COMMENTARY

Human Growth Hormone: A Paul Bunyan Drug or a Drug for Paul's Bunion

George T. Griffing, MD

Disclosures

December 03, 2007

People have been attracted to the tales of giants able to perform extraordinary feats of strength, like Paul Bunyan, the mythical American lumberjack. HGH, or human growth hormone, has had the promise to achieve the dreams of some people to become a real-life Paul Bunyan. This, together with the fact that HGH can't be detected, has increased the popularity of this doping agent for athletes.[1]

Recently some high-profile athletes have been identified receiving HGH. The HGH came from a shady Florida warehouse under investigation for illegally distributing prescription medications.

What is the truth about HGH?

HGH has some definite and proven medical benefits. It is currently approved medically in the United States for 2 primary indications, short-stature in children and growth hormone deficiency in adults.[2] All of these HGH benefits, however, are in individuals with growth hormone deficiency. In people with normal GH levels, HGH does not improve athletic performance in terms of muscle strength, flexibility, and endurance. In fact, several placebo-controlled studies have been negative.

A 4-week, double-blind Swedish study using 2 doses of HGH and placebo found no differences in subjects exercising on a bicycle in terms of power output and oxygen uptake.[3] In another study, a single injection of HGH increased plasma lactate and reduced exercise performance.[4]

Indeed, in the classic HGH excess experiment in nature, acromegalic subjects have increased muscle mass but histologic evidence of myopathy with muscle weakness and pain.[5]

In addition to the lack of effectiveness for enhancing athletic performance, HGH has a downside. It can cause dose-related side effects including diabetes, carpal tunnel syndrome, fluid retention, joint stiffness, muscle pain, and high blood pressure.[6]

It turns out that, like Paul Bunyan, the athletic benefits of HGH is a myth.

That's my opinion. I'm Dr. George Griffing, Professor of Medicine at St. Louis University and Editor in Chief of Internal Medicine for eMedicine.


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