(GH) secretion, but it is unknown whether there is a feedback of GH on ghrelin secretion. In this study, we characterized the relatedness of GH and ghrelin in a model of acute caloric deprivation in 10 healthy women (age 26.7 Ϯ 1.6 yr) during a 4-day fast in the early follicular phase. GH, ghrelin, and cortisol were assessed every hour over 24 h during an isocaloric diet and after a 4-day complete fast. Sampling during a normal diet at baseline demonstrated that ghrelin decreased 17.9% within 1 h after meals (P Ͻ 0.0001), but there was no meal effect on GH. BMI (22.3 Ϯ 0.4 vs. 21.5 Ϯ 0.4 kg/m 2 , P Ͻ 0.0001) and IGF-I (312 Ϯ 28 vs.124 Ϯ 22 ng/ml, P Ͻ 0.0001) decreased during fasting. Mean 24-h GH increased (2.6 Ϯ 0.5 vs. 5.6 Ϯ 0.5 ng/ml, P Ͻ 0.001), but ghrelin decreased (441.3 Ϯ 59.7 vs. 359.8 Ϯ 54.2 pg/ml, P ϭ 0.012). The peak ghrelin level decreased from 483.5 to 375.6 pg/ml (P Ͻ 0.0001), and the time of the peak ghrelin changed from 0415 to 1715. In contrast, the diurnal pattern of GH was maintained, with increases in the nadir (1.1 to 3.4 ng/ml) and peak GH concentrations (4.1 to 7.9 ng/ml) from the fed to fasted state (P Ͻ 0.0001). The change in morning GH concentrations was inversely related to the change in ghrelin (r ϭ Ϫ0.79, P ϭ 0.012). During complete short-term caloric deprivation in healthy women, ghrelin decreases, even as GH rises, and these processes appear to be reciprocal, suggesting that GH exhibits feedback inhibition on ghrelin. Our data provide new evidence of the physiological relationship of GH and ghrelin in response to changes in protein-energy metabolism. nutrition; hunger; neuroendocrine; appetite GHRELIN IS AN ENDOGENOUS LIGAND for the growth hormone (GH) secretagogue receptor (18). Ghrelin levels are significantly lower in obese than in lean subjects (5,13,33). Prior studies have reported that ghrelin increases preprandially (4) and in response to chronic caloric deprivation in patients with anorexia nervosa (1, 25) and is suppressed by food intake (4). In a previous study (19), we demonstrated ghrelin pulsatility and relatedness to GH during fasting in healthy men. Feedback inhibition of GH on ghrelin was suggested in response to testing with growth hormone-releasing hormone (GHRH)/arginine (19). In addition to potential effects of arginine and somatostatin on ghrelin, another explanation of our prior data is that increasing GH during arginine/GHRH testing contributes to decreased ghrelin by feedback inhibition. GH and ghrelin exhibited mirror image responses during GH stimulation testing in our prior paradigm, suggesting a classical neuroendocrine feedback loop (19). Coordinated regulation of ghrelin and GH may be an important component in nutrient signaling to the brain but has not previously been assessed. In this study, we sought to characterize the relatedness of GH and ghrelin in a model of acute caloric deprivation in women, recognizing that the physiology in men and women with respect to ghrelin may differ and that prior conclusions regarding ghrelin physiology in men can...