The aging process causes a gradual decline in growth hormone production by the pituitary gland beginning around age 35. At the age of 60, most adults have the same Growth Hormone levels indistinguishable from people with tumors of the pituitary who are unable to make growth hormone. Savine (Hormone Research, 2000) concluded that if an IGF-1 level of 300 is normal for a 30-year old, then virtually everyone over the age of 40 has a deficiency, and life without growth hormone is poor in quantity and quality. Chronic Inflammation and Aging: Chronic inflammation is the cause of many age-related diseases, and by reducing this we can stay healthy. A number of things can be done for example: 1) keep glucose and insulin levels under control 2) regular exercise, 3) eliminate the visceral abdominal fat which produces inflammatory substances (such as IL-6).
Omega3 Essential Fats, stress reduction, controlling free radicals, reducing homocysteine levels, reducing C-Reactive Protein levels, reducing advanced glycation end-products (AGEs), and supplementing with youthful hormones such as testosterone, estrogens, and growth hormone all decrease the chronic inflammatory response associated with aging.
GH the ultimate solution to reverse aging? No, it is not. But we are each on a downward spiral of programmed destruction culminating in death, and GH could help slow this down a little and improve our quality of life. If the benefits outweigh the risks, then something is worth doing. GH, as an anti-aging treatment, may not be perfect, but it is the best we have at present.
Benefits of Growth Hormone
Benefits of GH can be seen with the brain/nervous system, the cardiovascular system, the immune system, aerobic capacity, body composition, and bone. Cappola et al showed that women who had the best quality of life in terms of mobility, activities of daily living, brain function and so on had the highest GH levels and least inflammation.
Growth Hormone and the Brain:
Aging is associated with declining mental function, and GH improves memory, alertness, and concentration. Growth hormone improves cognitive capabilities, memory, motivation, and work capacity. Aleman et al showed that men with higher IGF-1 levels had better cognitive function. GH deficiency was correlated with poor emotional and psychosocial functioning.
Growth Hormone and Bone
HGH increases the strength and formation of cortical bone. Logobardi linked GH deficiency with reduced bone density, and GH with reversal of osteoporosis. Patients who sustain hip fractures tend to have lower IGF-1 levels. GH is synergistic with exercise, thus to get the maximum effect from GHRT it has to be combined with regular exercise. Van der Lely et al. gave GH treatment to elderly patients with hip fractures for six weeks. Results study showed that 94% of GH treated patients returned to normal life style within six weeks, compared with the 75% of control patients. Gillberg et al gave GH to osteoporotic men for 2 years with a significant improvement in bone mineral density.
Growth Hormone and the Cardiovascular System
GH deficiency is associated with increased cardiovascular mortality, while GH is associated with improved cardiovascular function. Research suggests that GH may help to reverse atherosclerosis, improve cardiomyopathy, and reduce carotid intima media thickness.
Adamopoulos et al treated patients with idiopathic dilated cardiomyopathy (IDC) with GH. Results showed that GH treatment led to a significant decrease in both inflammatory markers of TNF-a and IL-6 levels, and significant improvements in exercise capacity. GH improves endothelial dysfunction, which plays a significant role is both heart failure and arteriosclerosis. Sesmilo et al found that Homocysteine levels fell significantly in those patients treated with GH. The cardiovascular improvements seen with GH appears to be due to its effect upon the inflammatory pathway by reducing C-Reactive Protein. Cardiac contractility, stroke volume, and ejection fraction all improve with GH. After myocardial infarction, GH is important for recovery.
Growth Hormone, Body Composition, and Obesity
Johannsson et al studied middle-aged men with low GH and abdominal obesity. After nine months of treatment with GH, abdominal visceral fat decreased by 18%, insulin sensitivity improved, total cholesterol, LDL, and triglyceride levels dropped, and diastolic blood pressure decreased without any lifestyle changes.
Other Benefits of Growth Hormone
Gibney et al found a link between GH deficiency and chronic fatigue and depression. Meanwhile, GH was found to improve a person's sense of well-being and was associated with an improved quality of life. Gilchrist et al concluded that GH deficient adults have a poor quality of life, but that this poor quality of life could be altered with GH. Gilchrist found that GH significantly improved energy levels, vitality, anxiety, depression, well-being, and self-control.
GROWTH HORMONE SAFETY
Long term use of GH has been studied in a large numbers of children treated for growth deficiencies and found to be safe. In adults, Vance et al concluded that there is "No evidence that GH affects the risk of cancer or cardiovascular disease." Molitch concluded: "Although there has been some concern about an increased risk of cancer [with GH], reviews of existing, well-maintained databases of treated patients have shown this theoretical risk to be nonexistent. " Shalet et al concluded that there is "No evidence of an increased risk of malignancy, recurrent or de novo."
On the package insert on GH it says don't use in active malignancy. However, the Growth Hormone Research Society published a paper in the Journal of Clinical Endocrinology saying that there is no data to support this labeling, and that this line should be removed from the package insert because there is no evidence that GH or causes cancer or cancer recurrence.
GROWTH HORMONE AND SIDE-EFFECTS
The most common side-effects of GH are fluid retention, joint pain, and insulin resistance which are seen with the higher dosage schedules. These side effects are reversible by simply decreasing the dose. GH can cause insulin resistance which can be avoided by using the Atkins' diet or the Zone diet, both of which control insulin levels by reducing sugar intake. These diets share the same idea: that we need protein and good-quality fats. Carbohydrates should come from vegetables rather than processed breads and pastas which tend to raise blood sugar levels, and provoke high insulin leading to insulin resistance.
In conclusion, given the state of scientific medical knowledge today, GH is safe. GH is associated with less morbidity and mortality, less cardiovascular disease, less inflammation, improvements in body composition, improvements in exercise capacity, and a better quality of life. In the words of Peter Sonksen: "GH is essential for normal adult life, and without it life expectancy is shortened, energy and vitality are reduced, and the quality of this life is impaired. The medical case for GH replacement is now proven beyond any reasonable medical and scientific doubt.
Forever Young, by Ron Rothenberg, M.D.
Grow Young with HGH, by Klatz and Goldman
Adamopoulos S, Parissisc JT, Georgiadis M, Karatzas D, Paraskevaidis J, Kroupis C, Karavolias G, Koniavitou K, Kremastios DT. Growth hormone administration reduces circulating proinflammatory cytokines and soluble Fas/soluble Fas ligand system in patients with chronic heart failure secondary to idiopathic dilated cardiomyopathy. Am Heart J. 2002; 144:359-364.
Aleman A, Verhaar HJ, De Haan EH, De Vries WR, Samson MM, Drent ML, Van der Veen EA, Koppeschaar HP. Insulin-like growth factor-I and cognitive function in healthy older men. J Clin Endocrinol Metab. 1999;84:471-475.
Baffa R, Reiss K, El-Gabry EA, Sedor J, Moy ML, Shupp-Byrne D, Strup SE, Hauck WW, Baserga R, Gomelia LG. Low serum insulin-like growth factor 1 (IGF-1): a significant association with prostate cancer. Tech Urol. 2000; 6:236-239.
Blackman MR. Age-related alterations in sleep quality and neuroendocrine function: interrelationships and implications. JAMA 2000; 284: 879-881.
Borson-Chazot F, Serusclat A, Kalfallah Y, Ducottet X, Sassolas G, Bernard S, Labrousse F, Pastene J, Sassoas A, Roux Y, Berthezene F. Decrease in carotid intima-media thickness after one year growth hormone (GH) treatment in adults with GH deficiency. J Clin Endocrinol Metab. 1999;84:1329-1333.
Burgess W, Liu Q, Zhou J, Tang Q, Ozzawa A, VanHoy R, Arkins S, Dantzer R, Kelley KW. The immune-endocrine loop during aging; role of growth hormone and insulin-like growth factor-1. Neuroimmunomodulation. 1999;6:56-68.
CappolaAR, Bandeen-Roche K, Wand GS, Volpato S, Fried LP. Association of IGF-1 levels with muscle strength and mobility in older women. J Clin Endocrinol Metab. 2001;86:4139-4146.
Cappola AR, Xue QL, Ferrucci L, Guralnik JM, Volpato S, Fried LP. Insulin-like growth factor-1 and interleukin-6 contribute synergistically to disability and mortality in older women. J Clin Endocrinol Metab. 2003;88:2019-2025.
Chan JM, Stampfer MJ, Giovannucci E, Gann PH, Ma J, Wilkinson P, Hennekens CH, Pollak M. Plasma insulin-like growth factor-1 and prostate cancer risk: a prospective study. Science 1998;279:563-566.
Christiansen J. Effects of GH upon body composition. Growth Hormone in Adults, 1196. CambridgeUniversity Press.
Clark R. The somatogenic hormones and insulin-like growth factor-1: stimulators of lymphopoiesis and immune function. Endocr Rev. 1997;18:157-179.
Gibney J, Wallace JD, Spinks T, Schnorr L, Ranicar A, Cuneo RC, Lockhart S, Burnand KG, Salomon F, Sonksen PH, Russell-Jones D. The effects of 10 years of recombinant human growth hormone (GH) in adult GH-deficient patients. J Clin Endocrinol Metab. 1999;84:2596-2602.
Gillberg P, Mallmin H, Petren-Mallmin M, Ljunghall S, Nilsson AG. Two years of treatment with recombinant human growth hormone increases bone mineral density in men with idiopathic osteoporosis. J Clin Endocrinol Metab. 2002;87:4900-4906.
Gilchrist FJ, Murray RD, Shalet SM. The effect of long-term untreated growth hormone deficiency (GHD) and 9 years of GH replacement on the quality of life (QoL) of GH- deficient adults. Clin Endocrinol (Oxf). 2002;57:363-370.
Hedstrom M. Hip fracture patients, a group of frail elderly people with low bone mineral density, muscle mass and IGF-1 levels. Acta Physiol Scand. 1999;167:347-350.
