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The human growth hormone plays an essential role in maintaining your metabolic health and hormonal balance. If you have a deficiency, then the hormone may also be administered exogenously to help you cope with all the debilitating symptoms.
Unfortunately, some individuals may have to stop taking growth hormone injections, either temporarily or permanently. This may be due to various reasons such as:
- Cost and accessibility problems
- Other medical conditions
- Personal or lifestyle reasons
- Side effects
In this article, you will discover what to expect if you stop taking growth hormone therapy on a regular basis, as well as potential strategies on how to cope with any issues that may arise.
Overview of human growth hormone (hGH)
The human growth hormone is a naturally occurring messenger in your body. It is produced by the pituitary gland in your brain, which releases it intermittently, in pulses.
The hormone may peak once or several times within 24 hours, with the main peak typically occurring soon after falling asleep. Each peak lasts several minutes to hours and the serum levels of hGH may drop down to undetectable levels.
Childhood and especially adolescence are periods marked by higher levels of human growth hormone compared to adulthood. That is because the hormone is crucial for normal development and growth in children.
But adults also need to have normal hGH levels for several reasons:
- Human growth hormone stimulates fat loss, particularly from the fat depots around the abdomen.
- This essential hormone stimulates the production of insulin-like growth factor-1 (IGF-1) inside various tissues including the liver which also releases it in the serum.
- IGF-1 is the main anabolic mediator of hGH. IGF-1 stimulates cell proliferation, muscle mass increase, and even bone growth.
- hGH is also thought to play a critical role in sleep, energy levels, and other factors with a direct impact on quality of life.
This is why the main symptoms of growth hormone deficiency (GHD) in children is stunted growth, while adults experience more subtle symptoms such as increased abdominal obesity, muscle wasting, low energy levels and fatigue, and sleep problems.
HGH therapy for growth hormone deficiency (GHD)
The only effective therapy that you may receive for the management of GHD is the administration of a synthetic form of the hormone into your body.
This synthetic form is called recombinant human growth hormone (rhGH) and it has an identical structure and effects as the one normally produced in your body.
This is possible thanks to the so-called recombinant DNA technology, which allows scientists to produce a hormone with 100% identical amino acid sequence to its native counterpart.
Recombinant human growth hormone can be administered only via injections, as the amino acid structure of the hormone makes it easily inactivated in the digestive system, and its transdermal absorption is significantly limited.
The injections must be administered under the layers of the skin (subcutaneously) as this allows for a more gradual absorption of the hormone and more convenient dosing. More specifically, trials indicate that the plasma half-life of subcutaneously injected human growth hormone ranges from 7 to 10 hours, making it effective for once-daily dosing.
Conversely, when human growth hormone is injected intravenously, its plasma half-life is only 20 minutes, which is too brief to achieve a therapeutic effect with a single daily dose.
After being injected, hGH rapidly elevates serum growth hormone levels, peaking approximately four hours post-injection. The hormone levels return to baseline within about 11 to 12 hours after administration.
Meanwhile, IGF-1 also rises with hGH treatment but its levels do not change as abruptly. Consequently, IGF-1 levels may take up to a week to decline after the cessation of human growth hormone therapy.
How long can you stay on growth hormone?
Recombinant hGH therapy is meant to be administered as a long-term treatment, as GH-deficient adults can no longer synthesize the hormone naturally and there is no way to restore the lost function of the pituitary gland.
Moreover, the treatment does not suppress the natural synthesis of human growth hormone. If there is any remaining function of the pituitary gland after developing GHD it will continue with and without the therapy.
Thus, your hGH levels will return to pretreatment values after stopping the injections.
Long-term human growth hormone therapy is safe thanks to the low risk of side effects, especially when hGH is dosed properly and not taken at high doses.
When accurately dosed, hGH may lead to only temporary side effects such as water retention.
The condition typically manifests with symptoms such as:
- joint pain
- headaches
- limb edemas
- carpal tunnel syndrome
These signs of water retention quickly go away as your body gets used to the change in human growth hormone levels.
These can be avoided completely by starting with a very low dose such as 0.2mg/daily gradually increasing it to maintenance.
The growth hormone has anti-insulin effects, so hGH therapy may reduce the sensitivity of its receptor and increase the levels of insulin resistance.
This is another side effect that is also not permanent, and research suggests that insulin sensitivity usually goes back to normal within the first 3 months of therapy.
However, high doses, especially when administered for long periods of time, can lead to serious health risks such as increased risk of insulin resistance, pre-diabetes, and type 2 diabetes, as well as the development of acromegaly in adults.
Adults with acromegaly can experience abnormal bone growth and changes in facial features.
The only side effects that do not depend on the dose are local adverse reactions such as redness, swelling, and pain at the injection site.
How long does it take for hGH to get out of your system?
Following a single injection, it will take about 12 hours until your human growth hormone levels drop under therapeutic levels. However, traces of the hormone may remain for up to 48 hours until it is broken down into different metabolites.
During these 48 hours, the so-called isoform test can be used to detect the traces of hGH in your body. It works by comparing the levels of different types of human growth hormone in your body.
