Human growth hormone (HGH), also called growth hormone (GH), plays an important role in bone metabolism. This has led researchers to investigate whether recombinant human growth hormone could help people with osteoporosis.
Some clinical studies have reported potentially favorable effects on bone metabolism or fracture outcomes. However, the evidence remains limited, and growth hormone is not a standard treatment for age-related or postmenopausal osteoporosis in people without growth hormone deficiency.
This distinction is important because growth hormone replacement has an established role in appropriately diagnosed adults with growth hormone deficiency, which is a different medical condition from ordinary age-related declines in growth hormone secretion.
Key Takeaways
- Growth hormone influences bone growth, remodeling, and metabolism.
- Adults with true growth hormone deficiency can have impaired skeletal health, and GH replacement may benefit bone in appropriately diagnosed patients.
- Normal age-related reductions in growth hormone are not the same as growth hormone deficiency.
- Small studies have investigated recombinant growth hormone in postmenopausal osteoporosis, with mixed or uncertain results.
- A systematic review and meta-analysis found no significant improvement in bone mineral density at the lumbar spine, total hip, or femoral neck from GH treatment in older adults without growth hormone deficiency, although limited evidence suggested a possible reduction in fractures.
- Growth hormone is not recommended as routine treatment for postmenopausal osteoporosis in current clinical practice guidelines.
- People should not use HGH for osteoporosis, “anti-aging,” or general rejuvenation without an appropriate medical indication and specialist supervision.
What Is Human Growth Hormone?
Osteoporosis
Human growth hormone is a peptide hormone produced by the pituitary gland, a small endocrine gland located at the base of the brain.
Growth hormone has major effects during childhood and adolescence, when it contributes to normal growth and development. It also remains biologically important throughout adulthood.
Many of its effects are mediated through insulin-like growth factor 1 (IGF-1). Together, the GH/IGF-1 system influences bone remodeling, muscle and body composition, and other metabolic processes.
Growth hormone secretion normally changes throughout life. Levels are generally higher during periods of growth and tend to decline with increasing age.
However, a normal age-related decline in GH secretion should not be confused with adult growth hormone deficiency, which is a clinical disorder requiring appropriate diagnostic evaluation.
What Is Osteoporosis?
Osteoporosis is a skeletal disorder characterized by reduced bone strength and an increased susceptibility to fractures.
Fractures of the hip, spine, wrist, and other bones can have major consequences, particularly in older adults.
Bone is living tissue that undergoes continuous remodeling. Old or damaged bone is broken down and replaced with new bone. Osteoporosis develops when the balance between these processes results in progressive loss of bone strength.
Age, menopause, genetics, previous fractures, certain medications, some medical conditions, smoking, excessive alcohol intake, and other factors can influence osteoporosis risk.
How Does Growth Hormone Affect Bone?
Growth hormone and IGF-1 participate in normal bone development and remodeling.
This relationship is particularly apparent in people with genuine growth hormone deficiency.
The Endocrine Society’s clinical guideline on adult growth hormone deficiency notes that GH replacement can benefit skeletal integrity in appropriately diagnosed patients (Molitch et al., 2011).
This does not, however, mean that giving additional growth hormone to an otherwise GH-sufficient older adult will prevent or reverse osteoporosis.
Treatment of a hormone deficiency and pharmacologically increasing hormone exposure in someone without that deficiency are different clinical situations.
Is the Normal Decline in HGH With Age a Hormone Deficiency?
No.
Growth hormone secretion generally decreases with age, but this normal physiological change is not sufficient to diagnose adult growth hormone deficiency.
Adult growth hormone deficiency is usually associated with disorders affecting the hypothalamus or pituitary gland, previous treatment affecting these structures, or established childhood-onset growth hormone deficiency.
The Endocrine Society states that confirmation of adult growth hormone deficiency usually requires appropriate stimulation testing unless specific circumstances make additional testing unnecessary (Molitch et al., 2011).
Therefore, symptoms commonly associated with aging—such as changes in body composition, energy, skin, sexual function, or memory—should not automatically be attributed to low HGH.
Growth hormone treatment should not be recommended simply because a person is getting older.
What Did the Study of HGH in Postmenopausal Osteoporosis Find?
