Comprehensive Analysis of Human Growth Hormone (HGH) Injections: Exploring Medical Uses, Legal Issues, and the Risks of Off-Label Applications

Overview Of HGH Injections

One of the most powerful substances known to man is synthetic Human growth hormone (HGH). Like anabolic steroids, HGH has had its time in the spotlight, especially among bodybuilders, the fitness and anti-aging communities, actors, and the world of athletics. Among these groups, HGH is usually used for bodily aesthetics and performance enhancement.

HGH Injections

Surrounding HGH is hype and exaggerated claims. As a result, confusion may arise regarding what the hormone is, and what it’s supposed to be used for.

This article will cover a wide range of topics related to HGH including what HGH is, legal and approved uses of synthetic HGH, the dangers of abuse, and elevated costs.

If you are adamant about taking something to boost your HGH levels, then read on to discover safer, not to mention cheaper alternatives to do so.

The Beginning of HGH Popularity

The story of HGH is a subplot in a much bigger story, that of anti-aging. For many people, the thought of administering a thin painless injection to slow down aging is an attractive one. Let’s face it, you would not want to be subjected to the detrimental effects of aging, especially if you could help it.

This pressure to look younger at all costs is of cause intensified by the Hollywood scene. A flourishing community of bodybuilders popularized the use of synthetic HGH. It eventually reached those in the television and movie industries. Although its use is sometimes shrouded in secrecy, it’s known that several actors, Sylvester Stallone for instance, have used it.

The HGH Rudman Study

In 1990, Dr. Daniel Rudman published the results of a study detailing the clinical efficacy of HGH administered to men between the ages of 61 and 81. In 6 months, participants in this study gained muscle, lost body fat, and increased bone density. As you can imagine, such a study naturally sparked wild imaginations of potential applications. Not to mention that proponents of HGH naturally felt vindicated by these findings.

Of course, we know better: the findings of one 6-month study on a dozen men do not constitute the highest level of evidence in science! At least not the kind of evidence needed to warrant the widespread use of HGH for anti-aging or longevity reasons.

Alas, hype and frenzy have taken hold. Some doctors promote its use for anti-aging and view it as a solution, not a problem. As such, those in bodybuilding and show business continue to spend millions every year acquiring HGH.

Given such contrasting views, even among subject experts, it becomes quite difficult for the general public to filter and distill the truth. So let us break down the use of HGH and as such appreciate the truth or at least begin to.

Natural HGH

HGH also called somatotropin is a peptide hormone that helps in the development and maintenance of body tissues. HGH is produced naturally in a small gland situated at the base of the brain, the pituitary gland. Once produced it’s converted into another substance called Insulin-Like Growth Factor-1 (IGF-1), the mediator of HGH effects.  Such effects include the maintenance of lean muscle, lipolysis (fat breakdown), increase in bone density, and possibly immune system modulation.

Synthetic HGH Injections

The FDA approved the use of Synthetic HGH injections in the 1980s following its development. Currently, HGH is FDA-approved for the treatment of specific conditions none of which include use for an anti-aging.

What is Synthetic HGH?

Recombinant gene technology is used to synthesize HGH. This technology has not always existed though. Before recombinant gene technology, crashed cadaveric (corpses) pituitary glands were used as the source of HGH.  This process yielded results but was complicated by contamination and the risk of transmitting infections. Furthermore, cadavers were in limited supply.

The use of recombinant gene technology solved both the problem of supply and contamination. Simply put, recombinant gene technology transforms little bacteria into HGH-producing machines. A gene coding for HGH is inserted into the bacteria, essentially becoming part of the bacteria’s DNA. As the bacteria copies and reads its DNA as part of the normal biological function, it ‘unknowingly’ also copies and reads the HGH gene resulting in HGH production. This process occurs in the lab under controlled conditions. It takes little imagination to appreciate the effort and costs that go into producing therapeutic HGH. Production costs are directly reflected in the sale price; it’s not cheap.

The first such recombinant HGH, called protropin, was made by Genentech in 1985. Today there are several brands of synthetic HGH by various manufacturers.

HGH Injections Brands and Cost

Although different manufacturers call their synthetic HGH injections by different names, they all essentially contain the same chemical, somatropin. Somatropin is an analog of somatotropin, the natural HGH. Analog simply means the two chemicals look the same and have similar effects on the body. The only difference is that somatropin is made in the lab.

Brands will usually differ by the concentration of somatropin or by the type of packaging. No matter what brand it is, the administration is via a tiny needle injected into the fat under the skin- this is called a subcutaneous injection.

The table below shows common brands available in the US along with the average cost.

The average cost of synthetic HGH for a child who needs intensive therapy is about $35,000 per year.

Moreover, insurance will not cover HGH unless it’s for genuine medical reasons. As such, individuals who use it off-label will usually pay for overpriced products even when it’s from a doctor.

