Human growth hormone (HGH) has been used to stimulate growth in people with growth hormone deficiency (GHD) since the 1950’s. Although it was originally isolated from cadavers, cadaver-sourced HGH is now banned and has been replaced with a safer, recombinant HGH (rhGH). It is currently used for the treatment of not only GHD, but other diseases and syndromes that are associated with inhibited growth. HGH is prescribed not only to children, but also to adults with growth disorders. However, the role it plays in their treatment is different due to the effects that HGH has on the body at different stages of development. This article will cover the effects that HGH treatment has been found to have on people of different ages, as well as its effects in those who have no growth-related disorder.
Growth Hormone and Its Natural Role
When HGH was first discovered, it was found to stimulate growth, this earned it the name of “growth hormone”. It is a hormone expressed by the pituitary gland and it is vital to growth and development. Its release is stimulated by:
- Deep sleep: The pulsatile release of growth hormone is enhanced during both REM and non-REM sleep.1
- Exercise: There are many studies on the effect of exercise on GH release, with conflicting results. Some studies have shown that exercise can increase GH release shortly after commencement of physical activity and enhance GH release during sleep, while other studies have reported no significant effect on GH release after exercise.2
- Fasting: Fasting for 24 hours can produce a significant increase in GH release, with a greater magnitude of increase being observed in those with lower baseline GH levels.3
- Hormonal signals: Hormones such as growth hormone-releasing hormone (GHRH) and ghrelin stimulate the release of GH.4,5
Despite the nature of its discovery, research has found that it is responsible for more than just growth. It is most widely known to influence:
- Somatic growth: GH stimulates bone length and density and also promotes the growth of muscle mass in childhood.6,7
- Lipid metabolism: It activates lipase, mobilising fat from adipose tissue.8
- Carbohydrate metabolism: It affects glucose homeostasis by antagonising the effect of insulin, while also stimulating IGF-1 release, which acts in an insulin-like way.8
- Protein anabolism: GH promotes the building of proteins from amino acids.9
- Reproduction: GH is involved in the regulation of folliculogenesis, steroidogenesis, oocyte maturation and implantation.10
What is it Currently Prescribed For?
Due to its role in growth and development, it is prescribed for several conditions where growth is hampered, most notably GHD. The age at which it is administered, the condition it is being used to treat and the length of treatment all affect the health outcomes.
Treatment of Children with GHD and Idiopathic Short Stature (ISS)
When prescribed to children with GHD and ISS, the goal of treatment is to improve final adult height.
When treated with HGH, children with GHD achieved a final height of 169.5±6.93 cm, a significant improvement over the control group whose height averaged 165.54±7.59 cm.11 Similar results have been seen across other studies,12,13 and one research group noted that those who were taller when beginning treatment but had lower baseline GH saw a greater improvement in their height.
A meta-analysis abstracted data from ten clinical studies which involved 1089 patients and predicted the final adult height of children and adolescents with ISS receiving GH treatment. GH treatment was anticipated to increase adult height by about 4-6 cm.14 A review on the treatment of children with ISS concluded that GH and GnRH treatment could successfully be used to improve final adult height, with higher doses producing a greater increase in height.15
There are also some indications that the earlier treatment is started, the better the gain in height.16
Treatment of GHD in Pubertal Adolescents
A study looking at the effects of GH treatment on adolescents after 36 months of treatment found that the height of participants increased by 21.5±5.3 cm over the course of treatment, while a high dose of 0.7 mg/kg/week increased height by 25.1±4.9 cm. This gave the high-dose group a significantly higher predicted final adult height than the group receiving the standard dose.17
Treatment of GHD in Adults
In childhood, before bone plates have fused, GH stimulates chondrocyte proliferation, which results in endochondral ossification in the epiphyseal growth plates. As we reach adulthood, the growth of the cartilage in these growth plates slows before stopping completely in our early twenties.18 At this point, the epiphyseal growth plate has completely ossified and bones can no longer grow in length. However, appositional growth does not stop, meaning that bone thickness can still be stimulated in adulthood. HGH treatment can therefore not be used to increase the height of a fully developed adult. Instead, it confers several other benefits:
- Quality of life: People with GHD often suffer from anxiety, depression, OCD, panic disorders and have difficulty with focus, sometimes becoming socially isolated. In cases where patients are experiencing these symptoms, continuation of GH treatment can help to improve their well-being.19
- Bone remodelling: A deficiency in GH can lead to an increased risk of osteoporosis. GHD patients who are given GH treatment experience an increase in bone mineral density.20
- Fat distribution: GH treatment has been found to reduce intra-abdominal fat in those with GHD.21
- Cardiovascular health: People with GHD are at increased risk of atherogenesis and hyperlipidaemia. GH treatment can improve blood lipid profiles and other markers of cardiovascular disease, although it is not known how this affects the likelihood of cardiovascular events or mortality.22
GH Treatment in Those Without GHD, ISS or Growth-Related Syndromes
When we look at how GH treatment affects people with GHD, we can see that once GH levels are normalised, there are clear benefits. In people who already have sufficient GH, HGH treatment may still be of use. Preliminary research suggests that it can:
- Reduce intra-abdominal fat: As mentioned above, GHD patients experience a loss of intra-abdominal fat when on HGH treatment. A meta-analysis found that obese patients without GHD have also been found to lose visceral fat with HGH treatment.23 When combined with a low-calorie diet, fat loss is enhanced even further.24
- Increase muscle mass and strength: In addition to promoting fat loss, thigh muscle mass in obese participants was found to increase over the course of HGH treatment.23 In healthy men over the age of 50, it increased lower body strength.25
- Improve cognition: GHRH stimulates the release of GH from the pituitary. When treated with GHRH, the cognition of older adults was improved.26
- Increase skin thickness: In older men, HGH treatment increased skin thickness by 7.1%.27
- Improve sleep: An increase in GH secretion brought about by GHRH treatment can improve sleep in the elderly, although it is more effective in younger people.28
Risks of HGH Treatment
When used for treatment or at levels that exceed normal physiological levels, there is a risk of developing problems such as:
- Insulin resistance
- Joint complications
- Development of malignant tumours
- Headaches29
For this reason, HGH treatment must be prescribed and carefully monitored by a medical professional so that doses and treatment options can be adjusted according to each individual’s response.
Conclusion
HGH treatment is invaluable for growth-related disorders and can improve growth so effectively that children reach a normal or, in some cases, greater than average height. This ability to gain height through HGH treatment is lost once bone plates fuse, but the benefits of HGH do not end once adult height is reached. GHD comes with several symptoms which can lead to a decreased quality of life, such as depression, anxiety and increased risk of cardiovascular disease. For those with GHD, continuing HGH treatment may be of benefit to their health. HGH may also be a valuable medicine for the treatment of several other medical conditions unrelated to hindered growth. It has been tested on older and obese populations and has been found to decrease visceral fat, increase lean mass and improve skin quality, sleep and cognition. These new findings mean that HGH treatment may be beneficial to a far wider population than previously thought.
References
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- Horne BD, Anderson JL, May HT, et al. Weight loss-independent changes in human growth hormone during water-only fasting: a secondary evaluation of a randomized controlled trial. Front Endocrinol. 2025;15:1401780. doi:10.3389/fendo.2024.1401780
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- Chang CW, Sung YW, Hsueh YW, et al. Growth hormone in fertility and infertility: Mechanisms of action and clinical applications. Front Endocrinol. 2022;13:1040503. doi:10.3389/fendo.2022.1040503
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