New developments in the illegal provision of growth hormone for "anti-aging" and bodybuilding.

ACONSEQUENCE OF THE COMMITTEE ON OVERsight and Government Reform’s recent hearing on the Mitchell Report on steroid and growth hormone (hGH) use was recognition that the misguided use of hGH by professional athletes and entertainers contributes to the far more frequent and increasing problem of anti-aging clinics, Web sites, compounding pharmacies, and producers selling the drug to the general public for medically inappropriate uses. In the face of evidence of illegal distribution of hGH, in January 2007, the US Food and Drug Administration (FDA) published an alert specifying that anti-aging, bodybuilding, and athletic enhancement are not approved indications for hGH. Systematic reviews have found that hGH supplementation does not significantly increase muscle strength or aerobic exercise capacity in healthy individuals. Clinical evidence does support the therapeutic administration of hGH for children and adults with appropriate clinical indications. However, extrapolating from this evidence to conclude that hGH improves health or longevity in normally aging individuals is not justified. The American Association of Clinical Endocrinologists suggests that hGH misuse might make insurance companies less likely to cover the cost of hGH treatment for approved indications. Age-related diseases and syndromes should not be confused with adult growth hormone deficiency (GHD). In fact, adult GHD is rare; the most common causes are pituitary adenoma or treatment of the adenoma with surgery or radiotherapy. In our review of the most recent package inserts of the 7 brands of hGH indicated for adult GHD at the FDA’s Web site (http://www.accessdata .fda.gov/scripts/cder/drugsatfda/index.cfm), since early 2007, the stated criteria for allowed provision of hGH for adult GHD are identical: