HGH Dosage for Women: Label Doses, Estrogen Effect, IU to mg

All three labels allow either a non-weight-based or a weight-based regimen for adults with growth hormone deficiency (GHD). The non-weight-based regimen is the same on each. The weight-based figures differ by brand, so the last column shows the arithmetic for an example 60 kg adult, as an illustration of scale only.

The labels say the dose should be reduced if side effects appear or if IGF-1 rises above the age- and sex-specific normal range, and that older patients should start lower. Norditropin's label says its weight-based regimen is not recommended for obese patients, and Genotropin's notes that obese patients are more likely to have side effects on a weight-based regimen. Maintenance doses, in the Genotropin wording, "vary considerably from person to person, and between male and female patients."

This is the one place the labels treat women differently, and they are specific about it.

• Genotropin: "estrogen-replete women may need higher doses than men. Oral estrogen administration may increase the dose requirements in women."
• Norditropin: "Estrogen-replete women and patients receiving oral estrogen may require higher doses." Its interactions section adds that oral estrogens may reduce the IGF-1 response.
• Humatrope: "Women may require higher doses and patients receiving oral estrogen may require higher doses."

The labels speak of oral estrogen and oral estrogen replacement. They do not single out contraceptive pills, although combined pills also deliver estrogen by mouth; whether that changes a given dose is a question for the prescriber, who will judge it from IGF-1 results rather than from the pill alone.

Because women start in the same range as men but often end higher, titration matters more than the starting number. Each label ties dose changes to clinical response, side effects and age- and sex-adjusted IGF-1. The commonest adult side effects in the label data are fluid- and joint-related. In Genotropin's adult trials, over the first six months peripheral swelling was reported by 17.5% on somatropin against 5.1% on placebo, and joint pain (arthralgia) by 17.3% against 4.2%. In longer extension studies, 2% developed carpal tunnel symptoms, most of which eased with a lower dose or a pause.

No somatropin product is approved for weight loss, and 21 U.S.C. 333(e) makes it a federal offence to knowingly distribute human growth hormone, or possess it with intent to distribute, for any human use other than a disease or condition authorized by HHS and ordered by a physician.

Growth hormone has been studied in women with abdominal obesity, and the results explain both the interest and the reason it is not an approved weight-loss drug:

• Franco and colleagues (JCEM 2005) gave 0.67 mg/day for 12 months to 40 postmenopausal women with abdominal obesity. Visceral fat and LDL cholesterol fell and thigh muscle area rose compared with placebo.
• Bredella and colleagues (Eur J Endocrinol 2012) treated 79 obese premenopausal women for 6 months at a mean dose of 1.7 mg/day. Total abdominal fat fell and lean mass rose, but glucose tolerance worsened in a minority.

These were supervised trials measuring fat distribution and cardiovascular markers, not approvals, and the doses studied sit above the adult GHD starting range. For the medicines that are approved for weight loss, see weight loss injections. The fat-loss fragment sold as an HGH spin-off is covered in the HGH fragment 176-191 guide.

US labels dose somatropin in milligrams, but many vials and older references use international units (IU). The WHO second International Standard for somatropin (NIBSC 98/574) assigns 3.0 IU per mg, so 1 mg = 3 IU and 1 IU = 0.333 mg.

An easy mistake with growth hormone is reading "units" on an insulin syringe as IU. They are different things: syringe units measure volume (on a U-100 syringe, 1 unit = 0.01 mL), while IU measure biological activity. The formula is units = dose in mg ÷ (vial mg ÷ mL of water) × 100.

Example only: a vial labelled 10 IU (3.33 mg) mixed with 3 mL of water gives 1.11 mg/mL. A 0.2 mg dose is 0.18 mL, or 18 units on a U-100 syringe, and 1 IU is 30 units. Mixed with 1 mL instead, the same 0.2 mg is 6 units. Check your own numbers in the HGH calculator or the mg to mL to units converter, and see the syringe measurement guide for reading the barrel. Branded pens are dialled in mg and are not interchangeable with reconstituted research vials, whose labelled content is not verified. The HGH 191AA dosage page covers the compound itself.