These features are identical to those experienced by people suffering from the disease acromegaly, which is caused by tumors producing high levels of GH in an unregulated fashion.12 Acromegaly is similar to gigantism, a disease state which begins in childhood, resulting in extreme height and features of acromegaly. The primary difference is the lack of effect of acromegaly on height, as the growth plates of adults are fused, preventing further height changes.

The question might be raised “Why use so much GH and could less be used?” It’s impossible to say who started using GH, but it’s likely the first bodybuilders mimicked the doses used to treat dwarf children who are very short due to GH deficiency. These children are provided weekly with 0.3 milligrams per kilogram (2.2 pounds bodyweight); extrapolating those numbers to massive adult bodybuilders’ size results in a daily dose of 15–25 IU per day.13

Obviously, some bodybuilders have exceeded even those numbers as the price of GH has dropped with the introduction of Asian imports. The high dose of GH is desirable, or was in the days of size for size’s sake, because the anabolic effects of GH are dose dependent. The more GH used, the larger the muscles (head, organs, hands and feet) grew.14 However, as has been seen on stage and in the clinical realm, exceeding a reasonable dose of GH can lead to problems.