“Most people think of HGH as the miraculous treatment for children doomed to dwarfism, which over the past 30 years has saved tens of thousands from this fate. The next great benefit of HGH therapy appears to be in the aging population. People with age related deficiency of HGH become fat, flabby, frail, and lethargic, lose interest in sex, have trouble sleeping, concentrating, remembering things, tire easily, and in general, lose their zest for life. With HGH, all these so-called signs of aging are reversed.”
The following articles and information on Human Growth Hormone (HGH) are provided for your examination. At NBH Lifetime Health, we prefer to call HGH the “healing hormone” as this more appropriately describes its functions in the areas of preventive and anti-aging medicine. The more research that is conducted on this hormone, the more we find support for its use under the supervision of a medical clinic.
It should be noted that unlike certain hormones such as testosterone, thyroid and progesterone, where results can be seen in as little as 30 to 60 days, HGH is not a “quick fix. One can expect dramatic results – but only after a minimum of 6 to 12 months. Recent studies show that a decrease in body fat can take up to 12 months. The studies also show decreases in the incidence of diabetes and cardiovascular morbidity occur after 12 months.
In other studies, a full 12 months was necessary to realize the full effect of increased exercise strength and endurance (19% increase). Many studies show a decrease in cholesterol, apolipoprotein B, and increased HDL after 6 to 12 months.
HGH is a FDA Approved Drug
In August 1996, the FDA approved HGH for use in adult patients for the first time. Before this, it was only authorized for use to promote growth in HGH deficient children. The new indication is for “SDS,” or somatotropin (growth hormone) deficiency syndrome, as a result of pituitary disease, hypothalamic disease, surgery, radiation therapy or injury.
In effect, the FDA approval covers the use of HGH for anti-aging purposes since low levels of HGH or IGF-1 indicate a failure of the pituitary to release adequate amounts of this vital substance. In addition, the signs of SDS, such as decreased physical mobility, lower energy, higher risk of cardiovascular disease, are exactly the same as those seen in aging adults with low HGH levels. The FDA approval for HGH in adults means that any provider may now prescribe it to their HGH deficient aging patients without fear of practicing outside of conventional orthodox mainstream medicine.
Article written by Dr. Neal Rouzier, author of Healthy Aging
For years I have awaited the results of a study by Mark Blackman, M.D., once the Chief of Endocrinology at John Hopkins and now a director of The National Center of Complementary and Alternative Medicine at the NIH. I considered this provider to be the leader in growth hormone research, a superb scientist and an excellent speaker on HGH. The long anticipated results of his study on HGH appeared in the November 13, 2002 issue of JAMA. Dr. Blackman has studied hormones extensively and is a strong supporter of HGH for the prevention of deterioration that accompanies aging.
I was hoping that his study would put HGH on the front page of newspapers and quiet the fears and concerns of providers who remain skeptical. Unfortunately, it didn’t. In fact it made the situation worse. The good points of the article were that HGH was beneficial in increasing lean body mass, decreasing fat mass, increasing muscle strength and enhancing endurance. The problem was that HGH was termed dangerous due to side effects (edema and arthralgia) and the risk of causing diabetes in a few men. Past studies have shown that high doses of HGH can raise blood sugar and cause insulin insensitivity.
The purpose of this review is to dispel the fears, explain why the researchers found side effects, and to give a synopsis of the 300 plus articles I have recently and diligently reviewed. Keep in mind that this is just one study out of hundreds of studies and must be looked at accordingly. My systematic review will first summarize Dr. Blackman’s article and secondly compare it with other studies.
Dr. Blackman’s study reconfirmed what all other studies have shown: HGH and sex steroids improve body composition, strength, muscle mass, endurance and decrease visceral fat and total percent body fat. This comes as no surprise as this is precisely why we recommend HGH.
The problem was the high frequency of side effects: carpel tunnel pain, edema, arthralgias and glucose intolerance, are the identical dose-related, side effects that have been reported by previous studies. The starting dose of HGH used was 30 ug/kg or about 2.4 mg for an 80 kg man. This equates to a daily dose of 1mg/day, but it was given as the higher amount of 2.4 mg per each dose. The average dose we use is 0.2mg/day and increase to 0.4mg/day after one month. It is obvious that a much higher dose given less frequently should cause symptoms and it did.
Dr. Papadakis reported the same benefits and side effects in her article in the Annals of Internal Medicine five years ago. The problem in both studies is that they used HGH at such high doses and only three times per week! Anyone who has ever responsibly prescribed HGH would expect these types of side effects at such high doses. Many of us who prescribe HGH know that using smaller doses given daily will avoid such side effects. I have been teaching this technique to providers for five years and rarely have I encountered problems. The rare side effects are eliminated by dose adjustment.
