Sheehan syndrome can be accompanied by proven adult growth hormone deficiency (GHD) — a comorbidity that requires targeted clinical assessment and active management distinct from the broader hypopituitary picture.
This protocol applies to patients with Sheehan syndrome who have proven adult growth hormone deficiency. Adult GHD may be present from childhood or may occur during adulthood as an acquired condition. Biochemical confirmation of GHD is the essential prerequisite before treatment is initiated.
For patients with confirmed GHD and no contraindications, evidence-based guidance recommends growth hormone replacement. Dosing is individualised by patient age and is adjusted at regular intervals based on clinical response and hormonal monitoring.
The primary goal is maintaining IGF-1 levels below the upper limit of normal, with dose reduction indicated if side effects arise.
DOI: 10.1210/jc.2016-2118
Adult GHD (AGHD) may be present at childhood or may occur during adulthood as an acquired condition.
We recommend offering GH replacement to those patients with proven GHD and no contraindications.
We recommend a starting dose of 0.2–0.4 mg/d for patients younger than 60 years and 0.1–0.2 mg/d for patients older than 60 years.
We recommend titrating GH doses and maintaining IGF-1 levels below the upper limit of normal and reducing the dose if side effects manifest.
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