Growth hormone (HGH)
Human growth hormone, sold as somatropin, is an FDA-approved prescription drug for specific medical conditions. It is also one of very few drugs that federal law restricts to its approved uses, which makes anti-aging and bodybuilding supply illegal.
- Legal lane: FDA-approved, prescription only, for approved conditions
- Evidence grade: A for approved uses. Not supported for anti-aging.
- Form: injection under the skin, usually daily
- Sport: prohibited
What it is
Somatropin is a lab-made copy of the 191-amino-acid hormone your pituitary gland produces. Brands include Omnitrope, Humatrope, Norditropin, Genotropin and Serostim.
What it is approved for
- Growth hormone deficiency in children and adults
- Short stature linked to Turner syndrome, Prader-Willi syndrome, Noonan syndrome, SHOX deficiency and chronic kidney disease
- HIV-related wasting and short bowel syndrome (specific brands)
In adults, deficiency has to be confirmed by testing. An IGF-1 level that is low for a person's age is not, on its own, the diagnosis the approval is based on.
The law is unusual here
For most drugs, a doctor may prescribe for uses beyond the label. Growth hormone is an exception. A provision of the Food, Drug, and Cosmetic Act makes it a felony, punishable by up to five years in prison, to distribute growth hormone for a use that has not been authorized. Anti-aging, bodybuilding and athletic performance are not authorized uses.
Dosing
Dosing is set by the prescriber, depends on the brand and the condition, and is adjusted to response and blood IGF-1 levels. A Drug Enforcement Administration fact sheet summarizes the recommended dosage as 40 micrograms per kilogram a day for children and 25 micrograms per kilogram a day for adults. Individual product labels differ, so the label for the specific brand governs.
Side effects and risks
- In a trial in healthy older adults, 36% of those on growth hormone reported joint pain (versus 11% on placebo), 30% muscle pain (versus 12%) and 26% swelling (versus 3%).
- Carpal tunnel syndrome and raised blood sugar are also reported.
- Product bought outside a pharmacy is frequently diverted, smuggled or counterfeit.
Related compounds
Several peptides are marketed as ways to raise the body's own growth hormone instead of taking it directly. See sermorelin.