What Are HGH Injections Used For?

The use of HGH injection for bodybuilding, performance enhancement, and anti-aging is illegal in the U.S. Such applications are not approved by the FDA.

Legal medical use of HGH injection is always preceded by blood work aimed at proving an HGH deficiency. This is required to justify its use. These tests include a growth hormone stimulation test. The test essentially forces the pituitary gland to produce HGH. If it fails, and the patient demonstrates signs and symptoms of growth hormone deficiency, then treatment is warranted.

Note that insufficient production of natural HGH is not the only indication to use HGH injections. Following its development, synthetic HGH was also approved by the FDA for other specific uses in children and adults.

HGH injections Approved Uses in Children

Synthetic HGH is used for the treatment of short stature whose cause is unknown. A child is considered of short stature if his/her height is well below average for that child’s age and sex. More specifically, it is a height that is more than two standard deviations below the mean for age and gender.

In addition to increasing height, the following HGH uses are also approved:

• Turner’s syndrome is a genetic disorder whose most common feature is short stature. It affects the development of girls.
• Prader-Willi syndrome- another genetic condition affecting metabolism. It manifests as constant hunger. This may subsequently lead to obesity and type 2 diabetes.
• Chronic kidney disease
• States where there is insufficient HGH, proven by blood tests.
• Children born small for gestational age due to intrauterine growth restriction (poor growth during fetal development in the uterus) may initially benefit from HGH.

Approved Uses in Adults

In adults, HGH injections are approved for:

• Deficiency or insufficiency of natural HGH caused by pituitary tumors (most commonly pituitary adenomas) or their treatment.
• Short bowel syndrome- this condition can be a result of surgical removal of a segment of the intestine (large or small intestines) for therapeutic reasons such as colon cancer or intestinal ischemia- the death of intestinal tissue due to the poor blood supply.
• On-going treatment of growth failure due to deficient natural HGH production.
• On-going treatment of short stature caused by Turner syndrome.
• Wasting disease associated with HIV/AIDS.

Note that the above list is by no means exhaustive. It is intended to give you an idea of the sorts of situations in which HGH can be legally prescribed and thus be covered by medical insurance.

Off-Label and Illegal Use of Synthetic HGH Injections

The demand for quick fixes has led to rapid expansion of the anti-aging industry. More and more products continue to hit the market and we are often hit with an influx of products claiming to be the panacea for all physical ills.

Synthetic HGH is no different in this regard. Individuals who use it without medical grounds defend their decision quite heartily.  This group of proponents also includes some medical doctors. Of course, this latter group may be influenced by the amount of money to be made from the sale of HGH outside the insurance coverage.

Use In Anti-aging

Let us start by mentioning that the use of HGH injections for their anti-aging benefits is not approved by the FDA. Some so-called anti-aging experts believe that HGH injections can be used to offset the physical changes associated with aging, especially given that natural HGH production declines with age. The long-term effects of using HGH for this purpose are unknown.

Use In Athletics

Some athletes use HGH intending to improve performance. This too is not backed by substantial evidence. Some studies have of course demonstrated an increase in lean muscle in individuals on HGH injections. However, this increase in muscle mass has not been shown to translate to an increase in strength.  Despite strict restrictions in sports, some athletes continue to use it.

Use In Bodybuilding

Bodybuilders are another sub-group known to be highly dependent on HGH to maximize muscle gain. Among this group, HGH is often combined with other substances such as insulin and anabolic steroids resulting in a most dramatic muscularity. The high doses of HGH used to come at a cost, not only monetary-wise but health-wise as well.

Why You Should Never Use HGH Injections off-Label:

1. It is Costly

Acquiring HGH for illicit use is not cheap. Even doctors who sell it to their patients outside insurance coverage usually increase their prices. Moreover, given that the hormone has to be taken for an extended period, up to 6 months, costs do escalate.

2. Counterfeit and Black Market Products

Whenever there is money to be made, the crazies come out! Because of HGH’s high cost even with insurance coverage, the market has become flooded with products whose legitimacy is questionable. Some of these products are way cheaper than the pharmaceutical-grade ones. Take, for instance, Jintropin. It is a cheaper formulation of somatropin that is popular in the black market. This product is highly targeted by counterfeiters.

Some manufacturers have mitigated this issue by establishing stringent tracking programs where every dose is tracked directly to the patient. A good example is Serono who established the Serostim Secured Distribution Program. This also reduces the potential for reimbursement fraud relating to Serostim.

The Dangers of HGH Abuse

Note that HGH is quite beneficial when used in the right circumstances. However, when used for other purposes it has the potential to result in devastating side effects.

