Perceived anabolic benefits of GH and difficulty of detection have fuelled its abuse among both competitive and recreational athletes. While it is known that GH increases lean body mass, fluid retention largely contributes to this effect. Our recent data indicate that GH does not enhance muscle strength, power, or aerobic exercise capacity, but improves anaerobic exercise capacity. The yearning to boost performance however continues to bolster its inappropriate use in sports, despite many adverse effects. These include oedema, carpal tunnel syndrome, arthralgias, as well as a state mimicking acromegaly with increased risk for diabetes, cardiomyopathy and malignancy. When GH and testosterone are abused together, there is a potentiation of their effects on muscle mass and function, and also increased risk to develop side effects.

Two approaches have been developed for the detection of doping with GH. The GH isoform test has high specificity but limited window of detection, whereas the GH biomarker method, which is based on stimulation of IGF-I and collagen synthesis by GH, is less specific but has longer window of opportunity. As detection of GH abuse has its limitations, the perceived increase in muscle mass and certain aspects of performance makes GH a tempting target for abuse among athletes.