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The most common cause is insufficient pituitary somatotroph reserve, often from aging beyond the point where secretagogue therapy can restore adequate GH output

[21] Additionally, prednisone may suppress the transcription of numerous inflammatory genes, including those encoding cytokines such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha

For dental patients undergoing deep sedation or general anaesthesia, best practices include holding daily GLP-1 agonists on the day of procedure and weekly GLP-1 agonists a week prior to procedure, and adhering to or extending the current ASA fasting guidelines, with the possibility of an addition period of a clear fluid diet ahead of the recommended fasting period

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