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       #Post#: 1089--------------------------------------------------
       Timing of HGH
   DIR By: Road2HardCoreIron
       Date: September 23, 2022, 12:50 pm
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       Exogenous HGH Timing: Morning or Nighttime Dosing?
       In all variables we implement as bodybuilders we want to know
       what the “optimal” approach is. How much to do, when to do it,
       where to do it, etc. Human Growth Hormone dosing and timing is a
       variable that gets talked about a lot and a lot of times
       statements have little backing in scientific evidence. One of
       these questions is when is the best time to dose your human
       growth hormone (HGH)?
       We can turn to the literature to help us answer these types of
       questions. We have several studies implementing HGH in normal
       health adults and children, diseased population with HIV, muscle
       wasting, sarcopenia, cachexia, and hypopituitarism to name a
       few. Dosing utilized in these studies are very “real world” as
       well.
       Study:
       “Evening Versus Morning Injections of Growth Hormone (GH) in
       GH-Deficient Patients: Effects on 24-Hour Patterns of
       Circulating Hormones and Metabolites” Jorgensen et al 1999.
       Purpose:
       Investigate if the timing of HGH had an impact on its action
       Subjects:
       Eight GH deficient (3 girls, 7 boys) mean age 14.9 +/- 1.6 years
       Design:
       Three 4-week study blocks in random order: 2IU GH given at
       8:00am, 2IU GH given at 8:00pm, or no GH. All subjects were
       compared to a non-GH deficient reference range.  Serum GH,
       IGF-1, blood glucose, insulin, and alanine levels were monitored
       over 24 hours at the end of each 4-week study block.
       Results:
       Figure 1 below shows the change in serum GH between the AM, PM
       GH group, the no GH group. The shaded line is the reference
       group (adolescents without GH deficiency).
       The 2IU AM group has a serum peak GH level of 7.3 +/-1.9 ug/L.
       The PM 2IU GH group had peak GH of 14.9 +/-5.8 ug/L
       significantly higher than the AM group.
       The PM administration of GH mimicked a natural rise in nighttime
       GH as seen in comparison to the reference group (shaded line on
       figure).
       AM GH administration mirrored the No GH group GH serum levels
       during the sleep duration with no rise in GH seen.
       Serum IGF-1 was not significantly different between AM or PM
       dosing of HGH, 179.5 +/-5.3 ug/L and 189.8 +/-2.5 ug/L,
       respectively.
       No difference in Serum glucose between AM and PM dosing.
       However, Serum insulin was significantly higher in the AM group
       vs the PM group.
       Serum Alanine levels were higher at night in the group receiving
       GH in AM, I will explain the importance of this.
       Conclusions:
       There was an enhanced GH bioavailability with PM dosing. The
       authors hypothesized this could be due to elevated body
       temperature of subcutaneous and causing a rapid uptake of the
       growth hormone.
       Although IGF-1 mean serum levels were not different there was a
       significant difference in time duration. The AM dosing had drop
       off at night and not achieving a steady state level like in that
       of the PM dosing. We want a steady state of IGF-1 as IGF-1 is
       the main hormone effect growth and repair.
       Serum Insulin was also increased with AM dosing compared to PM
       dosing. AM dosing corresponds more with what we see in insulin
       resistance in GH administration. The PM dosing did not see this
       change in daytime serum insulin, as PM dosing does not have as
       much pancreatic beta cell challenge in a fasted state verse the
       fed state.
       Serum Alanine levels being higher at night in the AM GH dosage
       are indicative of increased protein catabolism. The authors
       state that AM dosing of GH might be unfavorable since it induces
       high levels of alanine indicative of protein degradation.
       Takeaway:
       1.     If selecting one time of day to dose GH, pre bed may be
       preferable due to enhanced GH bioavailability and decreased
       protein catabolism compared to AM dosing.
       2.     PM dosing mirrors that of normal endogenous production of
       GH and replacing your natural levels at a time the body is
       primed for GH can enhance the effects potentially.
       3.     PM dosing can be favorable as well in controlling serum
       insulin levels and decreasing stress on beta cell function.
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