Human Growth Hormone
The use of Human Growth Hormone continues to rise due to its popularity in aiding not only in new muscle growth, (unlike steroids that only make your existing muscle bigger) but in healing joints and aid muscle damage repair at an accelerated rate. Fat loss and fast muscle recovery are among the positive side effects sought after by users of HGH.
Length of Use: Users will want at a minimum of 6 months of use for maximum effectiveness, while most users will extend use to 2 to 3 years and beyond of continuous use.
Before you begin: A cancer screening is highly advised before the use of growth hormone due to its ability to enlarge existing cancer cells.
Users will most often use growth hormone with anabolic steroids for a pronounced effect.
Growth hormone adds new muscle growth, while anabolic steroids make existing muscles larger.
Athletes and actors are now more open about the use of HGH and rave about the positive effects of HGH.
The text below was taken from the book ANABOLICS 10th edition by William Llewellyn
We highly recommend you pick up a copy of this book. This book will be invaluable to you as a new or experienced user of anabolic steroids and various other compounds.
Geref® (sermorelin acetate)
Sermorelin is a synthetic analog of endogenous growth hormone-releasing hormone (GHRH or GRF). Sermorelin is a portion of this polypeptide hormone, specifically consisting of the first 29 of its 44 amino acid structure. As its name states very clearly, the biological activity of GHRH is to stimulate the synthesis of growth hormone, which occurs in the pituitary gland. Studies have shown, however, that the GHRH peptide can be partly truncated without sacrificing its GH stimulating ability.702 29NH2) was developed based on this research, and shares the full biological activity of GHRH with regard to increasing the endogenous production of growth hormone. Based on its structure and action, sermorelin is classified as a growth hormone releasing factor (GHRF) or GH secretagogue.
Sermorelin, as an acetate salt, is used in clinical medicine for two primary applications. The first is to diagnose pituitary deficiency. The procedure involves measuring the serum growth hormone response over a 1-2 hour window following a single IV infusion of sermorelin acetate.703 An intact hypothalamo-pituitary-growth-hormone axis should yield a predictable increase in the GH level. The second common medical application is the treatment of growth hormone deficiency in children. As with recombinant growth hormone medications (rHGH, somatropin), sermorelin acetate can provide the benefits of sustained elevations in GH, including enhanced IGF-1 (Insulin-like Growth Factor) output and increased linear height.704 Sermorelin is a very specific acting drug, and has no effect on prolactin, LH, FSH, insulin, cortisol, glucose, glucagon, or thyroid hormone levels.705 This also lends to its therapeutic potential.
Athletes are interested in sermorelin acetate for the same reasons they use recombinant human growth hormone. Among other things, growth hormone has anabolic and anti-catabolic properties. An elevated GH level may support new muscle tissue growth, and also enhance strength, energy levels, and connective tissues. GH is also a potent modulator of fat loss. The physique- and performance-enhancing properties of growth hormone are widely accepted by the bodybuilding and competitive athletic communities, such that rHGH medications are very popular. Although sermorelin acetate has a much shorter history of use, it is slowly gaining acceptance among the community as a viable alternative to low dose growth hormone injections. It is also presently popular in anti-aging medicine, where again it serves as an alternative to growth hormone in the treatment of age-related GH deficiency (“somatopause”).
When comparing this drug to recombinant human growth hormone, sermorelin acetate does appear to be less effective under normal therapeutic conditions. During clinical studies, fewer patients on average seem to respond favorably to therapy in contrast to somatropin, and for those that do respond the improvements are often less pronounced.706 Still, it would be a mistake to exclude sermorelin acetate as a viable therapeutic option. For example, studies have found that sermorelin acetate can result in significant increases in height velocity in children with GH deficiency.707 Furthermore, these improvements seem to be well sustained after one year of therapy.708 709 Antibodies to GHRH do develop in some patients during extended therapy, and may impair the potency of the drug.710 The full biological relevance of this antibody reaction, however, remains unclear.
Sermorelin is approved in the United States for the treatment of GH deficiency in children only. Prolonged studies treating adults with somatopause are lacking. One investigation looked at the effects of 2 mg sermorelin acetate per day for 6 weeks in a group of eleven healthy elderly men (aged 64 to 76) with low circulating IGF-1 levels.711 Various measures of body composition and performance were recorded at the beginning and end of the study. As a result of treatment, there was a significant increase in nocturnal GH output, area under peak GH release, and GH peak amplitude. This was accompanied by improvements in certain measures of strength and endurance including upright row, shoulder press, and abdominal crunch. Many other measures did not reach statistical significance, however, which may reflect study limitations such as small population sizes and a short duration of intake.
