Metabolic and QOL Effects of GH Treatment in Patients With TBI and AGHD

Exclusion Criteria

• •1. Other untreated pituitary deficiencies \[patients with other hormone deficiencies will have to be on stable replacement for at least three months before including them on the study; two months of stable replacement is required for hydrocortisone therapy for adrenal insufficiency\]
• •2. tumors, or other causes of AGHD (e.g. childhood onset GHD, pituitary surgery, tumors, radiation)
• •3. history of neurologic or psychiatric disorder such as stroke, spinal cord injury, bipolar disorder, or schizophrenia that has a significant impact in the Veteran's functional status and QoL
• •4. contraindication to rhGH therapy (e.g. hypersensitivity to rhGH or any of the components of the supplied product, including metacresol, glycerin, or benzyl alcohol)
• •5. acute medical illness, active infection, neoplastic disease or decompensated chronic medical illness such as diabetes mellitus (A1c \>9%), congestive heart failure or chronic obstructive pulmonary disease
• •6. evidence of alcohol dependence, alcohol abuse or drug use disorder during the three months previous to enrollment in the study
• •7. evidence of inadequate levels of effort in performing neuropsychological tests as suggested by scoring less than 41 on Trial I of the Test of Memory and Malingering (TOMM)
• •8. due to the decreased specificity of the AGHD diagnostic tests in this setting and weight/size limitations of the DEXA scanner, we will exclude morbid obese subjects defined as having a BMI greater than 35 or body weight \> 350 lbs
• •9. use of rhGH in the previous 6 months
• •10. active or recent (6 months) history of coronary artery or cerebrovascular disease