Growth hormone therapy benefits and side effects

There are a number of growth hormone therapy benefits, including positive changes in body composition, bone health, cardiovascular health and quality of life. There are, however, also some side effects, but some of these can be reduced by adjusting dosage.

Major benefits

Better body composition

One of the growth hormone therapy benefits includes a significant decrease in your total body fat content. This effect occurs in both subcutaneous and visceral fat, but is typically more prominent in visceral fat – the fat around the organs and top of the stomach. This change in fat composition occurs within six months of starting therapy and will continue if treatment continues.

An increase in your muscle mass is also likely, although the degree of change is usually less than the reduction in fat mass.

Physical performance and exercise capacity usually improve in growth hormone therapy. Key exercise parameters such as your maximum work capacity can increase significantly.

Better bone health

Growth hormone treatment is also associated with enhanced bone health, especially in those under 60 years of age. These effects are often more noticeable in women.

Better cardiovascular health

Growth hormone therapy benefits also include reducing arterial stiffness and increase flow-mediated dilatation, helping to improve circulatory health. Other advantages are that growth hormone therapy increases high-density lipoprotein (HDL) – the good cholesterol – and decreases low-density lipoprotein (LDL) – the bad cholesterol – as well as total cholesterol levels.

Better quality of life

Researchers suggest there is often a degree of improvement in quality of life with growth hormone treatment, although this improvement may be proportional. This means that if your quality of life is normal at ‘baseline’, then it is doubtful you would see a significant improvement in quality of life with therapy.

Improvements in insulin resistance is still under debate; however, several studies already demonstrate a positive association (Clemmons, 2004), which could be particularly important if you have a history of raised blood glucose, or you are have pre-diabetes.

Side effects

Most adverse effects from taking growth hormone are related to the metabolic effects of growth hormone itself, and are often dose related.

Therefore, if you are having growth hormone treatment and experiencing some of the side effects listed below, talk to your physician, and most likely, it can be resolved by adjusting dosage.

Fluid retention

The most common side effects are related to fluid retention, occurring in 5–18% of people. This includes joint stiffness, peripheral edema, arthralgia, and myalgia. Soft tissue edema is a particularly common adverse event among persons treated with growth hormone, and if you are a woman, the possibility of suffering from this side effect is greater.

Carpal tunnel syndrome

Carpal tunnel syndrome occurs in approximately 2% of treated growth hormone patients. If you are a woman, are overweight or obese, or are older, you have a greater chance of developing this complication.

Gynecomastia

Breast enlargement (abnormal development of large mammary glands) has been reported in normal elderly individuals receiving growth hormone treatment in high doses (Blackman et al., 2002).

Hypertension

Increased blood pressure is seen when fluid retention occurs, but you can avoid this problem with appropriate dosing.

Other side effects

Insulin resistance and type 2 diabetes have been reported in a few patients and growth hormone therapy is associated with a decline in glucose tolerance, impaired glucose tolerance and diabetes. If you have diabetes, your doctor should monitor you carefully.

There has been a concern that growth hormone therapy and its attendant increase in insulin-like growth factor 1 (IGF-1) could lead to tumors recurring or cancer developing. Although studies support an association with cancer, they do not support an association with tumor induction.

Moreover, extensive study of cancer survivors treated with growth hormone has failed to demonstrate an increase in tumors recurring or new cancers, but studies have shown a small increase in second malignant neoplasms.

If your pituitary gland is producing too much growth hormone, however, then you may have an increased risk of colorectal cancer.

If you do have a deficiency, then your doctor will carefully weigh the growth hormone therapy benefits and risks. They will take into account your general health status and any pre-existing conditions and will usually monitor you carefully.

If you are already receiving growth hormone treatment, mention any side effects you think you may be experiencing, as it may be possible to adjust your dose.

