Risk factors for adverse effects associated with GH:
(1) high doses
(2) prolonged administration
(3) products derived from human pituitary
(4) illicit products of uncertain origin
Adverse effects associated with GH using physiologic doses:
(1) reaction at the injection site
(2) carpal tunnel syndrome
(3) arthralgias and myalgias
(4) sodium retention by the kidneys, which leads to water retention and edema
(5) insulin resistance which may progress to diabetes
(6) cardiomyopathy
(7) skeletal changes of acromegaly (if dose is too high)
(8) headache
(9) paresthesias
(10) nausea and/or vomiting
(11) fever
Adverse events which may or may not be related to the GH:
(1) slipped femoral epiphysis in children
(2) enlargement of pre-existing nevi
(3) increased skin pigmentation
(4) gynecomastia
(5) pancreatitis
(6) benign intracranial hypertension
Growth hormone is not given to patients with a recent history of cancer:
(1) not given for 2 years after: medulloblastoma, ependymoma
(2) not given for 1 year after: leukemia, most other tumors
Before the availability of recombinant growth hormone growth hormone was prepared from human pituitaries collected at autopsy. These preparations were at increased risk for infectious complications (Creutzfeldt-Jakob, HIV, etc).
