Unconventional Uses of Human Growth Hormone

Growth hormone (GH), a 191-amino acid peptide produced by the anterior pituitary gland, plays a central role in linear growth, body composition, metabolism, and homeostasis. Exogenous GH has been used to treat GH deficiency (GHD) in children and adults since the early 1960s. GH used to be purified from human pituitaries obtained at autopsy, with the consequent limited availability and risk of Creutzfeld Jacob disease due to prion contamination. Since the mid 1980s all the GH used to treat humans is synthesized by recombinant DNA technologies (rhGH). rhGH is currently used in several conditions besides GHD, to promote linear growth in children with chronic kidney disease, patients with Turner syndrome, and in children with intrauterine growth retardation. Because of its metabolic effects, rhGH has been tried with varying results to improve the functional capacity of patients with cystic fibrosis, heart failure and critical illness, as well as the severe muscle wasting and lipodystrophy seen in patients with human immunodeficiency virus infection. Finally, rhGH has been used as an antiaging therapy and to improve athletic performance. Many of these unconventional uses of GH are certainly off label and can cause serious side effects. In the present review, we critically analyzed available data regarding these unconventional indications of rhGH.