Exact copy of human growth hormone. Used in children with growth hormone deficiency and other causes of short stature, and in adults with proven deficiency.
FDA (US): Approved since 1985 (the first recombinant growth hormones; brands such as Humatrope, Genotropin, Norditropin) for GH deficiency in children and adults, Turner syndrome, Prader-Willi, children born small for gestational age, chronic kidney failure, and other indications depending on the brand.
EMA (EU): Approved: several brands authorized nationally and others by the EMA (e.g., NutropinAq 2001, Omnitrope 2006 as a biosimilar), with pediatric indications and for adults with GH deficiency.
Dose
Always individualized by an endocrinologist according to weight, indication, and IGF-1 levels; the exact regimen varies by brand (see each product's FDA/EMA label). In adults, treatment starts at low doses and is adjusted according to IGF-1.
Safety
Fluid retention, edema, joint and muscle pain, carpal tunnel syndrome, insulin resistance. In children: benign intracranial hypertension, slipped capital femoral epiphysis, worsening of scoliosis. Contraindicated with active cancer and in acutely critically ill patients. Use without a deficiency (anti-aging or sports) is not approved, is banned in sports, and carries risks.
Interactions
Oral estrogens reduce its effect (higher dose needed). May require adjusting antidiabetic drugs. Glucocorticoids suppress growth; it may unmask a cortisol or thyroid deficiency.
Differences between women and men
Women taking oral estrogens (contraceptives or hormone therapy) need roughly double the dose to reach the same IGF-1; with transdermal estrogen the requirement is similar to that of men. View the study →
Effect by goal · level of evidence
Body composition and lipids in adults with deficiency
improvesHighmeta-analysis (AAA)in people
+2.6 kg lean mass
Meta-analysis of 22 RCTs (1,153 adults): lean mass +2.6 kg and fat −2.2 kg versus placebo; total cholesterol −0.38 mmol/L and LDL −0.42 mmol/L. High doses improved body composition more, but not lipids.
Meta-analysis of 11 RCTs (268 patients): small-to-moderate improvement in exercise capacity, with increases in peak power and maximal oxygen consumption.
In 37 adults with deficiency, women on oral estrogen needed about 867 µg/day of GH, versus 424 µg/day in women not on oral estrogen and 376 µg/day in men.
It binds to the growth hormone receptor, mainly in the liver, which produces IGF-1. Together they stimulate bone growth in children. In adults they promote muscle mass, reduce abdominal fat, and improve the lipid profile.
What the evidence says
In people
Body composition and lipids in adults with deficiency. Meta-analysis of 22 RCTs (1,153 adults): lean mass +2.6 kg and fat −2.2 kg versus placebo; total cholesterol −0.38 mmol/L and LDL −0.42 mmol/L. High doses improved body composition more, but not lipids. PubMed 24810900
Exercise capacity in adults with deficiency. Meta-analysis of 11 RCTs (268 patients): small-to-moderate improvement in exercise capacity, with increases in peak power and maximal oxygen uptake. PubMed 18697875
Oral estrogen and required dose. In 37 adults with deficiency, women on oral estrogen needed about 867 µg/day of GH, versus 424 µg/day in women not on oral estrogen and 376 µg/day in men. PubMed 10566634