Out of the hundreds of providers that I know prescribing HGH, I know of no one that prescribes HGH at this high of dose nor at only three times per week. Moreover, HGH manufacturers recommend daily injections, rather than one injection three times a week. The PDR also recommends that all HGH be dosed daily. If most providers prescribe daily injections without problems as the PDR recommends, why do these world-renown scientists use high doses three times weekly? Simply because that is what had always been done in past studies.
To me, it seems absurd and a waste of time, money, and expertise to conduct a study using doses sure to cause side effects. Mitchell Harman, M.D., who co-authored this study, is aware that providers throughout the world prescribe HGH daily and in smaller doses seemingly without problems and that this is the method that should be studied. However, in order to keep in concert with other studies, they continued to study HGH at the wrong dose and in the wrong method, in spite of a plethora of experience and information to the contrary. Had the dosing regimens been different, I’m sure the study would be viewed in a more positive light.
One must thoroughly understand HGH and the different dosing regimens to understand why this study is flawed. Hopefully one day a pharmaceutical company will give a grant to repeat the study using the correct and agreed upon dosing — only then would the results truly reflect HGH therapy.
An interesting and significant change instigated by Dr. Blackman was to not study adults with HGH deficiency, but rather healthy adults. An article in JAMA 2000;284:861-868 showed that adults over age 40 typically have 75% less growth hormone than younger adults. Although by definition this is not a true deficiency, most of us consider 75% less hormone a significant decline.
All studies up until now have only studied adults with a confirmed laboratory deficiency, whereas Blackman studied everyday, normal adults, which happens to be the group most often found to be taking HGH. I can’t help think that this study could have shined among the rest had it followed proper dosing. Medicine is anecdotal by nature and if patients have been successfully treated without problems, then it should be studied in that fashion, not in a way that has previously been shown to be problematic.
Since edema and arthralgia are dose related and can easily be corrected by dose adjustment, it’s considered only a minor problem. But what about the diabetes issue? Most studies document insulin resistance for the first 3 months with normalization thereafter. Most studies also note a decrease in visceral fat in 6-12 months, which improves insulin sensitivity. Blackman’s study was for only 6 months.
There are many studies documenting a significant decrease in cardiovascular disease, which is the overall goal. There are recent studies documenting improvement in HgBA1C, which indicates an improvement in diabetes, not a worsening as suggested by Blackman’s study. Again, I believe that the incorrect doses and the short duration of the study are responsible for the few reported cases of glucose intolerance. I tend to trust the multitude of long-term studies showing no trend towards diabetes, only protection against diabetes.
I believe that Dr. Blackman should be criticized for several things in addition to the dosing of HGH. First he used injectable testosterone at 100mg every 2 weeks. This certainly was not physiologic, but necessary to assure compliance. Secondly, he did not allow his subjects to exercise.
Any athlete knows that HGH and testosterone greatly enhances strength and endurance when exercise is permitted. I’m sure Blackman’s results would have been much better had exercise been allowed. Finally, Dr. Blackman should be embarrassed for using 10mg of the cancer causing medroxyprogesterone in the female subjects. First, 10mg far exceeds the average dose and second, Dr. Blackman should know the benefits of using natural progesterone over Provera.
Had I known their protocols in advance, I would have easily predicted the outcomes and could have written their paper for them. Even though there were great benefits from HRT use, I would have correctly predicted the side effects based on the high doses used and the incorrect method of administration. I would really like to design another study using the hormone replacement method that we use daily in our practice as opposed to the method they employed. Yet, that is the difference between clinicians and academicians. Unfortunately, because they have no insight into the inadequacies of this study, there are clinicians who will be hesitant to recommend HGH based on its conclusions. To me the study was worthless since it didn’t tell us anything new and it made it more confusing for those unfamiliar with HGH and the appropriate treatment protocols.
An article by Lewis Blevins (The Endocrinologist 2002; 12:405-411) reviews HGH and the beneficial effects in muscle strength, exercise capacity, bone remodeling, psychological well-being, fat reduction, and many other factors that prevent cardiovascular disease. He comments on new dosing regimens that maximize the benefits of HGH while minimizing the adverse effects. The decrease in body fat took up to 12 months and resulted in a decreased incidence of diabetes and cardiovascular morbidity.
Many studies also show a decrease in cholesterol, apolipoprotein B, and increased HDL. A full 12 months was necessary to realize the full effect of increased exercise strength and endurance (19% increase). There was a 15% increase in bone density, greater than that typically seen with estrogen or biphosphonate therapy. Most importantly, there was significant improvement in quality of life and vitality.
