Abstract
Human growth hormone (hGH) is secreted in a pulsatile fashion, generally following a circadian rhythm. A number of physiological stimuli can initiate hGH secretion, the most powerful, non-pharmacological of which are sleep and exercise. hGH has many varied roles throughout life, from growth itself, including the turnover of muscle, bone and collagen, to the regulation of selective aspects of metabolic function including increased fat metabolism and the maintenance of a healthier body composition in later life.
The exercise-induced growth hormone response (EIGR) is well recognised and although the exact mechanisms remain elusive, a number of candidates have been implicated. These include neural input, direct stimulation by catecholamines, lactate and or nitric oxide, and changes in acid-base balance. Of these, the best candidates appear to be afferent stimulation, nitric oxide and lactate.
Resistance training results in a significant EIGR. Evidence suggests that load and frequency are determining factors in the regulation of hGH secretion. Despite the significant EIGR induced by resistance training, much of the stimulus for protein synthesis has been attributed to insulin-like growth factor-1 with modest contributions from the hGH-GH receptor interaction on the cell membrane.
The EIGR to endurance exercise is associated with the intensity, duration, frequency and mode of endurance exercise. A number of studies have suggested an intensity ‘threshold’ exists for EIGR. An exercise intensity above lactate threshold and for a minimum of 10 minutes appears to elicit the greatest stimulus to the secretion of hGH. Exercise training above the lactate threshold may amplify the pulsatile release of hGH at rest, increasing 24-hour hGH secretion
The impact of chronic exercise training on the EIGR remains equivocal. Recent evidence suggests that endurance training results in decreased resting hGH and a blunted EIGR, which may be linked to an increased tissue sensitivity to hGH.
Whilst the potential ergogenic effects of exogenous GH administration are attractive to some athletes, the abuse of GH has been associated with a number of pathologies. Identification of a training programme that will optimise the EIGR may present a viable alternative.
Ageing is often associated with a progressive decrease in the volume and, especially, the intensity of exercise. A growing body of evidence suggests that higher intensity exercise is effective in eliciting beneficial health, well-being and training outcomes. In a great many cases, the impact of some of the deleterious effects of ageing could be reduced if exercise focused on promoting the EIGR.
This review examines the current knowledge and proposed mechanisms for the EIGR, the physiological consequences of endurance, strength and power training on the EIGR and its potential effects in elderly populations, including the aged athlete.
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References
Jenkins PJ. Growth hormone and exercise: physiology, use and abuse. Growth Horm IGF Res 2001; 11Suppl. A: S71–7
Caloa A, Marzullo P, Di Somma C, et al. Growth hormone and the heart. Clin Endocrinol (Oxf) 2001; 54(2): 137–54
Murray RD, Shalet SM. Growth hormone: current and future therapeutic applications. Expert Opin Pharmacother 2000; 1(5): 975–90
Baxter RC, Martin JL. Binding proteins for insulin-like growth factors: structure, regulation and function. Prog Growth Factor Res 1989; 1: 49–68
Waters D, Danska J, Hardy K, et al. Recombinant human growth hormone, insulin-like growth factor 1 and combination therapy in AIDS-associated wasting. Ann Intern Med 1996; 125: 865–72
Hoffman AR, Ceda GP. Should we treat the somatopause? J Endocrinol Invest 1999; 22 (10 Suppl.): 4–6
Morley JE, Unterman TG. Hormonal fountains of youth. J Lab Clin Med 2000; 135(5): 364–6
Wannenberg T, Khan AS, Sane DC, et al. Growth hormone reverses age-related cardiac myofilament dysfunction in rats. Am J Physiol Heart Circ Physiol 2001; 281(2): H915–22
Holt RI, Webb E, Pentecost C, et al. Aging and physical fitness are more important than obesity in determining exercise-induced generation of GH. J Clin Endocrinol Metab 2001; 86(12): 5715–20
Sacca L, Cittadini A, Fazio S. Growth hormone and the heart. Endocr Rev 1994; 15(5): 555–73
Hütler M, Schnabel D, Staab D, et al. Effect of growth hormone on exercise tolerance in children with cystic fibrosis. Med Sci Sports Exerc 2002; 34(4): 567–72
Cohen P, Rosenfeld RG. Growth regulation. In: Griffin JE, Ojeda SR, editors. Textbook of endocrine physiology. 3rd ed. New York: Oxford University Press, 1996
Kozlowski S, Chwalbinska-Moneta J, Vigas M, et al. Greater serum GH response to arm than leg exercise performed at equivalent oxygen uptake. Eur J Appl Physiol 1983; 52: 131–5
Argetsinger LS, Campbell GS, Yang X, et al. Identification of JAK2 as a growth hormone receptor-associated tyrosine kinase. Cell 1993; 74: 237–44
Kupfer SR, Underwood LE, Baxter RC, et al. Enhancement of the anabolic effects of growth hormone and insulin-like growth factor I by use of both agents simultaneously. J Clin Invest 1993; 91: 391–6
Brahm H, Piehl-Auhlin K, Saltin B, et al. Net fluxes over working thigh of hormones, growth factors and biomarkers of bone metabolism during short lasting dynamic exercise. Calcif Tissue Int 1997; 60(2): 175–80
Fryburg DA, Gelfand RA, Barrett EJ. Growth hormone acutely stimulates forearm muscle protein synthesis in normal humans. Am J Physiol 1991; 260: E499–504
Fryburg DA, Louard RJ, Gerow KE, et al. Growth hormone stimulates skeletal muscle protein synthesis and antagonizes insulin’s antiproteolytic action in humans. Diabetes 1992; 41(4): 424–9
Fryburg DA, Barrett EJ. Growth hormone acutely stimulates skeletal muscle but not whole-body protein synthesis in humans. Metabolism 1993; 42(9): 1223–7
Fujiwara TM, Morgan K, Bichet DG. Molecular biology of diabetes insipidus. Annu Rev Med 1995; 46: 331–43
Lammers R, Gray A, Schlessinger J, et al. Differential signalling potential of insulin and IGF-1 receptor cytoplasmic domains. EMBO J 1989; 8: 1369–75
Granner DK. Pituitary and hypothalamic hormones. In: Murray RK, Granner DK, Mayes PA, et al., editors. Harper’s Biochemistry. 25th ed. Stamford (CT): Appleton and Lange, 2000
Quabbe HJ, Bratzke HJ, Siegers U, et al. Studies on the relationship between plasma free fatty acids and growth hormone secretion in man. J Clin Invest 1993; 51: 2388–98
Pontiroli AE, Lanzi R, Monti LD, et al. Effect of acipomox, a lipid lowering drug, on growth hormone (GH) response to GH-releasing hormone in normal subjects. J Endocrinol Invest 1990; 13: 539–42
Pontiroli AE, Lanzi R, Monti LD, et al. Growth hormone (GH) autofeedback on GH response to GH-releasing hormone: role of free fatty acids and somatostatin in normal subjects. J Clin Endocrinol Metab 1991; 72: 492–5
Blackward WG, Hull EW, Lopez-S A. Effects of lipids on growth hormone secretion in humans. J Clin Invest 1971; 50: 1439–43
Casanueva F, Villanueva L, Penalva A, et al. Free fatty acids inhibition of exercise-induced growth hormone secretion. Horm Metab Res 1981; 13: 348–50
