So, is there much of a reason to ever check GH directly outside of suspected direct pituitary malfunction?
There an old bodybuilder “bro science” technique to check if your rHGH is legit. You inject 10 IU intramuscularly, as close as possible to 2 hours later check GH. It should be between 20-40ng. This was common pre Jano, pre dirt cheap rHGH from China, when rHGH was $8-12 IU, and fraud was rampant.
Today if you show signs of acromegally (like 75% of pro bodybuilders over 45 do), and IGF-1 tests above normal range, they’ll repeat the IGF-1 test on another day. If it’s still high, they’ll give you a shot of glucose to drink, then test GH at 30,60,90 and 120 minutes. It should be very low, less than 1ng (insulin released after drinking sugar should suppress growth hormone release).
If GH is higher than that, it means you have some anomaly, usually a tumor, causing GH to be continuously released, and therefore acromegaly.
Technically speaking, if you inject supraphysiological doses of rHGH, since it’s also “continuous” release and not suppressed by insulin, it’s “iatrogenic acromegally” and depending on how long it goes on and how high the dose, it’s possible to develop all the same symptoms of “late onset acromegally” (vs those who had it since childhood and look like giants). The shortest period to serious permanent changes I’ve seen in medical literature was 16 months at an IGF of roughly 400 in a 50 yo male (who stopped getting his IGF checked during the pandemic, his IGF crept up, but since docs didn’t know they never adjusted his 3iu dose.
It was discovered because he developed an underbite (lower jaw grew forward, very common) and a lisp (enlarged tongue, also common). Went up 2 shoe sizes.