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Typically, provocative tests of growth hormone secretion with pharmacological stimuli, such as insulin, glucagon, levodopa, clonidine, arginine or propranolol, are used to confirm growth hormone deficiency. The minimum normal peak serum growth hormone response to these tests has been arbitrarily set at 10 ug/L. However, these provocative tests have a number of limitations including sparse normative data, unclear mechanism of action and high variability of growth hormone responses.

Because of the variable responses with these conventional tests, it is recommended that at least 2 provocative tests be performed to confirm the diagnosis of growth hormone deficiency.

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