Growth hormone (GH), also known as somatotropin, is a member of a family of growth factors that includes prolactin, placental lactogens, proliferins, and somatolactin. It is synthesized primarily by somatotropes in the anterior pituitary and is stored in secretary granules. The pulsatile release of GH into circulation is regulated by the concerted actions of the hypothalamic hormones - GH-releasing hormone (GHRH) and somatostatin (SST) - as well as by signals from the periphery - ghrelin and leptin. Human GH is a pleiotropic cytokine that exerts its biological actions by binding to the transmembrane GH receptor, which is present in many cell types. GH stimulates the liver and other tissues to produce IGF-1, which regulates growth and metabolism. GH has also been shown to have direct effects on growth that is independent of IGF-1. GH, directly or indirectly via IGF-1, can act on B cells, T cells, NK cells, macrophages and neutrophils to exert immunomodulatory activities. In addition, GH can act directly on various cell types to induce lipolysis, lactation, amino acid uptake and protein synthesis.