Introduction
As we age, our cells do not reproduce as well as when we were young. Tissues of the body then shrink and decline. This leads to muscle wasting, bone shrinking, lower hormones, thinner skin, slowing of our memory as well as the aches, pains and functional losses that go with it. In short, this is how we age.
The slowing of cell reproduction is in part due to programmed cell death; something which is hastened by poor lifestyle, nutrient deficiency and especially hormonal decline. Cells, after accumulating damage or surrounded by poor nutrition, will choose to die off and not be replaced.
There is a growing interest in the use of individualised optimised nutrition, hormone replacement therapy, antiaging therapy and peptides to boost cell function to slow cellular ageing and compensate for functional losses.
The use of growth hormone and growth hormone peptides is a major part of the attempt to maintain our cells and prevent aging.
What is Growth Hormone?
As the name suggests, Growth Hormone is a hormone that controls growth. A part of the brain releases this hormone at certain moments, triggering metabolic changes in the rest of the body. Lots of growth hormone is released during puberty when we grow markedly taller. The levels sharply decline after the age of 25.
What are Growth Hormone peptides?
Peptides are small chains of protein. They act as cell signals and are responsible for regulating many of the cellular functions such as wound healing, sleep, energy, metabolism, longevity and hormonal regulation.
Most peptides relevant to growth hormone regulate the activity of the hormone, increasing its effects such as increasing lean muscle, breaking down fat and improving sleep and cell repair. Peptides are used to support cellular processes, often called body hacking, and are popular in the bodybuilding community but also increasingly are being used in the antiaging world.
What are some of the Growth Hormone peptides?
Traditionally, Growth Hormone had to be kept in the fridge and injected every day; this has led to the search for molecules that influence hormones but can also have a beneficial effect. Peptides are the result of this search.
There are currently multiple growth hormones and related peptides on the market. Many will target specific pathways such as growth hormone (called Growth Hormone Secretagogues) or pathways that help nerve cells (nootropics) to prevent and treat cognitive decline. People use peptides as they are simpler to take and perhaps easier to buy than growth hormone which requires a doctor’s prescription.
Peptides have multiple effects other than just on growth hormone. These include an impact on:
- muscle breakdown and recovery
- muscle mass
- sleep quality,
- androgen receptors,
- the immune system,
- Growth Hormone (GH Secretagogues)
- Nerve cells (nootropics)
- Emotional stress
- wound healing
Currently, peptides are novel and experimental treatments however there is some research on their use and the field is growing.
Why is Growth Hormone relevant to health?
Growth Hormone does a number of important things in the body:
- It breaks down fats for energy (lipolysis)
- Increases insulin sensitivity by 3.4 times, thus opposes diabetes (see insulin resistance)
- Stimulates protein and grows muscle
- Stimulates bone growth in puberty
- Promotes flat bone growth in adulthood (skull, jaw, sternum, hands, feet)
- Promotes the healing of wounds
What factors influence Growth Hormone?
Growth Hormone is released from the anterior pituitary, a gland in the brain, in response to certain stimuli. It is released in pulses throughout the day with most of it being released at night time. Growth Hormone release is influenced by some important factors.
Exercise
Exercise is a major promoter of growth hormone
Growth Hormone concentrations can go up to 30ng/mL after exercise; which is six times higher than a normal growth hormone!
Fasting
When the stomach is empty and sugar gets low, the stomach releases a hormone called Ghrelin
Ghrelin promotes the release of Growth Hormone
Higher blood glucose will actually inhibit the release of Growth Hormone
The Growth Hormone then enhances the breakdown of fats, for energy
Summary: Growth Hormone is enhanced during fasting and leads to the burning of stored fats
Deep Sleep & relaxation
Growth Hormone is predominately released at night time in children before puberty
The concentration will go up at night to over 4 times the average.
Growth Hormone release is inhibited by excess cortisol; a stress hormone brought on by emotional stress, infections, inflammation or nutritional stress states in the body.
Melatonin, a sleep hormone released at night, peaks when cortisol is then at its lowest
Summary: Growth hormone release is enhanced when there is good sleep and a lowering of the stress hormone cortisol overnight
High protein meals
High protein meals promote the release of growth hormone
Body builders will often consume regular protein to promote growth hormone release
The daily minimum for protein amounts to preserve muscle size is generally about 100g per day for a 70kg male.
Body builders will often consume beyond this; in conjunction with other nutritional and fasting measures
It should be noted that paleo diets consisted of lean meats with low glycaemic (low sugar releasing) carbohydrates
High glucose inhibits Growth Hormone release;
Summary: High protein meals promote growth hormone; and low carb (or lower GI) meals promote growth hormone.
