Growth Hormone Response to Exercise: Implications for Body Growth

  • Pietro Galassetti
  • Pamela C. Pablico


The various forms of exercise that occur during childhood and adolescence should not just be seen as fun activities which may also be “good” for children but as an obligatory component of physiological growth. Exe4cose-related benefits include cardiovascular protection, bone/muscle development, psychological balance, weight control, and many others.  The specific biochemical link between exercise and many related health effects remain incompletely defined, but a pivotal role appears to be played by exercise-induced stimulation of growth hormone of the GH–IGF-I axis and its interaction with molecules regulating inflammatory/oxidative homeostasis. Children spontaneously engage in brief but repeated, often intense bouts of exercise, each causing GH release and each therefore providing an expected and necessary stimulus for healthy development. Both the magnitude of the GH response to exercise and of the multiple inducible glucoregulatory, inflammatory, and oxidative factors that interact with GH depend on type, format, duration, and intensity of exercise, underscoring the importance of optimizing exercise characteristics to preserve the expected GH-mediated effects. Further, numerous factors can alter physiological GH responses, either acutely and reversibly (prior intense exercise, hypoglycemia, and lipid ingestion) or permanently (obesity and type 1 diabetes). The full manifestation of GH effects, in the context of the overall health effects of exercise, must therefore rely on the future effort to complete our current understanding of all related underlying mechanisms, many of which remain unclear.


Growth Hormone Growth Hormone Secretion Exercise Bout Growth Hormone Response Growth Hormone Release 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Body mass index


Granulocyte colony-stimulating factor


Growth hormone


Growth hormone-releasing hormone


Human growth hormone-releasing peptide


Hypothalamo-pituitary-adrenal axis


Insulin-like growth factor-binding protein I


Insulin-like growth factor I


Insulin-like growth factor-releasing peptide


Interleukin 1


Interleukin 1 beta


Interleukin 6


Interleukin 8


Interleukin 10


Tumor Necrosis Factor


Tumor necrosis factor receptor-1



The authors would like to acknowledge the expert editorial assistance of Ms Rebecca Flores. Dr Galassetti’s research is supported by research grant by the NIH (NIDDK) and by the American Diabetes Association.


  1. Cappon JP, Ipp E, Brasel JA, Cooper DM. Acute effects of high fat and high glucose meals on the growth hormone response to exercise. J Clin Endocrinol Metab. 1993;76:1428–22.CrossRefGoogle Scholar
  2. Cooper DM, Nemet D, Galassetti P. Exercise, stress, and inflammation in the growing child: from the bench to the playground. Curr Opin Pediatr. 2004;16:286–92.PubMedCrossRefGoogle Scholar
  3. Cryer PE. Hypoglycemia-associated autonomic failure in diabetes. Am J Physiol Endocrinol Metab. 2001;281:E1115–21.PubMedGoogle Scholar
  4. Davis SN, Mann S, Galassetti P, Neill RA, Tate D, Ertl AC, Costa F. Effects of differing durations of antecedent hypoglycemia on counterregulatory responses to subsequent hypoglycemia in normal humans. Diabetes. 2000;49:1897–903.PubMedCrossRefGoogle Scholar
  5. Elenkov IJ, Chrousos GO. Stress hormone, proinflammatory and antiinflammatory cytokines, and autoimmunity. Ann NY Acad Sci. 2002;966:290–303.PubMedCrossRefGoogle Scholar
  6. Eliakim A, Nemet D, Zaldivar F, McMurray RG, Culler FL, Galassetti P, Cooper DM. Reduced exercise-associated response of the GH-IGF-I axis and catecholamines in obese children and adolescents. J Appl Physiol. 2005;100:1630–7.PubMedCrossRefGoogle Scholar
  7. Farrell PA, Garthwaite TL, Gustafson AB. Plasma adrenocorticotropin and cortisol responses to submaximal and exhaustive exercise. J Appl Physiol. 1983;55:1441–4.PubMedGoogle Scholar
  8. Felsing NE, 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.PubMedCrossRefGoogle Scholar
  9. Galassetti P, Mann S, Tate D, Neill RA, Costa F, Wasserman DH, Davis SN. Effects of antecedent prolonged exercise on subsequent counterregulatory responses to hypoglycemia. Am J Physiol Endocrinol Metab. 2001a;280:E908–17.PubMedGoogle Scholar
  10. Galassetti P, Neill RA, Tate D, Ertl AC, Wasserman DH, Davis SN. Sexual dimorphism in counterregulatory responses to hypoglycemia after antecedent exercise. J Clin Endocrinol Metab. 2001b;86:3516–24.PubMedCrossRefGoogle Scholar
  11. Galassetti P, Tate D, Neill RA, Morrey S, Davis SN. Effect of gender on counterregulatory responses to euglycemic exercise in type 1 diabetes. J Clin Endocrinol Metab. 2002;87:5144–50.PubMedCrossRefGoogle Scholar
  12. Galassetti P, Tate D, Neill RA, Morrey S, Wasserman DH, Davis SN. Effect of antecedent hypoglycemia on counterregulatory responses to subsequent euglycemic exercise in type 1 diabetes. Diabetes. 2003a;52:1761–9.PubMedCrossRefGoogle Scholar
  13. Galassetti P, Tate D, Neill RA, Richardson MA, Davis SN. Effect of differing antecedent hypoglycemia on counterregulatory responses to subsequent exercise in type 1 diabetes. Diabetes. 2003b;52:A349.CrossRefGoogle Scholar
  14. Galassetti P, Tate D, Neill RA, Morrey S, Wasserman DH, Davis SN. Effect of sex on counterregulatory responses to exercise after antecedent hypoglycemia in type 1 diabetes. Am J Physiol Endocrinol Metab. 2004;287:E16–24.PubMedCrossRefGoogle Scholar
  15. Galassetti P, Larson J, Iwanaga K, Salsberg SL, Eliakim A, Pontello A. Effect of a high-fat meal on the growth hormone response to exercise in children. J Pediatr Endocrinol Metab. 2006a;19:777–86.PubMedCrossRefGoogle Scholar
  16. Galassetti PR, Iwanaga K, Crisostomo M, Zaldivar FP, Larson J, Pescatello A. Inflammatory cytokine, growth factor and counterregulatory responses to exercise in children with type 1 diabetes and healthy controls. Pediatr Diabetes. 2006b;7:16–24.PubMedCrossRefGoogle Scholar
  17. Giannoulis MG, Boroujerdi MA, Powrie J, Dall R, Napoli R, Ehrnborg C, Pentecost C, Cittadini A, Jorgensen JO, Sonksen PH. Gender differences in growth hormone response to exercise before and after rhGH administration and the effect of rhGH on the hormone profile of fit normal adults. Clin Endocrinol (Oxf). 2005;62:315–22.CrossRefGoogle Scholar
  18. Giustina A, Veldhuis JD. Pathophysiology of the neuroregulation of growth hormone secretion in experimental animals and the human. Endocr Rev. 1998;19:717–97.PubMedCrossRefGoogle Scholar
  19. Gray AB, Telford RD, Weidemann MJ. Endocrine response to intense interval exercise. Eur J Appl Physiol Occup Physiol. 1993;66:366–71.PubMedCrossRefGoogle Scholar
  20. Hagberg JM, Seals DR, Yerg JE, Gavin J, Gingerich R, Premachandra B, Holloszy JO. Metabolic responses to exercise in young and older athletes and sedentary men. J Appl Physiol. 1988;65:900–8.PubMedGoogle Scholar
