 Growth hormone (somatotropin) is an organic compound that stimulates the growth of bone, cartilage, and tissue. It also influences the metabolism (break down) of proteins, carbohydrates, and fat. Growth hormone is one of several hormones produced by the anterior (front) lobe of the pituitary gland, which is located at the base of the brain. Children need growth hormone to grow normally. Although an adult's bones have stopped growing lengthwise, adults continue to need growth hormone to maintain their bones, muscles, and body fat, as well as maintain their strength, energy, and quality of life. Various medical conditions occur when the body produces too much or too little growth hormone. These conditions are caused by gene mutations, pituitary gland damage (due to tumor, radiation, trauma, or surgery), or problems with the hypothalamus (which controls the pituitary gland). Growth hormone excess can lead to tall stature in children or enlarged features and thickened skin in adults. Growth hormone deficiency can lead to short stature in children or decreased muscle mass and weakness in adults. People with growth hormone excess or deficiency will typically be referred to a specialist called an endocrinologist. The endocrinologist will properly diagnose growth hormone levels in their patients and monitor their treatment accordingly. People diagnosed with excess growth hormone usually suffer from either pituitary gigantism or acromegaly. These conditions are typically caused by a slow-growing, noncancerous tumor located in the pituitary gland and result in tall stature. Treatment options include surgical removal of the tumor (up to 80% cure rate), radiation, and prescription medications. The medications work by either reducing the levels of growth hormone or by blocking the effects of growth hormone. Examples of medications to treat growth hormone excess include the following: octreotide injection (brand name Sandostatin)
Side effects include nausea, vomiting, stomach upset, gas, bloating, diarrhea, constipation, dizziness, headache, and injection-site reaction. pegvisomant (Somavert)
Side effects include diarrhea, dizziness, nausea, injection site reaction, severe allergic reaction, headache, joint pain, chest pain, flu-like symptoms, stomach pain, and swelling of the extremities. cabergoline (Dostinex)
Side effects include abdominal pain, constipation, diarrhea, dizziness, drowsiness, headache, hot flashes, indigestion, nausea, vomiting, nervousness, tiredness, severe allergic reactions, chest pain, irregular heartbeat, shortness of breath, swelling of the extremities, and vision disturbances. People with deficiencies requiring growth hormone treatment are prescribed a synthetic (man-made) medication. They work identical to the way the body's naturally occurring growth hormone works. These medications require prescriptions and are given by injection. Examples of medications to treat growth hormone deficiency include the following: somatropin (brand names Genotropin, Humatrope, Norditropin, Omnitrope, Saizen, Serostim, Tev-Tropin, Zorbitive, Nutropin and Nutropin AQ) or somatrem (Protropin). Treatment with synthetic growth hormone is generally considered to be safe. However, if a person with normal growth takes a synthetic growth hormone medication, serious side effects could occur. This happens when growth hormone levels in the body become too high and can lead to the development of diabetes, high blood pressure, hardening of the arteries, and abnormal growth of bones and organs (heart, kidneys, and liver). Typical side effects of growth hormone medication include headache, nausea, vomiting, fatigue, muscle pain or weakness, swelling of the extremities, hypoglycemia (low blood sugar), blurred vision, burning/tingling sensations, dizziness, nervousness, numbness, carpal tunnel syndrome, or serious allergic reaction. The safety and effectiveness of growth hormone has not been established for pediatric patients with AIDS or short bowel syndrome. Be sure to notify your doctor if you experience any side effects that become bothersome or severe. FDA (Food and Drug Administration)-approved conditions for treatment with somatropin:
• Adult growth hormone deficiency (including hypopituitarism)
Genotropin, Humatrope, Norditropin, Nutropin and Nutropin AQ, Omnitrope, Saizen, Tev-Tropin
• AIDS wasting
Saizen, Serostim
• Childhood growth hormone deficiency (including pituitary dwarfism and childhood hypopituitarism)
Genotropin, Humatrope, Norditropin, Nutropin and Nutropin AQ, Omnitrope, Saizen, Tev-Tropin
• Chronic renal insufficiency (in children whose height is less than the third percentile for their chronologic age)
Nutropin and Nutropin AQ
• Idiopathic short stature (children with height standard deviation scores of -2.25 or lower)
Humatrope
• Pituitary dwarfism
Humatrope
• Prader-Willi syndrome
Genotropin
• Short bowel syndrome (to lessen the requirement for intravenous nutrition)
Zorbitive
• Small-for-gestational age (children who fail to exhibit catch-up growth by age 2)
Genotropin
• Turner syndrome
Humatrope, Nutropin, Nutropin AQ FDA-approved conditions for treatment with somatrem:
• Adult growth hormone deficiency (including hypopituitarism)
• Childhood growth hormone deficiency (including pituitary dwarfism and childhood hypopituitarism)
• Chronic renal insufficiency
• Decreased body growth (Down syndrome and juvenile chronic arthritis)
• Diabetic foot ulcer
• Idiopathic short stature
• Pituitary dwarfism
• Turner syndrome
Because growth hormone wasn't marketed as a dietary supplement or food before the FDA approved it as a drug, growth hormone cannot be sold as a dietary supplement. Federal law prohibits the distribution of growth hormone outside a legitimate doctor-patient relationship. Not only do some Web sites illegally distribute human growth hormone without a prescription, some sites even sell counterfeit (fake) growth hormone drugs. However, you can choose to fill your online prescription orders with a pharmacy that carries the Verified Internet Pharmacy Practice Sites (VIPPS®) seal of approval. For a list of pharmacies that carry the VIPPS® seal, see http://www.vipps.info. Sources:
Drug Facts and Comparisons, Facts & Comparisons, 2006.Drugs and Supplements, "Growth Hormone (Parenteral Route)." http://www.mayoclinic.com. Mayo Clinic Health. Last accessed 3/21/2007.
Hormonal Disorders, "Pituitary Gland Disorders." http://www.merck.com/mmhe. The Merck Manual of Medical Information, 2nd Home Edition, online version. Last accessed 3/21/2007.
Medical Encyclopedia. http://www.nlm.nih.gov/medlineplus. Medline Plus. Last accessed 3/21/2007.
Micromedex® Healthcare Series. Thomson Micromedex, 2006. Last accessed 3/21/2007.
U.S. Food and Drug Administration, http://www.fda.gov. Last accessed 3/21/2007.
"Verified Internet Pharmacy Practice Sites™ (VIPPS®) Frequently Asked Questions." http://www.nabp.net. Last accessed 3/21/2007.
This answer prepared 3/21/2007.
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