Growth hormone therapy adverse effects

List the monitoring parameters necessary to assess therapeutic outcomes and adverse effects in patients receiving growth hormone therapy. 

Somatropin is being increasingly prescribed for growth hormone-deficient adults. Men have more adverse effects than women, probably because of a greater IGF-1 response (110). This was also seen in 74 elderly men and 57 elderly women in a controlled trial, and was not influenced by concomitant sex steroid therapy (41). 

Despite the lack of controlled clinical trials supporting its use, many clinicians supplement PN therapy with glutamine and recombinant growth hormone in an attempt to increase intestinal absorption and facilitate transition off PN. Recombinant growth hormone is a costly product with adverse effects, but PN is more costly and also has a serious adverse-effect pro-file. Larger controlled clinical trials are needed to determine the benefit of glutamine and rhGH in this patient population. 

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