Imaki T, Shibasaki T, Masuda A, et al. The effect of free fatty acids on growth hormone (GH)-releasing hormone-mediated GH secretion in man. J Clin Endocrinol Metab 1985; 60: 290–3
Newsholme EA, Leech AR. Biochemistry for the medical sciences. Chichester: John Wiley and Sons Ltd, 1983
Hales EN, Luzio LP, Siddle K, et al. Hormonal control of adipose tissue lipolysis. Biochem Soc Symp 1978; 43: 97–135
Chromiak JA, Antonio J. Use of amino acids as growth hormone-releasing agents by athletes. Nutrition 2002; 18(7–8): 657–61
Thompson DL, Weltman JY, Rogol AD, et al. Cholinergic and opiod involvement in release of growth hormone during exercise and recovery. J Appl Physiol 1993; 75(2): 870–8
Ellis S, Vodian MA, Grindeland RE. Studies on the bioassayable growth hormone-like activity of plasma. Recent Prog Horm Res 1978; 34: 213–38
McCall GE, Goulet RE, Grindeland JA, et al. Bed rest supresses bioassayable growth hormone release in response to muscle activity. J Appl Physiol 1997; 83: 2086–90
Dimond RC, Wartofsky L, Rosen SW. Heterogeneity of circulating growth hormone in acromegaly. J Clin Endocrinol Metab 1974; 39(6): 1133–7
Baumann G, Stolar MW, Amburn K. Molecular forms of circulating growth hormone during spontaneous secretory episodes and in the basal state. J Clin Endocrinol Metab 1985; 60(6): 1216–20
Baumann G. Growth hormone heterogeneity in human pituitary and plasma. Horm Res 1999; 51Suppl. 1: 2–6
Gosselink KL, Grindeland RE, Roy RR, et al. Skeletal muscle afferent regulation of bioassayable growth hormone in the rat pituitary. J Appl Physiol 1998; 84: 1425–30
McCall GE, Goulet RE, Roy RR, et al. Spaceflight supresses exercise-induced release of bioassayable growth hormone. J Appl Physiol 1999; 87(3): 1207–12
Gosselink KL, Grindeland RE, Roy RR, et al. Afferent input from rat slow skeletal muscle inhibits bioassayable growth hormone release. J Appl Physiol 2000; 88: 142–8
McCall GE, Grindeland RE, Roy RR, et al. Muscle afferent activity modulates bioassayable growth hormone in human plasma. J Appl Physiol 2000; 89(3): 1137–41
Hymer WC, Kraemer WJ, Nindl BC, et al. Characteristics of circulating growth hormone in women after acute heavy resistance exercise. Am J Physiol Endocrinol Metab 2001; 281(4): E878–87
Balon TW, Nadler JL. Evidence that nitric oxide increases glucose transport in skeletal muscle. J Appl Physiol 1997; 81(1): 359–63
Brann DW, Bhat GK, Lamar CHA, et al. Gaseous transmitters and neuroendocrine regulation. Neuroendocrinology 1997; 65: 385–95
Nelson RJ, Kriegsfeld LJ, Dawson VL, et al. Effects of nitric oxide on neuroendocrine function and behaviour. Front Neuroendocrinol 1997; 65: 385–95
Pinilla L, Tena-Sempere M, Aguilar E. Nitric oxide stimulates growth hormone secretion in vitro through a calcium- and cyclic guanosine monophosphate-independent mechanism. Horm Res 1999; 51: 242–7
Kusnar LL, Kaminski HJ. Nitric oxide synthase is concentrated at the skeletal muscle endplate. Brain Res 1996; 730: 238–42
Sears CE, Choate KJ, Paterson DJ. NO-cGMP pathway accentuates the decrease in heart rate caused by cardiac vagal nerve stimulation. J Appl Physiol 1999; 86(2): 510–6
Bilski J, Konturek SJ, Bielanski W. Role of endogenous nitric oxide in the control of exocrine and endocrine pancreatic secretion. J Physiol Pharmacol 1995; 46(4): 447–62
Laffranchi R, Gogvadze V, Richter C, et al. Nitric oxide stimulates insulin secretion by inducing calcium release from mitochondria. Biochem Biophys Res Commun 1995; 217(2): 584–91
Jungersten L, Ambring A, Wall B, et al. Both physical fitness and acute exercise regulate nitric oxide formation in healthy humans. J Appl Physiol 1997; 82(3): 760–4
