Too much of a good thing: the health risks of human growth hormone

You might think Ted Cassidy, the actor who played dour butler Lurch on the Addams Family, was tall at 2.06 metres.

But Richard Kiel, also known as the steel-toothed Jaws in the James Bond franchise, was even taller at 2.18 metres.

And both would have to look up to wrestler André René Roussimoff, or “André the Giant”, at 2.24 metres.

All of these actors had the same condition, acromegaly.

In acromegaly, the pituitary gland in the brain releases too much human growth hormone (somotrophin).  Often, this is caused by a benign tumour of the pituitary gland.

Bone growth from this hormone gave these performers extraordinary height, as well as enlarged hands, feet and facial features.

But complications of acromegaly include arthritis, sleep apnoea, diabetes, high blood pressure, heart disease and often premature death - external site.  Both Ted Cassidy and André René Roussimoff died at age 46 from cardiac complications related to their acromegaly.

Human growth hormone has a vital role in our growth and health, but abuse can cause permanent health issues and shorten your lifespan - external site.

Sometimes, too much of a good thing can be bad for you.

What is human growth hormone?

Human growth hormone is a peptide.  Like the proteins that make our hair, nails, muscles and skin, a peptide is a chain of amino acids.  Peptides are shorter than proteins, which means they degrade and digest more quickly.

Human growth hormone doesn’t promote growth directly.  Instead, it encourages the liver to release insulin-like growth factor 1 (IGF-1), which thickens and elongates bones. In addition to bone growth, IGF-1 grows muscle and reduces fat storage.

But too much IGF-1 enlarges the face, feet and hands, as we see in acromegaly.  It produces extreme height, especially during childhood and adolescence.  It stimulates secretion of insulin while reducing that hormone’s effectiveness - external site, which can cause fatigue and intense hunger.  And it can increase the pressure on the brain in the skull, which is associated with cancers.

Human growth hormone declines naturally as we age, but this decline may protect us against some cancers - external site.

Use and abuse

For most of us, human growth hormone helps us develop as children, and supports our health and fitness as adults.

Medically, human growth hormone is used to treat children who don’t grow, and adults with a growth hormone deficiency - external site.  It is also used to support people undergoing chemotherapy.

But abuse of human growth hormone or IGF-1 has serious risks.  High levels of human growth hormone over a long period can produce irreversible acromegaly, but even smaller doses can lead to complications such as heart disease and diabetes.  And because these hormones must be taken as injections, there are further administration risks such as a blood clot or dose error.

Some people believe human growth hormone can increase athletic performance, but research shows the benefit to athletic performance is uncertain. One review found that while the hormone increases muscle mass, it may not improve strength and can worsen exercise capacity - external site.  Health complications from abuse can also disrupt athletic performance.  Human growth hormone is on the World Anti-Doping Agency (WADA) Prohibited List - external site, which means athletes found to use it are banned from competition.

Because of the health risks of human growth hormone, it should only be used under the supervision of a doctor.  In Australia, a prescription is required to either possess or import human growth hormone, and it is illegal for companies to advertise it to the public.  In 2019, the Federal Court ordered a $10 million penalty against a company for advertising prescription peptides to the public.

Growth hormones are also considered controlled drugs, which require a permit from the Office of Drug Control - external site to import.  Import permits are not issued to patients, which means that you cannot import human growth hormone for personal use even if you have a prescription.  Instead, if necessary a doctor with a permit can import the hormone on behalf of a patient.

A dynamic balance

Our hormones have a dynamic balance.  Human growth hormone promotes the release of IGF-1, but IGF-1 reduces the secretion of human growth hormone.  Several other hormones also either encourage or discourage the release of human growth hormone.

This active balance keeps our human growth hormone at a healthy level, helping us avoid the complications of acromegaly or deficiency.

Unless you have a diagnosed deficiency or other clinical need, you don’t need injections to manage your level of human growth hormone.  Sleep, exercise and good diet all encourage the release of human growth hormone, as well as boosting your sense of wellbeing.

Human growth hormone sold outside pharmacies may also be counterfeit, which means it can be substandard or not contain the advertised dose or ingredient.  Illegally supplied products always have these risks.

If you have performance or image goals, you must look after your health.  Human growth hormone is important to our health and development, but too much of a good thing can harm you.