Articles, among many, that you will never see mentioned by anti-aging clinics, "doctors" and websites
The anti-aging industry will say there are thousands of articles supporting the use of GH for anti-aging. This is utter nonsence. THERE ARE NO PROPERLY PEER REVIEWED CLINICAL STUDIES SUPPORTING THE USE OF GH FOR AGING OR PROBLEMS ASSOCIATED WITH AGING. Furthermore, there are no studies demonstrating the long term safety of GH.
The support for GH is all concocted marketing by the anti-aging and age-management industry.
On the contrary. there is plenty of scientifically responsible and rigorous studies demonstrating that: *GH SHORTENS LIFESPAN IN MOUSE STUDIES *GH INCREASES CANCER RISK IN ADULTS *GH IS ASSOCIATED WITH NUMEROUS BOTHERSOME AND SERIOUS SIDE EFFECTS
The following are recent peer reviewed high profile academic journal articles that make it clear that there is substantial risk in the face of very little if any benefit in taking GH for aging and age-related problems or diseases.
Human growth hormone is no ‘fountain of youth’ January 28th, 2010
Human growth hormone (HGH) may not be the “fountain of youth”, according to a new study.
Researchers at the Johns Hopkins University School of Medicine have found that people, who are deficient in human growth hormone (HGH) due to a genetic mutation, live just as long as people who make normal amounts of the hormone.
“Without HGH, these people still live long, healthy lives, and our results don’t seem to support the notion that lack of HGH slows or accelerates the aging process,” said Dr. Roberto Salvatori.
For the study, the researchers, worked with an unusual population of dwarves residing in Itabaianinha county, a rural area in the northeastern Brazilian state of Sergipe.
Led by Salvatori, the researchers sought to sort out conflicting results of previous studies on the effects of HGH on human aging.
Some studies have suggested that mice whose bodies don’t efficiently produce or process the mouse equivalent to HGH have an extended lifespan.
HGH has been widely touted - especially on Internet sites - as an anti-aging marvel.
In an attempt to resolve the research discrepancies about HGH’s anti-aging value, the researchers studied 65 of the Brazilian dwarves.
Each member of this group has two mutant copies of a gene responsible for releasing HGH, leading to a severe congenital HGH deficiency.
All of the study subjects have unmistakable characteristics of the deficiency- very short stature, childlike facial appearance, and high-pitched voices.
After genetic tests confirmed the presence of the mutation, the researchers collected birth dates and, for those deceased, death dates for the dwarves and their 128 unaffected siblings among 34 families.
They compared these life spans with each other, as well as with the death rate in the general local population.
The researchers found that those deficient in HGH lived just as long as their unaffected siblings.
When this subgroup was excluded from the analysis, average lifespan among the dwarves and the general population was identical.
Salvatori said that the findings suggest that levels of HGH don’t affect lifespan positively or negatively.
The study has been published in the latest issue of the Journal of Clinical Endocrinology and Metabolism.
Apparently not. New research says there's no proof of its supposed anti-aging powers By Lisa Stein Many people will do almost anything to try to stave off aging--from undergoing painful nips and tucks to slathering on expensive creams to getting injections and downing pills that promise to erase wrinkles, lift sagging skin and keep the body forever young. One of the hottest anti-aging elixirs du jour is human growth hormone (GH), which has been touted for its supposed ability to do everything from build muscle to shave fat to thicken bones to lower cholesterol.
But beware: Eager as you might be to purchase youth in a bottle, a new study says there's zero scientific evidence that growth hormones are any more effective at turning back the clock than tap water or snake oil.
On the contrary: Researchers found that if taken by healthy adults it could cause a host of unhealthy side effects, including joint pain, soft tissue swelling, carpal tunnel syndrome, increased breast size in men, and a heightened risk of diabetes and pre-diabetes.
"Growth hormone should not be used for anti-aging purposes," says Hau Liu, a research fellow in endocrinology and health policy at Stanford University and author of the new study appearing in the January 16 issue of the Annals of Internal Medicine. "This costs hundreds to thousands of dollars a month and there is no scientific evidence supporting it and very real, potentially serious side effects."
Liu's team reviewed published studies of healthy senior citizens using growth hormones. At best, they found that the drugs increased lean body or muscle mass by slightly more than two kilograms (just over four pounds) and decreased fat mass by roughly the same amount. But Liu says the body changes did not translate into benefits: Longevity, bone density, cholesterol levels, stamina and blood sugar levels did not significantly change or improve.