One frequently cited study followed women who had participated in an earlier growth hormone trial.
Krantz, Trimpou, and Landin-Wilhelmsen studied 80 postmenopausal women aged 50 to 70 years with osteoporosis. Participants were receiving estrogen hormone replacement therapy and were initially randomized to one of two doses of recombinant growth hormone or placebo. All participants also received calcium and vitamin D (Krantz et al., 2015).
The growth hormone treatment period lasted three years, followed by longer-term observation.
Growth hormone increased bone mineral density and bone mineral content in a dose-dependent manner during treatment.
At the 10-year follow-up, 22 of the 80 women with osteoporosis had experienced fractures during the follow-up period. However, fractures were distributed across the original treatment groups, and the differences between those groups were not statistically significant (Krantz et al., 2015).
The researchers nevertheless reported favorable long-term bone and fracture outcomes for the osteoporosis cohort compared with its baseline fracture history and with an age-matched population group.
The results are interesting, but they should not be interpreted as definitive evidence that growth hormone prevents osteoporotic fractures.
Why Doesn’t This Study Prove HGH Is an Osteoporosis Treatment?
There are several important limitations.
The study included only 80 women with osteoporosis. The participants were also receiving other interventions relevant to bone health, including hormone replacement therapy, calcium, and vitamin D.
Growth hormone treatment lasted three years rather than the entire 10-year follow-up.
Most importantly, the long-term fracture numbers did not show a statistically significant difference between the original growth hormone and placebo groups (Krantz et al., 2015).
That makes it inappropriate to conclude from this study alone that HGH prevents fractures or should be routinely prescribed for osteoporosis.
What Does the Broader Evidence Show?
A systematic review and meta-analysis by Barake and colleagues specifically examined growth hormone therapy for age-related bone loss in adults without growth hormone deficiency.
The analysis included eight studies. Seven randomized a combined 272 postmenopausal women to growth hormone or a control intervention, while the eighth was an extension study (Barake et al., 2018).
The researchers found no significant effect of growth hormone on bone mineral density at the lumbar spine, total hip, or femoral neck compared with control treatment.
The analysis did find evidence of increased bone-turnover activity and reported a lower fracture risk among participants receiving growth hormone. However, the evidence base was small, and nearly all participants were receiving other osteoporosis therapies.
The researchers concluded that GH might affect fracture risk but emphasized that larger and longer studies are needed to establish its effects on bone quality and fractures (Barake et al., 2018).
This is a substantially more cautious conclusion than saying HGH has been scientifically proven to treat osteoporosis.
Is HGH an Approved Standard Treatment for Osteoporosis?
No. Growth hormone is not a standard osteoporosis treatment for adults without growth hormone deficiency.
Clinical guidelines from the Endocrine Society recommend established osteoporosis medications according to an individual’s fracture risk.
For postmenopausal women at high fracture risk, bisphosphonates are commonly recommended as initial therapy. Depending on the patient’s risk profile and circumstances, other options can include denosumab, teriparatide, abaloparatide, romosozumab, and selected hormone-related therapies (Shoback et al., 2020).
Growth hormone is not included as a routine pharmacological treatment for postmenopausal osteoporosis in these recommendations.
That does not mean the relationship between GH and bone is scientifically unimportant. It means that experimental or preliminary findings have not established GH as a routine osteoporosis therapy.
What About People With True Growth Hormone Deficiency?
This is a different situation.
Adults with confirmed growth hormone deficiency may receive recombinant growth hormone replacement when clinically appropriate.
The Endocrine Society reports that GH therapy in adults with genuine deficiency can provide benefits involving body composition, exercise capacity, skeletal integrity, and quality of life, with treatment individualized according to the patient’s circumstances (Molitch et al., 2011).
In these patients, growth hormone is being used to replace a documented hormonal deficiency.
The treatment should therefore not be confused with giving HGH to otherwise GH-sufficient adults specifically to treat osteoporosis or counter normal aging.
Does HGH Prevent Osteoporosis?
There is not enough evidence to recommend HGH for the prevention of ordinary age-related or postmenopausal osteoporosis.
Although growth hormone is involved in bone physiology and some studies have produced potentially encouraging findings, current evidence does not establish routine HGH treatment as an appropriate osteoporosis-prevention strategy in people without growth hormone deficiency.
