The pros and cons of sex steroid priming in growth hormone stimulation testing.

Diagnosing growth hormone deficiency (GHD) remains a challenge, and the role of sex steroid priming in the diagnosis of GHD continues to be debated. This review examines existing data on sex steroid priming during GHD diagnosis. Primary literature was reviewed in the area of sex steroid priming and growth hormone stimulation tests. Studies supporting sex steroid priming suggest improved diagnostic efficiency with reduced false diagnosis of GHD in peripubertal children. Those that do not support sex steroid priming note the potential for underdiagnosis of GHD and the lack of standardization in sex steroid priming procedures. To date, there is no consensus on the use of sex steroid priming prior to performing growth hormone stimulation tests in the evaluation of GHD. A more targeted approach to using sex steroid priming may be reasonable; however, the decision of whether or not to use sex steroid priming should remain with the individual clinician.