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Hormone testing guide · 2026
IGF-1 is a legitimate clinical marker with a narrow set of uses, and a heavily marketed one with a much wider set of claims. The two do not overlap much.
IGF-1 (insulin-like growth factor 1) is produced mainly by the liver in response to growth hormone. Because growth hormone is released in pulses and has a short half-life, a random GH level is close to useless — IGF-1 is stable through the day and therefore serves as the practical screening marker for growth hormone excess or deficiency. IGFBP-3 is its main binding protein and is sometimes measured alongside, particularly in children. Both must be compared against age and sex-adjusted reference ranges; a value that is normal at 25 may be abnormal at 60.
| Sample | Single blood draw; no fasting or specific timing required |
|---|---|
| Why not measure GH directly | GH is pulsatile with a short half-life, so a random level is uninformative |
| Reference ranges | Strictly age and sex adjusted |
| Lowered by | Malnutrition, liver disease, poorly controlled diabetes, hypothyroidism, oral oestrogen |
| Price | Listed on the MedEx lab test catalogue — same price nationwide |
| Interpretation | Doctor consultation or specialist teleconsultation to review the report |
Growth hormone is secreted in bursts, mostly at night, and clears from the blood quickly. Sampling it at a random moment tells you where you happened to land in a pulse, not what the axis is doing overall.
IGF-1, by contrast, integrates GH exposure over a longer period and stays comparatively stable across the day. That makes it the sensible first-line marker — though a screening abnormality still requires dynamic testing (an oral glucose tolerance test for suspected excess, or a stimulation test for suspected deficiency) before any diagnosis.
IGFBP-3 adds most value in paediatric assessment and in some cases of nutritional or hepatic influence on IGF-1. In adults it is often optional.
A persistently raised, age-adjusted IGF-1 raises the possibility of acromegaly — growth hormone excess, usually from a pituitary adenoma. Features develop slowly and are often missed for years: enlarging hands and feet with changing ring or shoe size, coarsening facial features, jaw prominence, new dental spacing, carpal tunnel syndrome, snoring or sleep apnoea, headaches, joint pain, sweating, and new hypertension or diabetes.
Confirmation requires demonstrating failure of growth hormone to suppress during an oral glucose tolerance test, followed by pituitary imaging. This is specialist territory — a specialist teleconsultation is the appropriate next step rather than repeat IGF-1 testing.
Order IGF-1 with the context markers that make it interpretable.
A low IGF-1 is far less specific. It is commonly caused by things that have nothing to do with the pituitary:
Genuine adult growth hormone deficiency is uncommon and usually occurs in a context: known pituitary disease, previous pituitary surgery or radiotherapy, or significant head injury. In an otherwise well adult with vague fatigue, a low-normal IGF-1 is not a reason for growth hormone therapy. Check thyroid, liver, coeliac and nutritional status first — all covered within a MedEx checkup package.
IGF-1 declines with age, which has made it a fixture of longevity marketing. The biology is genuinely interesting but does not point in one direction: in animal models, lower IGF-1 signalling is associated with longer lifespan, while in humans both high and low IGF-1 have been linked to adverse outcomes in different cohorts, and higher IGF-1 has been associated with increased risk of certain cancers.
Growth hormone is not approved as an anti-ageing treatment, has meaningful adverse effects including insulin resistance, fluid retention, joint pain and carpal tunnel syndrome, and is subject to prescribing restrictions in Thailand as elsewhere. Treating an age-appropriate IGF-1 as a deficiency to be corrected is not supported by evidence.
If longevity and metabolic health are the real interest, markers with far stronger evidence — blood pressure, ApoB and lipids, HbA1c, liver function, kidney function, VO2 and body composition — are more actionable. Discuss with a MedEx clinician or explore functional lab testing options.
Growth hormone is released in pulses and clears quickly, so a random level reflects only where you landed in a pulse. IGF-1 is stable through the day and integrates growth hormone exposure over a longer period.
No. Fasting and specific timing are not required, although a fasted morning appointment is convenient if other tests are being drawn.
Compared against an age-adjusted range, a persistently high result raises the possibility of acromegaly. Confirmation requires an oral glucose tolerance test with growth hormone measurement and pituitary imaging, arranged by a specialist.
Usually not. Low IGF-1 is more often explained by undernutrition, liver disease, poorly controlled diabetes, hypothyroidism or oral oestrogen. Genuine adult growth hormone deficiency almost always occurs in the context of known pituitary disease.
The evidence does not support treating an age-appropriate IGF-1 as a deficiency. Both high and low values have been linked to adverse outcomes in different studies, and growth hormone is not approved as an anti-ageing therapy.
Yes. Oral oestrogen lowers IGF-1 through a first-pass liver effect. Transdermal oestrogen has considerably less impact.
An abnormal IGF-1 needs specialist confirmation, not a repeat test.
Medical disclaimer: This article is general health information and does not replace medical advice, diagnosis or treatment. Laboratory reference ranges differ between laboratories and results must be interpreted alongside your symptoms, medicines and medical history. Speak with a qualified clinician before starting, stopping or changing any treatment. Service details, inclusions and prices can change — confirm them with MedEx before booking.
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