Dr. Blevens, a professor of endocrinology at Vanderbilt, warns that HGH dose must be individualized. Doses are given daily to avoid side effects(!) and HGH is initiated at .1 to .2 mg/day (which is exactly what we do, yet what Blackman failed to do). Doses are then slowly increased monthly based on clinical response and blood tests. (Again Blackman did not titrate slowly, which accounts for the side effects). Dr. Blevens notes that the common side effects-edema, myalgia, arthralgia-are due to the anti-natriuretic effect of HGH. These symptoms are mild, dose-related and easily corrected by dose adjustment, and usually resolved in 1 to 2 months.
As the result of decreased visceral fat, increased lean muscle mass, and improved lipoprotein profiles, there was no evidence of increased risk of diabetes. The initial decreased insulin sensitivity was short term and was not a factor due to increased metabolism.
This was also shown in the meta-analysis study published in the New England Journal of Medicine (N Engl J Med. 1999;1206:24-34) that documented an increase metabolic rate of 6-11%. “Based on overwhelming evidence of efficacy and safety, the American Association of Clinical Endocrinology has recommended GH replacement therapy. Therapeutic monitoring should focus on resolution of symptoms and normalization of IGF-1 levels.”
A recent study in Journal of Clinical Endocrinology and Metabolism (87:2725-2733, 2002) used HGH doses of .4 mg/day (typical of our dosing and much lower than what Blackman used). Again, there were significant changes in body fat and body composition. Echocardiography demonstrated improved cardiac output in both sexes. GH was well tolerated with side effects related only to transient edema and fluid retention. There were no cases of diabetes or glucose intolerance with this regimen.
Probably the best review of GH can be found in the official Journal of the Growth Hormone Research Society and the International IGF Research Society. A recent article (Growth Horm IGF Res.2002;12:1-33) reviews 273 recent articles on HGH. The authors very thoroughly reviewed glucose metabolism and insulin sensitivity. Most studies show initially reduced insulin sensitivity between months 1-6. Thereafter body composition improves and there is an increase in insulin sensitivity and improved glucose utilization, but only after six months. Again, Dr. Blackman’s study was for 6 months only. Many of these studies also utilized high dose HGH, but found no increased risk of diabetes at the 12-month mark.
The studies lasting 1-4 years showed initial reduced insulin sensitivity. Yet, after four years, there was improved insulin sensitivity, lower glucose levels and no deterioration in glucose tolerance. The two longest studies lasting ten years showed no reduction in insulin sensitivity. There were also no changes in glucose, insulin levels, C peptide levels or glucose tolerance. In fact, most adults were insulin resistant, but the decreased fat, increased metabolism, and improved lean body mass, decreased their risk of diabetes. “Hyperinsulinemia (insensitivity) persists up to one year, however there are no long term adverse sequelae with no increase in the development of diabetes. There is no difference in incidence of diabetes from what would be expected in the general population.”
I feel it would have been most appropriate had someone written an editorial review in JAMA based on the above literature to clarify the issues and prevent the misunderstanding that now exists. The lack of this editorial review is truly a disservice to providers and patients who will now believe that HGH causes diabetes when in reality it does not. In fact, it prevents the metabolic syndrome X that causes diabetes and the initial worsening of insulin sensitivity that occurs in a few individuals as in Dr. Blackman’s study.
Most importantly, this review in Growth Hormone and IGF Research assesses dosing and replacement regimens. Earlier studies investigating the effect of GH replacement in adults were based on doses used in children (unfortunately, Blackman’s study made the same mistake). With time, it is becoming apparent that these protocols cause over-treatment with the resulting adverse side effects.
Some studies now are designed to use much lower doses to avoid the side effects (which makes perfect sense). Reduced doses resulted in the same beneficial outcomes with reduced side effects. Other studies utilized slower dose titration with even fewer side effects. One study found that the mean dose in men required to normalize IGF-1 was 0.2 mg/day, whereas in women it was 0.4 mg/day. With time it became routine clinical practice to titrate GH dose according to IGF response.
Johannsson et al demonstrated that slowly titrating GH dosing resulted in less side effects but similar clinical efficacy as compared to standard high dose regimens (how about that!). The Growth Hormone Research Society has published consensus guidelines for GH replacement. They concluded that dose selection should be at a low dose and then titrated according to clinical and biochemical response.
There is no gold standard for measuring GH replacement and the whole clinical picture needs to be taken into consideration, including IGF-1, to ensure correct management. Dr. Blackman did not follow any of these guidelines, thereby causing significant adverse effects by an inappropriate high-dose regimen. Thus, his results and conclusions came as no surprise. It is an absolute waste of resources to study HGH in this fashion.
Finally, data from KIMS, a pharmaco-epidemiological survey of 6000 patients receiving HGH, showed only 32 patients developing diabetes on HGH. Most of those patients were obese with a family history of DM. In the HypoCC long-term compilation study by Eli Lilly, 1881 patients were followed with control groups. There was no increased incidence of diabetes, malignancies or mortality while on HGH.
