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Br J Sports Med. 2006 Jul; 40(Suppl 1): i35i39.

M Saugy, N Robinson, C Saudan, N Baume, L Avois, P Mangin, Swiss Laboratory for Doping Analyses, Institute of Legal Medicine, Lausanne, Switzerland

Correspondence to: M Saugy Swiss Laboratory for Doping Analyses, Institute of Legal Medicine, Lausanne, Switzerland; martial.saugy@chuv.ch

Recombinant human growth hormone (rhGH) has been on the list of forbidden substances since availability of its recombinant form improved in the early 1990s. Although its effectiveness in enhancing physical performance is still unproved, the compound is likely used for its potential anabolic effect on the muscle growth, and also in combination with other products (androgens, erythropoietin, etc.). The degree of similarity between the endogenous and the recombinant forms, the pulsatile secretion and marked interindividual variability makes detection of doping difficult. Two approaches proposed to overcome this problem are: the indirect method, which measures a combination of several factors in the biological cascade affected by administration of GH; and the direct method, which measures the difference between the circulating and the recombinant (represented by the unique 22kD molecule) forms of GH. This article gives an overview of what is presently known about hGH in relation to sport. The available methods of detection are also evaluated.

Review of the literature on GH in relation to exercise, and its adverse effects and methods of detection when used for doping.

The main effects of exercise on hGH production and the use and effects of rhGH in athletes are discussed. Difficulties encountered by laboratories to prove misuse of this substance by both indirect and direct analyses are emphasised. The direct method currently seems to have the best reliability, even though the time window of detection is too short. hGH doping is a major challenge in the fight against doping. The effect of exercise on hGH and its short halflife are still presenting difficulties during doping analysis. To date the most promising method appears to be the direct approach utilising immunoassays.

Keywords: hGH, doping, sport, athlete, abuse

The human growth hormone (hGH) is a naturally occurring peptide hormone secreted by the pituitary gland.1 Although the hormone in the body is rather heterogeneous, the major component is made up of 191 amino acids, stabilised by two disulphide bonds and reaching a molecular weight of 22kDa.2,3 Previously, the only source of hGH was human cadavers, but the contamination that led to CreutzfeldtJakob disease made this form of treatment obsolete. In the late 1980s, recombinant hGH (rhGH) was developed through genetic engineering and has been used with good results in the treatment of patients with hGH deficiencyallowing bone growth and impacting on the patient's final stature. This form of hGH has a sequence identical to the naturally occurring 22kDa hormone. Its misuse has been suspected in sport because of its anabolic properties. Athletes and bodybuilders claim that hGH increases lean body mass and decreases the fat mass.

The use of hGH in sport today is not only based on its anabolic properties, but also on its effect on carbohydrate and fat metabolism. rhGH has been found in swimmers and also in players taking part in major sports events. International federations and the International Olympic Committee have had hGH on the list of forbidden compounds since 1989, when it became obvious that the development of biotechnology products based on the recombination of DNA made hGH much more easily available on the regular and black markets.

In the 2006 Prohibited List, hGH in listed under class S2 of hormones and related substances. Erythropoietin (EPO) and corticotrophin as well as insulinlike growth factor (IGF)1 and insulin also belong to the same category of peptide hormones. During the 2004 Olympics in Athens, for the first time, the socalled direct method of Wu et al4 was used. None of the positive serum samples were finally declared positive; this was because of the tooshort time window of detection of the test and the short halflife of circulating GH (about 20minutes).5 Studies have shown that GH concentrations returned to baseline 816hours after intramuscular injection and 1120hours after subcutaneous injection.6

The effect of acute exercise on production of GH in the body has been widely described in the literature.7 The concentration of hGH in blood increases with time for a given work intensity and can increase 10fold during prolonged moderate exercise. During more intensive exercise (with accumulation of lactate at 70% Vo2 max for a short term period such as 1020minutes) hGH will increase by 510fold.8 With short exercise durations, levels of GH will generally peak at 1530minutes after the exercise. Furthermore, it appears that hGH response is more closely related to the peak intensity of exercise than the total work output.9 Endurance training generally amplifies the pulsatile release of growth hormone, elevating the GH amplitude. This appears evident when the training is very hard and above the aerobic threshold.10

Apart from exercise related increase, hGH secretion can be affected by other factorsfor example, GH secretion is increased in hypoglycaemia, increased temperature, and stress, whereas it decreases in obesity, or with a carbohydraterich diet and intake of 2 adrenergic agonists. Thus, it is hard to differentiate between the physiological increase in hGH levels seen in exercise and what can be from external hGH administration (as in doping). This problem makes the purely quantitative approach of measuring directly the total circulating GH not feasible in case of doping, except if the conditions of collection of biological samples are well controlled.

Somatotrope cells in the anterior pituitary secrete hGH in a pulsatile fashion. The secretion is regulated by two hypothalamic peptides, growth hormone releasing hormone, which stimulates hGH secretion, and somatostatin, which inhibits hGH secretion by back regulation. hGH exerts its biological effects on target cells by binding to specific receptors present throughout the whole body.