Another investigation looked at the effects of sermorelin acetate in a group of HIV+ men with lipodystrophy.712 HIV lipodystrophy tends to be characterized by the abnormal distribution of fat cells and suppressed levels of growth hormone. During this investigation, 31 men aged 18 to 60 years were given 1 mg of sermorelin acetate or placebo by subcutaneous injection twice daily for 12 weeks. The primary outcome of the study was a significant increase in serum IGF-1 in the sermorelin acetate group (104 ng/mL vs 6 ng/mL). This was accompanied by a favorable increase in lean body mass (+.9 kg vs -.3 kg) and decrease in visceral and subcutaneous fat. Sermorelin acetate was well tolerated, and did not result in any change in other health markers including blood pressure, cholesterol, triglycerides, insulin, or hemoglobin. None of the participants discontinued therapy due to side effects.
Sermorelin acetate could be viewed as offering a therapeutic advantage over recombinant growth hormone in some cases, in that it is less likely to result in GH excess.This is due to the fact that it relies on the body’s own hormone synthesis instead of exogenous supplementation. Thus, normal IGF-1 feedback inhibition is likely to help set a natural limit to the growth hormone stimulating effect.713 As such, hormone levels are more easily controlled with sermorelin acetate. Under normal conditions, while sermorelin will produce significant elevations in GH and IGF-1, these levels should not exceed the high end of the normal range.714 Given this feature, sermorelin acetate may be a more comfortable option for some patients. Studies seem to support this notion, finding many of the same physical and metabolic benefits of GH injections, without reporting the same issues with insulin resistance, fluid retention, or muscle pain.
Sermorelin acetate was developed during the early 1980s, and approved for prescription sale by the U.S. Food and Drug Administration in 1997. It was introduced to market under the brand name Geref Diagnostic by the international biotechnologies firm Serono. As the name implies, it was primarily developed as a diagnostic tool. It was specifically used for evaluating potential pituitary deficiency in GH production. Given its effect on growth hormone levels, however, the drug was also approved by the FDA for the treatment of GH deficiency in children. Geref was never widely prescribed, however, especially for uses relating to childhood GH deficiency, where it was never able to compete with somatropin. Serono ultimately discontinued the product in October 2008, citing supply issues with the active pharmaceutical ingredient.715 This was the only company manufacturing sermorelin as a commercial product in the United States, thus it is no longer available as a stock pharmacy item.The active material sermorelin acetate is still made by at least one licensed supplier, however, so the drug remains available here as a compounded medicine.
Geref Diagnostic was supplied in ampules containing dry lyophilized sermorelin acetate, equivalent to 50 mcg of sermorelin. This was reconstituted with a sterile diluent (also supplied) before use. Generic compounded versions of this medication typically contain between 3.0 and 7.5 mg of dry lyophilized sermorelin acetate in a multi-dose vial. Reconstitution before use is also required.
Sermorelin acetate is the acetate salt of a synthetic 29–amino acid peptide (GRF 1-29 NH 2) that corresponds to the amino-terminal segment of the naturally occurring human growth hormone-releasing hormone (GHRH) with 44 amino acid residues.
Sermorelin acetate should be used with care in epileptic patients. Obesity, uncontrolled hypothyroidism, hyperglycemia, or elevated plasma fatty acids may impair the effectiveness of sermorelin. Therapy should be discontinued in patients treated for childhood GH deficiency once the epiphyses have closed.
The most common side effects to sermorelin acetate therapy are injection site reactions such as pain, redness, and swelling. During clinical trials, this occurred in approximately 17% of patients. Less common side effects include difficulty swallowing, itching, dizziness, flushing, headache, nausea, vomiting, altered sense of taste, restlessness, and sleepiness.
When used medically for the treatment of idiopathic growth hormone deficiency in prepubertal children with growth failure, sermorelin acetate is administered by subcutaneous injection at a dosage of 0.03 mg per kg of body weight once a day at bedtime. Injection sites should be rotated to avoid irritation or the buildup of scar tissue. When used to evaluate pituitary capacity in adults, a single intravenous infusion of 1.0 mcg/kg body weight is administered in the morning after an overnight fast.This is followed by 60-120 minutes of periodic blood sampling to measure pituitary hormone output.
