From runway models to athletes, society has looked up to (literally) and admired taller humans. People have thus resorted to the use of synthetic Human Growth Hormone (HGH), exercise and surgery which includes cosmetic leg lengthening in an attempt to grow in height. What does one need to know about height? How do we grow taller? Is it possible to improve my height even during adulthood? Are there any repercussions? These are the questions we aim to answer.
What is HGH?
Human Growth Hormone (HGH) also known as somatotropin is the main hormone necessary for human growth, as the name suggests. HGH is the most abundant hormone released by the anterior pituitary gland in your brain. Its secretions usually occurs during intervals of 3 hours and its onset is triggered by sleep.
What does HGH do?
HGH is imperative for many bodily functions during childhood and through adulthood that include:
- Normal body composition, which is the muscle-to-fat ratio
- Normal organ growth and function
- Bone production, growth and maintenance
- Muscle function
- The oxidation of fat and decrease in glucose utilization (helps to maintain the muscle-to-fat ratio)
How does HGH work in the human body?
HGH acts either directly or indirectly.
- Direct Action
HGH binds to HGH-receptors on target cells that cause a cascade of signals that result in the transcription of genes that will allow for growth.
- Indirect Action
HGH stimulates not only the liver, but epiphyseal growth plates too to release Insulin-like Growth Factor 1 (IGF-1). IGF-1 is a substance found in the blood and its presence in plasma is an indication of HGH availability. IGF-1 promotes chondrogenesis which is the formation of cartilage. The formation of cartilage allows for longitudinal bone growth and it maintains healthy body function and movement.
HGH deficiency can be congenital due to genetic abnormalities and mutations. These cause a lack of HGH or of Growth Hormone receptors. Genetic disorders such as Turner syndrome cause insufficient HGH secretion. Inadequate HGH can also be due to unknown reasons and it can be acquired later on in a child’s development.
HGH deficiency is acquired through various ways such as:
- Traumatic injuries that damage the brain
- Pituitary tumors
- Radiation therapy for cancers that affects the pituitary gland
Additionally abnormalities that affect hypothalamic control and its association with the anterior pituitary gland could result in insufficient HGH production.
HGH deficiency in Children
This can occur due to idiopathic, congenital or acquired means resulting in pituitary dwarfism. The effects include growth retardation, short stature and slow skeletal maturation. During infancy, growth is usually normal; however, it begins to slow down.
If left without treatment, children grow up to four feet compared to the norm of approximately five feet 9 inches for the average American male and 5 feet 4 inches for women. The short stature is due to atrophy of the epiphyseal growth plates causing them to be narrower therefore resulting in lack of longitudinal bone growth.
Other effects seen in children include:
- The retention of ‘baby fat’
- Weight gain and decrease in muscle tone. These occur due to an increase in the fat-to-muscle ratio that is characteristic of HGH deficiency.
When children with HGH deficiency progress to adulthood, they are more susceptible to:
- Heart issues due to a decreased myocardial mass
- Osteoporosis due to decreased bone density
- Kidney problems, high blood pressure and diabetes that are caused by the increased weight and insulin resistance
HGH deficiency in Adults
Adults may also have deficiencies due to congenital, idiopathic or acquired means. However, most onsets are due to acquired means such as a tumor in the pituitary gland or due to traumatic injury to the brain. The symptoms that are present include:
- Decrease in energy
- Lack of concentration and memory
- Increase in abdominal body fat that can cause obesity
- Decrease in the ability to tolerate exercise
Current research shows that the changes that are characteristic during aging may be a direct link to the decrease in HGH. Changes that include loss of strength, loss of muscle mass, increase in weight, and increase in the fat-to-lean mass ratio, wrinkled skin and impaired cardiac function may occur due to decreased HGH levels.
Treatment for HGH Deficiency
Until 1985, treatment of HGH deficiency was from the extraction of HGH from the pituitary gland of human cadavers. The US Food and Drug Administration (US FDA) discontinued this practice after the outbreak of the fatal Creutzfeldt-Jakob Disease (CJD) that was found in patients who were treated with HGH from human cadavers in the 1960s. This lead to research and eventual manufacturing of recombinant human Growth Hormone (rhGH) through biosynthesis.