It appears as though providers and the public alike have become anti-hormone due to media hype and sensationalism. Nevertheless, when our hormone levels fall, we deteriorate resulting in less energy and vitality with a greater risk from the illnesses of aging. The literature is full of data documenting health and feel-good benefits with less morbidity and mortality from hormone replacement.
Hormones should be carefully prescribed, monitored and adjusted to physiologic levels. Synthetic, non-bio-identical hormones, or chemically altered hormones (Provera, Progestins) should be avoided. All natural hormones have scientific, documented benefits at optimum, physiologic levels and detrimental health consequences at lower levels seen with aging. GH is no different.
Our hypocratic oath states we should “do no harm.” However, by letting ourselves, and our patients, deteriorate when appropriate therapy is available is counterintuitive and indeed harmful. I hope the plethora of scientific studies supporting the use of GH is compelling and reassuring to you and that you can look at all of these studies objectively. Make the decision worthy of your patient’s health and well-being.
Body Composition-Cardiac Function-Bone Density
JUNE 2002 (University of Toronto, Toronto, Ontario, Canada): Dr. Ezzat and colleagues administered GH to 67 men and 48 women found to be growth hormone deficient. After a six-month treatment period, lean body mass increased by an average of 2.1 kg, fat mass decreased by 2.8 kg, left ventricular systolic function greatly improved and ejection fraction was significantly restored (“approaching normalcy”). GH treatment was well tolerated, with adverse events primarily related to effects on fluid balance. In both men and women, the researchers found: “No apparent relationship between IGF-I levels and the occurrence or severity of adverse events. GH replacement therapy in adults demonstrated beneficial effects on lean body mass composition [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][and] cardiac function improvement.”
APRIL 2002 (Hypoptiuitary Control and Complications Study International Advisory Board [an organization studying the efficacy and safety of GH therapy of adult
GH deficient patients in clinical practice]): Dr. Attenuation and colleagues reported on a three-year course of GH therapy administered to adult onset GH-deficient patients. Lean body mass increase was found to be greatest in the those younger than 40 years old, less but still significant in the middle group (40- 60 years), and unchanged in the oldest (>60 years). Conversely, decreases in the low density lipoprotein/HDL ratio were insignificant in the younger patients, but proved to be significant in the middle and older age groups. The researchers submit that “these observational data showed significant long-term efficacy of adult GH replacement therapy on body composition and lipid profiles and indicate that age is an important predictor of response.”
OCTOBER 2001 (University Hospital, Goetburg, Sweden): Dr. Gotherstrom and colleagues at the Research Centre for Endocrinology and Metabolism studied a five-year course of GH replacement in 70 men and 48 women (mean age 49.3 years), with adult-onset GH deficiency. They found a sustained increase in lean body mass and a decrease in body fat. The GH treatment increased total body bone mineral content as well as lumbar and femur neck bone mineral content. Total cholesterol and low density lipoprotein cholesterol decreased, and high density lipoprotein cholesterol increased. Serum concentrations of triglycerides and hemoglobin A(1c) were reduced. In conclusion, the researchers state: “Five years of GH substitution in GH-deficient adults is safe and well tolerated. The effects on body composition, bone mass, and metabolic indices were sustained. The effects on body composition and low density lipoprotein cholesterol were seen after 1 yr, whereas the effects on bone mass, triglycerides, and hemoglobin A(1c) were first observed after years of treatment.”
OCTOBER 2001 (University Hospital, Uppsala, Sweden): Dr. Gillberg and team found that three months of low-dose GH on 64 GH deficient adults increased serum levels of insulin-like growth factor (IGF)-I, IGF binding protein (IGFBP)-3 and lipoprotein (a), reduced total and low density lipoprotein cholesterol levels, and resulted with greater lean body mass and decreased fat mass. The researchers suggest, “This fixed low-dose regime resulted in improvements in body composition and lipid profile, without causing serious side effects. This is therefore a valid method to institute GH replacement in adults.”
APRIL 2002 (The Christie Hospital, Manchester, United Kingdom): Treating 67 GH deficient adults with a titered low-dose GH regimen designed to normalize serum IGF-1, Dr. Murray and co-researchers observed significant improvements in total cholesterol, LDL, triglycerides, and the ratio of total cholesterol to HDL. They reported observing the greatest improvements in patients with the most adverse lipid profiles at the start of GH treatment.
APRIL 2002 (University Hospital of Wales): Dr. Smith and colleagues administered GH to 19 men and 13 women (age range 19 to 64 years) over a three-month period. GH replacement resulted in increases in lipid hydroperoxides in plasma and neutrophil O(-)(2)- generating capacity. The researchers conclude that these marker improvements reduce oxidative stress, thereby mediating endothelial dysfunction that frequently results with a pro-atherogenic state associated with adult GHD.
