The biologic actions of endogeneous growth hormone (GH) depend on its secretion and clearance rates as well as sensitivity at the receptor level. Aberrations in GH pharmacokinetics and pharmacodynamics may occur with increasing age, and have been implicated in diseases such as obesity, diabetes mellitus, and critical illness. In this review, recent insights into the association between GH metabolism and age, body composition, binding proteins and other hormones are discussed. Copyright 2002 Elsevier Science Ltd.