"If you went to a gym pretty regularly, you might get that change without breaking into too much of a sweat," he says, "and you wouldn't spend $1,000 to $2,000 a month on something that appears to have minimal or no benefit and has the potential of some very serious side effects."
Liu notes that the biggest surprise was the dearth of data in this area, given the widespread popularity of GH as a supposed anti-aging therapy. In fact, he says, researchers reviewing scientific evidence found that there were only about 500 patients involved in rigorous controlled trials and that only a few more than 200 of them actually received growth hormones.
Human growth hormone is a protein naturally produced by the pituitary gland (at the base of the brain) that helps regulate growth during childhood and metabolism in adults. Production peaks during childhood and in the teen years and starts dipping at around age 30 and continues to decline into old age.
The Food and Drug Administration (FDA) has only approved the drug, now produced synthetically, to treat children with short stature (caused by growth hormone deficiency and some diseases and other growth problems)--and to treat adults who suffer from a growth hormone deficiency causing conditions like bone loss, high cholesterol and low energy.
The FDA bars pharmaceutical companies from marketing growth hormones for off-label uses such as anti-aging. But that hasn't stopped mostly Internet vendors from peddling--and thousands of people from snapping up--pills, sprays and injections supposedly containing GH as a passport to the Fountain of Youth. It is estimated that as many as 30,000 people in the U.S. used human growth hormone as an anti-aging agent in 2004, about 10 times as many as in the 1990s, despite the hefty price tag and the fact that it is not approved for such use.
Growth hormones took off as an anti-aging sensation in 1990 after a paper was published in the New England Journal of Medicine (NEJM) that presented the findings of a study involving a dozen men over age 60 injected with growth hormones three times a week for six months. At the end of the treatment, they had increases in lean body mass and bone mineral, unlike a group of nine men who had received no treatment.
The authors of that study did not make any claims that the treatment had reversed the aging process and stressed that more research was needed to draw any conclusions. But they did note that the increase in muscle and decrease in fat were "equivalent in magnitude to the changes incurred during 10 to 20 years of aging."
The statement attracted a heap of media attention, which triggered an explosion in use of growth hormones for anti-aging purposes. The NEJM tried but failed to quiet the hype with an editorial accompanying the article-- and one in 2003-- that warned against using growth hormones as an anti-aging therapy.
"My suggestion is that growth hormone should not be used for anti-aging," Liu says. "Rather than looking at growth hormone as a magic bullet or [ticket to] the fountain of youth, if you want to increase your chances of living a long and productive life, you should do the things that your moms and doctors always told you: Eat right, exercise often, get enough sleep, and don't smoke."
Study: Human growth hormone is no magic wand for aging
Human growth hormone is being sold in increasing amounts as a cure-all for the ravages of aging, but new research shows no evidence for these claims -- and even possible dangers from the treatments.
So concludes a study from Stanford University researchers reported in the Jan. 16 Annals of Internal Medicine.
Growth hormone is widely promoted on the Internet and its use as an anti-aging drug has been touted in media ranging from NBC's "Today" show to Business Week.
However, Dr. Marc Blackman, clinical director of the U.S. National Center for Complementary and Alternative Medicine, who was not involved in the new study, said: "I'm concerned this is a substantial and growing problem. In an aging society, wanting to age healthfully and well has included the use of this very powerful hormone, the effectiveness and safety of which are still under investigation and have not been proved for this purpose."
The negative side effects of growth hormone include joint swelling and pain, carpal tunnel syndrome and a trend toward an increased risk of diabetes or pre-diabetes, according to the study.
"Human growth hormone is not the fountain of youth," said the study's lead researcher, Dr. Hau Liu, a research fellow in the division of endocrinology at Stanford's Center for Primary Care and Outcomes Research.
Liu noted that as many as 30,000 people in the United States are taking growth hormone to try to stop the aging process. "They are spending anywhere from a few hundred to a few thousand dollars a month," he said. "They are spending this amount of money and getting only a slight, if any, benefit, but increasing the risk of serious side effects."
The researchers looked at 31 studies that included just 220 patients. "There is very little scientific evidence evaluating growth hormone for aging," Liu said. "This limited evidence suggests that there is very modest benefit and a potential for side effects."
Growth hormone caused small changes in body composition, such as a small gain in muscle mass and a small decrease in fat -- about 2 kilograms (4.4 pounds), Liu said. This is no more than you would get from moderate exercise, he noted. However, there was a potential for some serious side effects, including, in men, the risk for abnormal breast development. These side effects are reversible when one stops taking the hormone, Liu said.
Liu noted that growth hormone is not approved by the U.S. Food and Drug Administration for use as an anti-aging medication.