JUNE 2002 (National University Hospital, Oslo, Norway): In a course of twelve-months of GH replacement in 9 women and 16 men (mean age 46 years) with GH deficiency, Dr. Ueland and team found that bone mass and skeletal biomechanical competence were improved specifically as a result of GH treatment-related increases the accumulation of IGF-I and OPG in cortical and trabecular bone.
JULY 2001 (University of Bochum, Germany): In a six-year long study, Dr. Clanget and colleagues replaced GH in 4 women and 8 men (mean age 42.5 years) with GH deficiency. As a result, bone mineral density at the lumbar spine increased by 15.9%, and was paralleled by similar increases in the lumbar vertebrae. They conclude that “GH therapy in GH-deficient adults is able to progressively increase BMD and bone area at the lumbar spine over a period of at least 6 years.”
Specific Disease Treatment
JUNE 2002 (University of Queensland, Princess Alexandra Hospital, Australia): Nine adults with mild- to moderate-severity chronic liver disease (etiologies including alcohol and primary bilary cirrhosis) were treated with GH. Increases in serum IGF-1, IGFBP-3, improvements in body weight and resting metabolic rate were noted. Additonally, significant increases in whole-body protein catabolism, lipolysis and lipid oxidation, and insulin resistance were observed.
MAY 2002 (University of California San Francisco): Dr. Napolitano and colleagues at the Gladstone Institute of Virology and Immunology administered GH to five male HIV patients for six months. In all five subjects, GH treatment resulted in a marked increase in thymic mass, and significant increase in circulating naive CD4 T cells. The researchers conclude that “GH has significant effects on the human immune system, including the reversal of thymic atrophy in HIV-1-infected adults. De-novo T cell production may thus be inducible in immunodeficient adults.”
JANUARY 2002 (University Federico II School of Medicine, Naples, Italy): Dr. Napoli and team found that a three-month treatment with GH in patients with chronic heart failure corrected endothelial dysfunction and improved non-endothelium-dependent vasodilation. Specifically, they attributed these benefits to GH’s improvement of vascular reactivity. State the researchers: “The data highlight the potential role of GH in the progression of congestive heart failure.”
DECEMBER 2001 (Shimane Medical University, Izumo, Japan): Dr. Sohmiya and colleagues administered GH to eight anemic patients with adult GH deficiency. Erythropoietin secretion was stimulated within two weeks, and increased hemoglobin concentrations were observed after ten months of GH therapy. The researchers, noting that long-term administration of GH stimulates erythroid cells, conclude that there is “a beneficial effect of GH replacement in anemic patients with adult GH deficiency.”
SAFETY UPDATE ON HGH, January 2003
For over three decades, children diagnosed with dwarfism (short stature) have been prescribed Human Growth Hormone (HGH). In these tens of thousands of cases worldwide, short stature syndrome has been successfully and safely treated.
The 1990 study by Dr. Rudman of the Medical College of Wisconsin ushered in a new and exciting era for HGH therapy. The improvements seen in lean body mass and associated biological parameters in the study’s healthy, elderly men were unprecedented. Adult men and women could look forward to living their later years without becoming fat, flabby, frail, and lethargic. They no longer had to presume that their loss of sex drive, sleeping difficulties, memory changes, and lack of stamina and energy were inevitable.
Nearly a decade and hundreds of clinical studies later, in October 1999 the Johns Hopkins School of Medicine sponsored a Growth Hormone/Growth Factors Symposium. Some of the world’s leading endocrinologists and scientific researchers convened to discuss HGH therapy. One of the most notable findings reported at this event was that “GH replacement therapy in adults … is not associated with any increase in mortality.”
In 2002, two studies caused undue alarm and confusion on the part of the consumer public relating to HGH safety. Below we bottom-line the outcomes of these studies to clear some of the common misconceptions about HGH therapy in healthy adults.
Question: In the July 27, 2002 issue of The Lancet, Dr. Swerdlow and colleagues in the United Kingdom issued a report of a study that tracked 1,800 people who received HGH as children. Dr. Swerdlow stated that “there were risks about tenfold for colorectal cancer and Hodgkin’s disease.” Collectively, these people were at a three-fold increased risk of dying from cancer overall. Yet, Dr. Swerdlow also admits that his study was unable to show a direct causative effect between HGH replacement and cancer. What does this all mean?
Answer: To respond, we point to the study authored by Dr. David Cook, an endocrinologist at Oregon Health and Science University. His report appears in the August 6, 2002 issue of Annals of Internal Medicine, which is the journal of the American College of Physicians & American Society of Internal Medicine. Published just one week after Dr. Swerdlow’s study appeared in The Lancet, Dr. Cook presents a compelling scientific argument that counters Dr. Swerdlow’s findings.
