The therapeutic use of human growth hormone was first shown 45 years
ago. In these years the number of approved and proposed uses of human growth
hormone has grown from one to more than a dozen, and the number of patients
being treated with it has increased from a bunch to tens of thousands
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The formally approved uses of human growth hormone differ from nation to
nation, yet it is ordinarily used for children with growth hormone deficiency
or insufficiency, poor growth due to renal failure, Turner syndrome (girls with
a missing or defective X chromosome), Prader-Willi syndrome (usually due to
uniparental disomy in chromosome 15), and children brought into the world small
for gestational age with poor growth past two years of age. Recently the Food
and Drug Administration in the United States has also approved the use of human
growth hormone for short children with idiopathic short stature who are more
than 2.5 standard deviations below the mean or the shortest 1.2% of children.
In adults, the approved uses include AIDS-related wasting and growth hormone
deficiency (usually due to a pituitary tumour). The evidence supporting these
uses of human growth hormone comes from double visually impaired controlled
studies, clinical observations, and systematic meta-analyses.
Notwithstanding the generally accepted therapeutic uses of human growth
hormone, many proposed uses have not been established. Human growth hormone is
undisputedly a potent hormone with a wide variety of organic effects. The
anabolic actions of human growth hormone have made it attractive as a potential
agent for catabolic problems in a wide range of clinical conditions,
remembering severely catabolic patients for an intensive care environment,
burns, cystic fibrosis, inflammatory bowel disease, fertility problems,
osteoporosis, and Down's syndrome, and for people wishing to reverse the
effects of ageing and promote athletic prowess. These last two potential uses have
received the most attention as abuse of growth hormone.
The definitions of the word abuse include "improper or excessive
use." The classic type of "abuse" of human growth hormone are
athletes or bodybuilders who use it as an approach to gain an unreasonable
advantage over their competitors. Nothing more than bad memory evidence exists
that human growth hormone works in this setting. The lay bodybuilding
literature is full of testimonials. However, as the human growth hormone is as
least as potent as an anabolic agent, no uncertainty is left that growth
hormone should be banned in sport.
The use of human growth hormone to increase the height of children who
are already of typical height should also be considered abuse. Another regular
type of use of human growth hormone outside the established sign is in its alleged
activity of reversing or slowing the effects of ageing.6 The quest for a
"wellspring of youth" is an age-old dream, advertisements in print
media and on the internet promote the use of human growth hormone or agents
touted as increasing human growth hormone levels.
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