References

  • Attanasio AF, Howell S, Bates PC, Frewer P, Chipman J, Blum WF, Shalet SM. Body composition, IGF-I and IGFBP-3 concentrations as outcome measures in severely GH-deficient (GHD) patients after childhood GH treatment: a comparison with adult onset GHD patients. The Journal of clinical endocrinology and metabolism. 2002: 87: 3368-3372.
  • Baum HBA, Katznelson L, Sherman JC, Biller BMK, Hayden DL, Schoenfeld DA, Cannistraro KE, Klibanski A. Effects of physiological growth hormone (GH) therapy on cognition and quality of life in patients with adult-onset GH deficiency. J Clin Endocr Metab. 1998: 83: 3184-3189.
  • Blackman MR, Sorkin JD, Munzer T, Bellantoni MF, Busby-Whitehead J, Stevens TE, Jayme J, O’Connor KG, Christmas C, Tobin JD, Stewart KJ, Cottrell E, St Clair C, Pabst KM, Harman SM. Growth hormone and sex steroid administration in healthy aged women and men: a randomized controlled trial. JAMA : the journal of the American Medical Association. 2002: 288: 2282-2292.
  • Clayton PE, Cowell CT. Safety issues in children and adolescents during growth hormone therapy – a review. Growth Hormone & Igf Research. 2000: 10: 306-317.
  • Clemmons DR. The relative roles of growth hormone and IGF-1 in controlling insulin sensitivity. The Journal of clinical investigation. 2004: 113: 25-27.
  • Elgzyri T, Castenfors J, Hagg E, Backman C, Thoren M, Bramnert M. The effects of GH replacement therapy on cardiac morphology and function, exercise capacity and serum lipids in elderly patients with GH deficiency. Clin Endocrinol (Oxf). 2004: 61: 113-122.
  • Hoffman AR, Kuntze JE, Baptista J, Baum HBA, Baumann GP, Biller BMK, Clark RV, Cook D, Inzucchi SE, Kleinberg D, Klibanski A, Phillips LS, Ridgway EC, Robbins RJ, Schlechte J, Sharma M, Thorner MO, Vance ML. Growth hormone (GH) replacement therapy in adult-onset GH deficiency: Effects on body composition in men and women in a double-blind, randomized, placebo-controlled trial. J Clin Endocr Metab. 2004: 89: 2048-2056.
  • Holmes SJ, Shalet SM. Which Adults Develop Side-Effects of Growth-Hormone Replacement. Clin Endocrinol. 1995: 43: 143-149.
  • Jenkins PJ, Mukherjee A, Shalet SM. Does growth hormone cause cancer? Clin Endocrinol. 2006: 64: 115-121.
  • Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Shalet SM, Vance ML, Guidel ESC. Evaluation and treatment of adult growth hormone deficiency: An Endocrine Society clinical practice guideline. J Clin Endocr Metab. 2006: 91: 1621-1634.
  • Sesmilo G, Biller BM, Llevadot J, Hayden D, Hanson G, Rifai N, Klibanski A. Effects of growth hormone administration on inflammatory and other cardiovascular risk markers in men with growth hormone deficiency. A randomized, controlled clinical trial. Annals of internal medicine. 2000: 133: 111-122.
  • Smith JC, Evans LM, Wilkinson I, Goodfellow J, Cockcroft JR, Scanlon MF, Davies JS. Effects of GH replacement on endothelial function and large-artery stiffness in GH-deficient adults: a randomized, double-blind, placebo-controlled study. Clin Endocrinol (Oxf). 2002: 56: 493-501.
  • Svensson J, Fowelin J, Landin K, Bengtsson BA, Johansson JO. Effects of seven years of GH-replacement therapy on insulin sensitivity in GH-deficient adults. The Journal of clinical endocrinology and metabolism. 2002: 87: 2121-2127.
  • Thuesen L, Jorgensen JO, Muller JR, Kristensen BO, Skakkebaek NE, Vahl N, Christiansen JS. Short and long-term cardiovascular effects of growth hormone therapy in growth hormone deficient adults. Clin Endocrinol (Oxf). 1994: 41: 615-620.

Last reviewed 02/Jun/2017

 

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