Dr. Cook explains that epidemiological studies (of which the Swerdlow study is one) often suggest an increase in cancers in normal persons that corresponds to elevated levels of circulating (free) IGF-1. (This may be caused by increased serum concentrations of IGF-1, coupled with reduced levels of the binding proteins that take up IGF-1, which may result from HGH therapy). Dr. Cook submits that naturally-occurring situations in which circulating IGF-1 exist (such as in acromegaly) have not been associated with an increase in cancer. In the words of Dr. Cook, this suggests that “high-normal IGF-1 concentrations may be a marker for cancer but are not causally related to inducement or growth of cancer.”
Dr. Cook continues in his report to state that “appropriate growth hormone replacement therapy is associated with normalization, not elevation, of serum IGF-1 concentrations. In addition, levels of binding proteins are increased with growth hormone replacement, along with levels of IGF-1, resulting in normal, not elevated, free IGF-1 concentrations.”
Question: In one study by Dr. Blackman et al published in the November 13, 2002 issue of the Journal of the American Medical Association (JAMA), the researchers suggested that the side effects of HGH therapy outweigh potential benefits. The study involved 131 elderly men and women in overall good health, enrolling in a six-month long study of HGH. At the end of the study, the researchers reported that 18 of the HGH-therapy participants experienced carpal tunnel syndrome, joint pain, swollen limbs, diabetes, and blood sugar dysregulation. Is this cause for alarm?
Answer. Titering of the HGH treatment protocol by the administering provider is absolutely critical in ensuring that neurological and musculoskeletal side effects are avoided. When patients report unusual joint or limb symptoms while taking HGH, a dosage reduction is warranted. Within a matter of days, the reported side effects are eliminated. With regard to the Blackman study, it is important to note that the total duration of the study was six months, which is a very short timeframe that may not have allowed for proper titering to take place prior to the final reporting of both positive and negative effects.
Adult GH replacement therapy may cause transient blood sugar elevation during the course of treatment. However, it is important to understand that short-term blood sugar elevation is not equivalent to diabetic disease. Furthermore, it is a well-known fact of physiology that HGH antagonizes insulin, and in the short-term, elevated blood sugar levels may be experienced during HGH therapy. This correlation has existed in published medical literature for over 30 years. The Blackman study does a disservice to the public by suggesting that adult GH replacement therapy leads to the diabetic state and pancreatic damage. Diabetes is a permanent physiological condition, and a temporary and transient rise in blood sugar as may result from adult GH replacement therapy does not equate with the clinical disease known as diabetes. As of this writing, there is no peer-reviewed published scientific paper implicating adult GH replacement therapy with the onset of a permanent diabetic state.
The Blackman study states that “side effects went away after the hormone treatment was discontinued.” This is a testament to the reversible and short-lived involvement of side effects in HGH therapy. The side effect profile of HGH therapy is transient and can be managed effectively by a qualified provider.
Finally, it is important to note that the Blackman study reports a significant benefit to those in the study who received HGH. The report explicitly states that the women in the study “gained an average of 2 to 5 pounds of muscle and lost about five pounds of fat. Men on growth hormone had gained 7 to 10 pounds of muscle and shed about the same amount of fat.”
For well over forty years, HGH therapy has been under controlled and careful surveillance and research by the US Food and Drug Administration (FDA) and Centers for Disease Control (CDC). As a result of the monitoring activities of HGH replacement in adults by the FDA, CDC, medical societies overseas (where adult HGH therapy has been in-use longer than the US), and the five major pharmaceutical companies that manufacture HGH, this substance is one of the most extensively and carefully studied drug in history. Yet, not a single one of these entities has attributed any death to the use of HGH replacement when it is administered judiciously by a qualified endocrinologist or anti-aging provider.
Of all of the hormones in-use for adult replacement, HGH has the most extensive history of rigorous scientific trials and practical clinical application. Confusion and alarm have been fueled by media reports that proclaim harm while failing to properly explain the nuances of the study findings. There is a convincing body of literature demonstrating the safety of HGH therapy in the aggregate; however no single large-scale study has yet provided unequivocal evidence of improved health outcomes. As a result, studies involving small populations of adult men and women in good health who are administered HGH, and demonstrate positive benefits, are generally dismissed as “anecdotal.” Studies that administered HGH to acutely ill patients fail to provide insight into how HGH therapy affects healthy men and women. We submit that thorough and objective scientific data on adult HGH replacement therapy should continue to be collected through small- and large-scale research studies as well as applied clinical utilization.
HGH, The Master Hormone of Youth
Kelly Nelson began taking HGH in May 1997 and four months later she placed first in bodybuilding contest for the over-35 age division. Today she is 72 years old.