Secretion of hGH is slightly higher in women than in men,11 with the highest levels observed at puberty. Secretion decreases with age by around 14% per decade.12 Moreover, secretion varies with normal physiological and pathological conditions. hGH levels are higher during slow wave sleep and are increased by exercise, stress, fever, fasting and, with some amino acids (leucine and arginine). Some drugs, such as clonidine, ldopa and hydroxybutyrate, increase its secretion, as do androgens and estrogens.

hGH exerts its effects through target cells by binding to specific membrane receptors found in abundance throughout the body.13 It has both direct and indirect effects on the tissues; the indirect effects are mediated by IGF1, which is generated in the liver in response to GH.14

Human GH is prescribed for both childhood and adulthood hGH deficiency and for girls with Turner's syndrome. High doses of hGH are used for relief from excessive burns or other thermal injuries.15 Nevertheless, Takala et al16 showed that supraphysiological doses of GH administered to critically ill patients increased mortality when compared with placebo. Since the late 1950s, children with GH deficiency have been treated with hGH extracted from cadaver pituitary glands. Recently, due to the better availability of rhGH, hGH deficiency in adults has been recognised as a clinical syndrome and studied in clinical trials. In 1989, two major contributions were published describing the beneficial effects of GH treatment in GHdeficient adults, related on their body composition and metabolism.17,18 These seminal studies showed that rhGH treatment for a period of four to six months had favourable effects on body composition, exercise aptitude, renal and cardiac function, and in general, led to improvement in the quality of life. Long term GH administration studies have shown an increase in bone mass and persistence of the positive effects of hGH therapy.

The positive effects on the body composition are essentially due the anabolic, lipolytic, and antinatriuretic properties of GH. Among the effects that have been observed are: increase in the body cell mass (muscles) and total body water (extracellular); and decrease in the body fat with its redistribution from central to peripheral depots. The hGH dose in adults is generally individualised, but the typical dose is 12IU/day administered subcutaneously every evening. With therapeutic doses, no adverse side effects have been observed.19,20,21

GH has been considered as an ergogenic drug since the late 1980s. Since that time, official and nonofficial sources have reported that misuse in sport has steadily increased. The attractiveness of the product is based on popular knowledge that it is efficient, hard to detect, and without major side effects if well dosed. GH misusers primarily try to benefit from the known anabolic action of the drug, to increase their muscle mass and power.

The frequency of use and the dosage are hard to evaluate, but underground information suggests that the athletes misusing hGH take 1025IU/days three to four times a week to increase their lean body mass. We think that the mean dose is about 4IU/day in combination with other doping agents, such as anabolic steroids in power sports or EPO in endurance sport. GH is often taken in cycles of four to six weeks, as is the case for anabolic steroids in bodybuilding. In endurance sport, little is known about the optimum utilisation of hGH doping in combination with other products. It is highly individual and empirical.

The effectiveness of rhGH in the improvement of sport performance is still under debate among users. The positive effects described in hGH deficient adults are not that clear among athletes. Although many of these underground reports indicate some positive effect on muscle mass, it is difficult to differentiate benefits obtained when hGH is taken in combination with anabolic steroids or even if the hGH used was a less effective product. The use of hGH as an anabolic agent still seems to be widespread, but it is difficult to investigate the extent of the phenomenon. It has been reported that 5% of male American highschool students used or have used hGH as an anabolic agent.22 It is unknown how popular hGH is among female athletes, but some use has been reported because of the low risk of androgenic side effects that are seen with anabolic steroids. Not only is the anabolic effect of hGH favored by high power output athletes, but its use is also gaining acceptance in endurance sport in combination with methods for enhancing oxygen transport. Although there are anecdotal reports on the socalled dramatic increases in muscle mass and strength after large doses of hGH (especially among bodybuilders) their effectiveness under controlled conditions is generally less impressive.

As the results of controlled studies are generally not in agreement with subjective underground reports by misusers, it is difficult to draw any definite conclusions regarding the effects of excessive hGH administration on skeletal muscle function. It must be stressed that the regimen of hGH use in sport is designed to fulfil purposes other than just an increase in athletes' muscle mass. The doses involved are certainly specific to a discipline, its training model, and tailored to the regimen of other ergogenic substances being used concurrently.

GH misuse is still expensive and the high costs and difficulty in finding the right clean drug have certainly pushed some athletes to use products claimed to enhance GH production. Among these are the amino supplements such as arginine, ornithine, lysine, and tryptophan, but there are no clearly established results. The effectiveness of rhGH is also widely discussed among its users in the underground literature or in internet chat rooms without a clear positive position. Several aspects can be debated, but because of its price, some proportionality in the effects is to be expected by the users. Certainly disappointments are due to bad dosing, not combining with anabolic steroids, or a tooshort duration of use.