More specifically, your pituitary gland produces hGH alongside other naturally occurring molecules, and changes in this ratio cannot occur naturally, regardless of whether your gland functions normally or not.
On the other hand, exogenous hGH injections contain only the active human growth hormone. The isoform test compares the ratio between hGH and related molecules, and if the ratio is in favor of hGH, this means you have received the hormone exogenously.
In addition, the metabolites of hGH can be detected for up to 3 weeks after an injection, via the so-called biomarkers test.
What are the side effects of stopping HGH?
You can stop hGH therapy whenever you choose, though it’s likely that symptoms of GHD will return if you do.
For example, a specific study indicates that adolescents and young adults who stop taking growth hormone therapy often see a reduction in their metabolic rate as early as two weeks after they stop the treatment.
The study also found that the individuals who ceased using hGH saw an average increase of 4.3% in body fat within a year.
Thus GHD symptoms typically reemerge several months after human growth hormone therapy discontinuation, with an increase in waist adiposity being the first to appear.
Additionally, younger adults in this study experienced a decrease in body mass coupled with an increase in body fat, suggesting a reduction in lean muscle.
Further, children who have not yet achieved their full height and stop hGH therapy are likely to see an increase in body fat and a halt in linear growth, which may prevent them from reaching a normal adult height unless therapy is resumed before puberty ends.
Different research involving adults found that stopping hGH therapy for more than three years leads to detrimental effects on bone mineral density and elevated cholesterol levels in the blood. Thus, none of the hGH therapy’s benefits are permanent and all may be reversed upon therapy discontinuation.
What are the risks of HGH withdrawal?
hGH therapy does not cause physical or psychological addiction. Moreover, the treatment does not suppress the natural growth hormone synthesis in the pituitary gland. Your serum growth hormone levels will simply return to baseline after quitting the treatment.
Thus, discontinuing therapy does not cause any typical withdrawal symptoms.
Nevertheless, studies indicate that individuals with severe GHD are more likely to face negative psychological impacts akin to withdrawal symptoms as their severe symptoms resurface post-therapy. These may manifest as reduced energy, heightened fatigue, pain, irritability, and depression.
Such effects typically surface within the first three months after ceasing HGH injections. Furthermore, symptoms of adult growth hormone deficiency also exacerbate these issues, contributing to additional problems like weight gain, muscle degradation, osteoporosis, and chronic fatigue.
The persistence of these psychological effects is challenging to predict due to their overlap with severe GHD indicators, including severe fatigue, depression, and cognitive difficulties.
A gradual reduction in hGH dosage rather than an abrupt cessation may mitigate the reappearance of adult growth hormone deficiency symptoms.
However, the definitive approach to avoid any reemergence of GHD symptoms involves continued administration of HGH injections under the guidance of a healthcare professional.
Managing the transition after stopping hGH therapy
If you consider discontinuing hGH therapy, it’s critical to adopt effective lifestyle interventions to manage and mitigate the return of symptoms related to adult growth hormone deficiency.
Key strategies you should consider involve diet, physical activity, and sleep hygiene. Their goal is to help maintain muscle mass, prevent abdominal obesity, sustain energy levels, support athletic performance, and enhance the overall quality of life.
Diet and nutrition
A well-balanced diet is crucial in managing your body composition and metabolic health after stopping hGH therapy.
You should focus on a nutrient-rich diet that includes plenty of fruits and non-starchy vegetables in every single meal of your day. In addition, each meal should contain high-quality proteins, which can be accompanied by whole grains or starchy vegetables.
Such a diet supports muscle synthesis and prevents muscle loss. It is equally important to limit the intake of refined sugars and high-fat foods to combat the potential increase in abdominal fat.
Physical activity
Regular physical activity is another pillar crucial to maintaining muscle mass and managing weight. Strength training exercises may be the best option for you as they stimulate muscle growth and improve bone density, which will be compromised after stopping hGH therapy.
Keep in mind that maintaining healthy body weight and body fat levels will also help keep your cholesterol levels in check, which is important for reducing the risk of heart disease while off the hGH injections.
Sleep hygiene
Discontinuing hGH injections may have a negative effect on your sleep quality and energy levels. Thus, improving sleep hygiene is vital in managing the discontinuation of hGH therapy.
Practices such as maintaining a regular sleep schedule, creating a restful environment, and avoiding stimulants close to bedtime can enhance sleep quality. Good sleep supports metabolic health, improves mood, and enhances cognitive function.
hGH boosters and other supplements
It’s important to note that over-the-counter hGH boosters and similar supplements are generally ineffective for individuals with a non-functioning pituitary gland, as these products do not replace the hormone itself.
These supplements claim to support the body’s natural hormone production but do not provide any benefit in cases where the pituitary gland is damaged or dysfunctional.
Moreover, studies suggest that the potential benefits of hGH boosters are questionable even in healthy individuals.
If you have problems and concerns related to stopping hGH, or you have already done it and need support in dealing with the reemerging symptoms, make sure to contact a medical specialist who is experienced in hormonal treatments.