When used for physique- or performance-enhancing purposes, sermorelin acetate is given by subcutaneous injection. It is typically administered at a dosage of 0.2 to 0.5 mg per day (200-500 mcg), which is given before sleep. Studies, however, do suggest that this drug is more effective when given twice daily.716 Therefore, it is often preferred to divide the total daily dosage into two applications,one in the morning and one in the evening. Cycles of sermorelin acetate usually last between 8 and 12 weeks. Some anti-aging practitioners will prescribe the medication for much longer periods of time, however, and cycles lasting 24-48 weeks are not uncommon.The hope is that the extended maintenance of youthful growth hormone levels will yield more significant physiological changes.
Given its low financial value on global pharmaceutical markets, sermorelin acetate is subject to limited availability worldwide. The preparations most commonly found diverted for bodybuilding use include those made by private compounding pharmacies in the United States, and those sold by gray market research chemical supply companies.
Human Growth Hormone (somatropin)
As its name suggests, human growth hormone is an important mediator of the human growth process. This hormone is produced endogenously by the anterior pituitary gland, and exists at especially high levels during childhood. Its growth-promoting effects are broad, and can be separated into three distinct areas: bone, skeletal muscle, and internal organs. It also supports protein, carbohydrate, lipid, and mineral metabolism, and can stimulate the growth of connective tissues. Although vital to early development, human growth hormone is produced throughout adulthood. Its levels and biological role decline with age, but continue to support metabolism, muscle tissue growth/maintenance, and the management (reduction) of adipose tissue throughout life. Somatropin specifically describes pharmaceutical human growth hormone that was synthesized with the use of recombinant DNA technology. Somatropin (rhGH) is biologically equivalent to human growth hormone (hGH) of pituitary origin.
In a medical setting, somatropin is used to help treat a variety of health conditions. It is most notably prescribed in cases of childhood growth disorders that are characterized by insufficient growth hormone production. While usually not fully corrective, somatropin use is often capable of substantially increasing the linear growth rate and overall height before further growth is halted in adolescence. This medication is also used to accelerate growth in children that were born small and failed to catch up by the age of two. Other uses include the treatment of short bowel syndrome, growth failure due to renal insufficiency, muscle wasting associated with HIV infection, and adult growth hormone deficiency.
Somatropin is also sometimes prescribed to healthy men and women who are aging. Growth hormone levels tend to decline as we get older, and many physicians believe that its supplementation to more youthful levels can help slow some of the damage of aging. Given its beneficial metabolic effects on muscle mass, strength, energy, cell regeneration, and fat loss, there are many supporters of this use, even if hGH may not specifically retard the aging process. Note that in order to prescribe hGH for adult hormone deficiency in the U.S., the patient must have a diagnosed pituitary disease or history of childhood GH deficiency. It is specifically illegal according to Federal law to prescribe growth hormone for any off-label use, which includes anti-aging and bodybuilding purposes.717
Somatropin may be given by either subcutaneous or intramuscular injection. During clinical studies, the pharmacokinetic properties of somatropin following both methods of use were determined. When given by subcutaneous injection, somatropin has a similar but moderately higher level of bioavailability (75% vs. 63%). The rate of drug metabolism following both routes was also very similar, with somatropin displaying a half-life of approximately 3.8 hours and 4.9 hours after subcutaneous and intramuscular injection, respectively. Baseline hormone levels are usually reached between 12 hours and 18 hours following injection, with the slower times seen with intramuscular use. Given the delayed rise in IGF-1 levels, however, which can remain elevated 24 hours after hGH injection, the metabolic activity of human growth hormone will outlast its actual levels in the body. Although drug absorption is acceptable by both methods of use, daily subcutaneous administration is generally regarded as the preferred method of using somatropin.
A specific analysis of somatropin activity shows a hormone with a diverse set of effects. It is anabolic to skeletal muscle, shown to increase both the size and number of cells (processes referred to as hypertrophy and hyperplasia, respectively). The hormone also seems to have growth-promoting effects on all organs of the body excluding the eyes and brain. Somatropin has a diabetogenic effect on carbohydrate metabolism, which means that it causes blood sugar levels to rise (a process normally associated with diabetes). Excessive administration of somatropin over time may induce a state of type-2 (insulin resistant) diabetes. This hormone also supports triglyceride hydrolysis in adipose tissue, and may reduce body fat stores. Coinciding with this tends to be a reduction in serum cholesterol. The drug also tends to reduce levels of potassium, phosphorous, and sodium, and may cause a decrease in levels of the thyroid hormone triiodothyronine (T3). The latter effect marks a reduction in thyroid-supported metabolism, and can interfere with the effectiveness of extended therapy with somatropin.
