Growth hormone: avoid except for patients rigorously diagnosed with evidence-based criteria with GH deficiency due to established etiology. Which option best reflects this guidance?

• A. Avoid in most cases
• B. Avoid, except for rigorously diagnosed GH deficiency with established etiology
• C. Use for weight gain
• D. Use for cognitive protection

Answer: (B)

Growth hormone therapy in older adults is not recommended unless there is solid, evidence-based confirmation of growth hormone deficiency with a clear etiologic cause. The best option states the precise exception: avoid, except for rigorously diagnosed GH deficiency with an established etiology. This reflects the Beers Criteria approach, which reserves GH treatment for those with documented deficiency proven by proper testing and an identifiable cause, rather than for general aging, preventive aims, or non-deficiency indications. The other choices misrepresent the guidance: using GH for weight gain or cognitive protection is not supported, and saying to avoid in most cases without noting the exception lacks the necessary nuance.