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check IGF-1 at 6 weeks | | Clonidine | Alpha-2 suppression of SRIH | Potentiates GH response | Check IGF-1 at 6 weeks | | Levothyroxine (hypothyroid replacement) | Restores permissive thyroid tone | Normalises somatotroph response | Achieve euthyroid first | | GLP-1 agonists | Weight/fat reduction lowers SRIH tone | May potentiate GH response | Re-evaluate dose at 12 weeks | Special Populations and Interaction Considerations Paediatric GHD Walker et al