Espinosa and colleagues recently reported that normal basal GH is uncommon in patients with acromegaly, and these patients were significantly older, more likely to be male, harbor small and non-invasive microadenomas, with lower IGF-1 levels and nadir GH following OGTT, and yet had a similar disease duration and a similar clinical course to patients with elevated basal GH at diagnosis [30]. The gene discussed is IGF1; the disease is acromegaly.