Systematic Review: The Effects of Growth Hormone on Athletic Performance

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Liu, Hau, Dena M. Bravata, Ingram Olkin, Anne Friedlander, Vincent Liu, Brian Roberts, Eran Bendavid Olga Saynina, Shelley R. Scalpeter, Alan M. Garber, and Andrew R. Hoffman.

Annals of Internal Medicine 48.10 (20 May 2008): 747-758.

The purpose of this review was to evaluate evidence about the effects of growth hormone on athletic performance in physically fit, young individuals. Although HGH is widely used to enhance athletic performance, its safety and efficacy for this purpose are poorly understood. This review evaluated the effects of growth hormone on body composition, strength, basal metabolism and exercise capacity as well as identifying evidence of adverse effects.

MEDLINE, EMBASE, SPORTDiscus, and Cochrane Collaboration databases were searched for English-language studies published between January 1966 and October 2007. From the 7,599 articles reviewed, 27 study samples were selected. The selected studies were randomized, controlled trials, with a minimum of 5 participants that compared GH treatment with no GH treatment in community-dwelling healthy participants between 13 and 45 years of age.

The studies included 440 participants, 303 of which received growth hormone, representing 13.3 person-years of treatment. The study sizes were small, averaging 15 participants, and the dropout rates were low (2%). 85% of the participants were male, average age 27, lean and physically fit.

Seven of the studies evaluated the effects of a single dose of HGH, administered subcutaneously in 3 studies and intravenously in the other 4. The other 20 studies administered HGH subcutaneously for an average of 20 days. Only 3 studies evaluated HGH for more than 30 days and none more than 3 months. The average daily dose was 36 μg/kg.

Many of the studies provided outcome data on body composition and basal metabolic rate. Lean body mass increased significantly in growth hormone treated groups compared with groups who did not receive growth hormone. There was also a decrease in fat mass and some increase in weight reported. Daily basal metabolic rate and resting heart rate was higher in the participants that received HGH. Respiratory exchange ratio was lower in that group.

Only 2 of the studies evaluated strength outcomes. Those studies were 42 days and 84 days respectively, the longest treatment durations of all the studies. HGH use did not improve strength in biceps or quadriceps. One study also evaluated change in the strength of 7 other muscle groups but did not find a significant difference between those treated with HGH and those who were not treated. The 6 studies that measured exercise capacity outcomes also did not find improvement.

Adverse effects were reported by 16 of the studies. HGH treated participants more frequently experienced soft tissue edema, fatigue, joint pain and carpal tunnel syndrome than did those not treated with the hormone.

The reviewers concluded that claims that HGH enhances physical performance are not supported by the available research data. The limited published data suggests that although HGH increases lean body mass in the short term, it does not seem to increase strength, may worsen exercise capacity and in healthy young people is frequently associated with adverse effects.

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