Brief Answer:
IGF1

Detailed Answer:
First, glance at the age and gender adjusted normal range for IGF1 on your laboratory report. Kindly do not perform an internet search for this query. The reason for this is that normal ranges vary from l ab to lab depending on the method used. The technical term for this is 'assay'. This word refers to the specific scientific technique used to measure IGF1 levels in the blood. There are several methods available in the market.
Reputed laboratories of high standards use reliable assays for IGF1. So it is advisable to have it run in such laboratories only. This is important because IGF1 is not a simple test like blood glucose for example. It requires a specialized technique.
Then if your IGF1 value of 250 falls below the lower limit of normal for the range specified on your lab report, then I would recommend you to consult an Endocrinologist in-person to undergo a systematic evaluation for the possibility of GH (Growth Hormone ) deficiency.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.

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