Growth hormone has both direct and indirect effects. On the direct side, the hGH protein attaches to receptors in muscle, bone, and adipose tissues, sending messages to support anabolism and lipolysis (fat loss). Growth hormone also directly increases glucose synthesis (gluconeogenesis) in the liver, and induces insulin resistance by blocking its activity in target cells. The indirect effects of growth hormone are largely mediated by IGF-1 (insulin-like growth factor), which is produced in the liver and virtually all other tissues in response to growth hormone. IGF-1 is also anabolic to both muscle and bone, augmenting growth hormone’s activity. IGF-1, however, also has effects that are strongly antagonistic to growth hormone. This includes increased lipogenesis (fat retention), increased glucose consumption, and decreased gluconeogenesis. The synergistic and antagonists effects of these two hormones combine to form the character of hGH. Likewise, they also dictate the effects of somatropin administration, which include the support lipolysis, increased serum glucose levels, and reduced insulin sensitivity.
Somatropin is considered to be a controversial anabolic and performance-enhancing drug in the realm of bodybuilding and athletics. The main issue of debate is the exact level of potential benefit this substance carries. While studies with HIV+ patients in a wasting state tend to support potentially strong anabolic and anticatabolic properties, studies demonstrating these same effects in healthy adults and athletes are lacking. During the 1980s, a large body of myth surrounded discussions of hGH in bodybuilding circles, which may have been fueled by the high cost of the drug and its very name (“growth hormone”). It was once thought to be the most powerful anabolic substance you could buy. Today, recombinant human growth hormone is much more affordable and readily obtained. Most experienced individuals now tend to agree that it is the fat-loss-promoting properties of somatropin that are most obvious. The drug can support muscle growth, strength gains, and increased athletic performance, but its effects are generally milder than those of anabolic/androgenic steroids. For a highly advanced athlete or bodybuilder, however, somatropin can help push body and performance further than might have been possible with steroids alone.
The first human growth hormone preparations to be used in medicine were made from pituitary extracts of human origin. These are now commonly referred to as cadaver growth hormone preparations. Approximately 1 mg of hGH (a 1 day dose) could be obtained from each cadaver. The first successful treatment with human cadaver GH was reported in 1958.718 Soon after these medicines were introduced to market, and were sold in the U.S. until 1985. The Food and Drug Administration banned them that year after they had been linked to the development of Creutzfeldt-Jakob’s disease (CJD), a highly degenerative and ultimately fatal brain disorder, in a number of patients. The disease can be transmitted from one person to another under exceptional circumstances (usually blood transfusion or organ implantation are involved), and was likely caused by the extraction of hGH from infected cadavers. CJD has a very slow incubation period, and has been diagnosed anywhere from 4 to 30 years after therapy with growth hormone of cadaver origin. As of 2004 estimates, at least 26 patients that received cadaver GH drugs in the United States have been diagnosed with the disease.719 The overall incidence of this disease is less than 1%, as approximately 6,000 patients are documented to have received the medication.
The FDA approved the first synthetic human growth hormone drug in 1985. Synthesis produced a pure hormone without biological contamination, eliminating the possibility of CJD transmission. The drug approved was called somatrem (Protropin), and was based on a manufacturing technology developed by Genentech in 1979.720 Somatrem came at an important time given the removal of cadaver GH by the FDA that same year. This hormone is actually a slight variant of the hGH protein, but displays the same biological properties of the natural hormone. Protropin was initially very successful being it was the first synthetic GH product. By 1987, however, Kabi Vitrum (Sweden) had published methods for the production of pure synthetic somatropin with the exact amino acid sequence of endogenous growth hormone.721 It was also discovered that the unnatural structure of somatrem causes a much higher incidence of antibody reactions in patients, which can reduce drug efficacy.722 Somatropin would come to be viewed as a more reliable drug, and would dominate the global market within several years. Today, although somatrem products are still sold, somatropin retains the vast majority of hGH sales worldwide.
Somatropin is most commonly supplied in multi-dose vials containing a white lyophilized powder that requires reconstitution with sterile or bacteriostatic water before use. Dosage may vary widely from 1mg to 24mg or more per vial. Somatropin is also available as a stabile pre-mixed solution (Nutropin AQ) that is biologically equivalent to reconstituted somatropin.
