HGH
Recombinant human growth hormone (rhGH, Somatropin). Exogenous GH replacement, banned by WADA as doping.
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WHAT IS HGH?
Detailed overview
Recombinant human growth hormone (rhGH, Somatropin) is the biologically identical form of natural pituitary GH. FDA-approved for GH deficiency, Turner syndrome, idiopathic short stature, and AIDS cachexia (Genotropin, Humatrope, Norditropin, Saizen). In sport, off-label use for muscle mass + recovery + fat loss. WADA-banned (S2 category); short detection window (~24 h) makes biomarker testing essential. Long-term use leads to acromegaly, cardiac hypertrophy, and insulin resistance. **Key nuances**: (a) **IGF-1 is the primary effector** – GH alone is less anabolic; the hepatic IGF-1 paracrine/endocrine signal is the main mediator (70-80% of sport anabolism is IGF-1-routed); (b) **T4→reverse T3 conversion shift**: on HGH rT3 rises while active T3 drops → subclinical hypothyroidism risk; T4/T3 co-administration plus mid-cycle TSH/fT3/fT4/rT3 panel is MANDATORY; (c) **Carpal tunnel and peripheral edema**: extracellular fluid plus Na+ retention → nerve compression, mostly above 4-6 IU/day; (d) **Fasted-state SC administration**: before bed or at least 2-4 h after last meal, because insulin directly antagonizes GH – fasted state gives max GH pulse.
Mechanism
GH receptor agonist, IGF-1 elevator
Half-life
~3 hours (subcutaneous)
Onset
4-8 weeks (IGF-1 peak)
Legal status
USA: FDA Rx. HU/EU: Rx. WADA: banned.
Data console
Lab data
Safety
Side effects, stop signs, contraindications
Side effects · 8
- Insulin resistance and elevated fasting glucose: GH antagonises insulin and raises hepatic gluconeogenesis/glycogenolysis, pushing toward type 2 diabetes over time (rising HbA1c).
- Fluid retention and peripheral oedema: sodium and water retention, early and very common, especially above 4 IU/day (puffy face, ankle swelling).
- Carpal tunnel syndrome and paraesthesia: fluid-related nerve compression causes numbness, tingling and hand pain; usually reversible on dose reduction.
- Acromegalic changes with chronic/high-dose use: enlargement of hands, feet and jaw, coarsening facial features, organomegaly and arthralgia.
- Cardiac hypertrophy and cardiomegaly: long-term concentric left-ventricular hypertrophy and impaired contractile function, with the raised cardiovascular mortality seen in acromegaly.
- Thyroid shift: GH increases T4-to-reverse-T3 conversion and lowers active T3, potentially causing subclinical hypothyroidism (fatigue); rT3/fT3/fT4 monitoring is warranted.
- Arthralgia, myalgia and joint stiffness: common complaints, partly from fluid retention and partly from tissue growth.
- Theoretical tumour/growth-promoting risk: chronically high IGF-1 is mitogenic and may accelerate growth of an existing malignancy, hence contraindicated in active cancer.
Contraindications · 7
- Active malignancy or history of cancer: absolute contraindication due to the mitogenic effect of raised IGF-1.
- Diabetes, prediabetes or insulin resistance: GH is diabetogenic, worsening glycaemic control and potentially aggravating retinopathy.
- Acute critical illness (major surgery, multiple trauma, acute respiratory failure): high-dose somatropin increased mortality in ICU trials, contraindicated.
- Active proliferative or severe diabetic retinopathy: GH/IGF-1 signalling can drive progression.
- Overt heart failure, uncontrolled hypertension or pre-existing left-ventricular hypertrophy: fluid retention and myocardial growth can precipitate decompensation.
- Pregnancy and breastfeeding: avoided due to hormonal effects and glucose-metabolism disturbance; safety not established.
- Non-therapeutic (performance) use: the above risks are unmanageable without medical supervision; WADA-prohibited (category S2).
Related Performance Compounds
Same therapeutic category
Studies
Related research and clinical findings
Performance Enhancing Hormone Doping in Sport.
Pope HG Jr, Wood RI, Rogol A, Nyberg F, Bowers L, Bhasin S
Ghrelin Receptor Deletion or Pharmacological Inhibition Improves Muscle Function in Aging Male Mice.
Kerr HL, Krumm K, Myree N
Acromegaly: clinical features and management
Melmed S.
Application of the Athlete Biological Passport Approach to the Detection of Growth Hormone Doping.
Equey T, Pastor A, de la Torre Fornell R, Thuyne WV, Deventer K, Sottas PE
Telegram
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The information here is for educational and scientific purposes only. Performance-enhancing compounds (AAS, prohormones, stimulants, doping agents) are illegal without prescription in Hungary and most of the EU, and carry serious health and legal risks. WADA bans them in competitive sport. This is NOT a usage guide, and we do not encourage any illegal use. If you do use them, medical supervision and regular bloodwork are ESSENTIAL. Severe endocrine, cardiovascular, hepatic and psychiatric side effects are possible.