Optimal HGH Dosage for Adults

Recombinant human growth hormone (hGH) is the drug of choice for conditions such as growth hormone deficiency (GHD) due to pituitary gland problems. Its treatment goal is to address all symptoms of the condition without causing any side effects.

To achieve this, hGH must be dosed carefully by specialists with extensive clinical practice. Moreover, the therapy can be administered only via injections which require learning a proper technique for mixing and injecting growth hormone subcutaneously.

If you have a diagnosis of growth hormone deficiency, your doctor may estimate your dose of growth hormone by two main methods – either based on your body weight (weight-based) or by using a default starting dose (non-weight-based).

When considering the dose, your doctor must consider how long you have been taking hGH injections, whether you have experienced any adverse events, and what your body weight and body fat percentage are.

Never change your dose without contacting your doctor for approval

Keep in mind that this article can provide only general information based on current scientific studies.

In order to receive the most accurate and effective treatment according to your individual needs, you should consult with an experienced medical doctor.

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How Much hGH Should I Take?

You may be eligible for hGH therapy if you have inadequate secretion of endogenous growth hormone due to conditions such as GHD. Your doctor will determine if that is the case with a growth hormone provocative test and then assign you appropriate therapy to manage GHD.

In GHD patients, human growth hormone dosing involves once-daily administration to mimic the natural pulsatile release of the hormone in healthy individuals.

This is possible thanks to hGH’s half-life of about 3-4 hours when administered subcutaneously, as suggested by pharmacokinetic studies.

Therapy for growth hormone deficiency can be dosed according to one of the two widely-used hGH administration schedules, and your doctor will pick the one most suitable for you. The strategies include:

• The body weight-based regimen (BW-based dosing), which consists of calculating the daily hGH dosage per kilogram of your body weight (kgBW). Different hGH brands have slight variations, although they all contain the same medication. This strategy is typically used in pediatric patients such as children with growth hormone deficiency.
• The non-weight-based method, which is a well-established average dose for most people and is the same for every GH product. This strategy is preferred for dosing hGH in adults.

Regardless of the method chosen by your doctor, the therapy must be initiated at a low hGH dosage and it is gradually increased every 4 to 8-week intervals before reaching a maintenance dose.

This is done to prevent rapid increases in serum hGH levels and the occurrence of adverse effects.

Due to the gradual hGH dosage titration as well as other factors, it takes at least a month of therapy for the initial benefits to occur. The first noticeable benefits include fat loss around the abdomen and an increase in lean body weight.

According to scientific evidence, it takes six months or more for the majority of benefits to occur such as improved mood, higher energy levels, and better quality of life.

HGH Dosing for Adults

As mentioned, the non-weight-based regimen is the preferred method for dose estimations in adults. It is the most widely used dosing strategy for pituitary hormone deficiencies that affect the release of growth hormone, such as GHD.

The method consists of a fixed starting dose of 0.2mg/day (equal to 0.6 IU/day). This is a relatively low initial dose which can be slowly increased by 0.1-0.2mg every 4-8 weeks.

Typically, most patients with GHD achieve symptom relief at doses of around 1mg per day. Recombinant hGH injections administered at this dosing are meant as a long-term therapy for the successful chronic management of growth hormone therapy.

HGH Dosing for Children

The typical hGH dosing regimens in children, but also sometimes in adults, involved the BW-based regimen.

This method consists of calculating the hGH dosage per kilogram of the patient’s body weight (kgBW). It is widely used for the treatment of growth failure in children, including both prepubertal children and pubertal patients. HGH therapy is crucial for achieving normal adult height in these pediatric patients.

This daily dosing regimen allows for a very precise adjustment based on pediatric patients suffering from poor growth rates due to conditions like genetic growth hormone deficiency.

Once again, the hGH dosage is initiated low and escalated gradually to prevent side effects. Consequently, it is escalated and individualized based on the children’s growth response.

Each hGH brand has slightly different dose titration recommendations for patients with GHD:

• Norditropin– maximum initial treatment dose is 0.004 mg/kgBW and can be increased every 6 weeks up to 0.016 mg/kgBW
• Humatrope– maximum starting dose is 0.006 mg/kgBW and can be increased every 4-8 weeks up to 0.0125 mg/kgBW
• Genotropin– maximum starting dose is 0.006 mg/kgBW and can be increased every 4-8 weeks up to 0.012 mg/kgBW
• Saizen– maximum starting dose is 0.005 mg/kgBW and can be increased every 4 weeks up to 0.01 mg/kgBW

These guidelines are quite useful for precise hGH dosage in children. However, adult studies have revealed that when used in adults, the BW-based calculation method can lead to excessive daily dosing and side effects in overweight or obese patients. The occurrence of side effects calls for an immediate dose reduction

The best time to take HGH injections is in the evening

In order to avoid adverse events in overweight or obese individuals, starting with a reduced dose level of 0.2mg/day and slowly increasing the dose is the only viable and safe approach.

HGH Dosage for Different Conditions in Adults

Apart from GHD, there are other conditions in adults that might require human growth hormone therapy. Those include Short Bowel Syndrome (SBS) and cachexia due to HIV.

