Thread: HGH injection site iritation

Hey,

Just on my first go with HGH, I am experiencing some itchiness and slight discomfort for a few days after injecting. I am using U-100 needles and proper sterile procedures, and I know to expect some tenderness (I am stabbing myself with a needle afterall) but this seems a little more than what I might expect.

Just wondering if this is a common trait with HGH or not.

Originally Posted by chinooka

Injecting s/c in the abdomen, switching sides each day and different spots. Trying to find a place to get a blood test for serum levels in my area (Western Canada), I ended up with Kigtropin (i know......), my suppier swears by it but I definitely want to test for myself.

If you're Canadian just go to your PCP and convince him/her you need GH serum levels tested.
Take advantage of that Canadian socialized medicine system.

At a Glance

Why Get Tested?

To identify diseases and conditions caused by either a deficiency or overproduction of growth hormone (GH), to evaluate pituitary function, and to monitor the effectiveness of treatment for excess production of GH

When to Get Tested?

When slow growth in stature, delayed maturational development (in children), decreased bone density and/or muscle strength, and increased lipids (in adults) could be related to insufficient GH production; when a person has symptoms suggestive of gigantism (in children) or acromegaly (in adults) that may be a result of excess GH production; as part of an evaluation of pituitary function

Sample Required?

Usually several blood samples, drawn at timed intervals from veins in your arm; sometimes a single sample of blood, drawn following a fast and rest or after a period of strenuous exercise

Test Preparation Needed?

Follow any instructions you are given, such as to fast, in order to prepare for this test.



The Test

• How is it used?
• When is it ordered?
• What does the test result mean?
• Is there anything else I should know?

How is it used?

GH testing is not recommended for general screening. It is primarily ordered on those with symptoms of growth hormone abnormalities, as a follow-up to other abnormal hormone test results, or to help evaluate pituitary function.
Growth hormone tests are used to help identify excess or diminished GH production and give the doctor information about the severity of a person's condition. They are part of the diagnostic work-up required to find a cause for abnormal hormone production. In addition, GH can be measured to assess the success of therapy for acromegaly or gigantism.
An IGF-1 (Insulin-like growth factor ? 1) test is often ordered along with GH. IGF-1 mirrors GH excesses and deficiencies, but its level is stable throughout the day, making it a useful indicator of average GH levels.
Testing to diagnose GH abnormalities often involves either a GH stimulation test or a GH suppression test. These are used to evaluate pituitary response and changes in GH levels.

• GH stimulation tests help to diagnose GH deficiency and hypopituitarism. For a stimulation test, a sample of blood is drawn after 10-12 hours of fasting. Then, under close medical supervision, a person is given an intravenous solution of insulin or arginine. Blood samples are then drawn at timed intervals, and GH levels are tested in each to see if the pituitary gland was stimulated by the insulin (or arginine) to produce expected levels of GH. Other GH stimulants include clonidine and glucagon.
• GH suppression tests help to diagnose GH excess, which, in addition to other blood tests and imaging scans, can help identify and locate pituitary tumors. For a suppression test, a sample of blood is drawn after 10-12 hours of fasting. A person is then given a standard glucose solution to drink. Blood samples are drawn at timed intervals, and GH levels are tested in each to see if the pituitary gland is sufficiently suppressed by the dose of glucose.

Often other blood tests that reflect pituitary function, such as free T4, TSH, cortisol, FSH, LH, and testosterone (in men), are also ordered. These tests are usually performed prior to GH testing to make sure that they are normal and/or controlled with medication before GH testing is done. For example, hypothryoidism must be treated prior to testing for GH deficiency in children; otherwise, a falsely low GH result may be seen. Glucose levels are run on the samples collected during the GH suppression test, both to track glucose levels and to make sure that the person's system is sufficiently challenged by the glucose solution.
Since exercise normally causes a temporary increase in GH levels, some doctors may perform an initial evaluation of growth hormone deficiency by measuring GH after someone exercises vigorously for a period of time.
Periodic GH and IGF-1 measurements may be performed on children who have had radiation treatment of the central nervous system or whole body irradiation prior to stem cell transplants. This is common in acute lymphoblastic leukemia (ALL), where irradiation of the brain can affect the hypothalamus and pituitary gland, thus affecting growth.

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When is it ordered?

