Calculates the initial growth hormone (GH) replacement dose based on patient age for adults with proven growth hormone deficiency (GHD). Triggers include initiating GH replacement in patients with proven GHD requiring GH replacement.
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---
name: ata-gh-dosing-age
description: Calculates the initial growth hormone (GH) replacement dose based on patient age for adults with proven growth hormone deficiency (GHD). Triggers include initiating GH replacement in patients with proven GHD requiring GH replacement.
---
# Calculate initial GH replacement dose based on age
## STEP 1 — Gather Information
Collect patient age, confirm diagnosis of proven GHD, and assess for contraindications to GH therapy (e.g., active malignancy, uncontrolled diabetes).
## STEP 2 — Rule In / Rule Out
If proven GHD is confirmed and no contraindications exist, proceed to dose stratification; otherwise, do not initiate GH replacement.
## STEP 3 — Classify or Stratify
Stratify by age: <60 years versus ≥60 years.
## STEP 4 — Decide
Prescribe a starting dose of 0.2–0.4 mg/d for patients <60 years or 0.1–0.2 mg/d for patients ≥60 years.
## Clinical Guardrails / Mimics / Pitfalls
Do not use GH for athletic performance, avoid initiation in active malignancy, monitor IGF-1 to prevent over-replacement, and avoid dosing adjustments without biochemical assessment.
## Concrete Clinical Example
A 58-year-old man with confirmed GHD and no contraindications starts GH at 0.3 mg/d; a 62-year-old woman with confirmed GHD starts at 0.15 mg/d.
**Source:** Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, https://doi.org/10.1210/jc.2016-2118
> **TODO:** consider adding scripts/calc.py for the ata-gh-dosing-age calculator
