Use of growth hormone, IGF-I, and insulin for anabolic purpose: Pharmacological basis, methods of detection, and adverse effects

Mol Cell Endocrinol. 2018 Mar 15;464:65-74. doi: 10.1016/j.mce.2017.06.010. Epub 2017 Jun 9.


Hormones with anabolic properties such as growth hormone (GH), insulin-like growth factor-1 (IGF-I), and insulin are commonly abused among professional and recreational athletes to enhance physical ability. Performance enhancing drugs (PEDs) such as these are also commonly used by recreational athletes to improve body aesthetics. The perception of increased muscle mass due to supraphysiologic hormone supplementation, or doping, is widespread among PED users despite a paucity of evidence-based data in humans. Even still, athletes will continue to abuse PEDs in hopes of replicating anecdotal results. It is important to educate the general public and potential treating physicians of the risks of PED use, including the dangers of polypharmacy and substance dependence. It will also be important for the research community to address the common challenges associated with studying PED use such as the ethical considerations of PED administration, the general reticence of the PED-using community to volunteer information, and the constant need to improve or create new detection methods as athletes continually attempt to circumvent current methods. This review highlights the anabolic mechanisms and suggestive data implicating GH, IGF-I, and insulin for use as PEDs, the specific detection methods with cutoff ranges that may be utilized to diagnose abuse of each substance, and their respective side effects.

Keywords: Doping; Drug abuse; Muscle; Performance enhancing drugs; Side effects; Sports.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Anabolic Agents / adverse effects
  • Anabolic Agents / analysis*
  • Anabolic Agents / pharmacology*
  • Growth Hormone / adverse effects
  • Growth Hormone / analysis*
  • Growth Hormone / pharmacology*
  • Humans
  • Insulin / adverse effects
  • Insulin / analysis*
  • Insulin / pharmacology*
  • Insulin-Like Growth Factor I / adverse effects
  • Insulin-Like Growth Factor I / analysis*
  • Insulin-Like Growth Factor I / pharmacology*
  • Performance-Enhancing Substances / adverse effects
  • Performance-Enhancing Substances / analysis
  • Performance-Enhancing Substances / pharmacology


  • Anabolic Agents
  • Insulin
  • Performance-Enhancing Substances
  • Insulin-Like Growth Factor I
  • Growth Hormone