I know a woman who was fatigued for a while. She is around 50. I read her labs and her IGF-1 was around 120. That is similar to what mine was. It was barely in the range which is about 99-400. I am here to tell you guys that an igf-1 below 135 IMO requires an arginine/glucagon stimulation test to verify if your pituitary is producing any HGH. Only one stimulating agent should be used in the test, not two at once. She is now feeling much better on HGH when her test came back saying she failed the hgh stim test. This is the test needed for insurance companies to pay for HGH. The gh stim test should be covered by your insurance even if your igf-1 is in range. I'm here to say that both of us had in range, yet in the low side of the range igf-1 levels, and that this did not mean that we were producing enough hgh despite some physicians saying to us that we were fine with igf-1 being in range. She is also on some armor thyroid. I would recommend a full thyroid workup including free t3 and an igf-1 test as well to everyone with chronic fatigue. The GH seemed to solve her problems - yet I have had more problems to solve. It might work for you. Don't let your doctor tell you that your low side igf-1 means your gh production is fine. Definitely not the case as proven by multiple cases.