HUMAN
GROWTH HORMONE
There
is an old adage that states that...... Youth is wasted on
the young.
If this is true, why should it follow that experience and financial
security are 'wasted on the old' because they have lost the energy
and enthusiasm to enjoy the 'golden years?'
This does not have to be the case. For we have come to learn that
old age is simply a state of hormonal deficiency, a state of lacking
the previously bountiful hormones of youth. Then it follows that,
these symptoms of 'old age' are actually symptoms that can be
reversed.
Leading the list of the age-depleted hormones that can be replaced
and provide for longer, healthier, and more productive lives is
the human growth hormone (HGH). One of the most incredible points
to make about HGH is that it is not really incredible! Growth
hormone is natural; it is plentiful in the human body during youth.
In fact, it is a substance that actually retains the properties
of youth, but lessened with age.
Growth hormone is essential to growth. It is a supplement given
to children who suffer with abnormally slow bone growth to enable
them to grow taller. But HGH levels fall steadily in everyone
once they reach adulthood. Since we now realize that HGH is indispensable
throughout life, it must be considered a vital hormone for maintenance
of the adult body. Studies of its amazing effects in the elderly
population supports its primary role in improved longevity and
the betterment of the quality of one's life.
Produced in the anterior section of the pituitary gland deep in
the brain, HGH is a microscopic protein substance. Chemically,
it is somewhat similar to insulin although it is secreted in short
pulses during the first hours of sleep and after exercise; it
only remains in the circulation for a few minutes. As such, it
is extremely difficult to measure HGH in blood serum. However,
the body binds most of the growth hormone in the liver and converts
some into Somatomedin-C, another protein hormone also called Insulin-like
Growth Factor- I (IGF-I). Since Somatomedin-C remains in the blood
stream for 24-36 hours, a blood sample identifying Somatomedin-C
will be a more dependable indicator of competent HGH production.
Normal Somatomedin-C blood levels in adults range from 200 to
450 ng/ml (nanograms per milliliter). Yet, one-third of individuals
over 50 years of age show abnormal levels less than 200 ng/ml.
During the growth spurt of youth, HGH levels are maximum and the
Somatomedin-C will be measured well over 600- 800 ng/ml. Yet for
normal men and women under 40, less than 5% have levels below
250 ng/ml! After 40 many men and women have the same amount of
HGH as an octogenerian! And that may be the key to aging
as we now know it!
When one's Somatomedin-C level falls below the adult normal range,
his/her muscle and bone strength and energy levels most likely
will decrease. Tissue repair, cell regrowth, healing capacity,
upkeep of vital organs, brain and memory function, enzyme production,
and revitalization of hair, nails and skin will also diminish.
While aging and decreasing growth hormone levels go 'hand-in-hand'
those who lose their pituitary production of HGH due to surgery,
infection or accident, instantly suffer many profound, ill effects.
It is important to reiterate that HGH will decline in everyone
as they age!
In those who have no pituitary function, there is a shift in body
composition whereby body fat increases by 7-25% while lean body
mass decreases similarly. Muscle strength and muscle mass are
noticeably reduced. Bone density studies indicate long bone density
and spinal bone density decrease as significantly as if the individual
had aged 15 years. Pronounced weight gain of 30-50 pounds occur
when HGH wanes. Furthermore, there are negative effects on cholesterol;
triglyceride levels increase while high density cholesterol (HDL),
a 'good cholesterol', decreases. Increased risk of cardiovascular
disease may be related to vascular wall thickening and changes
associated with decreased cardiac output. Such insufficiencies
may contribute to these people reporting a rapid decline in exercise
capacity and early deaths from heart disease. They also report
an impaired sense of well-being and symptoms of fatigue, social
isolation, depression and a lack of the ability to concentrate.
New
Hope for Growth Hormone Deficiency:
F.D.A. Approves HGH for Adult Use!
Recombinant human growth hormone has been approved by the Food
and Drug Administration for adult men and women in the treatment
of hypopituitarism and somatotropin deficiency. If one suffers
with hypopituitarism, HGH therapy is available as normally payable
under an insurance policy. As part of our Hypopituitary Registry,
patients receive HGH replacement therapy and testing under supervision.
