Blood Work Done. Started With Testosterone Replacement. Pressure At The Back Of Head. IGF1 Level Are High. Need Advise?

Posted on Sun, 13 Oct 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 13 Oct 2013 Answered on

Tue, 5 Nov 2013 Last reviewed on

Question : I am 50 years old and have had blood work done 3 times since July 2013 because I have started testostorone replacement because my lab work came back at 192 for test. My IGF 1 levels were at 219. On my 2 blood work my IGF 1 levels were at 234 and the re-test came back at 237 IGF 1 levels. I have had pressure at the back of my head for about a month and it has moved to my eye area. My intern doc tells me it is a tenison headache. He does not know a lot about IGF 1 levels. I am really nervous because of my age and the IGF 1 levels being high. I do not have insurance so I want to be smart but I know my health is very important also. Please give me advice.

Answered by Dr. Shehzad Topiwala (33 minutes later)

Brief Answer:
Acromegaly must be ruled out

Detailed Answer:
IGF1 is a good screening test to look for a rare condition called acromegaly, which is essentially caused by excessive Growth hormone levels in the body. It is important to perform the next round of testing to confirm or rule out this diagnosis. The test is called Glucose Tolerance test. It entails having a baseline ('0' hour) blood draw for serum GH (Growth Hormone) levels. Then 75 grams of glucose is given in a glass of water, followed by a second blood draw at 2 hours for serum GH levels. A qualified endocrinologist will be able to interpret the results for you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (1 hour later)

What is the normal outcome if I do have this problem. Is this something that is fatal? Also u did not mention a pituiritary tumur. Is this not a concern? if it is not acromegaly what would be the other reason for the sudden spike in IGF 1 levels.

Answered by Dr. Shehzad Topiwala (19 hours later)

Brief Answer:
IGF1 is only a screening test

Detailed Answer:
IGF1is not a definitive diagnostic test for acromegaly. It is meant for initial screening. That is precisely why the next test is required to confirm the diagnosis ie the Glucose tolerance test. If this is normal then the elevated IGF1 levels can be monitored over time, if at all, to see if there is a significant increase later.

If diagnosed in a timely manner, fatal complications in acromegaly can be prevented.

Yes, the most common cause of acromegaly is a benign pituitary tumor. I did not mention it as I did not want you to get unnecessarily worried if you do not have the condition. But I am providing a link below for you to read more about this condition:

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar