A case report ties sermorelin and GH use to a neck bone spur

The report describes a 62-year-old former military recreational bodybuilder who came in with neck pain and left shoulder pain ¹. X-rays and an MRI of his neck showed wear in several places, including a prominent bony spur at C3-C4, the third and fourth neck bones, pressing on his esophagus, the food pipe ¹. When asked directly, he said he had occasional trouble swallowing with larger pieces of food ¹. He also reported a neck injury during jiu-jitsu training in 2001 or 2002, and about 20 years of using growth hormone from outside the body plus growth hormone secretagogues, substances that tell the body to release more growth hormone ¹. His reported use included cycles of somatropin, a form of growth hormone, a mix of Sermorelin research summary and GHRP-6 research summary, a peptide that also triggers growth hormone release, and ongoing nightly somatropin ¹. No swallowing test was done because his symptoms were mild and occasional ¹. The authors concluded that the case raises the idea that long-term growth hormone stimulation, combined with the old neck injury, may have helped create a clinically meaningful bony spur ¹.

This is a single observation, not a controlled comparison. The report does not give the dose, the length of use, or blood levels of growth hormone or IGF-1, a hormone that carries out many of growth hormone's effects ¹. The substance history was self-reported ¹. Those are the first limitations.

Sermorelin is a 29-amino-acid piece of growth hormone-releasing hormone, the natural signal that tells the pituitary gland to release growth hormone ². Controlled trials show that nightly injections raise overnight growth hormone secretion and IGF-1 in older adults ³. One 16-week trial used a nearly identical compound in older men and women. It found changes in hormone levels, slightly lower cholesterol, and small changes in lean mass and fat mass ⁴. That trial did not measure bone structure or bony spur formation ⁴.

Early studies with GHRH(1-29), the same type of piece, given twice daily to old men, reversed the age-related drop in growth hormone and IGF-1 ⁵. Studies in children who could not make enough growth hormone showed that treatment sped up height growth, but they measured height speed, not bony spur formation ⁶. A 2017 study of men with low testosterone found that growth hormone secretagogue treatment raised IGF-1, and the study did not report any bone imaging ⁷.

Reviews of growth hormone secretagogues note that the effects on body composition are modest and that safety data beyond a few months are not available ⁸. The existing literature on sermorelin focuses on hormone levels and body composition, and the reviews do not list bony spur formation as a reported side effect ⁹. The new case report therefore sits outside what the clinical trials measured. The trials were short, and their participants were not chosen because they had neck degeneration or long-term growth hormone use. That does not make the hypothesis false; it makes it untested.

The patient used both outside growth hormone and a sermorelin and GHRP-6 combination, so the specific contribution of sermorelin cannot be isolated ¹. Sermorelin works through the growth hormone-releasing hormone receptor on the pituitary gland, while GHRP-6 works through the ghrelin receptor, a receptor linked to hunger that also triggers growth hormone release, and both raise growth hormone pulses ¹². Outside growth hormone bypasses the pituitary's feedback controls entirely, so it is a different exposure ⁴.

The limitation is the design: one patient, a self-reported substance history, a neck injury from 2001 or 2002, and no objective swallowing test ¹. The case cannot separate long-term growth hormone stimulation, the old injury, or ordinary wear of the spine as the cause of the bony spur. At presentation, the patient was also using somatropin every night, which means the active exposure was outside growth hormone, not a secretagogue ¹. That further weakens any inference specifically about sermorelin.

To move from a hypothesis to evidence, researchers would need studies that follow people over time or compare groups, with the same neck imaging for everyone, measurements of growth hormone and IGF-1 exposure, and scans read by people who do not know each person's history. No such study exists. The growth hormone and IGF-1 system promotes growth, and acromegaly, a condition of too much growth hormone, is a known model of bone overgrowth, but that is a state of sustained, disease-level growth hormone excess ¹¹. The case report did not include blood levels of growth hormone, IGF-1, or bone turnover markers, and the dose and length of use of each substance were not independently verified ¹. Most of the data on GHRH analogs come from short trials of 16 weeks or less, which would not capture slow bony spur growth ⁴.

The direction of the available evidence leans toward hormone and metabolic effects, not structural bone changes. A single case report does not shift that direction, but it does identify a question worth asking in longer observational studies.

Recent reviews of injectable peptides in sports medicine and orthopedics describe the evidence for growth hormone secretagogues as limited, and they note that safety data are short-term ⁹. A 2020 review of growth hormone secretagogues in men with low testosterone notes that these agents raise IGF-1 but stresses that long-term safety has not been established ¹⁰. A 2026 review of therapeutic peptides in endocrine conditions discusses growth hormone stimulation and lists possible concerns, but it does not report neck bony spur formation as a documented outcome ¹¹. The absence of a documented outcome in these reviews does not prove it never happens, but it places the case report outside the current evidence base.

The case report itself does not claim causation. It uses the phrase "raises the hypothesis" and recommends non-surgical care and screening for trouble swallowing in patients with neck spine wear who report use of muscle-building substances ¹.

The available evidence cannot say whether long-term growth hormone stimulation at typical doses speeds up neck bone spur formation. It cannot say whether sermorelin adds anything beyond outside growth hormone or beyond the old neck injury. It cannot say whether screening for trouble swallowing in symptom-free long-term users would change outcomes. The case report is a starting point for a hypothesis, not a demonstration of causation.