There are few controlled studies on the effectiveness of GH on the performance of top level athletes. In general these studies have been performed with supraphysiological dosages but not with the large amounts claimed to be effective, for instance, by bodybuilders. The results of most of these controlled studies are generally less impressive than the claims of those who misuse the substance. A study of volunteers under heavy resistance training found decrease of free fatty mass but no difference in the muscle strength.23 With weight lifters, it has been shown that short term GH treatment does not increase muscle protein synthesis more than placebo24 or other factors such as maximal voluntary strength (biceps or quadriceps).25

These results conflict with reality, which is that rhGH misuse seems to exist in toplevel sport, because the compound is often found in police raids related to doping affairs. We believe that most of the time misusers will take rhGH as a part of their cocktail of specific preparations, rather than considering rhGH as a unique pharmaceutical preparation. The effects of GH on the metabolism are so widespread that one can be certain that this is taken in combination with other products. And the final effect generally occurs elsewhere, rather than in what is tested in the laboratories.

The long term risks of hGH use are not well known since epidemiological data regarding this type of treatment in healthy sportsmen are unavailable. Acromegaly, which results from a pathological increase in endogenous production of GH, is often cited as one of the major risks associated with excessive use of hGH. The major symptoms are swelling of the hands and feet, coarsened facial appearance, dentition problems, arthralgias, fluid retention, and excessive sweating. Acromegalic patients have an increased risk for diabetes mellitus and hypertension that can lead to premature mortality from cardiovascular diseases.26 It can be argued that long term hGH doping with high dosages will probably result in misusers experiencing symptoms of fluid retention and increased risk of development of diabetes mellitus and hypertension. There is also a risk of cardiomyopathy, osteoporosis, menstrual irregularities, and impotence. Some of these side effects are reversible after withdrawal of the drug. Furthermore, hGH misuse can disturb the lipid profile with decreased high density lipoprotein (HDL)cholesterol.

As hGH is administered by injection, if syringes are nonsterile or contaminated, there is a risk of crossinfection, such as HIV/AIDS and hepatitis. Even though cadaveric GH is now rare in the black market, its use is associated with a high risk of developing CreutzfeldtJakob disease, which is characterised by slowly progressive dementia.

Until the 2004 Olympic Games in Athens, hGH doping was considered undetectable. Growth hormone is a peptide with a very short halflife in blood and low concentration in urine. The peptidic nature of the substance forced analysts to investigate other methods than those used in the classic analyses for anabolic steroids or stimulants with relatively low molecular weights. The amino acid sequence of the recombinant molecule is identical to the major 22kDa isoform secreted by the pituitary gland. There is no way of using a posttranscription modification of the molecule to find out the difference between the recombinant and the natural forms.

Secretion of hGH by the pituitary gland is pulsatile, leading to highly fluctuating levels in the circulation. Moreover, hGH is considered to be a stress hormone regulated by factors such as sleep, nutritional status, exercise, and emotion. Thus, there is high intraindividual and interindividual variability in the secretion of hGH. Quantifying the hormone itself is not sufficient to detect exogenous rhGH. More stable serum variables implied in the biological cascade produced by hGH secretion, or a doping application, may be the route of successful detection of hGH. The growth factor IGF1 and some of its transport proteins (IGFBP3), have been proposed as possible candidates for indirect detection of hGH doping. But the interindividual variability is quite high and makes it hard to precisely define a quantitative cutoff level.

hGH doping is a major challenge in sport. This hormone is used by some athletes in combination with either anabolic steroids to increase their muscle mass or EPO to increase their aerobic power. Detection of rhGH is still controversial, but it appears that the direct method based on the ratio of several circulating forms is the most promising one.

Most antidoping samples consist of urine collected out of competition or after effort. Because of its convenient availability and relatively unlimited volume, attempts have been made to use urine for peptide detection. For example, urine has been used for successful detection of EPO because of the glycosylated form of this hormone. However, the only way to detect hGH in urine is to use an extremely sensitive immunotest to quantify the total amount of the hormone in urine. The average urine concentration of hGH is between 100 and 1000 times less than in blood. One notion has been to develop a screening test for outofcompetition testing in order to benefit from a relatively longer time window of detection.27 The limitations of this test have been clearly shown, because of the large influence of the process of renal excretion on the concentration measured in urine. The lack of discrimination and specificity of the result made the urinary test less promising than a blood test. Nevertheless, today, improvements in the organisation of target testing are quite obvious. It is considered feasible to do a urine test for GH in the morning, with an unannounced urine test outside any exercise session for other hormonal analyses. This may eventually be a solution for effective screening.

Two main strategies are currently being followed to detect hGH doping using blood: the indirect and direct approaches.

Increasing knowledge about the naturally occurring variability of several hGH dependent factors (that is, IGF1, the different IGF binding proteins (IGFBPs), or several markers of the bone turnover), individually or in combination, could provide a database of normal ranges for the concentration of these factors. This may lead to establishment of cutoff levels and description of socalled abnormal values outside the normal constellation of measures.