Treatment for HGH Deficiency in Children
Children with inadequate HGH are taken through therapy which uses rhGH injections. This method has been proven to be effective for children with deficiencies. This treatment occurs gradually with surges during puberty and is often discontinued after skeletal maturation. Irrespective, there may be lifelong rhGH therapy for deficient adults.
Various factors should be put into consideration before the onset of therapy:
- rhGH therapy usually occurs before the fusion of their epiphyseal growth plates to promote longitudinal growth. It is not recommended to children with normal HGH levels as it could lead to complications such as abnormal bone, kidney, heart and liver growth. These could lead to secondary issues such as hypertension or diabetes.
- rhGH is synthetic therefore requires refrigeration in order to maintain the quality and integrity of the hormone. It should also be kept away from the light. Therefore, storage has to be a priority.
- It is commonly injected through the pen delivery method which is similar to insulin injections where everything has already been mixed and filled. Other administrative inventions also include the use of hidden needles and auto-injectors. These have been designed to ease the use of rhGH. However, there may still be an element of pain and discomfort.
- Individuals may experience HGH side effects that include increased intracranial pressure, pain in muscles and joints and swelling.
|Pros of rhGH therapy||Cons of rhGH therapy|
|◊ Increase in growth and final height of children||◊ Storage of rhGH may be inconveniencing especially during travel|
|◊ Increase in lean body mas||◊ It is expensive|
|◊ Increase in bone density||◊ Side effects may be experienced|
|◊ Decrease in fat mass||◊ Discomfort/ fear from needles|
|◊ Better cardiovascular growth and function|
◊ Used to treat HIV associated wasting and short bowel syndrome
Table 1: Pros and cons of rhGH therapy
Treatment for HGH Deficiency in Adults
Some adults undergo rhGH therapy even in adulthood to maintain normal body function. However, to improve short stature, limb lengthening surgeries are undertaken. The process is known as distraction osteogenesis and currently, it is not just used by people who have dwarfism but for cosmetic reasons as well.
Distraction osteogenesis (Limb Lengthening Surgery)
- It occurs based on the principle that bone can be regenerated when mechanical strain is applied. A transverse section is usually cut between two bones and an external fixator is attached to the bones using the widely used Ilizarov method. New bone tissue, blood vessels and nerves form between the gap causing leg lengthening. This treatment has to be precise as it takes time for the mineralization and consolidation of bone which failure to do so would result in inadequate growth.
- New methods also include the implantation of prostheses and nails in the bone without the use of the Ilizarov method of external fixators. This method could prevent pin care infections.
- The pros of leg lengthening surgery is growth from anywhere between 2-4 inches and improvement of self-confidence and social abilities if the patient had insecurities concerning their height.
- The considerations and cons of surgery include:
- It is very expensive especially in the US
- Patients have to undergo physical therapy afterwards causing the treatment to be approximately 9 months
- After the Ilizarov frame is removed, a cast would be placed and possible foot braces thus reducing mobility
- Mineralization and consolidation takes long
Exercise, Healthy Diet and Lifestyle
- It is reported that exercise especially anaerobic training and a healthy diet could possibly increase the levels of HGH. During strength training and weight bearing exercises there is increased stress on muscle and bone. Increases in muscle mass could stimulate an increase in bone growth and density. This would be in order to accommodate the new loads and demands on the bone through adaptation. This may therefore induce some bone lengthening effect.
- Exercise, a healthy diet and lifestyle helps to maintain body and bone composition by preventing early onset degeneration that occurs due to aging. The release of HGH during exercise could also contribute to anti-aging effects. Regardless of the benefits, these mediums cannot guarantee a significant increase in height.
What is the way forward?
Before undergoing any form of procedures to become taller such as rhGH therapy, limb lengthening surgeries or even a training program, it is imperative to be aware of the pros and cons of the treatment plans.
Do your own research to allow you to make an informed decision. It is always useful to speak to someone who may have gone through the same experience as they are aware of the details often overlooked. In addition, consult your doctor or multiple doctors before starting any plans. This will allow you to make the most effective and affordable decision.
But, most importantly, love yourself!