HGH - Optimal Dosing Practices - Best Titration Method for Adults

The Optimal Dosing of HGH for Adult Growth Hormone Replacement

Norditropin HGH pen 10mg / 30Iu

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The Optimal Dose of Human Growth Hormone injections for Adults

The optimal dose of HGH when treating adults typically ranges between .34mg (~1 IU) to .67mg (~2 IU).

After treating thousands of adults with growth hormone replacement at the Anti-Aging and Wellness Clinics in Costa Rica and Mexico since 2013, we generally find the sweet spot (optimal dosing of HGH replacement therapy) falls within that range. 

Once growth hormone deficiency is diagnosed in an adult, it is treated with a growth hormone replacement therapy protocol using HGH, diet, and exercise. Periodically, treatment must be monitored with standardized blood tests measuring the biomarker Insulin-like Growth Factor 1 (IGF-1). Practitioners use this marker to identify the amount of growth hormone levels achieved from the HGH injection dosage prescribed. This amount is titrated until the optimal “physiological” level of IGF-1 circulates in the bloodstream.

Titration of Growth Hormone (hGH) until Best Therapeutic Levels are Reached

To titrate growth hormone means to gradually adjust the dosage of a medication or other treatment in order to achieve the desired effect or to maintain a certain level of the substance in the body. This is often done in a controlled and systematic way, using a process called titration.

Titration is a method used to determine the optimal dosage of growth hormone circulating in the body. It begins with a small initial dose and gradually increases over time until the desired effect is achieved as confirmed in blood tests. This allows healthcare providers to carefully monitor the patient’s response to the treatment and make adjustments as needed to ensure that the treatment is effective and safe.

Titration is often used when starting growth hormone therapy or treatment, or when adjusting the dosage of an existing treatment that has shown to be ineffective or has side effects.

Titrating growth hormone is an important tool for ensuring that patients receive the optimal amount of treatment, and can help to minimize the risk of negative side effects or other adverse reactions.

HGH treatment should be started at a low dose, i.e. about 1.0 IU/day, and increased gradually, by about 0.5 IU per month, until the target dose is reached.

Historically, patients feel best when their IGF-1 range is in the upper physiological part of the range. This is at or near 300 NG/ML as measured in an IGF-1 blood test.

Popular Method for Indirect Assay of HGH and IGF-1

Pituitary Description of Blood Test IGF-1 Range ng/mL
IGF-1 IGF-1 levels are directly related to growth hormone secretion and/or HGH therapy. Best levels for healthy adults is in the upper physiological range (290-315ng/ml). Some patients will require HGH dosage adjustments to achieve optimal levels of IGF-1. 200-320 ng/ml

The HGH / IGF-1 table above was reconstructed from the book Dr. Jeffry S. Life, M.D. Ph.D., The Life Plan: How Any Man Can Achieve Lasting Health, Great Sex, and a Stronger, Leaner Body, Edition May 2011, page 323.

Avoiding Excessively High Levels of Growth Hormone in Older Adults

It is important to receive treatment for growth hormone replacement from a qualified medical team to reduce the risk of side effects. Inexperienced users not seeking appropriate medical advice often take excessive amounts of HGH injections. This can lead to dangerous side effects. 

It’s important to monitor and not exceed the upper physiological range of IGF-1. High levels of IGF-1 may put you at an increased risk of certain types of cancer, such as breast, prostate, or colon cancer, as well as other health conditions. While low levels of IGF-1 may indicate a deficiency or imbalance in the body’s growth and development processes or may be a sign of poor diet or other health problems. 

The optimal dose of HGH was shown to reduce the negative effects of PD1 biomarker level, reducing the risk of cancer by boosting immune system function. See more on the TRIIM Protocol.


Licensed international medical clinics in Costa Rica and Mexico offer the same FDA-approved HGH at much lower cost than the United States. Costa Rica is a top location for adult growth hormone therapy due to its world-renowned healthcare system, medical tourism reputation, and proximity to the United States.

Costa Rica has direct flights daily from Atlanta, Miami, Orlando, Dallas, Houston, and New York. Our doctors hold dual citizenship (US/Costa Rica). Save thousands by getting your prescriptions through us. Same medicine, same manufacturers, without the inflated prescription drug prices in the USA. 

