Complications

Complication
Timeframe
Likelihood
short term
low

Thyroid function tests should be regularly monitored because hypothyroidism may be unmasked by treatment.[68]

Central hypothyroidism

long term
high

Prolonged untreated GHD results in a considerable deficit in final height. Untreated children with GHD achieve final height standard deviation scores of -4 to -6.[22][23]

long term
high

Untreated GHD is associated with reduced bone mineral density (BMD), and continuation of GH treatment in young adults with childhood-onset GHD is associated with improvement in BMD.[87]

Osteoporosis

long term
high

Adults with GHD often have low mood with reduced energy and libido and feelings of social isolation, which improve after GH treatment.[88][89][90][91]

long term
low

May be a risk of insulin insensitivity and type 2 diabetes mellitus. This is observed in untreated GHD adults, who on receiving treatment can deteriorate in terms of insulin sensitivity.[96]

Type 2 diabetes mellitus in adults

variable
medium

The long-term effects of GHD on cardiovascular morbidity and mortality are unclear. However, adults with GHD have an increased fat mass and decreased lean body and bone mass, are often overweight, and have elevated lipids. GH treatment is also associated with reduced carotid intimal thickness and insulin insensitivity.[92] Cardiovascular mortality is increased in patients with hypopituitarism, particularly in women.[93][94][95] GH treatment can reverse and reduce many abnormalities.[80][81] However, it is unclear whether treatment is associated with a reduction in the mortality.

Overview of acute coronary syndrome

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