The optimal dosage for growth hormone deficiency patients varies from 0.2 mg/day to 1 mg/day

Usually, GH therapy is applied as a short-term treatment in these conditions, which is why the recommendations are for considerably higher prescribed doses compared to the ones used in GHD. Also, larger doses are used from the start of the therapy and there is no gradual increase.

hGH therapy in SBS is typically administered alongside enteral feedings and other methods to improve the patient’s nutritional status.

It should last up to 4 weeks and the recommended dose is 0.1mg/kgBW daily or up to 8mg/day. Studies haven’t investigated the effects of longer therapies, but short-term therapies combined with other medications show favorable clinical response and lasting results (up to 3 months).

The recommended daily dose of hGH therapy in HIV-associated cachexia is 0.1 mg/kgBW or up to 6mg. The dosage can be administered daily or any other day for up to 12 weeks.

According to trials in HIV patients, common adverse effects due to high hGH doses include elevated blood sugar, edema, and pain in muscles and joints.

What is the Optimal HGH Dosage?

The optimal maintenance dosage varies in the range from 0.2 mg/day to around 1 mg/day for patients with growth hormone deficiency. It depends on the length of hGH therapy and individual characteristics such as gender, tolerance, effectiveness, and risk of adverse events.

For example, there are higher hGH requirements in women with GHD compared to men, particularly in estrogen-replete women due to the antagonistic effects of the female hormones on hGH.

Studies have also investigated the optimal hGH dosage for anti-aging, muscle gain, and surgery or injury recovery, by using higher doses for shorter periods.

For example, a trial in aged individuals found positive effects in adults at risk of sarcopenia such as increasing serum insulin-like growth factor-1.

Higher serum IGF-1 levels were reported to cause an improved whole-body protein turnover when growth hormone injections were applied as an intermittent treatment at doses of 2mg taken three times per week for six months.

This weekly dosage is equal to taking the standard 1mg/day dose for 6 days a week. The increased serum insulin-like growth factor-1 levels and protein turnover are typically associated with benefits for the human body such as:

• increased lean muscle mass
• improved physical endurance
• improved lean body mass to fat ratio
• potential anabolic effects on other tissues

A study in athletes investigating hGH effects on muscle gains achieved significantly increased muscle protein synthesis after 4 weeks of therapy while administering 5 mg per day. According to trials in surgery patients, healing can be sped up in less than a week of therapy by using even higher doses – 0.1 mg/kgBW daily.

However, such large doses must not be taken for longer than 3-4 weeks, because the risk of adverse events also increases with time. The most common reactions include body water and fluid retention, edemas, muscle and joint pains, carpal tunnel syndrome, and headaches.

The occurrence of these complaints requires immediate adjustment of the administration schedule and dose reduction.

While current evidence suggests that low-dose hGH therapy does not increase the risk of diabetes and other chronic conditions, the long-term risks after high-dose GH are not fully investigated.

One-time overdose can lead to acute adverse reactions such as shaking, sweating, hunger, weakness, fast heartbeat, and nausea. In such cases call your medical doctor or other healthcare providers immediately.

Is HGH Compatible With Other Drugs?

Generally, adults with growth hormone deficiency can combine hGH therapy with additional medications.

However, there are several chronic diseases and other concomitant pathologies that must be taken into account when dosing hGH.

For example, patients with adrenal insufficiency who are taking cortisone and prednisone might require an increase in the doses. On the other hand, short-term glucocorticoid treatment plan might reduce the effectiveness of growth hormone therapy.

Estrogen and oral estrogen medications also reduce the effectiveness of hGH therapy in female patients and lower the production of serum insulin-like growth factor 1.

Thus, adjusting the dose of growth hormone injections is recommended in both postmenopausal patients taking estrogen and estrogen-replete women.

Patients with type 2 Diabetes Mellitus might require dose titration of their hypoglycemic agents due to the insulin sensitivity-reducing effects of hGH therapy.

Furthermore, hGH therapy for dialysis patients with chronic kidney disease must involve administering the hormone at least 3-4 hours after the procedure.

This is done to prevent complications related to the anticoagulation therapy such as hematoma formation in hemodialysis patients.

What Time of Day Is Best to Take HGH?

If you have GHD, the best way to take hGH is to imitate your natural growth hormone production. Since GH levels peak when insulin levels are lowest, such as during sleep and early morning, then the best time to take hGH injections should be in the evening.

HGH injections should be taken once a day, 6-7 days a week, to mimic the natural pulsation of growth hormone in the body

This means that you will have to learn how to self-administer hGH injections subcutaneously. Therefore, your doctor will give you appropriate administration advice during your clinic visits and educate you on how to do it safely and effectively at home.

The subcutaneous injections of hGH should be taken once a day, 6-7 days a week, to mimic the endogenous growth hormone synthesis in the body

Scientific studies have also concluded that the metabolic effects of hGH injections are influenced by the time of administration and recommend mimicking the natural hGH secretion. Thus, it is recommended to take your hGH as a part of your bedtime routine, an hour before going to bed.

If you have missed a shot and it is almost time for the next one, you should skip the missed dose and continue taking your subcutaneous injections with hGH according to your administration schedule.

Never double the dose to compensate for a missed one. Consult with your doctor if you miss more than 3 consecutive doses.

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