Based on the literature and our experience with HGH replacement,
the positive changes noted may also apply to individuals with
low growth hormone levels. The term used is somatotropin deficiency
syndrome. We also treat individuals with Somatomedin-C (IGF-I)
levels below 200 ng/ml with recombinant HGH in our I.R.B. approved
registry. But, such individuals personally pay for HGH.
Note that by combining 'global hormonal' replacement therapy of
DHEA, pregnenolone, thyroid, testosterone, estrogen, and progesterone
when indicated with HGH, the dosage, costs and side-effects are
minimized.
Changes
with Growth Hormone Replacement
Body Composition
Growth hormone therapy results in profound changes in body
composition: fat mass is reduced while lean body mass increases.
Growth hormone, at the relatively low dose of 0.003mg/kg was shown
to normalize lean body mass over 6 months in 24 adults with HGH
deficiency(1). The improvement in lean body mass is associated
with increased protein synthesis, muscle mass and muscle function.
Total body fat also decreases after 6 months of HGH administration.
The decline in fat mass is most significant in the lower abdomen
and trunk, compared to the arms, neck and legs. This suggests
that HGH replacement therapy may reverse the central abdominal
fat mass associated with HGH deficiency and decrease an individual's
cardiovascular risk(6).
| GROWTH
HORMONE DEFICIENCY |
|
HGH
ENHANCEMENT BENEFITS |
[-]
Increased cardiovascular death
[-]
Abnormal body fat distribution
[-]
Decreased energy
[-]
Dehydration
[-]
Reduce bone density
[-]
Impaired physical performance
[-]
Psychological defects
[-]
Depression and social isolation
[-]
Insomnia and Poor sleep pattern
[-]
Skin thinning
[-]
Decreased immune function
|
|
[+]
Increased cardiac output
[+]
Reduces muscle waisting
[+]
Increases energy levels
[+]
Improved fluid balance
[+]
Increased boned density
[+]
Enhanced exercise capacity
[+]
Better sense of wellbeign
[+]
Socialization
[+]
Restores REM (deep) sleep
[+]
Restores skin and elasticity
[+]
Ehnaced immune system |
Cardiovascular
and Lipid Metabolism
HGH replacement in adults may have a beneficial effect on lipids.
In a recent study, it was reported that short courses of HGH reduced
LDL (bad) cholesterol(7) while it improved exercise capacity and
cardiac function. Patients showed increased oxygen uptake and
power output during cycling. HGH is associated with increased
muscle mass and longer and stronger action on the treadmill.(8)
Recent work by Fazio demonstrated an improvement in heart failure
patients given high dose HGH replacement.(9)
Bone
Density
One of HGH's most dramatic effects is on the connective tissue,
muscle, and healing potential of the skeletal system. Fragile
skin with ulcers, fractured bones that do not heal, and profound
gains in muscle strength have been noted. Not only does the skin
look younger with less wrinkles, some report a regrowth of hair
on the head. For growth hormone, DHEA, and testosterone are clearly
anabolic hormones: they build tissue. And with increased age,
our bodies break down tissue faster than we can repair them. This
is called catabolism. Therefore, HGH tends to reverse the catabolic
state.
The potential role of HGH in the maintenance of the skeleton is
its ability to make and repair these tissues. HGH stimulates osteoblast
(bone) and fibroblast (supporting tissue) proliferation[8]. In
a recent study using the sensitive techniques of quantitative
tomography and single photon absorptiometry, significant increases
of 5% and 4% were demonstrated in spinal and cortical bone density
over 12 months of therapy in HGH-deficient adults(4). It thus
appears that HGH administration may act to improve skeletal repair
of not only bone and skin but all organs as well.
Other anabolic effects include a gain of muscle and renewed appetite,
better exercise capacity, increased lung capacity, and faster
wound healing. Many report there 'old age spots', skin "senile
keratosis" disappear within two months of HGH therapy.
