HGH (Human Growth Hormone)
Human Growth Hormone in Professional Bodybuilding: A Comprehensive Guide from a Physician-Trainer Perspective
By Dr. Alexander Reynolds, MD, CSCS – Sports Medicine Specialist & Performance Consultant
Introduction
HGH (Human Growth Hormone), also known as somatotropin, has long been a topic of fascination, controversy, and clinical intrigue in the world of professional bodybuilding. As both a licensed physician and a certified strength and conditioning specialist, I have spent over 15 years advising elite athletes on performance optimization, recovery, and endocrine health. Few substances generate as much debate as HGH—praised for its anabolic and anti-aging properties, yet heavily scrutinized for its misuse, side effects, and legal status.
This article aims to provide a comprehensive, science-based overview of HGH—its history, physiological role, use in bodybuilding cycles, dosing strategies, synergistic effects with other compounds, nutritional considerations, and the medical risks involved. My goal is not to endorse or encourage illicit use, but to inform athletes, coaches, and trainers about the realities of HGH from a clinical and practical standpoint.
A Brief History of HGH
HGH is a 191-amino-acid polypeptide hormone produced by the anterior pituitary gland. Its discovery dates back to the 1940s when researchers first isolated it from human cadavers. In 1956, Dr. Maurice Raben successfully administered purified HGH to a child with growth hormone deficiency, marking the dawn of clinical endocrinology in growth disorders.
For decades, HGH was extracted from human pituitary glands—until 1985, when several recipients developed Creutzfeldt-Jakob disease (a rare brain disorder), prompting a global halt. The advent of recombinant DNA technology in the 1980s revolutionized HGH production. Genentech introduced synthetic HGH (somatropin) in 1985, making it safer and more accessible for medical use.
Approved indications today include:
– Pediatric growth hormone deficiency
– Turner syndrome
– Chronic kidney disease in children
– Prader-Willi syndrome
– Adult growth hormone deficiency (AGHD)
– Muscle-wasting conditions in HIV/AIDS
Despite its legitimate medical uses, HGH has become widely misused in sports, particularly bodybuilding, due to its ability to enhance lean mass, reduce fat, and accelerate recovery.
The Physiology of HGH: How It Works
HGH exerts its effects both directly and indirectly. The primary mediator of its anabolic action is insulin-like growth factor-1 (IGF-1), which is produced mainly in the liver in response to HGH stimulation.
**Key Mechanisms in Bodybuilding Context:**
1. **Lipolysis**: HGH promotes fat breakdown by stimulating hormone-sensitive lipase, especially in visceral adipose tissue.
2. **Protein Synthesis**: Enhances amino acid uptake and protein synthesis in skeletal muscle, supporting muscle growth.
3. **Cellular Regeneration**: Stimulates satellite cell activation and proliferation, aiding muscle repair.
4. **Collagen Synthesis**: Increases connective tissue strength—beneficial for joint and tendon health under heavy training loads.
5. **Anti-Catabolic Effects**: Reduces protein breakdown during caloric deficits, preserving lean mass.
HGH is pulsatile in secretion, with peak release occurring during deep sleep (especially stages 3 and 4 of NREM), after exercise, and in response to fasting or low blood glucose. Its secretion declines with age—by about 14% per decade after age 20—leading some to view it as an “anti-aging” hormone.
HGH in Bodybuilding: Why Athletes Use It
Professional bodybuilders use HGH primarily for:
Enhanced muscle fullness and hardness
Improved recovery and reduced soreness
Greater fat loss, especially during cutting phases
Joint and connective tissue repair
Skin and hair quality improvements
Synergy with anabolic steroids and insulin
Unlike anabolic-androgenic steroids (AAS), HGH does not bind to androgen receptors. Its effects are subtler and more systemic, taking weeks to manifest. There is no “pump” or immediate strength gain. Instead, gains are gradual, sustainable, and often more “quality” than “quantity.”
Many elite bodybuilders report that HGH contributes to the elusive “dry” and “dense” look—critical in competitive physique sports. It helps maintain muscle mass during extreme dieting and enhances vascularity and muscle definition.
HGH Dosing and Cycling in Bodybuilding
There is no standardized “safe” dose for performance enhancement, as HGH is not approved for this use. However, clinical experience and athlete reports suggest common patterns.
Typical Dosing Ranges:
Beginner/First-time users: 2–4 IU/day
Intermediate users: 4–8 IU/day
Advanced/professional bodybuilders: 8–16 IU/day (or higher, though risks increase significantly)
Note: 1 IU (International Unit) ≈ 0.33–0.35 mg of somatropin.
Cycle Length:
Bulking: 12–24 weeks
Cutting/Pre-Contest: 16–24 weeks
Off-Season Maintenance: 4–8 IU every other day, 3–6 months
HGH is typically injected subcutaneously (abdomen, thigh) once daily, preferably before bed to align with natural pulsatility. Some split dosing—half in the morning, half at night—to maintain stable serum levels.
Timing with Training and Diet:
– HGH is most effective when combined with resistance training and adequate protein intake.
– Fasted-state injections (before breakfast or before bed) may enhance lipolytic effects.
– Avoid carbohydrates immediately post-injection to prevent insulin spikes that may suppress endogenous HGH.
Usagee with Other Compounds
HGH is rarely used alone. Its true power lies in combination with other performance-enhancing drugs (PEDs).
With Anabolic Steroids:
– Testosterone, trenbolone, or deca durabolin amplify HGH’s anabolic effects.
– Steroids increase androgen receptor sensitivity, while HGH boosts IGF-1—creating a powerful anabolic environment.
With Insulin:
– Common in advanced cycles, especially pre-contest.
– Insulin enhances nutrient shuttling into muscle cells, while HGH increases glucose uptake and glycogen storage.
