The Purpose of Human Growth Hormone (HGH) Goes Beyond Muscle Building
Can HGH Really Help You Grow Muscle, Burn Fat, and Delay Ageing?
To separate fact from fiction, we interviewed patients, doctors, and researchers to understand the benefits and promise of HGH. But, firstly, let’s review what HGH is and what it does.
Every night when you sleep, your pituitary gland, a kidney-bean-size gland at the base of your brain, goes to work, squirting out HGH, a polypeptide consisting of 191 amino acids. HGH flows into your bloodstream and binds to specific cell-surface receptors found throughout your body, including your brain, where those receptors are especially dense in the regions responsible for learning and memory.
It also binds to fat cells, causing them to release part of their cargo, and stimulates your liver to produce a powerful hormone called insulin-like growth factor 1 (IGF-1), which promotes the growth of bone, cartilage, and muscle.
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HGH surges during childhood and adolescence, but by the time you’re 40, you’re producing only about half as much as you were at 20.
Still, even that small amount is critical for body maintenance.
The FDA approved the use of recombinant HGH in 1985 for one thing: extreme deficiency, mostly among the 15,000 children at risk of being unusually short. It was later cleared for HIV/AIDS patients who suffer from muscle wasting, and for people with a condition known as short bowel syndrome. Before 1985, HGH had to be painstakingly extracted from cadavers, a practice that was banned when researchers determined that it could transmit a brain illness similar to mad cow disease into patients.
Shortly afterward, two companies developed a limitless, contamination-free method of producing the drug that worked by inserting the coded gene for growth hormone production into bacteria, turning them into microscopic HGH factories.
In 1990, amid tension about sports doping, lawmakers voted for restrictions on HGH. At the time, endocrinologists feared that declaring it a controlled substance and lumping it in with steroids and narcotics would stigmatise the thousands of children who needed it.
So Congress put unprecedented limits on prescriptions instead, making HGH the only drug that can’t be prescribed off-label. That’s why it’s arguably the most restricted legal drug in America. As is often the case with prohibition, the market moved underground and overseas.
So what can and can’t HGH do? Let’s look at the claims.
What HGH can and can’t do
CLAIM:Grows muscle and burns fat.
Growth hormone is popular among athletes because “it is widely believed by illicit users that growth hormone works,” says Harrison Pope, M.D., a psychiatrist at Harvard Medical School.
“The problem is that growth hormone is almost always used in conjunction with anabolic steroids, and anabolic steroids clearly do work.” So it’s hard to know what portion of the muscle gain, if any, comes from growth hormone.
One Australian study parsed the issue and examined sprint performance in 96 cyclists who injected either HGH, testosterone, HGH plus testosterone, or a placebo (salt water) for eight weeks. Compared with the placebo group, those taking HGH saw their sprint capacity improve by almost 4%; those taking HGH plus testosterone had an 8% improvement. The HGH-only group, however, saw no gains in muscle strength.
In truth, despite what’s on the Internet, HGH doesn’t build muscle in otherwise healthy adults the way testosterone would, says Michael Kjaer, M.D., Ph.D., a professor of sports medicine at the University of Copenhagen.
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In one of the few studies of healthy volunteers, Dr. Kjaer gave men in their 20s injections of HGH and compared muscle growth to that of men who received a placebo. He found stimulation in connective tissues but not muscle.
Growth hormone does not appear to help older men either. As a 2013 University of Southern California medical school review on the matter concluded, “There is no compelling data that empiric treatment of older men with [HGH] improves muscle strength or performance.”
VERDICT:No to muscle gain, yes to fat loss; but it is expensive.
CLAIM:HGH speeds injury recovery
The use of HGH for injury repair has long been a part of sports lore. Whether the tales are true or not, medical science is in need of better treatment for battered joints, says Christopher Mendias, Ph.D., a researcher in orthopedic surgery at the University of Michigan.
“With an ACL tear, you typically need about six months to a year between the time you have surgery and the time you actually go back on the field,” he says.
The difficulty isn’t so much the ligament itself, but the tissue that supports it. “If you look at the mechanics in terms of the strength of that new ligament that you put in, it’s pretty good,” he says.
“The problem is the muscle weakness that occurs after that surgery. By the time athletes are able to return to the field or court, the side that had the ACL tear is about 40 percent weaker.”
Mendias has just begun studies that involve administering 0.3 milligram of growth hormone directly into patients’ injured ACLs twice a day for six weeks in order to measure the effect on tendon and muscle strength.
The first participants are all men between ages 18 and 35 undergoing an ACL reconstruction. His hypothesis, somewhat simplified, is that HGH will help preserve the muscle around the joint by activating IGF-1 that stimulates muscular growth while blocking another protein, myostatin, which is triggered by injury and curbs that growth.
The research is funded by the Mark Cuban Foundation, and the Dallas Mavericks owner has publicly stated that he thinks HGH should be legal to aid in joint repair.
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Danish researchers are also looking into HGH as a treatment for patients with tendinopathy—long-term tendon pain.
Mendias has the measured optimism of a scientist; he says the research is still too sparse to draw conclusions. Results won’t be released until 2019. Among his biggest concerns is that the possible side effects are still uncertain. It’s well known that too much growth hormone can lead to carpal tunnel syndrome (because it stimulates connective tissue). Still other side effects may exist. But if his research turns out to be successful, it could usher in a new era of better, faster recovery from sports injuries.
VERDICT:The jury is out, awaiting more evidence.
CLAIM: HGH delays ageing
A 2014 review in Clinical Interventions in Ageing noted that while giving HGH to a deficient person does appear to have benefits, giving the hormone to an older person who’s experiencing a natural decline has “unclear pros and cons.”
One of the biggest cons is the risk of cancer. Since HGH promotes the growth of tissue throughout the body, fledgling tumors that may grow slowly or not at all could get a jumpstart into malignancy.
Metabolic complications may also happen. For example, when you exercise and metabolise fat for fuel, that’s healthy. But when HGH melts fat, the sudden dump of glucose into your bloodstream can overwhelm the normal processes that clear it, leading to a risk of insulin resistance and diabetes. What’s more, there is no evidence that HGH will help you live longer.
If you’re worried that you’re deficient in growth hormone—only one in 50,000 people are, according to Danish scientists—talk to an endocrinologist about an HGH-stimulation test.
VERDICT:Not likely (but you may look younger).
CLAIM:HGH heals brain injuries
Preliminary research is promising. Data from the University of Texas Medical Branch (and Europe) supports the notion that restoring growth hormone to normal levels can improve lives, at least for some. If you’ve had a brain or head injury, says UTMB’s Dr. Urban, and develop profound fatigue and cognitive dysfunction, see a physician—and preferably also an endocrinologist.
Video: Muscle Building Hormones: The Science of HGH & IGF-1 | Thomas DeLauer
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