People concerned about osteoporosis should instead have their individual fracture risk assessed and discuss evidence-based prevention or treatment options with a qualified healthcare professional.
Should Older Adults Take HGH to Stay Younger?
HGH should not be presented as a general “rejuvenation” therapy.
The natural decline in growth hormone secretion with aging does not by itself establish a hormone deficiency, nor does it mean that replacing HGH will prevent the diseases associated with aging.
Claims that HGH broadly prevents cardiovascular disease, diabetes, stroke, memory loss, sexual dysfunction, or other age-related conditions go beyond the evidence and should not be used to justify treatment.
Growth hormone therapy is a medical treatment with specific indications and requires appropriate diagnosis, dosing, and monitoring.
Related Reading:
HGH Benefits: What Human Growth Hormone Can—and Cannot—Do
HGH Injections: Approved Uses, Off-Label Risks, and Legal Concerns Explained
HGH Combined With Alendronate Can Lower the Risk of Bone Fractures in Patients With Osteoporosis
Final Thoughts
Growth hormone plays an important role in bone biology, and researchers have reasonably investigated whether recombinant human growth hormone could help treat osteoporosis.
The available research has produced some intriguing findings. A long-term study in postmenopausal women with osteoporosis reported favorable bone outcomes after a three-year course of GH, while a later systematic review found a possible reduction in fractures but no significant improvement in bone mineral density at major skeletal sites compared with controls (Barake et al., 2018; Krantz et al., 2015).
These findings are not strong enough to establish HGH as a standard osteoporosis treatment.
Current clinical guidelines recommend therapies with substantially stronger evidence for reducing osteoporotic fractures, while growth hormone replacement remains appropriate for selected patients with confirmed growth hormone deficiency (Molitch et al., 2011; Shoback et al., 2020).
The most accurate conclusion is therefore straightforward: HGH is important to bone health and may benefit the skeleton of people with true growth hormone deficiency, but it should not be considered a proven or routine treatment for age-related or postmenopausal osteoporosis in people without that deficiency.
Frequently Asked Questions About HGH and Osteoporosis
HGH and Bone Health
Does human growth hormone increase bone density?
Growth hormone plays an important role in bone remodeling and works partly through insulin-like growth factor 1 (IGF-1). However, this does not mean that taking additional HGH will increase bone density in every adult.
A systematic review and meta-analysis of adults without growth hormone deficiency found no significant improvement in bone mineral density at the lumbar spine, total hip, or femoral neck with growth hormone treatment compared with control treatment (Barake et al., 2018).
Does HGH make bones stronger?
Growth hormone contributes to normal bone metabolism, but bone strength depends on more than bone mineral density alone. Bone structure, quality, remodeling, age, previous fractures, medications, and other health factors also matter.
Current evidence does not support using HGH routinely to strengthen the bones of otherwise growth hormone-sufficient adults.
Can low growth hormone affect bone health?
Yes. Adults with confirmed growth hormone deficiency may have impaired skeletal health. Growth hormone replacement can benefit skeletal integrity in appropriately diagnosed patients (Molitch et al., 2011).
This is different from the normal decline in growth hormone secretion that occurs with aging.
HGH as an Osteoporosis Treatment
Is HGH a treatment for osteoporosis?
HGH is not a standard treatment for postmenopausal or age-related osteoporosis in people without growth hormone deficiency.
Small clinical studies have investigated growth hormone for osteoporosis, but the available evidence is not strong enough to establish it as routine therapy (Barake et al., 2018; Krantz et al., 2015).
Can HGH prevent osteoporosis?
There is insufficient evidence to recommend HGH for preventing ordinary age-related or postmenopausal osteoporosis.
People at risk of osteoporosis should instead receive an individualized assessment and use prevention or treatment strategies supported by established clinical evidence.
Can HGH prevent osteoporotic fractures?
This has not been established.
The long-term study by Krantz and colleagues reported potentially favorable fracture findings, but differences in fractures between the original growth hormone and placebo groups were not statistically significant at the 10-year follow-up (Krantz et al., 2015).
A later systematic review reported a possible reduction in fracture risk but emphasized the small evidence base and need for larger, longer studies (Barake et al., 2018).
