Volume 30, Issue 170, April 2026

Human growth hormone abuse in elite sports: physiological efficacy, adverse health effects, and antidoping challenges: A narrative review

Bartłomiej Kowalski^♦, Natalia Kriese, Jakub Szyszkowski, Ewelina Komorowska, Brygida Tucka, Paweł Woś, Zuzanna Zgrzywa, Paulina Wądołowska, Izabella Zawadzka, Jakub Jaworski

Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

^♦Corresponding author
Bartłomiej Kowalski, Medical University of Warsaw, Żwirki i Wigury 61, 02- 091 Warsaw, Poland

ABSTRACT

Athletes abuse recombinant human growth hormone (rhGH) in an attempt to lose body fat and build muscle mass. However, extensive clinical studies have demonstrated that even doses of rhGH, which promote large increases in reported “lean body mass” do not translate into increased myofibrillar strength. Most of this increased lean mass is due to water retention and collagen synthesis. Furthermore, the long-term clinical management of both intentional and severe supratherapeutic abuse of hGH has taught us that the negative health consequences of chronic use include marked insulin resistance and acromegalic cardiomyopathy. From an antidoping perspective, it represents one of the most formidable analytical challenges. Since exogenous hGH is biologically and immunochemically identical to the endogenous hormone, this structural parity severely complicates detection for the World Anti-Doping Agency (WADA). Ongoing scientific research has led to the development of isoform and biomarker-based tests to detect abuse of hGH by athletes. To continue to protect the health and safety of athletes and to promote integrity in competitive sports, WADA and allied anti-doping authorities must continuously advance hGH detection methodologies to combat ongoing abuse. This Volume summarizes current detection methods and aims to catalyze the development of next-generation analytical strategies.

Keywords: human growth hormone, sports doping, somatropin, performance enhancement, World Anti-Doping Agency

Medical Science, 2026, 30, e75ms3850

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DOI: https://doi.org/10.54905/disssi.v30i170.e75ms3850

Published: 18 April 2026