Kobzik L, Reid MB, Bredt DS, et al. Nitric oxide in skeletal muscle. Nature 1994; 372: 546–8
Favero TG, Zable AC, Colter D, et al. Lactate inhibits Ca2+-activated Ca2+-channel activity from skeletal muscle sarcoplasmic reticulum. J Appl Physiol 1997; 82: 447–52
Kinderman W, Schnabel A, Schmitt WM, et al. Catecholamines, growth hormone, cortisol, insulin and sex hormones in anaerobic and aerobic exercise. Eur J Appl Physiol 1982; 49: 389–99
Chwalbinska-Moneta J, Krysztofiak F, Ziemba A, et al. Threshold increases in plasma growth hormone in relation to plasma catcholamine and blood lactate concentration during progressive exercise in endurance-trained athletes. Eur J Appl Physiol Occup Physiol 1996; 73: 117–20
Gordon SE, Kraemer WJ, Vos NH, et al. Effect of the acid-base balance on the growth hormone response to acute high-intensity cycle exercise. J Appl Physiol 1994; 76(2): 821–9
Elias AN, Wilson AF, Naqvi S, et al. Effects of blood pH and blood lactate on growth hormone, prolactin and gonadotropin release after acute exercise in male volunteers. Proc Soc Exp Biol Med 1997; 214: 156–60
Sutton JR, Young JD, Lazarus L, et al. The hormonal response to physical exercise. Australas Ann Med 1969; 18: 84–90
Kicman AT, Cowan DA. Peptide hormones and sport: misuse and detection. Br Med Bull 1992; 48: 496–517
Brown-Séquard C-E. A history of growth hormone research. Horm Res 1996; 46(4–5): 236–47
Sale DG. Neural adaptation to resistance training. Med Sci Sports Exerc 1988; 20 (5 Suppl.): S135–45
Cureton KJ, Collins MA, Hill DW, et al. Muscle hypertrophy in men and women. Med Sci Sports Exerc 1988; 20(4): 338–44
Häkkinen K, Pakarinen A, Kallinen M. Neuromuscular adaptations and serum hormones in women during short-term intensive strength training. Eur J Appl Physiol Occup Physiol 1992; 64(2): 106–11
Garhammer J. Power production by Olympic weightlifters. Med Sci Sports Exerc 1980; 12(1): 54–60
Vanhelder WP, Radomski MW, Goode RC. Growth hormone responses during intermittent weight lifting exercise in men. Eur J Appl Physiol 1984; 53: 31–4
Kraemer WJ, Marchitelli L, Gordon SE, et al. Hormonal and growth factor responses to heavy resistance exercise protocols. J Appl Physiol 1990; 69(4): 1442–50
Kraemer WJ. Hormonal mechanisms related to the expression of muscular strength and power. In: Komi PV, editor. Strength and power in sport. Oxford: Blackwell Scientific Publications. 1991
Kraemer WJ, Aguilera BA, Terada M, et al. Responses of IGF-I to endogenous increases in growth hormone after heavy-resistance exercise. J Appl Physiol 1995; 79(4): 1310–5
Kraemer WJ, Patton JF, Gordon SE, et al. Compatibility of high intensity strength and endurance training on hormonal and skeletal muscle adaptations. J Appl Physiol 1995; 78(3): 976–89
Ivy JL. The insulin-like effect of muscle contraction. Exerc Sport Sci Rev 1987; 15: 29–51
Constable SH, Favier RJ, Cartee GD, et al. Muscle glucose transport: interactions of in vitro contractions, insulin and exercise. J Appl Physiol 1988; 64(4): 2329–32
Yarasheski KE. Growth hormone effects on metabolism, body composition, muscle mass and strength. Exerc Sport Sci Rev 1994; 22: 285–312
Zachwieja JJ, Yarasheski KE. Does growth hormone therapy in conjunction with resistance exercise increase muscle force production and muscle mass in men and women aged 60 years or older? Phys Ther 1999; 79(1): 76–82
Yarasheski KE, Zachwieja JJ, Campbell JA, et al. Effect of growth hormone and resistance exercise on muscle growth and strength in older men. Am J Physiol 1995; 268: E268–76
