The growth and cell production is achieved by growth hormone (GH), a peptide hormone secreted by the pituitary gland. In earlier times, this growth hormone was extracted from human pituitary glands, with the enhancement in medical sciences, GH is now produced by recombinant DNA technology and is put to use in treatment of many medical

Cadaver growth hormone is the term for GH extracted from human pituitary glands between 1960 and 1985 for therapy of deficient children. In the U.S., cadaver GH, also referred to as NPA growth hormone, was provided by the National Pituitary Agency, and by other national programs and commercial firms as well. rhGH refers to recombinant human growth hormone (somatropin). It contains the identical amino acid sequence of human GH and is ‘natural sequence’ GH. It is chemically identical to the growth hormone produced by the pituitary gland.

Growth hormone deficiency is treated by replacing GH. All GH prescribed in North America, Europe, and most of the rest of the world is a human GH, manufactured by recombinant DNA technology. As GH is a large peptide molecule, it must be injected into subcutaneous tissue or muscle to get it into the blood. Nearly painless insulin syringes make this less trying than is usually anticipated but perceived discomfort is a subjective value.

When a person has had a long-standing deficiency of GH, benefits of treatment are often obvious, and side effects of treatment are rare. When treated with GH, a deficient child will begin to grow faster within months. Other benefits may be noticed, such as increased strength, progress in motor development, and reduction of body fat. Side effects of this type of physiologic replacement are quite rare. Known risks and unsettled issues are discussed below, but GH deficient children receiving replacement doses are at the lowest risk for problems.

Still, costs of treatment in terms of money, effort, and perhaps quality of life, are substantial. Treatment of children usually involves daily injections of growth hormone, usually for as long as the child is growing. Lifelong continuation may be recommended for those most severely deficient as adults. Most pediatric endocrinologists monitor growth and adjust dose every 3–4 months. Assessing the psychological value of treatment is difficult but most children and families are enthusiastic once the physical benefits begin to be seen. Treatment costs vary from country to country and by size of child.

Research has shown that GH treatment can provide a number of measurable benefits to severely GH-deficient adults, such as enhanced energy and strength, and improved bone density. Muscle mass may increase at the expense of adipose tissue. Blood lipid levels improve, but long term mortality benefit has not yet been demonstrated. Treatment of healthy, normally aging individuals found the only benefit to be a slight increase in muscle mass, with frequent side-effects and no evidence that it is safe to use long-term.

GH for severe adult deficiency is usually prescribed as daily injections at a weekly dose about 25% of children’s doses and comparably lower cost.