HGH Injections – Optimal Dosing for HGH Replacement

HGH Injections and proper dosages have long been considered an important part of proper compliance for growth hormone replacement therapy. Unlike testosterone and other injectable therapies, HGH must be injected frequently, usually once daily. Doctors will differ on the number of HGH injections days per week, but at present, the consensus is 5-daily injections per week, with two days off.

HGH Injections – What’s the Difference between 191 AA HGH and 192 AA HGH?

Another concern related to HGH Injections and Dosages relates to the type of molecular structure of HGH. Originally, dating back to 1958, HGH was 100% bioidentical, but it was harvested from cadavers. Obtaining HGH from cadavers was obviously very labor intensive and time-consuming. It also posed the risk of spreading diseases from the host. Eventually, genetic engineering allowed for mass production of (synthetic) HGH in the laboratory around 1985. Soon thereafter, HGH prescriptions were all of the synthetic type and it was no longer harvested from cadavers.

When it was discovered HGH could be mass-produced through genetic engineering, the first synthetic versions of the medication were 192 amino acid (AA) HGH. Natural HGH circulating in our bodies consists of 191 amino acids (AA). However, in the 1980s, the technology wasn’t perfected enough for manufacturing true 100 % bioidentical synthetic HGH. The 192 AA HGH did work but came with the risk of the body rejecting a part of it as foreign. That is, in many instances, depending on the length of time used, eventually, the 192 AA HGH would cause the body to begin developing antibodies (a resistant reaction to the effect of HGH). Over time, once antibodies are created, the body begins developing a tolerance to the HGH, reducing its efficacy.

Watch our doctor explain the Norditropin HGH Pen. Click button above to see video. See both Norditropin Nordilet and FlexPro Pen Versions, including dosage charts.


By the mid-1990s, most HGH manufacturers in the industrialized world improved lab technology to a level that permitted 100% bioidentical HGH of 191AA to be reproducible. The risk of developing antibodies (resistance) from 191AA HGH is virtually none.

The only main concern with 192AA HGH in the modern era usually is when it is purchased as a generic on the black market, like from some unknown sources overseas. Why? Well, 192AA HGH is much less costly to produce, so generics and bootleg versions of HGH are more than likely to be made of the 192AA variety, and not the 100% molecular equivalent HGH circulating within the body.

HGH Injections – Normal consensus calls for 5 days of injections with 2 days off.

Now most physicians prescribe HGH injections for replacement therapy as follows:

  • A daily dosage of 1 or 2 IUs per injection.
  • Injected in the late evening to mimic the body’s natural growth hormone secretion cycle.
  • Injected 5 days per week, with two days off.

Research suggests, for adults being treated with HGH replacement therapy, this may not necessarily be the most effective protocol. In fact, an argument can be made that injecting HGH 5 or more days per week may reduce some of its benefits.

In 1994, a Korean study looked at 28 patients over a 12-month period.  All participants selected for the study were adults with human growth hormone deficiency. Each subject had been diagnosed after 20 years of age. The study separated the participants into three groups:

  • Group 1: They were given HGH Injections 3 days per week.
  • Group 2: They were given HGH Injections 7 days per week.
  • Group 3: This group was given a placebo.

The dosages given to the two non-placebo groups were as follows:

  • Group 1 / 3-Day: 0.18 units/kg/week. (Approx. 4 IU per Injection).
  • Group 2 / 7-Day: 0,42 units/kg/week. (Approx. 4 IU per injection).

Blood exams were taken frequently to monitor HGH levels, lipids, and other biomarkers. The results of the study were surprising, as in many biometrics tracked, the 3-day HGH injection group saw more benefit. The key results break out as follows:

Weight: In all three groups, the body weight remained virtually the same.

Lean Body Mass: The 3-day HGH injection group added 2.8kg of lean muscle mass. The 7-day HGH injection group added 2.9kg of lean muscle mass. Not a significant difference.

Body Fat Reduction: The 3-Day HGH Injection group saw a 1.5% reduction in body fat, while the 7-day HGH injection group saw a 2.8% reduction in body fat. This seems to be the one metric where injecting HGH 7 days per week benefits you over injection 3 days per week. See the discussion below.

Lean Thigh Mass: The 3-day HGH injection group saw more increased muscle mass in their thighs, while both the 7-day HGH injection group and the placebo group saw no measurable increase. For men, this may be of interest, since larger thigh muscle mass is often associated with higher serum testosterone levels.

Exercise Capacity: The 3-day HGH Injection group saw increased exercise capacity over the 7-day HGH injection group and the placebo group.

