Growth hormone

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Growth hormone

Effects on body functioning

Growth hormone (somatropin, somatotropin, HGH) is the body’s own product, produced from the anterior pituitary. It serves to regulate functions including growth. Growth hormone effects through the growth factors (IGF-1) produced mainly in the liver.

Growth hormone has many kinds of functions in the metabolism of carbohydrates and fat. Growth hormone is an anabolic (tissue building) hormone that increases the transport of certain amino acids to cells and accelerates protein synthesis and affects fat metabolism and the fluid balance of the body. Growth hormone enhances the muscle-growing effects of testosterone and anabolic steroids [1].

Production methods

All of the growth hormone preparations that are licensed in Finland are produced by recombinant DNA-technology. Sale of human-originated growth hormone, which is made from the pituitary glands of deceased individuals, is prohibited in Finland because the risk of the fatal Creutzfeldt-Jacob’s disease related to it.

Doses in medical use

The dosage of growth hormone in medical use varies according to the disease being treated and its severity. When treating growth hormone insufficiency in adults, the initial dose is 0.15 to 0.3 milligrams (about 0.5 to 1 IU). For long-term treatment, the recommended dose is a maximum of 1 to 1.3 milligrams a day (3 to 4 IU).

Rules for medical use of growth hormone

Growth hormone is a prescription drug that can be prescribed only by doctors who specialize in endocrinology, pediatric endocrinology or pediatric nephrology. In medicine, growth hormone is used for children with growth disturbances caused by insufficient growth hormone secretion. Sometimes adults with remarkable growth hormone insufficiency are also treated with growth hormone.

Certain limitations and recommendations are set for the licensing conditions of growth hormone preparations. Only a doctor who is appropriately familiar with and specialized in growth hormone insufficiency diagnosis and its treatment, is permitted to make a growth hormone insufficiency diagnosis, to start growth hormone treatment, and to supervise such treatment.

The diagnosis must be carefully ensured by using different kinds of exercise tests that measure the growth hormone secretion before starting the use of growth hormone. A doctor can be found guilty of treatment error if he/she describes growth hormones to a patient without seeing him/her or without making a careful diagnosis.

A patient receiving growth hormone must be monitored carefully, for example by conducting thyroid gland function tests and patient examinations for the possibility of glucose intolerance (sugar metabolism disturbance). It is recommended that the dose is checked every six months.

Abuse

Growth hormone is a doping substance according to the Decree 705/2002 that defines the doping substances that are to be regarded as doping substances referred to in Chapter 44, §16, Subsection 1 of the Penal Code.

Growth hormone is used for the anabolic effects [2, 3]. It is thought that growth hormone increases muscle mass and strength, helps the body adjust to harsh physical exertion, and accelerates the healing of injuries.

Adverse effects

When using growth hormone with appropriate medical doses, the most common adverse effects are joint and muscle pains and different types of swelling because of fluid retention. Swelling can lead to an increase in intracranial pressure or swelling of the eyeground. It can also lead to carpal tunnel syndrome.

Acute overdosing can cause hypoglycemia (low blood sugar) initially and later even coma. Later on, the consequence is hyperglycemia (high blood sugar). Long-term use can cause heart muscle degeneration, diabetes and acromegaly (excessive growth of gristles, fingers and chin) [1, 2, 3, 4].

Timo Seppälä
Medical Director
The Finnish Antidoping Agency FINADA

[1] Karila, Karjalainen, Mäntysaari, Viitasalo & Seppälä (2003): Anabolic androgenic steroids produce dose-dependent increase in left ventricular mass in power athletes, and this effect is potentiated by concomitant use of growth hormone. International Journal of Sport Medicine 24: 337–343.

[2] Neely & Rosenfeld (1994): Use and abuse of human growth hormone. Annual Review of Medicine 45: 407–20.

[3] Segura, Gutiérrez-Gallego, Ventura, Pascual, Bosch, Such-Sanmartín, Nikolovski, Pinyot & Pichini (2009): Growth hormone in sport: beyond Beijing 2008. Therapeutic Drug Monitoring 31(1): 3–13.

[4] Karila, Koistinen, Seppälä, Koistinen & Seppälä (1998): Growth hormone induced increase in serum IGFBP-3 level is reversed by anabolic steroids in substance abusing power athletes. Clinical Endocrinology 49: 459–463.

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