John Baron found that on HGH his waist narrowed from a heart attack threatening 44 inches to a healthy 38 inches, his skin tightened, his energy, concentration, and memory improved dramatically. Most heartening for this 82 year-old provider, his sex life is now as good as when he was 45.
Paul Bernstein found that HGH and DHEA brought his muscle tone back to what it was in his late 30s, picked up his energy level by about 20%, dropped his cholesterol level by 30 points and reduced his body fat 4%. At age 64, he looks like Mr. Fitness USA, the title he was awarded three decades ago
Most people think of HGH as the miraculous treatment for children doomed to dwarfism, which over the past 30 years has saved tens of thousands from this fate. HGH therapy has been so effective for our young that a remake of The Wizard of Oz is nearly impossible today, due to this medical achievement.
The next great benefit of HGH therapy appears to be in the aging population. People with age related deficiency of HGH become fat, flabby, frail, and lethargic, lose interest in sex, have trouble sleeping, concentrating, remembering things, tire easily, and in general, lose their zest for life. With HGH, all these so-called signs of aging are reversed.
Like Kelly Nelson, John Baron, and Paul Bernstein, tens of thousands of people around the world are experiencing the multiple life-enhancing benefits of HGH replacement. They all feel that they have turned back the clock and regained their youthful bodies, mind, and spirit. They feel a renewed sense of optimism, an excitement about starting each new day, and a sense that they are children once again with the whole world in front of them.
But individual cases, no matter how compelling, are not objective science. Real evidence must come from the lab, animal studies, and most of all from well controlled clinical studies — preferably those that are double-blind, where neither the researcher nor the provider knows who is receiving the real treatment and who is getting the placebo. In this chapter, we present a sampling of the evidence from the experts who have published over 20,000 studies, abstracts and reports affirming the value of HGH in the world’s most respected and reputable scientific and medical journals. But first let us look at the remarkable molecule called HGH.
HGH for Anti-Aging and Longevity
HGH appears to be the silver bullet of life extension. The most consistent extension of life span comes from experiments in which animals have their food intake restricted. In well-carried out experiments, animals on a calorie restricted diet have enjoyed a maximum life span that was more than twice the average life span for that species. In human life expectancy, this would be equivalent to a life span of about 160 years!
Dr. William Sonntag at the Bowman Gray School of Medicine at Wake Forest University in Winston-Salem, North Carolina, has examined what happens to HGH and IGF-1 secretion in animals that are diet restricted. Normally when we age, the amount of HGH and IGF-1 decreases along with protein synthesis. But, Sonntag and his associates found just the opposite happened in the diet restricted animals. Young rats on a moderate food restricted diet actually had their growth hormone secretion go down, but by the time they reached 26 months (old age for a rat) their growth hormone pulses were the same as that of a young control rat.
Could a significant factor in these animals’ ability to defy death be growth hormone? More growth hormone meant higher rates of making new proteins needed by the cell. While the rates of protein synthesis went down in old control rats, the aged restricted rats had 70% increase of new protein in the heart and 30% in the diaphragm compared with the unrestricted animals.
With all these amazing benefits, HGH — which vanquished dwarfism over the past 30 years in children — may yet again prove to be the wonder drug of the next decade; this time, for adults seeking the multitude of benefits of anti-aging medicine.
Growth Hormone Deficiency and the Chronically Ill
Growth Hormone Deficiency (GHD) (Table 3) occurs in patients with pituitary tumors, trauma, and post-surgically, comprising approximately 50% of the total etiology of GHD. I submit that the remaining 50% is associated with chronic inflammatory diseases, characterized by immune system dysregulation, adrenal dysregulation and hypercoagulation state.
The GHD symptom complex can occur after a chronic illness and has been studied extensively in relation to CFS, FMS, rheumatoid arthritis, and other diseases. The concept of anoxia caused by the immune system activation of coagulation with infection cytokine excess and vasculitis contributes to the decline and dysregulation of HPA axis.
Table 3. Manifestations of Adult Growth Hormone Deficiency (GHD)
|Disturbed lipid pattern||Decreased exercise capacity|
|Abnormal body composition||Defective sweat secretion & thermoregulation|
|Excess weight and central adiposity||Increased tone in the sympathetic nervous system|
|Impaired glucose homeostasis||Decreased bone mineral content|
|Impaired fibrinolysis||Decreased activity in osteoclast precursor and proliferation and differentiation of osteoclasts|
|Impaired cardiac functioning||Problems with sleep quality|
|Reduction in arterial distensibility (esp. carotid artery in women)||Decreased social contact and stiffness|
|Low nitric oxide levels, contributing to atherosclerosis||Significantly more health issues than others of sex/age|
|Premature atherosclerosis||Major risk factor in CHF and heart disease and premature death|
There are several similarities between the symptoms in fibromyalgia and GHD, and the two conditions are somewhat interrelated (Table 4). A working definition of fibromyaligia (Figure 2) is that infection releases toxins, causing liver cells to produce cytokines including interleukin-6 (IL-6).