Johannsson G, Marin P, Lonn L, Ottoson M, Stenlof K, Bjorntorp P, Sjostrom L, Bengtsson BA. Growth hormone treatment of abdominally obese men reduces abdominal fat mass, improves glucose and lipoprotein metabolism, and reduces diastolic blood pressure. J Clin Endocrinol Metab. 2001;86:3604-3610.
Molitch ME. Diagnosis of GH deficiency in adults-how good do the criteria need to be? J Clin Endocrinol Metab. 2002;87:473-476.
Munzer T, Harma SM, Hees P, Shapiro E, Christmas C, Bellantoni MF, Stevens TE, O'Connor KG, Pabst KM, St. Clair C, Sorkin JD, Blackman MR. Effects of GH and/or sex steroid administration on abdominal subcutaneous and visceral fat in healthy aged women and men. J Clin Endocrinol Metab. 201;86:3604-3610.
Nam SY, Kim KR, Cha BS, Song YD, LimSK, Lee HC, Huh KB. Low-dose growth hormone treatment combined with diet restriction decreases insulin resistance by reducing visceral fat and increasing muscle mass in obese type 2 diabetic patients. Int J Obes Relat Metab Disord. 2001;25:1101-1107.
Nyberg F. Growth hormone in the brain: characteristics of specific brain targets for the hormone and their functional significance. Front Neuroendocrinol. 2000;21:330-348. Pfeifer M, Verhovec R, Zizek B, Prezelj J, Poredos P, Clayton RN. Growth hormone (GH) treatment reverses early atherosclerotic changes in GH-deficient adults. J Clin Endocrinol Metab. 1999;84:453-457. Ren J, Samson WK, Sowers JR. Insulin-like growth factor 1 as a cardiac hormone: physiological and pathophysiological implications in heart disease. J Mol Cell Cardiol. 1999;31:2049-2061.
Rothenberg R. Quality of Life Improves with GH Therapy. Anti-Aging Medical News 2002; Summer-Fall: 34.
Rudman D, Feller AG, Nagraj HS, Gergans GA, Lalitha PY, Goldberg AF, Schlenker RA, Cohn L, Rudman IW, Mattson DE. Effects of human growth hormone in men over 60 years old. N Engl J Med. 1990;323:1-6.
Schaeffer A. Science 1998;281:1285.
Sesmilo G, Biller BM, Llevadot J, Hayden D, Hanson G, Rifai N, Klibanski A. Effects of growth hormone (GH) administration on homocyst(e)ine levels in men with GH deficiency: a randomized controlled trial. J Clin Endocrinol Metab. 2001; 86:1518-1524.
Shalet SM, Brennan BM, Reddingius RE. Growth hormone therapy and malignancy. Horm Res. 1997;48 Suppl :29-32.
Slonim AE, Bulone L, Damore MB, Goldberg T, Wingertzahn MA, McKinley MJ. A preliminary study of growth hormone therapy for Crohn's disease. N Engl J Med. 2000;342: 1633- 1637.
Sonksen PH. Growth hormone replacement in adults with GH deficiency-the first 10 years. Growth Horm IGF Res. 1998;8:275-276.
Swerdlow AJ, Higgins CD, Adlard P, Preece MA. Risk of cancer in patients treated with human pituitary growth hormone in the UK, 1959-85: a cohort study. Lancet. 2002;360:273-277.
Swerdlow AJ, Reddingius RE, Higgins CD, Spoudeas HA, Phipps K, Qiao Z, Ryder WD, Brada M, Hayward RD, Brook CG, Hindmarsh PC, Shalet SM. Growth hormone treatment of children with brain tumors and risk of tumor recurrence. J Clin Endocrinol Metab. 2000;85:4444-4449.
Tacke J, Bolder U, Hermann A, Berger G, Jauch KW. Long-term risk of gastrointestinal tumor recurrence after postoperative treatment with recombinant human growth hormone. J Parenter Enteral Nutr. 2000;24:140-144.
Takala J, Ruokonen E, Webster NR, Nielsen MS, Zandstra DF, Vundelineckx G, Hinds CJ. Increased mortality associated with growth hormone treatment in critically ill adults. N Engl J Med. 1999;341:785-792.
Van der Lely AJ, Lamberts SW, Jauh KW, Swierstra BA, Hertlein H, Danielle De Vries D, Birkett MA, Bates PC, Blum WF, Attanasio AF. Use of human GH in elderly patients with accidental hip fracture. Eur J Endocrinal. 2000;143:585-592.
Vance ML, Muras N. Growth hormone therapy in adults and children. N Engl J Med. 1999;341:1206-1216.
Verhelst J, Abs R. Long-term growth hormone replacement therapy in hypopituitary adults. Drugs 2002;62:2399-2412.
Weltman A, Weltman JY, Veldhuis JD, Hartman ML. Body composition, physical exercise, growth hormone and obesity. Eat Weight Disord. 2001;6:28-37.
Jeffrey Dach MD
7450 Griffin Rd Suite 180/190
Davie, FL 33314