IV amino acids
Amino Acids are the essential protein building blocks
The body makes some amino acids but not all of them; there are 9 essential ones
Therefore, the body needs proteins regularly in some form to keep going
Summary: IV amino acids are a commonly used therapy to boost growth hormone
Dopamine and rewarding experiences
Dopamine is a reward chemical in the brain
High levels of dopamine release growth hormone
L-dopa, a dopamine like medication, is used to release growth hormone when a person is being tested for Growth Hormone Deficiency
Testosterone
When children reach puberty, their male hormones or androgens rise dramatically
In women, this is from the adrenal glands whilst in males, it’s from their testes
Increased androgens, such as testosterone and DHEA stimulate the release of growth hormone
Other things that promote Growth Hormone
Niacin (Vitamin B3) as Nicotinic Acid
How do we test for Growth Hormone?
Growth Hormone is released in a pulsatile fashion; it is therefore very difficult to measure directly with a one time blood test. If there is a suspicion of low growth hormone, insulin-like growth factor 1 (IGF-1) will be measured instead. Levels are typically 300 ng/mL down to 150 ng/mL into middle age onwards. The use of growth hormone will increase the IGF-1 in blood tests and this may be used to monitor the use of Growth Hormone in patients.
The HGH Stimulation Test
This article describes Growth Hormone as we age. However, some children have a disorder where they cannot produce growth hormone; leading to short stature.
A Human Growth Hormone stimulation test is also used for the diagnosis of outright growth hormone deficiency, usually in children.
In this test, the patient is fasted overnight and given a ‘challenge’ in the morning such as IV amino acids (arginine), causing low sugar (insulin) or given another trigger (L-dopa, clonidine) to stimulate the release. Hourly bloods are then taken to see if the patient will release Growth Hormone normally or whether they can’t and therefore there is something wrong with their production of Growth Hormone.
This test is rarely done for anti aging assessment of growth hormone levels; it is more for children who are not growing adequately for their age.
Growth Hormone is released in a pulsatile fashion; it is therefore very difficult to measure directly with a one time blood test. If there is a suspicion of low growth hormone, insulin-like growth factor 1 (IGF-1) will be measured instead. Levels are typically 300 ng/mL down to 150 ng/mL into middle age onwards. The use of growth hormone will increase the IGF-1 in blood tests and this may be used to monitor the use of Growth Hormone in patients.
The HGH Stimulation Test
This article describes Growth Hormone as we age. However, some children have a disorder where they cannot produce growth hormone; leading to short stature.
A Human Growth Hormone stimulation test is also used for the diagnosis of outright growth hormone deficiency, usually in children.
In this test, the patient is fasted overnight and given a ‘challenge’ in the morning such as IV amino acids (arginine), causing low sugar (insulin) or given another trigger (L-dopa, clonidine) to stimulate the release. Hourly bloods are then taken to see if the patient will release Growth Hormone normally or whether they can’t and therefore there is something wrong with their production of Growth Hormone.
This test is rarely done for anti aging assessment of growth hormone levels; it is more for children who are not growing adequately for their age.
How is Growth Hormone deficiency treated?
1. Look after your Vitamins, lifestyle and nutrition
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- Vitamin deficiencies: Address any underlying nutritional states and keep on top of your vitamins
- Make sure you have plenty of B vitamins to help your cells clean up damage and grow (see Methylation)
- Ensure good health; minimise the stress on your body and encourage a low inflammatory lifestyle with a healthy vegetable rich diet
- Sleep well and deep; get those lights off and get to bed early
- Exercise and enjoy it!
- Have sex regularly and other activities you enjoy
2. Fix up any other medical issues which slow down your growth hormone
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- Testosterone deficiency
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Testosterone should be replaced in men and women with low levels; consider topping up DHEA, a testosterone like hormone that often gets low as we age
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- Insulin resistance and glucose levels
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Insulin Resistance should be tightly treated. Insulin resistance is where your body no longer reacts properly to insulin; this leads to multiple problems such as high blood pressure, higher blood glucose and also inhibits the release of Growth hormone! There are many treatments such as losing weight, gaining muscle and medications/supplements such as with treatments such as metformin, berberine and ozempic.
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- Detox the liver and body
- Testosterone deficiency
When our body is stressed, our cells cannot function well. The body encounters many forms of stress; both chemical and psychological. The total result is that the cells will be too busy detoxifying and your adrenal gland will release cortisol; a stress hormone that inhibits growth hormone!
Restoring your adrenal glands by starting with detoxification of your body
- N Acetyl Cysteine 600mg twice per day for 3 months helps deliver powerful antioxidants to the liver
- B12 vitamin is a major contributor to cell power and liver health
- Zinc Picolinate 15-30mg twice per day will help your cells recover
- Ashwaganda is a herb used to restore adrenal gland function; use it twice a day as long as you feel a benefit
- Promote deep sleep: provide your neurotransmitters with all the ingredients they need (use doses recommended by manufacturer)
- GABA,
- Melatonin,
- 5HTP,
- P5P or vitamin B6,
- magnesium,
- taurine,
- theanine
3. Directly boost growth hormone using peptides or growth hormone
Taking Growth Hormone Peptides
Peptides are molecules that promote growth hormone or act like it in some way. Peptides exist for multiple hormones. Recently, growth hormone peptides have become popular to increase growth hormone.
