Growth Hormone Secretagogues: A New Path for Hypogonadal Men's Body Composition

Hypogonadism, a condition characterized by insufficient sex hormone production, often leads to adverse changes in body composition, including increased fat mass and reduced lean muscle. While androgen replacement therapy is the cornerstone of treatment, it may not fully address all aspects of body composition or may have contraindications for some patients. This review explores the potential role of growth hormone secretagogues (GHS) as an adjunctive or alternative strategy to improve body composition in hypogonadal males.

The review highlights that GHS can significantly improve body composition in populations with GH deficiency or age-related decline, which often overlaps with hypogonadism. Studies discussed indicate that GHS therapy can lead to a significant reduction in fat mass, with some reports showing reductions of 10-15% in visceral fat over 6-12 months. Concurrently, there is evidence of an increase in lean body mass, with some trials reporting increases of 2-5 kg in muscle mass. Furthermore, the synthesis of data suggests improvements in bone mineral density, with increases of 1-3% at the lumbar spine. These benefits are often accompanied by improvements in strength and exercise capacity, suggesting a broader metabolic impact beyond simple weight changes. The most important finding is the consistent evidence that GHS can independently and synergistically improve body composition metrics, including a ~12% decrease in total fat mass and a ~4 kg increase in lean body mass, even in contexts where androgen therapy alone might be insufficient.