Tell Your Teens: Little to Gain, Much to Lose with HGH

The percentage of U.S. teens who reported ever using synthetic human growth hormone (HGH) without a prescription more than doubled from 2012 to 2013, from five to 11 percent. The Partnership for Drug-Free Kids discovered the sharp trend in increased use with data collected from over 3,700 high school students in 2013.

Black and Hispanic teens were more likely than white teens to report ever using HGH (15 and 13 percent, respectively, vs. nine percent). Boys used synthetic HGH at a rate of 12 percent, with girls' usage at nine percent, not far behind them. The group reports that the proportion of teens who perceived HGH use as moderately or greatly risky dropped to 81 percent (from 86 percent in 2012). Still, it is encouraging that the vast majority of teens perceive use of the drug as a health risk.

Teen peers, parents and coaches all have a role in educating young people about the risks associated with HGH use. The study suggests that this is a mounting rather than shrinking problem in U.S. Schools.

Synthetic HGH was developed in 1985 and approved by the FDA for specific uses in children and adults. In children, HGH injections are approved for treating “short stature of unknown cause” as well as poor growth due to a number of medical causes, including Turner's syndrome and kidney insufficiency.

The known possible side effects of HGH use include nerve, muscle and joint pain; edema (a build-up of fluid causing swelling); carpal tunnel syndrome; numb or tingling skin; high cholesterol; increased diabetes risk and risk of cancerous tumors. There is also a significant risk of injecting an unknown counterfeit drug since synthetic HGH is costly and inconvenient to obtain through a doctor, and so often purchased on the black market.

Performance enhancing drugs are not all aptly named. As far back as 2008, the Annals of Internal Medicine has reported that HGH fails to boost athletic performance. Six years ago the safety and efficacy of synthetic HGH for this purpose were even more poorly understood.

The study evaluated evidence about the effects of growth hormone on athletic performance in physically fit, young individuals. Databases were searched for studies published between January 1966 and October 2007. The meta-analysis looked at randomized, controlled trials that compared growth hormone treatment with no growth hormone treatment in community-dwelling healthy participants between 13 and 45 years of age.

The authors found 44 articles describing 27 study samples that met criteria for inclusion. A total of 303 participants received HGH, representing 13.3 person-years of treatment. The mean age of the participants was 27, and they generally had a  lean body mass (BMI mean was 24 kg/m2). They were physically fit,  with a mean VO2max of 51 mL/kg of body weight per minute. Growth hormone dosage and treatment duration varied. The mean dose was 36 microg/kg per day; mean treatment duration was 20 days.

Lean body mass increased in growth hormone recipients compared with participants who did not receive growth hormone, but strength and exercise capacity did not seem to improve. The lean body mass increase was about 2 kg. Lactate levels during exercise were significantly higher in two of three studies that looked at this outcome. Growth hormone-treated participants more frequently experienced soft tissue edema and fatigue, than those not treated with HGH.

Although few studies evaluated athletic performance and dosage in the studies may not reflect real-world doses and regimens, it is noteworthy that the scientific community thus far fails to find a clear link between HGH intake and improved athletic performance. Claims that growth hormone enhances physical performance are simply not supported by the literature. The authors conclude: “Although the limited available evidence suggests that growth hormone increases lean body mass, it may not improve strength; in addition, it may worsen exercise capacity and increase adverse events.”

Partnership for Drug-Free Kids, 2013, The Partnership Attitude Tracking Study: Teens & Parents, http://www.drugfree.org/wp-content/uploads/2014/07/PATS-2013-FULL-REPORT.pdf

Annals of Internal Medicine, 2008, Vol. 148, No. 10, pp. 747-758, http://www.ncbi.nlm.nih.gov/pubmed/18347346

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