The cytokines interact with nerves that travel to the brain which signals down the spinal cord, causing amplified pain signals.
Three cytokines, IL-1, IL-6, and IL-8, cause severe widespread pain, fatigue and disturbed sleep. IL-6 is related to fatigue and impaired concentration. TNF alpha activates hypothalamus corticotrophin releasing hormones (CRH) and releases IL-1 that does not stimulate the pituitary or adrenal glands.
Treatment of GHD should only be initiated once infections are cleared, as acute infection can be detrimental. It is my clinical experience that treatment of GHD has minimal risks. In actuality, for chronically ill patients, GHD replacement therapy imparts great psychological, psychosocial and cardiovascular health benefits. The treatment adds greatly to quality of life and to maintaining a healthy life style. Benefits of growth hormone replacement therapy may include:
- Reduction in body fat mass
- Increase in lean body mass
- Increase in total body water
Report from Dr. Ron Rothenberg
In my anti-aging practice, I have about 160 patients being treated with growth hormone therapy (GHRT) for normal aging. One parameter which is often missing from evaluations of medical treatments is “quality of life” . Many factors come together to produce a good quality of life or more simply feeling good or feeling great.
Just about every week a patient tells me something like, “This is the best I’ve felt in as long as I remember.” Of course, I’m not just treating them with GHRT. Lifestyle comes first: nutrition, exercise, stress reduction. Beyond lifestyle, GHRT takes my patients to a different level of wellness and quality of life. There are consistent benefits mentioned by my patients.
My patients report improved memory and cognition, a more positive attitude and less depression. Discontinuing prescribed antidepressants is not uncommon. Many patients simply tell me that they feel happier. At times I have been told about an increased esthetic awareness of the beauty of the world. Body composition improves with more lean body mass and less fat mass. This is observed even when patients already had optimized diet and exercise programs before beginning GHRT. More rapid recovery from minor sports injuries is typical. Exercise performance increases.
Patients report that they are told they look better, look healthier with better skin and often with reversal of hair loss. Combining GHRT and lifestyle in motivated patients often lead to objective lab values improving. Insulin sensitivity and cardiovascular risk factors including lipid profile and C-reactive protein are optimized. Other benefits mentioned in the medical literature such as reversal of atherosclerosis and improved immune function are difficult for patients to observe one way or the other.
Growth hormone is not a “fountain of youth” or a guarantee of immortality. Patients on GHRT are still prey to illnesses and injuries like anyone else. They are just operating on a younger, stronger, healthier physiological level.
One patient, a 52 year old attorney, explains it this way: When you are in your twenties, you don’t get up in the morning and pound your chest and exclaim: I’m twenty and I feel great and I recovered quickly from that basketball game and I’m not gaining fat and sex is great! You just live your life and go with the ups and downs. After being on GHRT for a while that is what it is like. You don t marvel at the effects every day, you just live on a better level.
As anti-aging providers, our goal is to rectangularize the functionality curve of the human lifespan, helping our patients to stay strong and vigorous as long as possible without gradual and protracted deterioration. We know GHRT is a proven defense against frailty and when added to lifestyle this is our chance to stay stronger and more functional. If we were to stay perfect, why intervene? But since we don’t, this is one route to maintaining function while we await the genetic and biochemical therapies that will be available in the near future. Patients treated with GHRT are happier and healthier. Just ask one.
Note from NBH: There are many articles regarding HGH. There are also many fraudulent claims made for non-injectible forms of HGH. The fraudulent claims often cite real HGH studies and attempt to bootstrap their product onto the back of the legitimate research.
HGH is costly although the long term benefits and results are well worth the cost if one has the disposable income to afford the program. It also requires patience as it is not a quick fix remedy. Natural Bio Health provides the lowest cost HGH of anyone we know. We believe the benefits are so tremendous that we are doing our best to make it affordable for as many people as possible.
At Natural Bio Health, Dr. Gary Albertson and NBH are working to make HGH more cost effective so that more patients will enjoy the life time benefits of HGH.
Benefits of Human Growth Hormone Supplementation
- Decrease the % of body fat while increasing lean muscle mass by stimulating the body’s ability to increase protein synthesis
- Increase bone mass, reversing damage that leads to osteoporosis
- Reverse the degeneration of neurological functions
- Improve cardiac function
- Improve skin tone, thickness, and elasticity
- Improve pulmonary functions
- Improve the functioning of the immune system
- Improve kidney function
In fitness and health,
NBH, Clinic Director of NBH Lifetime Health