This approach, proposed in the mid1990s, was investigated by an international panel of endocrinologists, but did not lead to a final solution for detection of hGH doping.28,29,30 The advantage of an indirect approach to target GH use is certainly that these biological factors are less variable or less sensitive than GH itself and should have a longer halflife in the body. A main objective of the study was to investigate the variation of these secondary variables during or after exercise. IGF1 and IGFBP3 in the hGH biological cascade as well as selected peptides involved in bone metabolism (for example the Nterminal peptide from the procollagen named PIIIP) or osteocalcin were considered as good biological markers of GH doping. These variables showed slight but significant changes after acute exercise. Moreover, the interindividual variability in the reaction to GH administration makes the use of indirect measurements almost impossible in a forensic description of GH misuse. It is obvious that rather than depending on the observation of a single value, a solution may be found in an algorithm combining all the biological variables from the cascade. Nevertheless, all these investigations clearly show that the indirect approach can certainly be used for screening and targeting purposes when a biological follow up of athletes will be acceptable in the sport community. But it cannot stand in front of a court as an absolute proof of doping. The regular evaluation of individual normal ranges in sportspeople could in fact lead to, as is currently done with haematological substances, better screening and targeting of the athletes and direct detection of hGH misuse as proposed in the following section.

The direct method of detection, based on double immunological tests needs to be well evaluated and validated. This review has described the difficulty sports authorities will face to prove hGH doping. At present, the short time window of detection of any method and the effect of exercise on natural hGH secretion still make any approach quite risky.

The StrasburgerBidlingmaier group in Munich developed a socalled direct method for the detection of hGH doping.4,6 Two specific immunoassays have been developed to quantify several types of hGH isoform. Recombinant hGH is exclusively represented by the native 22kDa form whereas the circulating hGH in the human blood is present in several forms (table 1). When the recombinant form is injected in the body, this increases, for a period of time, the proportion of the 22kDa form in comparison with all other circulating forms. Moreover, with long term use, classic back regulation of the endogenous secretion of natural hGH occurs, which favours the proportion of the major 22kDa sequence.

The proposed test was used during the Olympics in Athens (2004) and in Torino (2006). To fulfil the requirements of the World AntiDoping Agency (WADA) code and the standards for laboratories, two double tests were applied to serum samples: the first test quantified specifically the 22kDa form and the second test was a comprehensive assay measuring all forms present in the serum (see fig 1). The ratio was established and a cutoff defined to differentiate normal subjects (negative samples) from those having a significant higher proportion of 22kDa hGH (positive samples). A second double sample test was used for confirmation purposes. The time window of detection for these tests is claimed to be between 24hours and 36hours after the last injection, depending on the dosage used. It is thought that hGH doping, to be efficient, needs multiple injections. Environmental influences, such as exercise, have been evaluated by Wallace et al.31 These authors measured total, pituitary, 22kDa, recombinant, non22kDa, 20kDa, and immunofunctional GH. They concluded that all isoforms increased during exercise, peaked at the end, and declined after exercise. At peak exercise, 22kDa GH was the predominant isoform. After exercise, the ratio of non22kDa/total GH increased and that of recombinant/pituitary GH decreased. But it is considered that these changes will not invalidate the test after competition. Moreover, even if GH was used out of competition, this test should act a deterrent for its use. Since the test was introduced in 2004, no adverse analytical findings have been declared from any of the WADA laboratories that have validated the tests.

Figure 1Molecular basis of direct detection of hGH abuse by differential immunoassay. A ratio is then calculated between the signal given by assay 1 to the signal given by assay 2. Two of these double tests must be applied in case of positive ...

With new biotechnology products on the market, such as rGH and its precursors, the fight against doping must evolve with new analytical techniques and strategies based on different biological matrices. These new methods will need to be fully validated forensically before being submitted to any court challenge.

GH - growth hormone

IGF - insulinlike growth factor

rhGH - recombinant human GH

Competing interests: none declared

9. Vanhelder W P, Goode R C, Radomski M W. Effect of anaerobic and aerobic exercise on circulating growth hormone in men. Eur J Appl Phys 198452257257.257

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Group

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Human growth hormone doping in sport - ncbi.nlm.nih.gov

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Oct 9th, 2016 | Filed under Human Growth Hormone

Exercise is a potent stimulus for the release of human growth hormone (hGH), but the time course of the hGH response to sprint exercise has not been studied. The aim of the present study was to determine the time course of the hGH response to a 6 s and a 30 s maximal sprint on a cycle ergometer. Nine males completed two trials, on one occasion performing a single 6 s sprint and on another a single 30 s sprint. They then rested on a couch for 4 h while blood samples were obtained. Three of the participants completed a further control trial involving no exercise. Metabolic responses were greater after the 30 s sprint than after the 6 s sprint. The highest measured mean serum hGH concentrations after the 30 s sprint were more than 450% greater than after the 6 s sprint (18.5 +/- 3.1 vs 4.0 +/- 1.5 microg l(-1), P < 0.05). Serum hGH also remained elevated for 90-120 min after the 30 s sprint compared with approximately 60 min after the 6 s sprint. There was a large inter-individual variation in the hGH response to the 30 s sprint. In the control trial, serum hGH concentrations were not elevated above baseline at any time. It would appear that the duration of a bout of maximal sprint exercise determines the magnitude of the hGH response, although the mechanism for this is still unclear.

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The Time Course of the Human Growth Hormone Response to a 6 s and a 30 ...

