Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (965 page)

   Malnutrition

   Renal failure

   Cirrhosis

   Stress, exercise, prolonged fasting

   Uncontrolled diabetes mellitus

   Anorexia nervosa

Decreased In

   Pituitary dwarfism

   Hypopituitarism

   Adrenocortical hyperfunction

   Limitations

   Random levels provide little diagnostic information.

   GH levels vary throughout the day, making it difficult to define a reference range or to judge an individual’s status based on single determination.

   Periods of sleep and wakefulness, exercise, stress, hypoglycemia, estrogens, corticosteroids,
l
-dopa, and factors influence the rate of growth hormone secretion.

   Because of its similarity to prolactin and placental lactogen, earlier GH immunoassays were often plagued with falsely high values in pregnant and lactating women.