Side
Effects with Low Dose HGH Replacement
The dose of recombinant HGH is an important consideration
in the therapy of acquired HGH-deficiency. Large, pharmacological
doses of HGH are often associated with the clinical signs of HGH
excess, including fluid retention, carpal tunnel, and hypertension.
However, by incorporating smaller, physiological such symptoms
are not noted. At a dose of 0.03mg/kg/week, Bengtsson et al. demonstrated
only minor side effects including slight fluid retention and mild
joint pain. There was only one reported incident of carpal tunnel
syndrome6. In all cases, further reduction of the HGH dosage resulted
in the elimination of side effects. In another recent study in
which a smaller dose of HGH was used, 0.01 mg/kg was administered
three times per week without any reported side effects(8). Multiple
studies support the conclusion that low dose HGH replacement is
associated with minimal side-effects.
Positive Effects of HGH Replacement
- Get Lean:
Loss of fat and increase in muscle mass combine for up to
20 pound shift in body composition. This equates to a general
feeling of physical well being, a stronger libido, and improved
self image.
- Get Energetic:
Without a need for the afternoon food cravings of sweets,
caffeine, stimulants or nicotine, HGH patients have more energy.
This improves both their self control image and their general
health state (because they exercise).
- Get
Smart: An interesting yet unproved side-effect of HGH has
been the return of mental acuity and a "sharp" memory. Such
HGH improves the vascular and intracellular nutrient support
for cells, it is not surprizing that this has been reported
by many individuals.
Future
Directions
Important issues remain as to the precise clinical definition
and best treatment of partial vs. complete HGH deficiency. In
addition, it is unclear whether some of the observed beneficial
effects of HGH replacement will be seen with the low dose, combination
therapies. Nevertheless, it is already apparent that even these
small doses, unassociated with symptoms of HGH excess, may be
enough to achieve desired metabolic results. We hope that our
registry and continued research will help define specific recommendations
for dosage and any long term beneficial effects of HGH therapy,
specifically with respect to cardiovascular morbidity and generalized
mortality.
References
- Salomon
F, Cuneo RC, Hesp R, et al. The Effects of Treatment with
Recombinant HGH on Body Composition and Metabolism in Adults
with Growth Hormone Deficiency. New Eng JMed1989;321:1797-03.
- Bengtsson
BA. The Consequences of Growth Hormone Deficiency in Adults.
Acta Endocrin 1993;128:2-5.
- Cuneo
RC, Salomon F, Wiles CM et al. HGH Treatment in GH Deficient
Adults. II. Effects on Exercise Performance. J Appl Physiol
1991;70:695-700.
- O'Halloran
DJ, Tsatsoulis A, Whitehouse RW et al. Increased Bone Density
after Growth Hormone (HGH) Therapy in Adults with Isolated
HGH Deficiency. J Clin Endo Metab 1993;76:1344-48.
- McGauley
GA, Cuneo RC, Salomon F et al. Psychological Well-Being Before
and After Growth Hormone Treatment in Adults with HGH Deficiency.
Hormone Research 1990;33(Suppl 4):52-54.
- Bengtsson
BA, Eden S, Lonn L et al. Treatment of Adults with Growth
Hormone (HGH) Deficiency with Recombinant (HGH).J Clin EndoMetab1993;76:309-17.
- Johnston
DG, Bengtsson BA. The Effects of GH and GH Deficiency on Lipids
and the Cardiovascular System.Acta Endocrinologica 1993;128(Suppl
2):69-70.
- Amato
G, Carella C, Fazio S et al. Body Composition, Bone Metabolism,
and Heart Structure and Function in Growth Hormone (HGH)-Deficient
Adults Before and After HGH Replacement Therapy at Low Doses.
J. of Clinical Endocrinology&Metabolism. 1993;77:1671-76.
- Fazio
S, Sabatini D, Capaldo B, et.al. A preliminary study of GH
in the treatment of dilated cardiomyopathy. New Engl J Medicine.1996;334:809-14.
.