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Sep 8th, 2016 | Filed under Human Growth Hormone

Human Growth Hormone (HGH) is a protein hormone that is produced by the pituitary gland located in the brain. Itstimulates growth and cell reproduction in humans.HGH supplements are used to treat children with HGH deficiency. Children who consumehuman growth hormone supplements showan increase in growth rate with an increased strength and stamina. It aids indiminishingbody fat, often without significant side effects. Earlier, human growth hormone was extracted from the human pituitary glands. However nowadayshuman growth hormone supplements aresynthetically designed.

GH can also beutilizedto treat people who are short in staturethough not necessarily dueto thedeficiencies in GH. The result may not be as effective when compared tothe treatment of patients suffering fromthe deficiency of GH. Theshort stature in people results due toTurner syndrome, chronic renal failure, Prader-Willi syndrome, intrauterine growth retardation and severe idiopathic short stature.However it can be treated with GH.

Increase in GHin the body improves muscle mass andhelpsreduce body fat. HumanGrowth Hormone is also useful in maintaining muscle mass wasting due to AIDS. GH can also be used in patients with short bowel syndrome to diminishthe requirement for intravenous total parenteral nutrition.

HGH is associated withthe growth varioustissuess,tissue repair, cell replacement, bone strength,body healing, healthy brain function, sexual function,integration of hair, nails and skin.

Thebody shouldsecreteenough amounts of HGH otherwiseit wont be able to function properly. Once you reachtwenty years of ageyour body will start loweringits production of HGH levels every year and by the time you reach sixty years of age aboutthree fourths of your HGH production levels will decline.

OtherHGH uses include

GH treatment for remission of Multiple sclerosis

GH treatment to reverse the effects of old age

GH treatment to diminishweight gain in obese people

GH treatment for fibromyalgia

GH treatment for Crohns disease and ulcerative colitis

GH treatment for idiopathic short stature

GH treatment for bodybuilding or good athletic performance

The use of bovine somatotropin to increase milk production in cattle

Gh is also useful for anti-aging purposes.The claim thatGH is used as an anti-aging treatment date goes backto the year 1990 when the New England Journal of Medicine published a study where GH was used to treat 12 men over 60. The study revealed thatwas an increase in lean body mass and bone mineral in allmen.

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HGH definition - HGH for sale

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Sep 3rd, 2016 | Filed under Human Growth Hormone

Natural hGH vs Synthetic

Human Growth Hormone, or HGH, has been called the fountain of youth. It is what our bodies produce naturally when we are young, giving us lean muscles, healthy bones, low fat (BMI), resilient skin, and youthful energy. hGH is what makes us feel young and vital.

Science has manufactured a synthetic hGH equivalent which has quickly become the exclusive youth formula for the rich and famous of Hollywood hills.

For decades, doctors have been injecting this synthetic hGH substance into their most exclusiveclients at a cost of over one thousand dollars a month, due to its ability to make you look and feel decades younger. Not years DECADES younger. Synthetic hGH has taking the anti-aging world by storm.

The problem with synthetic hGH is that it is synthetic not NATURAL, and it is expensive. Costs can exceed $12,000 a year or more. Thats why, for years, the scientific community has been trying to develop an effective method to increase serum HGH levels without the cost and inconvenience of prescription injections, in a natural form rather than the synthetic form found in the HGH injections.

Increase hGH Naturally Feel Young Again

And now, finally, science has succeeded. Limitless Worldwide has discovered a radical new compoundthat when tested in a double-blind, placebo-controlled clinical trial, caused a mean 682% increase in serum growth hormone levels after a single oral serving of the supplement.* This compound is available without a prescription, and at a tiny fraction of the cost of painful and expensive HGH injections.

The research was done at a prestigious university, and measured real, bioactive, serum hGH levels.It allows consumers to experience the benefits of increased, NATURAL growth hormone levels within a normal range for about $100 per month instead of the $1,000 per month you would pay for synthetic injections.

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hGH Human Growth Hormone - Natural hGH Supplement

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Aug 24th, 2016 | Filed under Human Growth Hormone

Who should not use Norditropin? Do not use Norditropin if: you have a critical illness caused by certain types of heart or stomach surgery, trauma or breathing (respiratory) problems; you are a child with Prader-Willi syndrome who is severely obese or has breathing problems including sleep apnea; you have cancer or other tumors; your healthcare provider tells you that you have certain types of eye problems caused by diabetes; you are a child with closed bone growth plates (epiphyses); or you are allergic to any of the ingredients in Norditropin.

Norditropin is a prescription medicine that contains human growth hormone and is used to treat:

Please click here for NorditropinPrescribing Information.

Norditropin is a prescription medication.

Novo Nordisk provides patient assistance for those who qualify. Please call 1-866-310-7549 to learn more about Novo Nordisk assistance programs.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

Talk to your health care provider and find out if Norditropin is right for you or your child.

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Norditropin Growth Hormone Therapy

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Aug 24th, 2016 | Filed under Human Growth Hormone

Human growth hormone (hGH) is a proteohormone secreted by the pituitary gland. It acts through binding to the hGH receptor, inducing either direct effects or initiating the production of insulin-like growth-factor I (IGF-I), the most important mediator of hGH effects. Growth hormone is primarily known to promote longitudinal growth in children and adolescents, but has also various important metabolic functions throughout adult life. Effects of hGH on the adult organism are well established from studies with recombinant growth hormone (rhGH) therapy in growth hormone deficient subjects. In this particular group of patients, replacement of hGH leads to increased lipolysis and lean body mass, decreased fat mass, improvements in VO(2max), and maximal power output. Although extrapolation from these findings to the situation in well trained healthy subjects is impossible, and controlled studies in healthy subjects are scarce, abuse of hGH seems to be popular among athletes trying to enhance physical performance. Detection of the application of rhGH is difficult, especially because the amino acid sequence of rhGH is identical to the major 22,000 Da isoform of hGH normally secreted by the pituitary. Furthermore, some physiological properties of hGH secretion also hindered the development of a doping test: secreted in a pulsatile manner, it has a very short half-life in circulation, which leads to highly variable serum levels. Concentration alone therefore cannot prove the exogenous administration of hGH.Two approaches have independently been developed for the detection of hGH doping: The so-called "marker approach" investigates changes in hGH-dependent parameters like IGF-I or components of bone and collagen metabolism, which are increased after hGH injection. In contrast, the so-called "isoform approach" directly analyses the spectrum of molecular isoforms in circulation: the pituitary gland secretes a spectrum of homo- and heterodimers and - multimers of a variable spectrum of hGH isoforms, whereas rhGH consists of the monomeric 22,000 Da isoform only. This isoform therefore becomes predominant after injection of rhGH. Specific immunoassays with preference for the one or the other isoform allow analysis of the relative abundance of the 22,000 Da isoform. Application of rhGH can be proven when the ratio of this isoform relative to the others is increased above a certain threshold. Because the "marker method" and the "isoform method" have a different window of opportunity for detection, complementary use of both tests could be a way to increase the likelihood of detecting cheating athletes.

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Growth hormone. - National Center for Biotechnology Information

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Aug 22nd, 2016 | Filed under Human Growth Hormone

In 1513, the Spanish explorer Juan Ponce de Len arrived in Florida to search for the fountain of youth. If he got any benefit from his quest, it was due to the exercise involved in the search.

Few men today believe in miraculous waters, but many, it seems, believe in the syringe of youth. Instead of drinking rejuvenating waters, they inject human growth hormone to slow the tick of the clock. Some are motivated by the claims of the "anti-aging" movement, others by the examples of young athletes seeking a competitive edge. Like Ponce de Len, the athletes still get the benefit of exercise, while older men may use growth hormone shots as a substitute for working out. But will growth hormone boost performance or slow aging? And is it safe?

Growth hormone (GH) is a small protein that is made by the pituitary gland and secreted into the bloodstream. GH production is controlled by a complex set of hormones produced in the hypothalamus of the brain and in the intestinal tract and pancreas.

The pituitary puts out GH in bursts; levels rise following exercise, trauma, and sleep. Under normal conditions, more GH is produced at night than during the day. This physiology is complex, but at a minimum, it tells us that sporadic blood tests to measure GH levels are meaningless since high and low levels alternate throughout the day. But scientists who carefully measure overall GH production report that it rises during childhood, peaks during puberty, and declines from middle age onward.

GH acts on many tissues throughout the body. In children and adolescents, it stimulates the growth of bone and cartilage. In people of all ages, GH boosts protein production, promotes the utilization of fat, interferes with the action of insulin, and raises blood sugar levels. GH also raises levels of insulin-like growth factor-1 (IGF-1).

GH is available as a prescription drug that is administered by injection. GH is indicated for children with GH deficiency and others with very short stature. It is also approved to treat adult GH deficiency an uncommon condition that almost always develops in conjunction with major problems afflicting the hypothalamus, pituitary gland, or both. The diagnosis of adult GH deficiency depends on special tests that stimulate GH production; simple blood tests are useless at best, misleading at worst.

Adults with bona fide GH deficiencies benefit from GH injections. They enjoy protection from fractures, increased muscle mass, improved exercise capacity and energy, and a reduced risk of future heart disease. But there is a price to pay. Up to 30% of patients experience side effects that include fluid retention, joint and muscle pain, carpal tunnel syndrome (pressure on the nerve in the wrist causing hand pain and numbness), and high blood sugar levels.

Adults who are GH deficient get larger muscles, more energy, and improved exercise capacity from replacement therapy. Athletes work hard to build their muscles and enhance performance. Some also turn to GH.

It's not an isolated problem. Despite being banned by the International Olympic Committee, Major League Baseball, the National Football League, and the World Anti-Doping Agency, GH abuse has tainted many sports, including baseball, cycling, and track and field. Competitive athletes who abuse GH risk disqualification and disgrace. What do they gain in return? And do they also risk their health?

Because GH use is banned and athletic performance depends on so many physical, psychological, and competitive factors, scientists have been unable to evaluate GH on the field. But they can conduct randomized clinical trials that administer GH or a placebo to healthy young athletes and then measure body composition, strength, and exercise capacity in the lab.

