #Endotwitter

Here are some considerations on who to test for GHD. Highest being those w/ prior pituitary/brain surgery -- if they have 3 or more pituitary deficits then it is more likely they have GHD than not. #AACE2021 #Endotwitter #ghd

Characteristics of GH stimulation tests. ITT still gold standard but not very tolerable/safe or speedy. Glucagon cheap, safe but remember the BMI cut off pts. Macimorelin very fast, easy to use and well tolerated but very expensive #AACE2021 #Endotwitter #ghd

Transitioning from peds to adult with GHD can be hard. Here are some of the barriers and tips on how to be effective in transition #aace2021 #Endotwitter #ghd

Algorithm for testing transition patients with clinical suspicion of GHD #Endotwitter #aace2021 #ghd

Now that GHD is confirmed here is how you start and monitor GHD treatment --higher doses in kids, lower doses as you age. Monitor clinical and biochemical parameters #Endotwitter #aace2021 #ghd