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The effects of growth hormone on body composition and performance in recreational athletes
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Patients occasionally ask me about human growth hormone therapy to enhance athletic performance. They have heard about this from friends, in the media or on the internet.
GH is indicated by the FDA for treatment of GH deficiency. In individuals with GH deficiency due to hypopituitarism, body composition, sense of well-being and muscle strength may improve with GH replacement therapy.
However, the World Anti-Doping Agency and other organizations prohibit the use of GH as an ergogenic aid in competitive athletes. Nevertheless, there are practitioners who prescribe GH to improve athletic performance as well as an anti-aging therapy. GH in combination with anabolic steroids and/or testosterone has been used illicitly with the goal of enhancing performance. Despite our understanding of the benefits of GH in treating GH deficiency, until recently there has been little evidence in the literature to support the use of GH for other purposes.
Meinhardt et al studied the effects of GH on body composition and performance in recreational athletes. In this randomized, placebo-controlled, blinded study, 96 recreationally trained athletes underwent eight weeks of treatment. Men were randomized to placebo, GH (2mg per day), testosterone (250 mg per week intramuscularly) or a combination of therapy. Women were assigned to either placebo or GH therapy.
Body composition (fat mass, lean body mass, extracellular water mass, and body cell mass) as well as physical performance (endurance, strength, power and sprint capacity) were assessed. During the study, GH significantly reduced fat mass, increased lean mass and increased body cell mass in men when combined with testosterone. GH also significantly increased relative sprint capacity in men and women by 3.9%. When combined with testosterone in men, the relative increase in sprint capacity was 8.3%. There were no changes in other performance measures. The increase in sprint capacity was not maintained six weeks after discontinuation of therapy. This is the first demonstration of improvement in athletic performance with GH in people without GH deficiency.
What do the results mean and how should they be interpreted? This is difficult to say.
There are risks to therapy. Some of the study participants experienced adverse events related to GH, including joint and muscle pain, swelling and acne. The long-term effects of GH therapy to enhance athletic performance is unknown. I have seen at least one patient who had iatrogenic acromegaly as a result of exogenous GH therapy.
The use of GH to enhance athletic performance is not FDA approved. It is prohibited by the World Anti-Doping Agency and banned by most professional sports associations. Nevertheless, there continues to be a great deal of excitement (and money being made) regarding GH for uses other than the treatment of GH deficiency.
Lui H. Ann Inter Med. 2008;148:747–58.
Meinhardt. Ann Inter Med. 2010;152:568-577.