Growth Hormone in Sport: What Athletes Should Know | USADA

When it comes to building speed, strength, and recovery, growth hormone (GH), and more specifically human growth hormone (hGH), has often been touted as one way to get an edge. Athletes, however, should know the risks associated with growth hormone from a health and clean sport perspective.

Humans naturally produce growth hormone, which controls how the body grows from childhood to adulthood but doesnt directly act on the bones and muscles. When growth hormone is released by the pituitary in the brain, it circulates in the blood and stimulates the release of a protein called IGF-1 from the liver. The IGF-1 protein is what ultimately stimulates the growth of bones, muscle, and other tissues.

Growth hormone levels are highest in children and decrease with age. While adults still produce growth hormone, the levels are much lower than in children and adolescents.

Yes. Growth hormone is in the category of Anabolic Agents on the World Anti-Doping Agency (WADA) Prohibited List and is prohibited at all times and for all levels of athletes, including elite, junior, and masters-level athletes. Even if you are prescribed growth hormone by a doctor for one of the conditions mentioned below, an approved Therapeutic Use Exemption (TUE) is required to use growth hormone in sport.

Growth hormone may only be legally prescribed for a small number of conditions. In pediatric patients, doctors can prescribe it to treat growth hormone deficiency, Prader-Willi syndrome, Turner syndrome, idiopathic short stature (when children are smaller than normal but there isnt a clear reason) and to treat growth failure in children born small who dont catch up by the time they are two.

In adults, growth hormone can also be prescribed to treat growth hormone deficiency as a result of pituitary disease, radiation therapy, or trauma. However, the medical use of growth hormone is complex because determining the right time to give the medication and figuring out who will actually benefit from it can be subjective. Growth hormone does not always cause a measurable increase in the rate of growth or development.

The use of growth hormone for an off-label use (not approved by the Food and Drug Administration) is unlawful and a felony under the Food, Drug, and Cosmetic Act. According to a statement by the Drug Enforcement Agency, growth hormone that is sold for wellness or anti-aging purposes is marketed, distributed, and illegally prescribed off-label to aging adults to replenish declining hGH levels and reverse age-related bodily deterioration.

Some wellness or anti-aging clinics also prescribe drugs that cause the body to release more growth hormone, such as growth hormone releasing hormone (GHRH) and other factors. Many compounds that are advertised to have these effects are investigational new drugs that are not yet approved by the FDA. Under the WADA Prohibited List, growth hormone releasing factors are prohibited at all times.

Athletes should check the anti-doping status of any medication they are prescribed on GlobalDRO.com before using them in sport.

Dietary supplements that claim to contain growth hormone or that advertise to cause the release of growth hormone should be avoided by athletes. The use of any dietary supplement is at the athletes own risk.

There are many reported side effects from the use of growth hormone, including irritation at the injection site, increased blood pressure in the brain, damage to the retina and vision in people with diabetes, damage to the growth plates in the femur in pediatric patients, faster progression of scoliosis in people who have this condition, hypothyroidism, pancreatitis, swelling or stiffness in the arms and legs, and generalized pain.

Long-term, the use of growth hormone may cause the body to stop producing its own, or to downregulate the growth hormone pathways.

For questions about specific products, substances, and methods, contact USADAs Drug Reference Line at drugreference@usada.org or call (719) 785-2000, option 2.

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Growth Hormone in Sport: What Athletes Should Know | USADA