Growth hormone and the adolescent athlete: What are the data for its safety and efficacy as an ergogenic agent?

There is great interest among athletes and in the sports and general media for the subject of doping with human growth hormone (hGH). The hype about this substance goes far beyond the available data. The issue of administration of recombinant rhGH to adolescents, whether for athletic performance or for esthetic purposes adds another wrinkle because normal pubertal growth and the acquisition of adult body composition depends upon the GH/IGF-I and the hypothalamic-pituitary-gonadal axes. The range of normal is wide and it is more difficult to determine the natural evolution of pubertal development from that fueled by rhGH (or anabolic steroids). There are no compelling data based on clinical trials to indicate enhanced athletic performance (young adults); however, one cannot be sure how rhGH is used in combination with other agents, including anabolic steroids and anabolic supplements. There are no studies in adolescent athletes. The detection of administration of rhGH to adolescents using the analytes of the GH/IGF-I and of collagen turnover (bone modeling and remodeling) is complicated by the physiologic increases in these parameters during normal puberty. it should be noted that many older adolescents are physiologically younger, especially in those aesthetic sports that demand the thin (linear) physique. (C) 2009 Elsevier Ltd. All rights reserved.