I think the best way to take it is to split the dose. I am taking 9iu/day, 5 iu right at bedtime, 2 iu morning, and another 2 iu mid afternoon. If I were doing 6 iu/day, I'd do 3 iu at bed, then 1.5 iu morning and mid-afternoon.
These studies were posted by Nandi on CEM.

ITwice Daily GH Injections Give Higher IGF-1 Levels
Here is an interesting abstract. They took the same amount of GH and compared the effects of one injection vs dividing the amount into two injections. The twice daily regimen gave a 20% higher serum IGF-1 level. Notice that they gave 2/3 at night and 1/3 in the morning to more closely approximate the natural circadian GH pattern.

Clin Endocrinol (Oxf) 1994 Sep;41(3):337-43 Related Articles, Links


Metabolic effects of growth hormone administered subcutaneously once or twice daily to growth hormone deficient adults.

Laursen T, Jorgensen JO, Christiansen JS.

Medical Department M (Diabetes and Endocrinology), Aarhus Kommunehospital, Denmark.

OBJECTIVE: The aim of this study was to compare the metabolic effects of GH administered subcutaneously either once or twice daily. The actions of GH might depend upon a pulsatile pattern of serum GH. Pulsatile and continuous intravenous delivery of GH, however, induce similar short-term metabolic effects in GH deficient patients. An improved growth response is obtained in GH deficient children when a fixed weekly GH dose is administered by daily subcutaneous injections instead of twice or thrice-weekly intramuscular injections. A more pulsatile pattern and serum GH levels above zero might be achieved by further increasing the injection frequency. Increased daytime GH levels might, however, adversely affect the circadian patterns of metabolic indices, which have been demonstrated to be more successfully reproduced by evening compared with morning GH administration. DESIGN AND MEASUREMENTS: In a cross-over study, 8 GH deficient patients (age 16-43 years) were treated with 3 IU/m2/24 h of human GH. The dose was injected in the evening for 4 weeks and for another 4 weeks two-thirds was injected in the evening and one-third in the morning. At the end of each period the patients were admitted to the hospital for 37 hours. Steady-state profiles of GH, IGF-I, IGF binding proteins 1 and 3, insulin, glucose, lipid intermediates and metabolites were obtained following administration of 3 IU/m2 of GH (at 1900 h (one injection) and at 1900 and 0800 h (two injections)). RESULTS: Similar mean integrated levels of serum GH (mU/l) were obtained (7.46 +/- 0.84 (one injection) vs 6.46 +/- 0.62 (two injections) (P = 0.15)). Mean levels +/- SEM of serum IGF-I (micrograms/l) were significantly increased (P < 0.01) following two daily GH injections (330.3 +/- 48.1 (one injection) vs 399.1 +/- 53.0 (two injections)). Serum IGFBP-3 levels were not significantly different on the two occasions, while levels of the GH independent IGFBP-1 (micrograms/l) were slightly but significantly lower following twice-daily GH injections (1.61 +/- 0.42 vs 1.13 +/- 0.56, respectively (P < 0.04)). The pattern of IGFBP-1 was opposite to that of insulin. Similar levels of insulin and glucose were obtained with both GH regimens, while levels of non-esterified fatty acids were significantly higher following once-daily GH injection (P < 0.001). CONCLUSIONS: Twice-daily GH injections, apart from producing a more physiological serum GH profile, were superior to one injection in increasing serum IGF-I and decreasing IGFBP-1 levels. Both of these changes tend to amplify the effects of the administered GH. Twice-daily injections, however, resulted in lower night-time levels of lipid intermediates.

I just posted a bunch of stuff a while back over at anasci about IV GH. I'll see if I can go over there and get it. As for evening GH, there are quite a few studies showing it improves growth and nitrogen retention during replacement therapy. It is probably not the optimal way to administer if you are trying to preserve some semblance of a normal pattern on a low dose regimen, but for large doses where you don't care about your own GH, evening is optimal. Here is an abstract from a review article:

Horm Res 1990;33 Suppl 4:77-82 Related Articles, Books, LinkOut


Pharmacological aspects of growth hormone replacement therapy: route, frequency and timing of administration.

Jorgensen JO, Moller J, Moller N, Lauritzen T, Christiansen JS.

Second University Clinic of Internal Medicine, Aarhus Kommunehospital, Denmark.