Somatropin is human growth hormone protein manufactured by recombinant DNA technology. It has 191 amino acid residues and a molecular weight of 22,125 daltons. It is identical in structure to human growth hormone of pituitary origin.
Do not freeze. Follow package insert for storage information. Refrigeration (2º to 8ºC, 35º to 46º F) may be required before and after reconstitution.
Side Effects (General):
The most common adverse reactions to somatropin therapy are joint pain, headache, flu-like symptoms, peripheral edema (water retention), and back pain. Less common adverse reactions include inflammation of mucous membranes in the nose (rhinitis), dizziness, upper respiratory infection, bronchitis, tingling or numbness on the skin, reduced sensitivity to touch, general edema, nausea, sore bones, carpal tunnel syndrome, chest pain, depression, gynecomastia, hypothyroidism, and insomnia. The abuse of somatropin may cause diabetes, acromegaly (a visible thickening of the bones, most notably the feet, forehead, hands, jaw, and elbows), and enlargement of the internal organs. Due to the growth promotion effects of human growth hormone, this drug should not be used by individuals with active or recurring cancer.
Side Effects (Impaired glucose tolerance):
Somatropin may reduce sensitivity to insulin and raise blood sugar levels. This may occur in individuals without preexisting diabetes or impaired glucose tolerance.
Side Effects (Injection site):
The subcutaneous administration of somatropin may cause redness, itching, or lumps at the site of injection. It may also cause a localized decrease of adipose tissue, which may be compounded by the repeated administration at the same site of injection.
Somatropin is designed for subcutaneous or intramuscular administration. One milligram of somatropin is equivalent to approximately 3 International Units (3 IU). When used to treat adult onset growth hormone deficiency, the drug is commonly applied at a dosage of .005/mg/kg per day to .01mg/kg per day. This equates to roughly 1 IU to 3 IU per day for person of approximately 180-220 lbs. A long-term maintenance dosage is established after reviewing the patient’s IGF-1 levels and clinical response over time.
When used for physique- or performance-enhancing purposes, somatropin is usually administered at a dosage between 1 IU and 6 IU per day (2-4 IU being most common). The drug is commonly cycled in a similar manner to anabolic/androgenic steroids, with the length of intake generally being between 6 weeks and 24 weeks. The anabolic effects of this drug are less apparent than its lipolytic (fat loss) properties, and generally take longer periods of time and higher doses to manifest themselves.
Other drugs are commonly used in conjunction with somatropin in order to elicit a stronger response. Thyroid drugs (usually T3) are particularly common given the known effects of somatropin on thyroid levels, and may significantly enhance fat loss during therapy. Insulin is also commonly used with somatropin. Aside from countering some of the effects somatropin has on glucose tolerance, insulin can increase receptor sensitivity to IGF-1, and reduce levels of IGF binding protein-1, allowing for more IGF-1 activity723 (growth hormone itself also lowers IGF binding protein levels).724 Anabolic/androgenic steroids are also commonly taken with somatropin, in an effort to maximize potential muscle-building effects. Anabolic steroids may also further increase free IGF-1 levels via a lowering of IGF binding proteins.725 Note that the stacking of somatropin with thyroid drugs and/or insulin is usually approached with great care and caution, given that these are particularly strong medications with potentially serious or life threatening acute side effects.
Somatropin is produced by many different drug companies, and is distributed in virtually all developed countries. The most common brand names include Serostim (Serono), Saizen (Serono), Humatrope (Eli Lilly), Norditropin (novo nodisk), Omnitrope (Sandoz), and Genotropin (Pharmacia).
Somatropin products are high value targets for drug counterfeiting operations. Many counterfeits are highly deceptive in nature, and have been found in both illicit and legitimate drug distribution channels. Some counterfeit growth hormone products are made by relabeling vials of hCG, which bear a very close visual resemblance to somatropin. A home pregnancy test is sometimes used to help determine if hCG has been used to make a counterfeit hGH product. This test works by detecting hCG in the urine. A few days into a cycle with somatropin, the individual will take a 3-4 IU injection prior to bed. Upon rising, the pregnancy test will be used, and a positive result will indicate that an hCG counterfeit has been used. The powder in the vial of somatropin should also be in the form of a solid (lyophilized) disc. Do not take any product that contains loose powder.