GH stimulation testing is ordered when a child has symptoms of growth hormone deficiency (GHD), such as:

• A growth rate that slows down in early childhood and the child is significantly shorter than others of the same age;
• Thyroid testing (e.g., free T4) shows that the child is not hypothyroid (low thyroid levels can also cause slowed growth);
• X-rays show delayed bone development;
• A doctor suspects that a child's pituitary gland is under-active.

Stimulation testing may be ordered in an adult when he has symptoms of GHD and/or hypopituitarism, such as decreased bone density, fatigue, adverse lipid changes, and reduced exercise tolerance. Other hormone testing is typically done first to rule out other conditions that may cause similar symptoms. GH deficiency is rare in children and adults. It is possible in adults if GH deficiency was diagnosed in childhood or there is a history of hypothalamic or pituitary disease.
GH suppression testing is done when children show signs of gigantism or when adults show signs of acromegaly. Suppression testing may be done when a pituitary tumor is suspected and may sometimes be used along with IGF-1 levels and other hormone levels to monitor the effectiveness of treatment for these conditions.
GH and IGF-1 testing may be ordered at regular intervals for many years to monitor for recurrence of GH abnormalities in cases of GH excess.

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What does the test result mean?


Care must be taken when interpreting results of GH tests. Since GH is released by the pituitary in bursts, random GH levels are not very useful. There is too much overlap between abnormal results and normal daily variation. GH levels will be higher first thing in the morning and will increase with exercise and stress. It is more useful to compare GH results with IGF-1results and evaluate responses to GH stimulation or suppression.
GH stimulation test
If GH levels are not significantly stimulated during a GH stimulation test (they stay lower than they should) and the person has symptoms of GHD and a low IGF-1 level, then it is likely that there is a GH deficiency that the doctor may treat. If the person's TSH level is low, then that should be addressed first as thyroid deficiencies can cause symptoms similar to GHD. A person may also have hypopituitarism and/or a more general decrease in pituitary function. GH testing for GH deficiency should not be performed until a person's thyroid function has been evaluated. If hypothryoidism is present, it should be treated and the child's growth rate evaluated before GH testing is considered.
If a person exercises vigorously and does not experience an increase in GH levels, then they may have a GH deficiency. This finding would need to be followed up with further testing.
GH suppression test
If a person's GH levels are not significantly suppressed during a GH suppression test (they stay higher than they should) and the person has symptoms of gigantism or acromegaly and a high IGF-1 level, then it is likely that the person tested is producing too much GH. If a mass shows up on an X-ray, CT scan, or MRI, then a pituitary tumor (usually benign) is likely present. If someone is being monitored for a previous tumor, then increases in GH may indicate a recurrence.

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Is there anything else I should know?

Pituitary tumors are the most common cause of excess GH production but may also cause deficiencies. Presence of a pituitary tumor not only can affect GH production but may also affect production of other pituitary hormones, such as ACTH (Cushing syndrome) or prolactin (galactorrhea). If the tumor is relatively large, it may inhibit all pituitary hormone production and cause damage to the surrounding tissues.
Factors that can interfere with GH testing include:

• Drugs that can increase GH (e.g., amphetamines, arginine, dopamine, estrogens, glucagon, histamine, insulin, levodopa, methyldopa, and nicotinic acid)
• Drugs that can decrease GH levels (e.g., corticosteroids and phenothiazines)
• Radioactive scan within week of test (with some laboratory methods)

Abnormal GH levels can usually be modified once the causes are identified. Synthetic GH is available to alleviate deficiencies in children (treatment of adults with GHD is more controversial). Combinations of surgery, medication, and radiation can be used to treat pituitary tumors that are causing excess GH production. The important thing is to identify GH abnormalities as soon as possible for good outcomes. The bone growth changes associated with gigantism and acromegaly are permanent and, if left untreated, the GH deficient child's short stature will remain.
There can be long-term complications from GH abnormalities. Acromegaly, for instance, can cause colon polyps (increasing a person's risk of developing colon cancer), diabetes, high blood pressure, and visual abnormalities. If a pituitary tumor permanently damages pituitary cells, then multiple hormone replacement may be necessary. Increased bone growth may also lead to trapped nerves (carpal tunnel syndrome), arthritis, and weak bones.
It should be noted that most cases of short stature are not due to GH deficiencies. They can also be related to familial traits, a variety of diseases and conditions, and to other genetic disorders.
Rarely, a person may have symptoms associated with GH deficiency but normal or elevated GH levels due to an inherited resistance to GH. In cases of GH resistance, whereas GH levels are high, IGF-1 levels are low.