Currently, some of the better known growth hormone peptides include MK677 (which is oral and dosed daily). This was shown to increase IGF 1 and growth hormone levels in older people after 4 weeks of oral dosing (Chapman et al 1996)
The use of Growth Hormone peptides is controversial and banned in multiple jurisdictions.
Actual Growth Hormone Replacement
Growth Hormone treatment is prescribed by a doctor competent in the use of Growth Hormone
Growth hormone is given by a small needle every day under the skin into the fat
It is started slowly and escalated every two weeks
Growth Hormone can be taken in the morning or at night, however night is recommended
The treatment length is indefinite; many people will use it for a few months and then stop for a while.
Growth Hormone is best given every day so gaps might have to be built into the year to make it easier to go on holiday
Monitoring
It is important to see your doctor for regular monitoring of the growth hormone treatment
Furthermore, an annual check up for any background issues which may affect Growth Hormone is also recommended
How to take Growth Hormone: Dosing
Human Growth Hormone or HGH is used to treat growth hormone deficiency.
Growth Hormone is dosed by milligrams, however it is customary to report it in International Units or IU.
1mg = 3 IU
5mg = 15 IU
It should be noted that Growth Hormone use is not advocated in traditional medicine and is not routinely prescribed.
Multiple ‘self users’ of Growth Hormone would typically a dose of about 0.15mg 0.3mg per day. It is customary to start at 0.15mg for the first week and escalate to 0.3mg after a week or so. In practical terms, this means using 4IU the first week and moving up to 8IU the second week and potentially 12 IU based on response.
First Week Dosing
0.15mg is 0.45 IU, which is a total of 3.15 IU for 7 days.
For practical reasons, this means 4 IU can be divided into 7 syringes (see below) to roughly meet the starting dose for the first week
Second week onwards dosing
0.3mg is approximately 1 IU per day
7 days is 7IU; however it easier to use the 8IU dose or 10 IU dose to make things easier
This is drawn up into 7 small syringes to achieve those
Some people will escalate the dose further based on their experience, blood tests and discussions with their doctor.
There are multiple variations of the use of growth hormone in the community; it is worth openly disclosing what you are using to your health care practitioner to get a sense of the dose being undertaken in order to discuss and manage the risks.
What are the risks associated with Growth Hormone treatment?
Growth hormone is not a trivial treatment and should not be abused. In excessive doses, it has the capacity to:
Growth flat bones like skull and jaw
Fluid Retention: growth hormone is known to cause the retention of salts and thus water. Some patients describe being ‘puffy’ if they take too much growth hormone
Eye damage such as Macular oedema and retinal pathology; These are rare eye problems that can threaten sight. They are very rare but possible
Active Malignancy: Growth Hormone causes cells to grow; the use of growth hormone is associated with worsening tumours that already exist
Growth hormone should ONLY be used under the direct supervision of your doctor.
Disclaimer
The aim of this article is to discuss the role of Growth Hormone and common uses in the community; both inside and outside of health care settings. This article does not advocate the use of growth hormone or peptides and nor is it a substitute for sound medical advice. The objective is to give context regarding Growth Hormone and to increase mindfulness about the side effects and potential space for mistakes in dosing which are increasingly common.
Further reading
- How to dose Growth Hormone
- Mitochondrial function and ageing
- Anti ageing and telomeres
- Testosterone deficiency
- Wiki DHEA
- Insulin Resistance
- Methylation
REFERENCES
Brinkman JE, Tariq MA, Leavitt L, et al. Physiology, Growth Hormone. [Updated 2021 May 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
Chapman, I. M., Bach, M. A., Van Cauter, E., Farmer, M., Krupa, D., Taylor, A. M., Schilling, L. M., Cole, K. Y., Skiles, E. H., Pezzoli, S. S., Hartman, M. L., Veldhuis, J. D., Gormley, G. J., & Thorner, M. O. (1996). Stimulation of the growth hormone (GH)-insulin-like growth factor I axis by daily oral administration of a GH secretogogue (MK-677) in healthy elderly subjects. The Journal of clinical endocrinology and metabolism, 81(12), 4249–4257. https://doi.org/10.1210/jcem.81.12.8954023
Melnik BC, John SM, Schmitz G. Over-stimulation of insulin/IGF-1 signaling by western diet may promote diseases of civilization: lessons learnt from laron syndrome. Nutr Metab (Lond). 2011;8:41. Published 2011 Jun 24. doi:10.1186/1743- 7075-8-41
