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Review
. 2018 Sep/Oct;10(5):419-426.
doi: 10.1177/1941738118782688. Epub 2018 Jun 22.

The Use and Abuse of Human Growth Hormone in Sports

David M Siebert  1 , Ashwin L Rao  1
Affiliations
Review

The Use and Abuse of Human Growth Hormone in Sports

David M Siebert et al. Sports Health. 2018 Sep/Oct.

Abstract

Context: Recombinant human growth hormone (rHGH) has become a target of abuse in the sporting world. Conversely, sports medicine clinicians may encounter athletes using rHGH to achieve normalcy in the context of growth hormone (GH) deficiency.

Evidence acquisition: Medline and PubMed databases were queried using the following keywords: GH, GH physiology, GH deficiency, acromegaly, GH athlete, GH sports, GH athletic performance, and GH deficiency concussion. Articles focusing on GH physiology, deficiency, excess, and its effects in both deficient and healthy patients were included.

Study design: Clinical review.

Level of evidence: Level 3.

Results: GH is a naturally occurring hormone with important roles in human physiology. Patients with GH deficiency (GHD) present variably, and GHD has numerous etiologies. rHGH treatment has substantial therapeutic benefits for patients with GHD. The benefits of rHGH treatment in otherwise-healthy adults are uncertain. GH excess may cause health problems such as acromegaly. Professional, collegiate, and international sports leagues and associations have banned rHGH use to maintain athlete health, safety, and fair play. Athletes misusing GH may face prolonged suspensions from competition. Implementing GH abuse testing is challenging, but new methods, such as the biomarker testing procedure, are being finalized.

Conclusion: rHGH is not only an important therapeutic agent for GH-deficient patients but also a target of abuse in competitive athletics. Its benefits in a healthy, adult population are uncertain. A safe exercise and competition plan, developed with a physician knowledgeable of GH use, physiology, and abuse potential, should be of benefit to a longitudinal clinician-patient relationship.

Keywords: athlete; athletic performance; drug testing; human growth hormone; performance-enhancing drugs.

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Conflict of interest statement

The following author declared potential conflicts of interest: Ashwin L. Rao, MD, has received payment for serving as an AMSSM MSK ultrasound course teacher.

Figures

Figure 1.
Figure 1.
GH, IGF-1 axis. GH, growth hormone; GHRH, growth hormone–releasing hormone; GHIH, growth hormone–inhibiting hormone; IGF-1, insulin-like growth factor-1.
See this image and copyright information in PMC

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