How do I install the Endo Target Age Normalized Igf1 skill?

Run npx skillmds@latest add dromlakhani/endo-target-age-normalized-igf1 in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Endo Target Age Normalized Igf1 safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Endo Target Age Normalized Igf1?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Endo Target Age Normalized Igf1 free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Endo Target Age Normalized Igf1?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Endo Target Age Normalized Igf1 by dromlakhani

Name: Endo Target Age Normalized Igf1
Rating: 4.2 (5 reviews)
Author: dromlakhani

Endo Target Age Normalized Igf1

Suggests a biochemical treatment goal of age-normalized serum IGF-1 value to indicate disease control in acromegaly. Use when setting therapeutic targets after initiating medical therapy or surgery, e.g., post-op IGF-1 at 12 weeks or random GH >1 µg/L.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Target age-normalized serum IGF-1 as biochemical goal

STEP 1 — Gather Information

Collect serum IGF-1 using the same assay throughout, record patient age, and obtain the age-specific median IGF-1 for that assay from laboratory reference tables.
Compute the age-normalized IGF-1 value (patient IGF-1 ÷ age-specific median).

STEP 2 — Rule In / Rule Out

Is the age-normalized IGF-1 ≤1.0 (within age-adjusted normal range)?

If yes → disease biochemically controlled.
If no → disease not controlled.
If ≤1.0, maintain current therapy; if >1.0, proceed to step 3.

STEP 3 — Classify or Stratify

Stratify the degree of elevation: mild (1.0–1.5), moderate (1.5–2.5), severe (>2.5).
Assign treatment intensification level based on elevation tier.

STEP 4 — Decide

For mild elevation, consider optimizing current somatostatin receptor ligand dose; for moderate, add pegvisomant or cabergoline; for severe, evaluate for radiotherapy or repeat surgery.
Implement the selected therapeutic adjustment (dose optimization, add-on agent, or definitive therapy).

Clinical Guardrails / Mimics / Pitfalls

Assay variability requires using the same method; age‑specific ranges differ by assay and population. Do not rely on random GH alone when pegvisomant is used, as it interferes with GH assays. Avoid applying adult normal ranges to children or elderly. In pregnancy, hepatic or renal failure, IGF‑1 interpretation is unreliable. Never adjust therapy based on a single IGF‑1 value without confirming assay consistency.

Concrete Clinical Example

A 48‑year‑old man 3 months after transsphenoidal surgery on lanreotide autogel 90 mg monthly has IGF‑1 720 ng/mL; age‑adjusted median for his assay is 600 ng/mL → ratio 1.20 (mild). Increase lanreotide to 120 mg monthly.

Source: Acromegaly: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2014, https://doi.org/10.1210/jc.2014-2700

TODO: consider adding scripts/calc.py for the endo-target-age-normalized-igf1 calculator

---name: endo-target-age-normalized-igf1description: Suggests a biochemical treatment goal of age-normalized serum IGF-1 value to indicate disease control in acromegaly. Use when setting therapeutic targets after initiating medical therapy or surgery, e.g., post-op IGF-1 at 12 weeks or random GH >1 µg/L.---# Target age-normalized serum IGF-1 as biochemical goal## STEP 1 — Gather InformationCollect serum IGF-1 using the same assay throughout, record patient age, and obtain the age-specific median IGF-1 for that assay from laboratory reference tables. Compute the age-normalized IGF-1 value (patient IGF-1 ÷ age-specific median).## STEP 2 — Rule In / Rule OutIs the age-normalized IGF-1 ≤1.0 (within age-adjusted normal range)? - If yes → disease biochemically controlled. - If no → disease not controlled. If ≤1.0, maintain current therapy; if >1.0, proceed to step 3.## STEP 3 — Classify or StratifyStratify the degree of elevation: mild (1.0–1.5), moderate (1.5–2.5), severe (>2.5). Assign treatment intensification level based on elevation tier.## STEP 4 — DecideFor mild elevation, consider optimizing current somatostatin receptor ligand dose; for moderate, add pegvisomant or cabergoline; for severe, evaluate for radiotherapy or repeat surgery. Implement the selected therapeutic adjustment (dose optimization, add-on agent, or definitive therapy).## Clinical Guardrails / Mimics / PitfallsAssay variability requires using the same method; age‑specific ranges differ by assay and population. Do not rely on random GH alone when pegvisomant is used, as it interferes with GH assays. Avoid applying adult normal ranges to children or elderly. In pregnancy, hepatic or renal failure, IGF‑1 interpretation is unreliable. Never adjust therapy based on a single IGF‑1 value without confirming assay consistency.## Concrete Clinical ExampleA 48‑year‑old man 3 months after transsphenoidal surgery on lanreotide autogel 90 mg monthly has IGF‑1 720 ng/mL; age‑adjusted median for his assay is 600 ng/mL → ratio 1.20 (mild). Increase lanreotide to 120 mg monthly.**Source:** Acromegaly: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2014, https://doi.org/10.1210/jc.2014-2700> **TODO:** consider adding scripts/calc.py for the endo-target-age-normalized-igf1 calculator

Frequently asked questions