In this respect, a key finding is that in sera of NICTH patients most of the IGFs, including big IGF‐II, are not sequestered in 150 kD complexes with IGFBP‐3 and ALS, but instead predominantly circulate in binary complexes with IGFBPs, especially IGFBP‐2.3, 18, 77, 78 This is partly caused by the usually strongly reduced levels of the GH dependent ALS in NICTH sera. This evidence concerns the gene IGFBP3 and amyotrophic lateral sclerosis.