Cooper DM, Moromisato DY, Zanconato S, et al. Effect of growth hormone suppression on exercise training and growth responses in young rats. Pediatr Res 1994; 35: 223–7
Goldberg AL. Work-induced growth of skeletal muscle in normal and hypophysectomised rats. Am J Physiol 1967; 213: 1193–8
Gollnick PD, Ianuzzo CD. Hormonal deficiencies and the metabolic adaptations of rats to training. Am J Physiol 1972; 223: 278–82
Grindeland RE, Roy RR, Edgerton VR, et al. Interactive effects of growth hormone and exercise on muscle mass in suspended rats. Am J Physiol 1994; 267 (1 Pt 2): R316–22
Grossman EJ, Grindeland RE, Roy RR, et al. Growth hormone, IGF-1, and exercise effects on non-weight-bearing fast muscles of hypophysectomized rats. J Appl Physiol 1997; 83(5): 1522–30
Nevill ME, Holmyard DJ, Hall GM, et al. Growth hormone responses to treadmill sprinting in sprint- and endurancetrained athletes. Eur J Appl Physiol 1996; 72: 460–7
Felsing N, Brasel JA, Cooper DM. Effect of low and high intensity exercise on circulating growth hormone in men. J Clin Endocrinol Metab 1992; 75: 157–62
Kanaley JA, Weltman J, Veldhuis JD, et al. Human growth hormone response to repeated bouts of aerobic exercise. J Appl Physiol 1997; 83(5): 1756–61
Cappon J, Brasel JA, Mohan S, et al. Effect of brief exercise on circulating insulin-like growth factor 1. J Appl Physiol 1994; 76(6): 2490–6
Bang P, Brandt J, Degerblad M, et al. Exercise-induced changes in insulin-like growth factors and their low molecular weight binding protein in healthy subjects and patients with growth hormone deficiency. Eur J Clin Invest 1990; 20: 285–92
Cuneo RC, Wallace JD. Growth hormone, insulin-like growth factors and sport. Endocrinol Metab 1994; 1: 3–13
Luger A, Watschinger B, Deuster P, et al. Plasma growth hormone and prolactin responses to graded levels of acute exercise and to lactate infusion. Neuroendocrinology 1992; 56: 112–7
Farrell PA, Grathwaite TL, Gustafson AB. Plasma adrenocorticotropin and cortisol responses to submaximal and exhaustive exercise. J Appl Physiol 1983; 55: 1441–4
Naveri H. Blood hormone and metabolite levels during graded cycle ergometer exercise. Scand J Clin Lab Invest 1985; 45: 599–603
Wasserman K, Hansen JE, Sue DY, et al. Principles of exercise testing and interpretation. Philadelphia (PA): Lea and Febiger, 1987
Pritzlaff CJ, Wideman L, Weltman JY, et al. Impact of acute exercise intensity on pulsatile growth hormone release in men. J Appl Physiol 1999; 87(2): 498–504
Weltman A, Weltman J, Schurrer R, et al. Endurance training amplifies the pulsatile release of growth hormone: effects of training intensity. J Appl Physiol 1992; 76(6): 2188–96
Isgaard J, Carlsson L, Isaksson OGP, et al. Pulsatile intravenous growth hormone (GH) infusion to hypophysectomised rats increases insulin-like growth factor 1 messenger RNA in skeletal tissues more effectively than continuous GH infusion. Endocrinology 1988; 123: 2605–10
Jansson JO, Ekberg S, Hoath SB, et al. Growth hormone enhances hepatic epidermal growth factor receptor concentration in mice. J Clin Invest 1988; 82: 1871–6
Weltman A, Weltman J, Womack CJ, et al. Exercise training decreases the growth hormone (GH) response to acute constant-load exercise. Med Sci Sports Exerc 1997; 29(5): 669–76
Hartley LH. Growth hormone and catecholamine response to exercise in relation to physical training. Med Sci Sports Exerc 1975; 7: 34–6
Koivisto V, Hendler R, Nagel E, et al. Influence of physical training on the fuel-hormone response to prolonged low intensity exercise. Metabolism 1982; 31: 192–7
