It seems like the controversies over human growth hormone never to end.

A couple of weeks ago, a Nevada physician was acquitted of illegally prescribing growth hormone to his patients. The Olympic Committee is worried about growth hormone. Sylvester Stallone was busted with human growth hormone. ABC news claims it’s the secret to eternal youth.

Professional baseball is embroiled in a growth hormone scandal over a banned substance that doesn’t work if taken orally and doesn’t “juice” the way testosterone and pure anabolic steroids do. The Mitchell report came out yesterday. I’m still chewing through it since it’s over 400 pages. All it seems to be is one tedious tale of how players obtained steroids and hormones after another. The list of players involved is extensive, but the report does little to demonstrate that it mattered. To Major League Baseball the simple question is whether players used hGH because it was against the rules.

It’s definitely against the rules for pro-athletes, but because of odd twists of law even medical professionals who understand growth hormone deficiency have trouble figuring out whether it’s legal or not. It turns out that it is legal to use to replace growth hormone for people truly deficient, but the exact means needed to satisfy the legal requirement is fuzzy. It may be that an examination and history by a physician is enough to meet the requirement. Diagnosis might require labs though there is some question as to which blood levels are the right levels to follow.

So what are patients and physicians to do? How can doctors tell whether their patients are truly deficient of growth hormone or suffering some other complication?

Well, the American Academy of Anti-Aging Medicine holds regular physician training. The problem is, this organization has some controversies and by some is considered outside the mainstream.

The more widely accepted group, The Endocrine Society has a policy statement on growth hormone, including extensive clinical guidelines. Sticking to these guidelines will no doubt keep physicians in the clear legally.

There are other sets of guidelines to be sure. There are also more aggressive approaches based on published medical articles. Depending on how much legal risk the physician is willing to take on, they might be more aggressive than just the Endocrine Society guidelines.

Regardless, the evidence and clinical opinions are clearly adding up. Replacement of human growth hormone for patients with real, documented deficiency is absolutely an accepted practice by physicians trained enough to understand the deficiency syndrome.

I’ll talk more about growth hormone deficiency later. Despite what the media might portray over the coming days because of the Major League Baseball scandal, use of human growth hormone in medicine is legitimate, real and in no way “juicing.”