Bone Mineral Density: No group saw an increase in bone mineral density. However, since the study was a relatively short 12-month study, it’s not significant. HGH use has been shown to increase bone mineral density in other studies of longer length and with 191AA HGH.

Cholesterol / Lipid Profiles: None of the groups saw any significant improvement in cholesterol and other lipids. However, this study was done in Korea using the Korean population. Their diet is much different than the Standard American Diet (SAD), and other western culture diets, so more than likely their cholesterol levels and lipids were already relatively good, so not a lot of improvement could be made anyway.

Discussion on HGH Injection Frequency and Dosage

As the 1994 study shows us, when it comes to HGH injections, more is not necessarily better. In fact, it may impede athletic performance. Although more investigation is required, it is possible that too high a dose too frequently injection may produce a limited amount of HGH resistance. It’s very natural for the body to block high levels of any physiological event. We know this from a growing number of insulin-resistant pre-diabetes epidemics we now see unfolding in modern society due to frequent over-feeding, creating high levels of hyperinsulinemia.

The one major difference between the two groups was in body fat reduction. The 7-dau HGH injection group saw a 2.8% decrease in body fat, whereby the 3-day HGH injection group only saw a 1.5% reduction. Besides this difference, those on a limited budget may find injecting HGH 3 – 4 days a week will save you money and will save you money. For those concerned about the fat loss component, you can work with one of our practitioners on the HCG Diet or HCG Fast Diet program.

HGH Injections in Children Dosages and IGF-1 Axis

In other studies, higher doses of HGH have been shown to increase idiopathic short stature (ISS) in children. One such study done in 1988, investigated 223 patients divided into three groups.

Group 1: 3 IUs per day, 6 days per week.

Group 2: 4.5 IUs per day, 6 days per week.

Group 3: 3 IUs per day, 6 days per week for year 1, then 4.5 IUs per day, 6 days per week thereafter.

Growth was compared among the three groups.

Year 1: Height velocity doubled in the 4.5 IU per day group over the 3 IU per day group. In the second year, height velocity no longer changed among the groups, as they were all taking similar dosages at that stage. Other similar studies have been done in children and generally, show similar results.

The conclusions of the study stated the following:  During 4 years of rhGH therapy, growth and final height prognosis improved, slightly more with 4.5 IU/m2 than with 3 IU/m2 or 3 to 4.5 IU/m2. However, bone age advanced on average of 4.8 years during this period; therefore, any effect on final height will probably be modest.

Because of studies such as these which were done with children, many physicians and practitioners still think higher IUs mean better results. However, differences between children’s studies and the adult human growth hormone study done in Korea give us clues as to why children may benefit from higher dosages for short-duration use versus adults. It is likely due to the higher IGF-1 Axis and its growing impact on bones.

When growth hormone increases combined with high protein diets, IGF-1 increases from growth hormone metabolized in the liver, but also from high protein metabolism. However, other research suggests that IGF-1 may be pro-cancer and pro-aging in adults, while lower IGF-1 may be of benefit for aging adults. Since children’s bones are growing, they benefit most from the IGF-1 conversion, while adults may benefit less from it.

Click the button below to download a pdf file of the Thrice Weekly Research Study.

What about Dosage of HGH for Fat Loss?

At our medical clinics, we generally see the best results with fat loss at an HGH dose between 1 and 2 IU. However, we can improve those results even further by also including a Saxenda Injection. Saxenda is a medical weight loss medication. It reduces hunger and increases energy metabolism. It is a GLP-1 class of medication. 

What Does Growth Hormone Stimulate

HGH stimulates protein synthesis in muscle tissue and the release of fatty acids from adipose tissue. This in turn helps to regulate body composition, muscle and bone growth, along with energy metabolism.

Detailed Steps – Growth Hormone Release Chart

The growth hormone release process begins when the hypothalamus releases growth hormone-releasing hormone (GHRH). GHRH stimulates the pituitary to release growth hormone. 

This begins two major metabolic activities:

Growth Effects: Increases uptake of amino acids from the blood and enhances cellular proliferation which in turn reduces cell apoptosis. This targets the muscle, bones, immune system, etc. 

Glucose-sparing effect: Stimulates adipose cells to break down fat in order to fuel growth. A similar effect is achieved from fasting. 

Feedback Loop: Growth hormone is metabolized in the liver resulting in insulin-like growth factor 1 (IGF-1). High IGF-1 signals received by the hypothalamus provide a feedback mechanism to downregulate further HGH production. Growth hormone-inhibiting hormone (GHIH) is released to inhibit the overproduction of growth hormone.   