  21. Hakkinen K, Pakarinen A. Acute hormonal responses to two different fatiguing heavy-resistance protocols in male athletes. J Appl Physiol. 1993;74:882–7.PubMedGoogle Scholar
  22. Hakkinen K, Pakarinen A, Alen M, Kauhanen H, Komi PV. Neuromuscular and hormonal responses in elite athletes to two successive strength training sessions in one day. Eur J Appl Physiol Occup Physiol. 1988;57:133–9.PubMedCrossRefGoogle Scholar
  23. Hartley LH, Mason JW, Hogan RP, Jones LG, Kotchen TA, Mougey EH, Wherry FE, Pennington LL, Ricketts PT. Multiple hormonal responses to prolonged exercise in relation to physical training. J Appl Physiol. 1972;33:607–10.PubMedGoogle Scholar
  24. Holt RI, Webb E, Pentecost C, Sonksen PH. Aging and physical fitness are more important than obesity in determining exercise-induced generation of GH. J Clin Endocrinol Metab. 2001;86:5715–20.PubMedCrossRefGoogle Scholar
  25. Kanaley JA, Weatherup-Dentes MM, Jaynes EB, Hartman ML. Obesity attenuates the growth hormone response to exercise. J Clin Endocrinol Metab. 1999;84:3156–61.PubMedCrossRefGoogle Scholar
  26. Kanaley JA, Weltman JY, Pieper KS, Weltman A, Hartman ML. Cortisol and growth hormone responses to exercise at different times of day. J Clin Endocrinol Metab. 2001;86:2881–9.PubMedCrossRefGoogle Scholar
  27. Karagiorgos A, Garcia JF, Brooks GA. Growth hormone response to continuous and intermittent exercise. Med Sci Sports. 1979;11:302–7.PubMedCrossRefGoogle Scholar
  28. Katz LEL, DeLeon D, Zhao H, Jawad AF. Free and total insulin-like growth factor (IGF)-I levels decline during fasting: relationships with insulin and IGF-binding protein-1. J Clin Endocrinol Metab. 2002;87:2978–83.PubMedCrossRefGoogle Scholar
  29. Kraemer WJ, Marchitelli L, Gordon SE, Harman E, Dziados JE, Mello R, Frykman P, McCurry D, Fleck SJ. Hormonal and growth factor responses to heavy resistance exercise protocols. J Appl Physiol. 1990;69:1442–50.PubMedGoogle Scholar
  30. Kraemer WJ, Gordon SE, Fleck SJ, Marchitelli LJ, Mello R, Dziados JE, Friedl K, Harman E, Maresh C, Fry AC. Endogenous anabolic hormonal and growth factor responses to heavy resistance exercise in males and females. Int J Sports Med. 1991;12:228–35.PubMedCrossRefGoogle Scholar
  31. Kraemer WJ, Fleck SJ, Dziados JE, Harman EA, Marchitelli LJ, Gordon SE, Mello R, Frykman PN, Koziris LP, Triplett NT. Changes in hormonal concentrations after different heavy-resistance exercise protocols in women. J Appl Physiol. 1993;75:594–604.PubMedGoogle Scholar
  32. Lassarre C, Girard F, Durand J, Raynaud J. Kinetics of human growth hormone during submaximal exercise. J Appl Physiol. 1974;37:826–30.PubMedGoogle Scholar
  33. LeRoith D, Adamo M, Werner H, Roberts CT. Insulinlike growth factors and their receptors as growth regulators in normal physiology and pathologic states. Trends Endocrinol Metab. 1991;2:134–9.CrossRefGoogle Scholar
  34. Luger A, Watschinger B, Deuster P, Svoboda T, Clodi M, Chrousos GP. Plasma growth hormone and prolactin responses to graded levels of acute exercise and to a lactate infusion. Neuroendocrinology. 1992;56:112–7.PubMedCrossRefGoogle Scholar
  35. Naveri H. Blood hormone and metabolite levels during graded cycle ergometer exercise. Scand J Clin Lab Invest. 1985;45:599–603.PubMedCrossRefGoogle Scholar
  36. Naveri H, Kuoppasalmi K, Harkonen M. Metabolic and hormonal changes in moderate and intense long-term running exercises. Int J Sports Med. 1985;6:276–81.PubMedCrossRefGoogle Scholar
  37. Nemet D, Hong S, Mills PJ, Ziegler MG, Hill M, Cooper DM. Sysemic vs. local cytokine and leukocyte responses to unilateral wrist flexion exercise. J Appl Physiol. 2002a;93:546–54.PubMedGoogle Scholar
  38. Nemet D, Oh Y, Kim H-S, Hill MA, Cooper DM. The effect of intense exercise on inflammatory cytokines and growth mediators in adolescent boys. Pediatrics. 2002b;110:681–9.PubMedCrossRefGoogle Scholar
  39. Pritzlaff CJ, Wideman L, Weltman JY, Abbott RD, Gutgesell ME, Hartman ML, Veldhuis JD, Weltman A. Impact of acute exercise intensity on pulsatile growth hormone release in men. J Appl Physiol. 1999;87:498–504.PubMedGoogle Scholar
  40. Raynaud J, Drouet L, Martineaud JP, Bordachar J, Coudert J, Durand J. Time course of plasma growth hormone during exercise in humans at altitude. J Appl Physiol. 1981;50:229–33.PubMedGoogle Scholar
  41. Raynaud J, Capderou A, Martineaud JP, Bordachar J, Durand J. Intersubject viability in growth hormone time course during different types of work. J Appl Physiol. 1983;55:1682–7.PubMedGoogle Scholar
