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Hormones · Blood

IGF-BP3

The protein that binds the growth factor IGF-1 in the blood; follows the activity of growth hormone, but less sharply than IGF-1 itself.

At a glance

  • Measured in blood
  • In 1 test panel
  • No special preparation

IGF-BP3

  • Explanation
  • Result
  • Reliability
  • Who it is for
  • Test panels
  • Sources

Explanation

IGF-BP3: what is measured?

IGF-BP3 (insulin-like growth factor-binding protein 3) is the main protein to which IGF-1 is bound in the blood; by far most IGF-1 circulates in a complex with IGF-BP3. The liver makes IGF-BP3, just like IGF-1, under the influence of growth hormone from the pituitary gland. As a result, the value follows the average activity of growth hormone and is stable over the day. The value depends strongly on age: high during puberty and then gradually lower.

What can it detect?

  • Too much growth hormone (acromegaly), as an addition to IGF-1
  • A shortage of growth hormone, especially in children with delayed growth, together with IGF-1
  • Monitoring of treatment with growth hormone
  • Use of growth hormone or of substances that stimulate its release

Result

What does the result mean?

IGF-BP3 too high

A high value is normal during puberty. In adults, a raised value is often due to the use of growth hormone or substances that stimulate its release. The value can also be higher with reduced kidney function. A value that is clearly too high for your age, together with a raised IGF-1, may fit acromegaly: too much growth hormone due to a usually benign tumor of the pituitary gland, with slowly enlarging hands and feet, coarsening facial features and heavy sweating.

IGF-BP3 too low

IGF-BP3 gradually falls with age; a lower value in older people is usually normal. Malnutrition, rapid weight loss, liver disease, poorly controlled diabetes, an untreated underactive thyroid and estrogens taken by mouth can lower the value. A low value may fit a shortage of growth hormone, for example due to a damaged pituitary gland, but does not prove it; that requires a stimulation test.

After an abnormal result

With an abnormal value, the GP usually has IGF-1 measured and looks at age, diet, illnesses and medicines. With an IGF-1 that is too high for your age and matching symptoms, you are referred to an internist-endocrinologist; a child with delayed growth is referred to a pediatrician. A slightly abnormal value without symptoms usually does not lead to further testing.

Reliability

How reliable is the test?

IGF-BP3 follows the activity of growth hormone less sharply than IGF-1 and overlaps more between people with and without a disorder. In adults, IGF-1 says more when something is abnormal, both when acromegaly is suspected and when monitoring treatment. In children with delayed growth, IGF-BP3 can help together with IGF-1, because IGF-1 is naturally low in young children. A shortage or excess of growth hormone is only confirmed with a stimulation test or glucose drink test. As a measure of fitness or aging, IGF-BP3 is not supported by evidence.

What can affect the result?

  • Age: the reference values differ strongly by age group; a result can only be interpreted against the limits for that age.
  • Measuring methods give different results from each other; preferably compare results from the same laboratory.
  • Nutritional status, liver and kidney function, thyroid function and diabetes affect the value.
  • Growth hormone and substances that stimulate its release raise the value; estrogens taken by mouth lower it.

Who it is for

Who is the test useful for?

Useful for

The result says the most together with IGF-1, in children with delayed growth, with symptoms that fit acromegaly or with a known pituitary condition. Not suitable as a measure of aging, fitness or muscle building in healthy people. In people without symptoms, a single value says little.

How common is it?

Acromegaly is rare: in the Netherlands, it is diagnosed in about 50 to 100 people per year. A shortage of growth hormone in adults mainly occurs in people with a known pituitary condition or after pituitary surgery or radiotherapy.

Maastricht UMC+, Department of Endocrinology

Drawbacks and risks

  • A slightly abnormal value without symptoms can lead to unnecessary worry about the pituitary gland and to unnecessary tests such as an MRI.
  • A low value is sometimes taken as a reason to use growth hormone; use without a proven shortage has no medical basis and is on the doping list.

Get tested

IGF-BP3: test panels

IGF-BP3 is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.

  • IGF-BP3

    Blood draw

    IGF-BP3

    IGF-BP3; binding of IGF-1.

    € 60,00

Evidence

Sources

This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.

More about risks and results
  • NVKC, allesovertesten.nl: IGF-1
  • NVKC, allesovertesten.nl: Groeihormoon
  • Maastricht UMC+, afdeling Endocrinologie: Acromegalie
  • Maastricht UMC+, afdeling Endocrinologie: Hypofyse-uitval
  • Dopingautoriteit: Verbodenstoffenlijst

More explanations

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