Question:
I have been on genotropin (growth hormone) for several years. I gained
about 10 lbs in the first few months. The next year I was able to lose
almost 20 lbs and kept it off for over a year. I was feeling pretty
good for the first time in many years. Now, I have gained 10 lbs in
just 3 months and am so tired all the time I can hardly stay away. I
don't know why I am so tired or gaining so much weight. I read that
fatigue and weight gain can be a side effect of growth hormone. My
dose has been adjusted over the years from .2 to .4 to .6 to .8 and
now back to .6mg daily. I am also on thyroid and estrogen replecement
and the levels are OK. My IgF-1 fluctuates from the 70 to about 2-300
then back down to the 70's. I am confused and don't know what to do
about the fatigue and weight gain. My doctor says everything is fine
and wants to see my again in 3 months. Any ideas?

Answer:
Hey AK, how are you doing? Standard hormonal replacement therapy
should be monitored closely when treatment with GENOTROPIN is
instituted. In patients with hypopituitarism (multiple hormonal
deficiencies), patients should have periodic thyroid function tests
and be treated with thyroid hormone when indicated. Hypothyroidism
may develop during treatment with GENOTROPIN, and inadequate treatment
of hypothyroidism may prevent optimal response to GENOTROPIN.
Hypopituitarism is a condition in which the pituitary gland (a small
gland at the base of the brain) does not produce one or more of its
hormones or not enough of them. Some persons may have no symptoms or a
gradual onset of symptoms. In other persons, the symptoms may be
sudden and dramatic. The symptoms depend on the cause, rapidity of
onset, and the hormone that is involved. # ACTH deficiency:
Symptoms include fatigue, low blood pressure, weight loss, weakness,
depression, nausea, or vomiting. # TSH deficiency: Symptoms include
constipation, weight gain, sensitivity to cold, decreased energy, and
muscle weakness or aching. # FSH and LH deficiency: In women,
symptoms include irregular or stopped menstrual periods and
infertility. In men, symptoms include loss of body and facial hair,
weakness, lack of interest in sexual activity, erectile dysfunction,
and infertility. # GH deficiency: In children, symptoms include
short height, fat around the waist and in the face, and poor overall
growth. In adults, symptoms include low energy, decreased strength and
exercise tolerance, weight gain, decreased muscle mass, and feelings
of anxiety or depression. # Prolactin deficiency: In women,
symptoms include lack of milk production, fatigue, and loss of
underarm and pubic hair. No symptoms are seen in men. # ADH
deficiency: Symptoms include increased thirst and urination. For
excellent patient education resources, visit eMedicine's Endocrine
System Center and Growth Hormone Deficiency Center. Also, see
eMedicine's patient education articles Anatomy of the Endocrine
System, Hypopituitary, Growth Hormone Deficiency, and Understanding
Growth Hormone Deficiency Medications. Best wishes,