Forensic Toxicology Case Study 5 Part 3: HGH Results Interpretation

This forensic toxicology case study, focusing on part 3, analyzes and interprets human growth hormone (HGH) test results. The study examines various conditions related to HGH levels, including gigantism, acromegaly, and dwarfism, and explores the roles of IGF-1. It discusses HGH stimulation and suppression tests, providing insights into diagnosing deficiencies and excesses. The case study considers conditions such as hypopituitarism, thyroid issues, and the impact of tumors on HGH production. By analyzing test results and understanding the underlying mechanisms, the study aims to improve the effective interpretation of lab tests. The conclusion summarizes the key learnings from the three parts of the assignment, emphasizing the importance of accurate result interpretation for medical professionals.

Running head: FORENSIC TOXICOLOGY CASE STUDY 5 PART 3 1
Forensic Toxicology Case Study 5 Part 3
Name
Institution

FORENSIC TOXICOLOGY CASE STUDY 5 PART 3 2
The spectra of each case samples linked to the testing of Human Growth Hormone is
interpreted in this section based on the confirmatory results. Together with the information
obtained in part one and two of the case study, this paper presents a written final case report on
all the case samples.
Interpretation
High HGH levels linked to high levels of IGF-1. Normal HGH and IGF-1 receptors
trigger gigantism (kids) and acromegaly (adults). The conditions are: tumor in pituitary gland
often result in benign adenoma. Also, multiple endocrine neoplasia type 1 (MEN-I). Non-
pituitary gland tumor situated in lungs, pancreases, adrenal gland and elsewhere secreting either
HGH or HGH-releasing hormone (GHRH). It can then stimulate the production of HGH by

FORENSIC TOXICOLOGY CASE STUDY 5 PART 3 3
pituitary gland. Also, McCune-Albright Syndrome can ensue. High levels of HGH are never
linked to high IGH-1 levels and have been observed in such conditions as: uncontrolled diabetes
mellitus, starvation, kidney illness, inherited GH resistance also called Laron syndrome. High
GH levels linked to high IGH-1 levels are seen in such conditions as: dwarfism as a result of
IGF-1 resistance due to inactivating mutation in IGF-1 receptor. Low levels of GH linked to low
IGF-1 levels trigger dwarfism in kids alongside imprecise, broad-based symptom alongside
surged risk of CVD (adults). It is observed in such condition as hypopituitarism (Meyer, Burgos-
Robles, Liu, Correia & Goosens, 2014).
The GH stimulation test: where levels of GH remain insignificantly stimulated during the
HGH stimulation test (stay lower than normal), and the individual has signs and symptoms of
GHD (and lower IGF-1 level), when measured), it is probably that there is a HGH deficiency that
the health provider might treat. Where the TSH and/or T4 level of an individual stays normal,
then it will probably be addressed initially as thyroid illness can trigger symptoms identical to
GHD. An individual might further have hypopituitarism and/or a more general drop in function
of pituitary. The HGH testing for GH deficiency must not be carried out till an individual’s
thyroid function has been effectively evaluated (Lewis et al., 2015).
Where hypothyroidism is present in a child, it must be treated and the growth rate of the
child evaluated before testing GH is considered. Where an individual exercises vigorously and
doesn’t experience a rise in levels of GH, then such a person might have a deficiency of GH
which has to be followed up with GH testing. HGH suppression test: In case an individual levels
of GH are never significantly suppressed in the course of HGH suppression test (stay higher than
normal), and the individual has signs and symptoms of GH excess (acromegaly or gigantism),
and IGF-1 level high (when measured), it is probably that the individual tested is secreting too

FORENSIC TOXICOLOGY CASE STUDY 5 PART 3 4
much HGH. Where a mass showcases on an X-ray, MRI, CT scan, the pituitary tumor (often
benign) is probably present Where a person is being monitored for a past tumor, the surges in
HGH might denote a recurrence. Pituitary tumours remain the common trigger of HGH
production, however, they might as well trigger deficiencies. The tumor presence can affect both
production of HGH and ACTH and prolactin. Where tumor is comparatively huge, it might
inhibit the production of all pituitary-secreted hormones and trigger surrounding tissues damage
(Gonzalez, Windram, Sathyapalan, Javed, Clark & Atkin, 2017). In conclusion, from the three
assignments; 1, 2 and 3, I have been able to understand how to test and interpret the results of lab
test effectively.
References

FORENSIC TOXICOLOGY CASE STUDY 5 PART 3 5
Gonzalez, S., Windram, J. D., Sathyapalan, T., Javed, Z., Clark, A. L., & Atkin, S. L. (2017).
Effects of human recombinant growth hormone on exercise capacity, cardiac structure,
and cardiac function in patients with adult-onset growth hormone deficiency. Journal of
International Medical Research, 0300060517723798.
Lewis, A. L., Jordan, F., Patel, T., Jeffery, K., King, G., Savage, M., ... & Illum, L. (2015).
Intranasal Human Growth Hormone (hGH) Induces IGF-1 Levels Comparable With
Subcutaneous Injection With Lower Systemic Exposure to hGH in Healthy Volunteers.
The Journal of Clinical Endocrinology & Metabolism, 100(11), 4364-4371.
Meyer, R. M., Burgos-Robles, A., Liu, E., Correia, S. S., & Goosens, K. A. (2014). A ghrelin–
growth hormone axis drives stress-induced vulnerability to enhanced fear. Molecular
psychiatry, 19(12), 1284-1294.