HGH therefore should not be described as a proven way to prevent osteoporotic fractures.
Growth Hormone Deficiency and Aging
Is declining HGH with age the same as growth hormone deficiency?
No. Growth hormone secretion naturally decreases with age, but this physiological change is not the same as medically diagnosed adult growth hormone deficiency.
True growth hormone deficiency usually requires an appropriate clinical evaluation and, in many circumstances, specialized stimulation testing (Molitch et al., 2011).
Should women take HGH after menopause?
HGH is not routinely recommended simply because a woman has reached menopause.
Postmenopausal women concerned about osteoporosis should have their fracture risk evaluated and discuss established prevention and treatment options with a healthcare professional.
Should adults take HGH after age 40 to prevent bone loss?
No evidence-based guideline recommends routine HGH treatment beginning at age 40 to prevent osteoporosis.
Age alone is not an indication for growth hormone replacement.
HGH Versus Established Osteoporosis Treatments
What treatments are actually recommended for osteoporosis?
Treatment depends on an individual’s fracture risk, medical history, bone mineral density, previous fractures, and other clinical factors.
Evidence-based medications for appropriately selected postmenopausal women can include bisphosphonates, denosumab, anabolic agents such as teriparatide or abaloparatide, romosozumab, and selected hormone-related therapies (Shoback et al., 2020).
The appropriate treatment should be determined individually with a healthcare professional.
Is HGH better than bisphosphonates for osteoporosis?
There is no good evidence establishing HGH as superior to bisphosphonates for routine osteoporosis treatment.
Bisphosphonates have extensive evidence supporting fracture-risk reduction and are recommended as initial therapy for many postmenopausal women at high fracture risk. Growth hormone is not recommended as a routine alternative for osteoporosis in people without growth hormone deficiency (Shoback et al., 2020).
HGH Safety and Appropriate Use
Can HGH be used as an anti-aging treatment?
Normal aging should not be treated as growth hormone deficiency.
Claims that HGH can broadly reverse aging, rejuvenate the body, or prevent multiple age-related diseases go beyond established evidence. Growth hormone is a medical therapy that should be used for appropriate indications rather than as a general anti-aging treatment.
Who may legitimately need growth hormone treatment?
Adults with properly diagnosed growth hormone deficiency may be candidates for recombinant growth hormone replacement.
Treatment is individualized and requires medical supervision because the appropriate dose, expected benefits, potential risks, and monitoring requirements differ between patients (Molitch et al., 2011).
Should I take HGH if I have osteoporosis?
Do not start HGH solely because you have osteoporosis unless a qualified clinician has identified a separate medical indication for growth hormone treatment.
For most people with osteoporosis, the appropriate approach is to assess fracture risk, identify possible secondary causes of bone loss, and select an evidence-based osteoporosis treatment when medication is indicated.
References
Barake, M., Arabi, A., Nakhoul, N., El-Hajj Fuleihan, G., El Ghandour, S., Klibanski, A., & Tritos, N. A. (2018). Effects of growth hormone therapy on bone density and fracture risk in age-related osteoporosis in the absence of growth hormone deficiency: A systematic review and meta-analysis. Endocrine, 59(1), 39–49. https://doi.org/10.1007/s12020-017-1440-0
Krantz, E., Trimpou, P., & Landin-Wilhelmsen, K. (2015). Effect of growth hormone treatment on fractures and quality of life in postmenopausal osteoporosis: A 10-year follow-up study. The Journal of Clinical Endocrinology & Metabolism, 100(9), 3251–3259. https://doi.org/10.1210/jc.2015-1757
Molitch, M. E., Clemmons, D. R., Malozowski, S., Merriam, G. R., & Vance, M. L. (2011). Evaluation and treatment of adult growth hormone deficiency: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 96(6), 1587–1609. https://doi.org/10.1210/jc.2011-0179
Shoback, D., Rosen, C. J., Black, D. M., Cheung, A. M., Murad, M. H., & Eastell, R. (2020). Pharmacological management of osteoporosis in postmenopausal women: An Endocrine Society guideline update. The Journal of Clinical Endocrinology & Metabolism, 105(3), dgaa048. https://doi.org/10.1210/clinem/dgaa048