A team of researchers from California conducted a detailed review of 44 high-quality studies of growth hormone in athletes. The subjects were young (average age 27), lean (average body mass index 24), and physically fit; 85% were male. A total of 303 volunteers received GH injections, while 137 received placebo.

After receiving daily injections for an average of 20 days, the subjects who received GH increased their lean body mass (which reflects muscle mass but can also include fluid mass) by an average of 4.6 pounds. That's a big gain but it did not translate into improved performance. In fact, GH did not produce measurable increases in either strength or exercise capacity. And the subjects who got GH were more likely to retain fluid and experience fatigue than were the volunteers who got the placebo.

If you were a jock in high school or college, you're likely to wince at the memory of your coach barking "no pain, no gain" to spur you on. Today, athletes who use illegal performance-enhancing drugs risk the pain of disqualification without proof of gain.

Among its many biological effects, GH promotes an increase in muscle mass and a decrease in body fat. As men age, GH levels fall. During the same time span, muscle mass declines and body fat increases. And so, the theory goes, the way to arrest these effects of aging is to inject GH.

Similar claims have been made for other hormones that decline with age, including testosterone and dehydroepiandrosterone (DHEA) in men, and estrogen in women. Research shows that estrogen replacement does more harm than good in older women, and there is no solid evidence that testosterone and DHEA are safe and effective for healthy older men. But that has not stopped the growth of "anti-aging" and "regenerative medicine" clinics and Web sites.

Expensive injections of growth hormone are offered by many practitioners, even though the FDA has not approved the use of GH for anti-aging, body building, or athletic enhancement, and the marketing or distribution of the hormone for any of these purposes is illegal in the U.S. According to one estimate, 20,000 to 30,000 Americans used GH as "anti-aging" therapy in 2004 alone; according to another, 100,000 people received GH without a valid prescription in 2002.

To evaluate the safety and efficacy of GH in healthy older people, a team of researchers reviewed 31 high-quality studies that were completed after 1989. Each of the studies was small, but together they evaluated 220 subjects who received GH and 227 control subjects who did not get the hormone. Two-thirds of the subjects were men; their average age was 69, and the typical volunteer was overweight but not obese.

The dosage of GH varied considerably, and the duration of therapy ranged from two to 52 weeks. Still, the varying doses succeeded in boosting levels of IGF-1, which reflects the level of GH, by 88%.

As compared to the subjects who did not get GH, the treated individuals gained an average of 4.6 pounds of lean body mass, and they shed a similar amount of body fat. There was a slight drop in total cholesterol levels, but no significant changes in LDL ("bad") cholesterol, HDL ("good") cholesterol, triglycerides, aerobic capacity, bone density, or fasting blood sugar and insulin levels. But GH recipients experienced a high rate of side effects, including fluid retention, joint pain, breast enlargement, and carpal tunnel syndrome. The studies were too short to detect any change in the risk of cancer, but other research suggests an increased risk of cancer in general and prostate cancer in particular.

"Every man desires to live long," wrote Jonathan Swift, "but no man would be old." He was right, but the fountain of youth has proved illusory. And while more study is needed, GH does not appear to be either safe or effective for young athletes or healthy older men. But that doesn't mean you have to sit back and let Father Time peck away at you. Instead, use the time-tested combination of diet and exercise. Aim for a moderate protein intake of about .36 grams per pound of body weight; even big men don't need more than 65 grams (about 2 ounces) a day, though athletes and men recovering from illnesses or surgery might do well with about 20% more. Plan a balanced exercise regimen; aim for at least 30 minutes of moderate exercise, such as walking, a day, and be sure to add strength training two to three times a week to build muscle mass and strength. You'll reduce your risk of many chronic illnesses, enhance your vigor and enjoyment of life, and it's true slow the tick of the clock.

May 1, 2010

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Growth hormone, athletic performance, and aging - Harvard ...

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Oct 30th, 2015 | Filed under Human Growth Hormone

Most men are interested in Human Growth Hormone (HGH) because they're trying to lose weight, build muscle mass, increase endurance, or a combination of the three. While there are certain circumstances when men do require HGH supplementation, such as when a man suffers from a true growth hormone growth deficiency, chances are HGH isn't the problem. It's normal for HGH levels to drop off in men, especially after the age of 30. Typically, the symptoms that men experience as they get older aren't caused by a growth hormone deficiency, but rather declining levels of testosterone. Men with low growth hormone levels have many options outside the rather significant treatment cost of human growth hormone (HGH). BodyLogicMD affiliated physicians focus on proper nutrition, supplementation, exercise and balancing of the hormone pathways naturally using bioidentical hormones. These integrated protocols almost always lead to an acceptable increase in the body's growth hormone production. In a few cases, various supplements can be used without the need for the expense of HGH. In fact, only a handful of our patients even order HGH monthly.

Growth hormone deficiencies occur when the pituitary gland isn't producing enough growth hormone. As children mature into adults, they rely on growth hormone for optimal development. After we stop growing, we still need growth hormone throughout adulthood, although in smaller quantities. Adequate levels of HGH in adults, helps to ensure that the body maintains a healthy body-fat ratio and also aids in calcium and protein absorption, promoting strong muscles and bones. The only way to know for sure is to have your hormone levels tested.

