The age-related decrease in GH secretion is associated with changes in functional capacity, body composition, and hormonal status which mimic those observed in adults with GH deficiency. These changes have raised questions similar to those focused around the decline in sex steroids with aging or menopause, including whether there is a net benefit in reversing this decline; if so, how; and who should be treated. Since the aging pituitary remains responsive to GHRH (41), GHRH has come under study both as a potential probe for assessing the status of the GH axis and as a potential therapeutic agent as an alternative to GH administration.

It is difficult to place these roles in context when the broader questions which frame them are still open. As with GH itself (see Chapter 12), we do not yet know whether reversing the age-related decline in GH secretion with GHRH would provide long-term benefits in excess of its side effects; which specific populations might benefit, whether with short-term or chronic treatment; or whether evaluating the functional status of the GH axis is an important part of identifying the people (if any) who would benefit the most. Answers to these questions are not now available.

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