Bunt JC. Sex and training differences in human growth hormone levels during prolonged exercise. J Appl Physiol 1986; 61: 1796–801
Kjaer M, Bangsbo J, Lortie G, et al. Hormonal response to exercise in humans: influence of hypoxia and physical training. Am J Physiol 1998; 254: R197–203
Houmard JA, Egan PC, Neufer PD, et al. Elevated glucose transporter levels in exercise-trained middle-aged men. Am J Physiol 1991; 261(24): E437–43
Houmard JA, Shinebarger MH, Dolan PL, et al. Exercise training increases GLUT-4 protein concentration in previously sedentary middle-aged men. Am J Physiol 1993; 264 (6 Pt 1): E896–901
Jorgensen JOL, Christiansen JS. Brave new senescence: HGH in adults. Lancet 1993; 341: 1241–8
Neely EK, Rosenfield RG. Use and abuse of human growth hormone. Annu Rev Med 1994; 45: 407–20
Phillips WT, Pruitt LA, King AC. Lifestyle activity: current recommendations. Sports Med 1996; 22: 1–7
American College of Sports Medicine. Position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998; 30: 975–91
Kang J, Robertson RJ, Hagberg JM. Effect of exercise intensity on glucose and insulin metabolism in obese individuals and obese NIDDM patients. Diabetes Care 1996; 19: 341–9
Romijin JA, Coyle EF, Siddossis LS, et al. Regulation of endogenous fat and carbohydrate metabolism in relation to exercise intensity duration. Am J Physiol 1993; 265: E280–391
Richter EA, Garetto LP, Goodman MN, et al. Muscle glucose metabolism following exercise in the rat: increased sensitivity to insulin. J Clin Invest 1993; 69: 785–93
DeMeirleir K, Naaktegeboren N, VanSteirteghem A, et al. Beta-endorphin and ACTH levels in peripheral blood during and after aerobic and anaerobic exercise. Eur J Appl Physiol Occup Physiol 1986; 55: 5–8
Goldfarb AH, Hatfield BD, Armstrong D, et al. Plasma beta-endorphin concentration: response to intensity and duration of exercise. Med Sci Sports Exerc 1990; 22: 241–4
Goldfarb AH, Hatfield BD, Potts J, et al. Beta-endorphin time course response to intensity of exercise: effect of training status. Med Sci Sports Exerc 1991; 12(3): 264–8
McMurray RG, Forsythe WA, Mar MH, et al. Exercise intensity-related responses of beta-endorphin and catecholamines. Med Sci Sports Exerc 1987; 19(6): 570–4
Rahkila P, Hakala E, Alen M, et al. Beta-endorphin and corticotropin release is dependent on a threshold intensity of running exercise in male endurance athletes. Life Sci 1988; 43(6): 551–8
Fitarone MA, Marks EC, Ryan ND, et al. High-intensity strength training in nonagenarians: effects on skeletal muscle. JAMA 1990; 263(22): 3029–34
Häkkinen K, Pakarinen A. Acute hormonal responses to heavy resistance exercise in men and women at different ages. Int J Sports Med 1995; 16: 507–13
Nicklas BJ, Ryan AJ, Treuth MM, et al. Testosterone, growth hormone and IGF-I responses to acute and chronic resistive exercise in men aged 55–70 years. Int J Sports Med 1995; 16: 445–50
Acknowledgements
The authors would like to acknowledge and thank the British Olympic Medical Trust for their financial support in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.
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Godfrey, R.J., Madgwick, Z. & Whyte, G.P. The Exercise-Induced Growth Hormone Response in Athletes. Sports Med 33, 599–613 (2003). https://doi.org/10.2165/00007256-200333080-00005
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DOI: https://doi.org/10.2165/00007256-200333080-00005
Keywords
- Nitric Oxide
- Growth Hormone
- Resistance Exercise
- Tibialis Anterior
- Lactate Threshold