For evaluation of suspected growth hormone deficiency in short stature, what test is checked?

• A. TSH
• B. Growth hormone levels
• C. ACTH stimulation test
• D. IGF-1 levels only

Answer: (B)

Growth hormone deficiency is diagnosed by testing the pituitary–GH axis’s ability to release GH, not by a single random GH measurement. Because GH is secreted in pulses, a baseline GH level can be normal even if the body can’t mount an adequate GH response when needed. The practical test checks how much GH is released in response to a provocative stimulus; you measure growth hormone levels after stimulation and look for a peak that fails to reach the established threshold. A blunted or absent peak supports GHD.

Other options don’t directly prove the axis’s functional capacity: TSH assesses thyroid function, the ACTH stimulation test assesses adrenal axis function, and while IGF-1 levels reflect GH action over time, they are not definitive for diagnosing GH deficiency on their own because they can be influenced by nutrition, liver function, and other factors.