Two or three weekly, daytime intramuscular injections of GH has been the traditional treatment of GH deficiency since the first studies. A recent reevaluation of the feasibility of subcutaneous GH injections revealed no side-effects, but a very strong preference by the patients for the subcutaneous route, and also an increase in growth rate in studies where the patients received daily injections given in the evening. That could indicate that the route, frequency and timing of GH administration may be of clinical importance. Subcutaneous injections result in a slower absorption, a smaller peak value, and a prolonged serum disappearance phase compared to intramuscular injections. This extends the periods of elevated serum GH levels in the patient, which might be advantageous. On the other hand, a reduced bioavailability of GH by the subcutaneous route has also been reported. The frequency of subcutaneous injections correlates positively with growth rate in animal studies. This is commonly ascribed to a closer resemblance to the endogenous pulsatile pattern. However, frequent subcutaneous injections do not induce a pulsatile pattern, but a pattern which is intermediary between continuous and true pulsatile administration. In a short-term patient study, we observed that pulsatile and continuous intravenous administration of GH generated identical increases in serum insulin-like growth factor I, which suggests that both pulsatory and constant, small elevations in serum GH are important for its actions. Concerning the time of administration, evening GH injections yield a more physiological pattern, and it has been shown that evening GH administration induces increased nitrogen retention and is more successful in normalizing circadian patterns of pertinent hormones and metabolites
This study might help. The previous study showed that 2 injections is better that 1, and this one shows 8 is better than 2 and just as good as a continuous infusion. I would ask myself how many times a day am I willing to inject? If 8 then so be it; you could replicate the conditions of this study. They just gave IV boluses (boli?) so shoot it all in at once. They used 2 IU per day divided into equal doses. I think I have only done 3 GH cycles in my life so I am not an expert on doses. I get way more for my dollar from AAS and insulin for size, and T3 + clen for cutting. But that is irrelevant to this discussion.

Here is what I would do. I like the fact that the previous study used the larger dose at night. That agrees with the other research showing evening doses are the most anabolic. Suppose you run 6 IU per day. Do 2 before bed IV, then 4 1 IU doses equally spaced during the day. This sounds like a reasonable compromise. Since this is all speculation as to efficacy, you can alter the regimen to your liking. I would just keep the big bolus for bedtime.



J Clin Endocrinol Metab 1990 Jun;70(6):1616-23 Related Articles, Links


Pulsatile versus continuous intravenous administration of growth hormone (GH) in GH-deficient patients: effects on circulating insulin-like growth factor-I and metabolic indices.

Jorgensen JO, Moller N, Lauritzen T, Christiansen JS.

Second University Clinic of Internal Medicine, Aarhus Kommunehospital, Denmark.

The episodic and pulsatile nature of GH secretion in normal man is well established. Studies in hypophysectomized rats have indicated that pulsatile administration of GH is superior to continuous infusion in promoting growth, but similar studies have not yet been conducted in human subjects. We compared three different iv GH administration schedules in six GH-deficient patients. They were hospitalized three times for 44 h on three occasions, separated by at least 4 weeks without GH treatment. On each occasion they received 2 IU GH, administered iv as either 1) two boluses (at 2000 and 0200 h), 2) eight boluses (at 3-h intervals starting at 2000 h), or 3) a continuous (2000-0200 h) infusion. Serum insulin-like growth factor-I (IGF-I) after eight boluses and that after continuous infusion were almost identical, with a steep increase reaching a peak at 2000-2400 h, followed by a steady decline. The total areas under the curve, expressed as mean levels (micrograms per L), were 147.6 +/- 11.8 (eight boluses) and 151.2 +/- 8.9 (infusion; P = NS). The change with time in IGF-I after the two-bolus regimen differed significantly from that in the other studies (P less than 0.001), displaying only a modest increase, as also reflected in a smaller area under the curve of serum IGF-I (125.3 +/- 8.7 micrograms/L; P less than 0.05). No differences in blood glucose, serum insulin, or plasma glucagon were observed when comparing the three studies. Both blood glucose and serum insulin tended to be elevated during the second night of each study. Almost identical fluctuations were recorded in lipid intermediates in the three studies, with nightly elevations being more pronounced on the first night. Alanine and lactate exhibited nearly identical patterns in the three studies and were characterized by low nocturnal levels. These data indicate that small but frequent iv boluses and continuous infusion of GH are equally effective in generating an increase in IGF-I in GH-deficient patients, whereas the same amount of GH given as two large boluses results in a significantly smaller increase in IGF-I. This could mean that a prolongation of the period during which serum GH is above zero in GH-treated subjects is just as essential as pulsatility for the growth-promoting effects of the hormone.




Last edited by Nandi12 on 08-31-2002 at 01: