Provocative GH secretory tests have been used as the gold standard for determining insufficiency in GH secretion. Specifically, two blunted provocative tests are used. This has been controversial as suggested by GH neurosecretory studies and the observations of many clinicians. Recently, somatostatin pretreatment was used to reduce the variability of GHRH stimulation testing (129). This refinement may help because the timing of the GHRH stimulus to the GH pulse influences the magnitude of the response. Somatostatin pretreatment could bring all subjects to the same trough level of GH. It is possible to speculate that this methodology could be applied to all GH-provocative tests.
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