– Caution: This combination dramatically increases hypoglycemia risk. Requires strict blood glucose monitoring and carbohydrate timing.
With IGF-1 or IGF-1 LR3:
– Some athletes use IGF-1 peptides to bypass liver production and directly stimulate muscle growth.
– HGH + IGF-1 creates a “stack” for maximal hypertrophy and recovery.
With Testosterone Replacement Therapy (TRT):
– Many bodybuilders maintain TRT-level testosterone (100–200 mg/week) year-round.
– HGH complements TRT by improving body composition and energy.
Nutritional Considerations When Using HGH
Nutrition is paramount when using HGH—both to maximize benefits and minimize side effects.
Protein Intake:
– Aim for 2.2–2.6 g/kg of body weight daily.
– High-quality sources: whey, casein, eggs, lean meats, fish.
– HGH increases protein synthesis, so amino acid availability is critical.
Carbohydrates:
– Moderate to high intake (4–7 g/kg/day), especially around workouts.
– Complex carbs (oats, sweet potatoes, rice) help manage insulin sensitivity.
– Post-workout carbs replenish glycogen and support recovery.
Fats:
– 20–30% of total calories.
– Focus on essential fatty acids (omega-3s from fish oil, flaxseed) to support hormone production and reduce inflammation.
Hydration and Electrolytes:
– HGH can cause fluid retention and carpal tunnel-like symptoms.
– Drink 3–4 liters of water daily and ensure adequate potassium, magnesium, and sodium.
Supplements:
– Alpha-lipoic acid (ALA): May improve insulin sensitivity and reduce neuropathy risk.
– Taurine: Supports cardiovascular health and may reduce edema.
– Vitamin D and K2: Critical for bone and cardiovascular health—HGH increases bone turnover.
– Liver support (NAC, milk thistle): Especially important with long-term use.
Side Effects and Health Risks
While HGH offers benefits, it is not without risks—especially at supraphysiological doses.
Common Side Effects:
– Fluid retention: Swollen joints, carpal tunnel syndrome, puffy face (“HGH bloat”).
– Insulin resistance: Elevated fasting glucose and increased diabetes risk.
– Arthralgia: Joint pain due to cartilage and connective tissue growth.
– Carpal tunnel syndrome: Numbness/tingling in hands from median nerve compression.
– Acromegaly-like symptoms: With long-term high-dose use—enlarged hands, feet, jaw.
Long-Term Risks:
– Cardiomegaly: Enlarged heart due to increased muscle mass and fluid load.
– Increased cancer risk: Theoretical concern due to IGF-1’s role in cell proliferation.
– Accelerated aging of organs: Some studies suggest HGH excess may shorten lifespan despite youthful appearance.
Withdrawal and Endogenous Suppression:
– Long-term exogenous HGH suppresses natural production.
– After discontinuation, users may experience fatigue, depression, and loss of muscle fullness until the HPA axis recovers.
Monitoring and Medical Oversight
Any athlete considering HGH should undergo regular medical screening:
Baseline Tests:
– IGF-1 levels (primary marker of HGH activity)
– Fasting glucose and HbA1c
– Lipid panel
– Liver and kidney function
– Thyroid panel
– Echocardiogram (if using high doses long-term)
During Cycle Monitoring:
– IGF-1 every 4–6 weeks to avoid excessive elevation (>500 ng/mL in adults is high; >700 is very high)
– Glucose tolerance testing if insulin resistance is suspected
– Hand/wrist exams if numbness or pain occurs
Post-Cycle:
– Gradual tapering may help mitigate withdrawal.
– Consider HGH-releasing peptides (e.g., GHRP-6, CJC-1295) to stimulate natural production during recovery.
Legal and Ethical Considerations
HGH is a **Schedule III controlled substance** in the United States under the Anabolic Steroids Control Act. Possession without a prescription is illegal. The World Anti-Doping Agency (WADA) bans HGH in all sports.
While enforcement in bodybuilding is inconsistent (especially in non-tested federations), the ethical dilemma remains. Natural athletes face an uneven playing field, and long-term health consequences are still not fully understood.
Real-World Application: Sample HGH Cycle
Goal: Pre-contest cutting (16 weeks)
User Profile: Male, 30 years old, 100 kg, experienced with PEDs
Cycle Design:
– HGH: 8 IU/day, subcutaneous, before bed
– Testosterone Enanthate: 500 mg/week
– Trenbolone Acetate: 75 mg every other day (weeks 8–16)
– Anavar: 40 mg/day (weeks 12–16)
– Insulin (Regular): 4–6 IU post-workout, with 50–75g dextrose
– Support: HCG, aromatase inhibitor (as needed), NAC, fish oil, vitamin D
Diet:
– Calories: 2,600 kcal (deficit of ~500 kcal)
– Protein: 260g
– Carbs: 300g
– Fats: 80g
Training:
– 5-day split, high volume, moderate intensity
– Cardio: 45 min LISS daily, 2 HIIT sessions/week
Monitoring:
– IGF-1 tested at week 4, 8, 12
– Glucose checks 2x/week
– Wrist and joint assessment weekly
Outcome (Expected):
– 8–10 kg fat loss
– Minimal muscle loss
– Improved muscle hardness and vascularity
– Slight fluid retention managed with sodium control
Conclusion: A Tool, Not a Magic Bullet
HGH is one of the most powerful tools in the bodybuilder’s arsenal—but it is not a shortcut. It requires meticulous planning, medical supervision, nutritional precision, and realistic expectations. The gains are real but gradual. The risks are significant and often underestimated.
As a physician, I urge athletes to prioritize long-term health over short-term aesthetics. If HGH is used, it should be done with full awareness, regular monitoring, and respect for the body’s endocrine balance.