  42. Reichlin S. Neuroendocrine-immune interactions. N Engl J Med 1993;329:1246–53.PubMedCrossRefGoogle Scholar
  43. Roth J, Glick SM, Yalow RS, Berson SA. Secretion of human growth hormone: physiologic and experimental modification. Metabolism. 1963;12:577–9.PubMedGoogle Scholar
  44. Scheet TP, Mills PJ, Ziegler MG, Stoppani J, Cooper DM. Effect of exercise on cytokines and growth mediators in prepubertal children. Pediatr Res. 1999;46:429–34.CrossRefGoogle Scholar
  45. Segel SA, Fanelli CG, Dence CS, Markham J, Videen TO, Paramore DS, Powers WJ, Cryer PE. Blood-to-brain glucose transport, cerebral glucose metabolism, and cerebral blood flow are not increased after hypoglycemia. Diabetes. 2001;50:1911–7.PubMedCrossRefGoogle Scholar
  46. Snegovskaya V, Viru A. Elevation of cortisol and growth hormone levels in the course of further improvement of performance capacity in trained rowers. Int J Sports Med. 1993;14:202–6.PubMedCrossRefGoogle Scholar
  47. Stokes KA, Nevill ME, Hall GM, Lakomy HK. Growth hormone responses to repeated maximal cycle ergometer exercise at different pedaling rates. J Appl Physiol. 2002;92:602–8.PubMedGoogle Scholar
  48. Stokes KA, Nevill ME, Lakomy HK, Hall GM. Reproducibility of the growth hormone response to sprint exercise. Growth Horm IGF Res. 2003;13:336–40.PubMedCrossRefGoogle Scholar
  49. Stokes KA, Nevill ME, Cherry PW, Lakomy HK, Hall GM. Effect of 6 weeks of sprint training on growth hormone responses to sprinting. Eur J Appl Physiol. 2004;92:26–32.PubMedCrossRefGoogle Scholar
  50. Stokes K, Nevill M, Frystyk J, Lakomy H, Hall G. Human growth hormone responses to repeated bouts of sprint exercise with different recovery periods between bouts. J Appl Physiol. 2005;99:1254–61.PubMedCrossRefGoogle Scholar
  51. Stouthard JM, Romijn JA, Van der Poll T, Endert E, Klein S, Bakker PJ, Veenhof CH, Sauerwein HP. Endorinologic and metabolic effects of interleukin-6 in humans. Am J Physiol. 1995;268:E813–9.PubMedGoogle Scholar
  52. Sutton JR. Hormonal and metabolic responses to exercise in subject of high and low work capacities. Med Sci Sports. 1978;10:1–6.PubMedGoogle Scholar
  53. Sutton J, Lazarus L. Growth hormone in exercise: comparison of physiological and pharmacological stimuli. J Appl Physiol. 1976;41:523–7.PubMedGoogle Scholar
  54. Tsigos C, Papanicolau DA, Defensor R, Mitsiadis CS, Kyrou I, Chrousos GP. Dose effects of recombinant human interleukin-6 on pituitary hormone secretion and energy expenditure. Neuroendocrinology. 1997a;66:54–62.PubMedCrossRefGoogle Scholar
  55. Tsigos C, Papanicolau DA, Kyrou I, Defensor R, Mitsiadis CS, Chrousos GP. Dose-dependent effects of recombinant human interleukin-6 on glucose regulation. J Clin Endocrinol Metab. 1997b;82:4170.CrossRefGoogle Scholar
  56. VanHelder WP, Casey K, Goode RC, Radomski WM. Growth hormone regulation in two types of aerobic exercise of equal oxygen uptake. Eur J Appl Physiol Occup Physiol. 1986;55:236–9.PubMedCrossRefGoogle Scholar
  57. Veldhuis JD, Iranmanesh A, Ho KK, Waters MJ, Johnson ML, Lizarralde G. Dual defects in pulsatile growth hormone secretion and clearance subserve the hyposomatotropism of obesity in man. J Clin Endocrinol Metab. 1991;72:51–9.PubMedCrossRefGoogle Scholar
  58. Veldhuis JD, Liem AY, South S, Weltman A, Weltman J, Clemmons DA, Abbott R, Mulligan T, Johnson ML, Pincus S. Differential impact of age, sex steroid hormones, and obesity on basal versus pulsatile growth hormone secretion in men as assessed in an ultrasensitive chemiluminescence assay. J Clin Endocrinol Metab. 1995;80:3209–22.PubMedCrossRefGoogle Scholar
  59. Viru A, Karelson K, Smirnova T. Stability and variability in hormonal responses to prolonged exercise. Int J Sports Med. 1992;13:230–5.PubMedCrossRefGoogle Scholar
  60. Wideman L, Consitt L, Patrie J, Swearingin B, Bloomer R, Davis P, Weltman A. The impact of sex and exercise duration on growth hormone secretion. J Appl Physiol. 2006;101:1641–7.PubMedCrossRefGoogle Scholar
  61. Zaccaria M, Varnier M, Piazza P, Noventa D, Ermolao A. Blunted growth hormone response to maximal exercise in middle-aged versus young subjects and no effect of endurance training. J Clin Endocrinol Metab. 1999;84:2303–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.ICTS, UCIOrangeUSA
  2. 2.West Sacramento, School of Medicine, University of CaliforniaDavisUSA

Personalised recommendations