When HGH is used for performance enhancement or bodybuilding, it is administered in higher doses. The following is a list of potential detrimental effects of doing so:

• It is well known that HGH can lead to insulin resistance, potentially increasing the risk of diabetes.
• The effect of HGH, as the name implies, is growth. As a consequence of this, it has the potential to contribute to the growth of cancerous tumors as demonstrated in animal studies. One of the contraindications to using HGH is a history or potential for cancer in a patient. This point underscores the need to be under a doctor’s supervision when using this hormone.
• HGH injections are known to contribute to high cholesterol levels. Cholesterol, especially elevated levels of low-density lipoprotein cholesterol (LDL-cholesterol) is linked to heart disease. Moreover, HGH can also lead to direct overgrowth of heart muscles resulting in a condition called hypertrophic cardiomyopathy. A similar manifestation is seen in patients with gigantism, a condition in which the pituitary produces excessive amounts of HGH. Such an overgrown heart is prone to acute myocardial infarction (heart attacks) and failure.
• Carpal tunnel syndrome- a condition caused by compression of nerves, specifically the median nerve, in the wrist. This results in pain, tingling, and numbness of the fingers. It is also not uncommon for users to experience muscle and joint pain.
• Edema or swelling of body tissues due to fluid accumulation. This is a consequence of HGH’s effect on the body’s fluid balance.

Safer Alternatives to HGH Injections

There are certain lifestyle choices that one can follow, especially as we age, that are believed to optimize growth hormone release from the pituitary. Additionally, supplements are available that act as pituitary support, if you will. Such supplements are generally of benefit to our health. Below is a discussion on these safer and quite obviously cheaper alternatives.

Lifestyle Choices that Support Natural Growth Hormone Release.

1. Regular physical exercise particularly at high intensity. High-intensity exercise stimulates HGH release the most. Note however that all forms of exercise are of benefit.
2. Lower your body fat. Studies have shown that there is an inverse relationship between body fat, especially abdominal fat, and the amount of HGH released in 24 hours. That is, the less fat you have on your body, the greater the amount of HGH released. Exercise will, of course, be of benefit in this regard as well.
3. Fast periodically. Intermittent fasting, a type of fasting where you abstain from food for up to 16 hours a day is beneficial. It has been shown to lead to 2-3 times more HGH release.
4. Lower your intake of sugar, especially simple sugars. Eating sugary foods leads to a spike in insulin levels. Insulin has the physiological effect of lowering HGH levels. This is one of the reasons why fasting increases HGH. While in a fasting state, insulin levels drop significantly.
5. Do not eat immediately before going to bed. This again is tied to insulin. During sleep, HGH is released in large amounts. This effect is based on the body’s internal clock or circadian rhythm. Eating within 3-4 hours of bedtime will impede this natural process as you will experience an insulin spike.
6. Get adequate sleep. As noted above, during sleep, a large amount of HGH is released.

Pituitary Support Supplements

HGH Supplements (Sponsored Ad)

Although HGH cannot be taken orally owing to its digestibility in the stomach, there are specific supplements that can. Once consumed, these supplements act as HGH secretagogues. Simply put, they stimulate the release of HGH without the dangerous side effects associated with HGH injections. It is worth noting that some of these supplements have not been studied rigorously, but they may be beneficial.

1. Melatonin- can increase the quality and duration of sleep. By doing so, it allows HGH release owing to the circadian rhythm already mentioned. It is a fairly safe supplement but do consult with a doctor before initiating it.
2. Gamma-aminobutyric acid (GABA) – is a neurotransmitter produced in the brain. It transmits electrical activity in the brain. Taking supplemental GABA has been shown to increase HGH up to 2-4 times. Note however that such an increase is short-lived. As such, we are uncertain as to the long-term benefits of the supplement. GABA also tends to increase the quality and length of sleep, thus aiding the release of HGH that occurs abundantly while we sleep.
3. Vitamin C or Ascorbic acid.
4. L-Glutamine boosts HGH release.
5. L-arginine- is another amino acid that boosts HGH release.

Concluding Thoughts

HGH is a powerful and very useful hormone when used for its intended purpose. However, it can be quite dangerous if used illicitly. For purposes of increasing natural HGH release, it is better to choose safer and cheaper alternatives as discussed above. Additionally, you can never go wrong with regular exercise, a healthful diet, moderate alcohol use, and smoking cessation.

References

Zeman, N. (2012). Vial of Youth? Hollywood’s Burgeoning Addiction to Human Growth Hormone. Vanity Fair. Retrieved from https://www.vanityfair.com/style/2012/03/human-grown-hormone-hollywood-201203

Drugs.com. (n.d.). Prices, Coupons & Patient Assistance Programs. Retrieved from https://www.drugs.com/price-guide/

Greenwood, F. C., Landon, J., & Stamp, T. C. (1966). The plasma sugar, free fatty acid, cortisol, and growth hormone response to insulin. I. In control subjects. Journal of Clinical Investigation, 45(4), 429–436. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC292717