Adults with HGH deficiency can benefit significantly from HGH replacement therapy. However, if too much concentration is placed on IGF-1 increases, then many can be missing the point in gaining maximum benefit from their therapy. In addition, HGH is the most expensive form of hormone replacement therapy.

Properly dosing to maximize benefit, is why patients should choose the right anti-aging medical group to support them in their treatment. Minimizing cancer risk is important by monitoring IGF-1 levels, diet and nutrition, and ensuring proper doses improve lean muscle mass, blood lipids, energy and other benefits as to be expected with HGH replacement therapy.

For those concerned mostly about managing fat loss. That is accelerated with the HCG Fast Diet program. It’s an intensive medically supervised weight-loss program using HCG, structured nutrition planning around macro-nutrients and incorporates fasting – like intermittent fasting and fasting-mimicking dieting. It’s more than just a normal diet, it’s a metabolic reboot focusing on accelerating fat loss using nutritional ketosis along with the HCG medication.

Get more information and speak with one of our age management experts on how we can structure an affordable program that works best for you and your budget.

Optimal dose hgh stimulation.

Traveling and Storage with Norditropin HGH

According to the Norditropin website, all Norditropin products must be refrigerated (36°F to 46°F) prior to first use.

Do not freeze and avoid direct light.

After the first injection, the pens can either be stored outside of the refrigerator (up to 77°F) for use for 21 days.

If stored in the refrigerator after first use the Norditropen HGH pen will last for 4 weeks. The temperature range should be between 36°F and 46°F.

Never place your pens in a freezer.