The highly trained bioidentical hormone doctors at BodyLogicMD offer state-of-the-art diagnostic testing to assess your hormone levels. After analyzing blood and saliva samples, your doctor will determine whether or not the symptoms your experiencing are caused by underlying hormonal imbalance. If a hormonal imbalance is identified, a BodyLogicMD affiliated physician will personalize a wellness program that is individually tailored to help you reach your personal wellness goals. Be it losing weight, getting ripped or just getting back in shape - we have a wellness program that's right for you.

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BodyLogicMD - Human Growth Hormone in men

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Oct 24th, 2015 | Filed under Human Growth Hormone

Week of March 23, 2009

Pamela W. Smith, MD, MPH Director for Anti-Aging and Functional Medicine Fellowship

Pamela W. Smith, M.D., MPH spent her first twenty years of practice as an emergency room physician with the Detroit Medical Center.

She is currently the owner and director of The Center for Health Living and Longevity. Dr. Smith is the Director of the Fellowship in Anti-Aging, Regenerative, and Functional Medicine, which is the only fellowship of its kind in the U.S.

At the upcoming 17th World Congress on Anti-Aging and Regenerative Medicine in Orlando April 23-25, 2009), Dr. Smith will be chairing The Fellowship in Anti-Aging Regenerative & Functional Medicine, Modules III and VII. To download the Fellowship program, click here. To download the Fellowship Schedule, click here. For more information, call 1-888-997-0112

Dr. Smith will also be presenting at the Palm Beach County Obstetrics and Gynecology Society's 42nd Annual Educational Seminar & Retreat on Friday, March 27, 2009 at the PGA National Resort & Spa, Palm Beach Gardens, Florida. For more information, call Penny Linch 561-881-3828. Continue reading

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Human Growth Hormone | Worldhealth.net Anti-Aging News

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Oct 22nd, 2015 | Filed under Human Growth Hormone

Human growth hormone (HGH) is a protein hormone secreted by the anterior pituitary gland. It stimulates growth, cell reproduction and cell regeneration in humans. It is also very important for several complex physiologic processes, such as metabolism.

The hypothalamus of the brain produces GHRH (growth hormone releasing hormone), which stimulates the pituitary gland to produce human growth hormone (HGH). HGH is converted into IGF-1 (insulin-like growth factor-1) in the liver, which has many important functions. The anterior pituitary gland releases growth hormone in spurts every 3 to 5 hours throughout the day. Growth hormone levels are often the highest about an hour after the onset of sleep, and 50% of daily growth hormone production is produced during deep sleep (stages 3 and 4 of NREM).

Growth hormone levels can be affected by many factors, including:

Growth hormone is considered an anabolic hormone because it stimulates the

build-up of tissues and cells. Growth hormone has many important functions in the body, including:

Adult-onset growth hormone deficiency is diagnosed in adults who have symptoms of low growth hormone as well as a medical condition causing low growth hormone levels. Medical conditions causing low growth hormone levels are often conditions that cause damage of the pituitary gland (from a tumor, radiation, surgery, trauma, or loss of blood supply). Growth hormone deficiency in adults due to pituitary disease is rare, occurring in 10 out of every 1 million people.

Like the other hormones in the human body, human growth hormone significantly declines with aging. The symptoms that people often attribute to aging are actually due to low hormone levels caused by age-related hormone decline. Human growth hormone (HGH) is a perfect example of this. Human growth hormone is measured by the amount of insulin growth factor (IGF-1) in the blood. On average, IGF-1 levels decline from 260 ng/ml at age 20 to 120 ng/ml at age 45. Thats more than a 50% decline! The decline then continues to an IGF-1 level of 50 or less by age 85.

Symptoms of low growth hormone levels include:

Your Solution: HGH Treatments for Low Growth Hormone Levels

There are many treatment options for low growth hormone levels. Balancing other hormone deficiencies often significantly improves growth hormone levels. Lifestyle changes such as sleeping better, regular exercise, and healthy eating can improve growth hormone levels. There are also some pharmaceutical-grade supplements that will stimulate growth hormone levels. Your physician may recommend medications for growth hormone if you are symptomatic and your growth hormone levels remain low despite balancing of the other hormones and incorporation of healthy lifestyle changes.

Hormone balance with natural bioidentical hormone replacement therapy significantly improves the patients quality of life and health while preventing chronic disease and illness. Balancing growth hormone levels will have the following benefits:

Testing HGH Levels

Genemedics Health Institute offers state-of-the-art lab testing to assess all of your hormone levels, including human growth hormone. Your expert bioidentical hormone replacement therapy doctor will customize a hormone therapy regimen, nutrition plan, pharmaceutical-grade supplement regimen, and exercise program based on your symptoms and lab results. This personalized wellness program will significantly improve your quality of life and help you reach your health and fitness goals. Continuous monitoring by your physician through routine office visits and lab testing will assure that you maintain optimal health and wellness during the aging process.

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Human Growth Hormone (HGH) | Genemedics

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Oct 22nd, 2015 | Filed under Human Growth Hormone
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