A typical month's supply will cost $450. The same HGH from the same manufacturer in the USA will cost 3 times more. The leading brand of human growth hormone now in Mexico and the United States is Norditropin. Norditropin is the only leading pharmaceutical brand of growth hormone that comes premixed. It can go 14-21 days without refrigeration due to the proprietary preservation technology of Novo Nordisk.
HGH is three times or more in the United States than in many other countries. The main reasons for this are 1) pharmaceutical middlemen called "Pharmacy Benefit Managers" (PBMs) and the list-pricing strategies set by big-pharma companies. Please see for more information on Pharmacy Benefit Managers work in the USA on our "why is HGH so expensive in the USA?" You can ask Google, Siri, or Alexa and our page will be at the top of the list.
We only prescribe name-brand "FDA Approved" pharmaceutical HGH from major manufacturers like Novo Nordisk, Pfizer, and Merck. In the modern era with Google search and social media, these black market online internet pharmacies are rapidly exposed. We use real doctors and we promote our doctors. You get to know them and they get to know you. They are professionals and they want you to be healthy so that you tell others about our services. Unfortunately, the United States health care system is broken. It's too expensive for insurance to cover HGH treatments, so they've made it extremely difficult for patients to qualify. Metabolic health related to hormone decline with aging is not yet supported by the U.S. health care system. Insurance companies developed more on serving acute injuries, such as serving the needs of patients suffering from acute injury either by accident or a chronic condition. Insurance companies are less enthusiastic about metabolic wellness related to hormone decline, insulin resistance, and obesity. This leads to accelerated age-related chronic diseases like heart attacks, cancers, diabetes, and strokes. To a large degree, it is the primary reason health care expenditures amount to over 17% of the US GDP. We operate very openly on the internet and through promotional material like print media. We've advertised in Airline Flight Magazines, major Newspapers and on Television. We've been caring and treating medical tourists since 2013 from all over the United States and Canada. We only prescribe the same FDA approved pharmaceutical HGH brands that you find in the United States. The only difference is the USA must pay 2 or 3 times the price. Why? Because of big pharma's global pricing models and the problematic insurance model which exists in the United States. Both Republicans and Democrats have demonized big pharma for its inflated pricing, but nothing ever seems to get resolved.  Recently, some states have begun to take action. Utah recently passed "Right to Shop" legislation which allows its public employees to buy legally lower-cost prescription medications in Tijuana Mexico. Click the link. It is widely reported in some of the press. Other states are looking at similar legislation: . Mexico has very good control of their legal prescription drug programs.  We work closely with only the leading pharmaceutical companies. The process has a complete and safe chain of custody when it comes to name-brand prescription pharmaceuticals. 
No, it is not illegal to use human growth hormone with your doctor's prescription. HGH is an approved medication for certain medical conditions such as an HGH deficiency. It must be prescribed by your doctor. Border patrol, as well as the FDA, require international travelers to carry their doctor's prescription and keep the medication in its original packaging.
HGH begins working almost immediately. Most long-term improvements are seen within 3-6 months. Men given HGH from ages 61-81 were given HGH over a 6 month period. At the end of the six months, they had approximately 15% body fat loss, an 8.8% increase in lean muscle mass, and an increase in bone mineral density.
Most adults on our program range between 1-2 IU between 3-5 days per week. Common protocols call for one daily injection each evening 5-days per week. However, some research shows similar benefits may be achieved from a less frequent dosing schedule of only 3 days per week. Most adults on HGH replacement therapy will settle in between 1 and 2 IUs for each injection. HGH is further enhanced by following an intermittent fasting protocol. And for those who may be overweight and have some degree of insulin resistance, metformin may be prescribed. Berberine is also a good over-the-counter substitute. Most individuals on a 3-day injection dose will see a slower degree of fat loss. But when combined with intermittent fasting, metformin, and/or berberine, results on fat loss will accelerate in most individuals.
A one month supply of prescription HGH in Costa Rica will cost approximately $550 USD per month for Norditropin Growth Hormone.
HGH in the United States generally is three times the amount in Mexico, Costa Rica and Panama. Typical price for one month's supply of HGH at a U.S. pharmacy is approximately $1,250 USD. Only name-brand (non-generic) versions of growth hormone are legal. Name-brand prescription medications are generally always 3 times more than in other countries because of the retail price set by large pharmaceutical companies and middle men known as Pharmacy Benefit Managers (PBMs). See our video at the top of this page.
Yes. As long as you have a prescription. If you are traveling internationally you will want a letter from the doctor. We have all of the legal paperwork from the major manufacturers so if TSA or US Border Patrol is concerned, you can show them the information. Keep in mind, according to the Center for Disease Control, most adults over 40 years of age are on 2 or more prescription medications. International travel would cease to function if you were not afforded the basic human right of crossing borders with your prescribed medications. Always carry your prescription and your letter from the doctor to avoid confusing border professionals and TSA.
No. HGH is not an anti-aging medication. What HGH does is it supports the growth pathways in support of normal energy metabolism. Growth hormone works closely with the regenerative growth cycle of your body. However, it is now much more understood that this energy state is not ideal 100% of the time. In order for patients to see the best benefits related to anti-aging at the cellular level, they need to understand what the research on longevity and aging shows. The body operates best with it goes through natural anabolism and catabolic states (i.e., feast and famine). This reproduces a growth, cleanse phase at the cellular level. HGH used in combination with metformin, and DHEA, did show an age reversal in epigenetic markers. The research was published in 2019. It is linked to on this web page. However, we think this study can be improved upon by mimicking some of the new research by Dr. Sinclair of Harvard and Dr. Valter Longo of USC. They both promote the benefits of triggering mechanisms that influence AMPK and mTOR. To key elements of the longevity pathways. They do this with time restricted feeding and in some instances metformin.
Currently nearly 590,000 Americans die each year from some form of cancer. What doesn't give you cancer? Probably one of the most associated element we would guess is related to cancer is poor energy metabolism. One of the major reasons HGH is criticized for potentially promoting cancer in adults is that it increases IGF-1. Elevated IGF-1 is often associated with those with cancer. It's an insulin like growth factor, so for a tumor, it is simply assumed its going to feed growth. To some extent, we agree. In an overfed, processed-food rich lifestyle, with poor glucose regulation, we think it is a reasonable fear people should have. But with that said, if you follow the recent works of researchers into aging and longevity like Dr. David Sinclair and Dr. Valter Longo, you learn that we need to be attentive to the AMPK/mTOR pathway. If you go to our Metfomin Blog page, you can learn a little about this pathway as well as how metformin is being studied as an anti-aging drug because of its ability to regulate this pathway for those eating and living the standard American lifestyle. Our goal is to help you understand as best you can what modern science is saying about this and its role in cancer. We are no longer living in the 1990s and this information is much better understood than ever before. With that said, we recognize there is much more research required to draw any conclusions. What we can say is that cancer is a big problem in the world, especially the United States. Those who are in better shape, have a better body composition, and have excellent blood markers are less likely to get cancer. Our role as a medical treatment center is to help you achieve this goal. We want to see your risk factors for all these age-related metabolic diseases decline.