"If you want to increase your probability of living a long, healthy life, (then) eat right, get some exercise, get enough sleep. Those things probably increase your probability of living a long, fruitful life," Liu said.
One expert believes that growth hormone has no place as an anti-aging remedy and may come with dangers.
"The hucksters touting growth hormone as a magic bullet against aging claim that thousands of studies have been conducted on the hormone. Liu demonstrates definitively that this is not true -- only a handful of studies have ever been conducted using growth hormone in adults," said S. Jay Olshansky, a professor of public health and senior research scientist at the Center on Aging at the University of Illinois, Chicago.
Olshansky also accused people who dispense growth hormone of acting irresponsibly.
"If those running anti-aging or so-called longevity clinics continue to openly and brazenly administer growth hormone to their patients as an anti-aging intervention, they will not only be openly violating the law, they may very well be jeopardizing the health of their patients," he said.
As men and women age, there is a progressive slow decline in the release of growth hormone, Blackman said. By the time people reach their late 60s or 70s, the reduction in the production of growth hormone is as much as 50 percent to 75 percent less than when they were in their 20s, he explained.
Growth hormone boosts fluid not muscle
Anna Salleh
ABC Science Online
Monday, 4 June 2007
Fluid retention, not increased muscle mass, is what you can expect if you take human growth hormone to cheat at sport, a new study shows. So why are drug cheats taking it? (Image: iStockphoto)
Cheating athletes who take human growth hormone to bulk up are wasting their time as well as risking their career and health, say Australian researchers.
A new study has found the hormone retains fluid rather than builds muscle, although not all experts are convinced by the findings.
A team co-ordinated by Dr Anne Nelson of the Garvan Institute of Medical Research in Sydney reports its findings at a conference in Canada this week.
"Using high but safe doses, we were somewhat surprised to find that human growth hormone did not increase muscle mass or improve sports performance," says Nelson.
"We believe that if there had been a dramatic effect [on muscle mass] we would have seen it."
A total of 63 male and 33 female recreational athletes were recruited for the study. They were young and healthy and did 2-10 hours of exercise a week.
They were given either a placebo or a dose of human growth hormone (hGH) four times the body's normal level. The men were also given testosterone or a combination of testosterone and hGH.
After two months the study participants were tested for muscle mass, strength, power and endurance.
While the results showed that human growth hormone increased body mass, this was not mainly because of increased muscle mass.
"It put on fluid rather than muscle," says Nelson.
The team could also find no benefits of hGH to sports performance.
Testosterone effects
While hGH did not have any effects on its own, when taken with testosterone, it did increase muscle mass, says Nelson.
And it also increased one aspect of performance called sprint power, measured by how fast people could cycle on an exercise bike in short period of time.
Nelson speculates there is a synergistic effect between the two hormones, which act through different mechanisms.
The team also evaluated the effectiveness of a new hGH test they are helping to develop and found it could pick up the hormone several weeks after it was taken.
The researchers found the test was more sensitive when hGH and testosterone were taken together.
A lab technician prepares samples for doping analysis (Image: Reuters/Jean-Bernard Sieber)
Nelson says assuming the World Anti-Doping Authority approves the test, it could complement the existing test used to pick up hGH.
"My final words would be any one thinking of taking growth hormone should really think very carefully about it," says Nelson.
She says that as well as causing fluid retention, high levels of hGH taken long term can lead to cardiovascular problems and diabetes.
Sports physician Dr Peter Larkins says he hopes the findings are supported by future studies but for now he does not think they will stop the cheats.
"It's unlikely that people are going to be deterred because one study says we don't think [hGH] helps all that much," says Larkins, a medical consultant to the Australian Institute of Sport.
He says people are influenced by powerful anecdotal evidence from the gym, body building and weightlifting worlds that taking five to 10 times the normal levels of hGH makes you leaner and boosts muscle.
The body shape achieved when fluid is retained is quite different to what people are reportedly seeing, says Larkins.
He says he also finds it hard to believe that fluid retention is the main effect of growth hormone given its normally function in the body is to boost protein synthesis.
Larkins would like to see the study repeated using conditions that are closer to those in the field.
But Nelson says there are ethical restrictions on using higher doses and elite athletes.
"We had to be very careful that we didn't have anyone in the study who would be subject to drug testing, or in a situation where taking these drugs was banned," she says.
One interesting finding from the double-blinded study is that there was a very strong placebo effect.
"Half of those who were on placebo actually thought they were taking active treatment," says Nelson.
"In men 80% of the placebo group thought they were on active treatment."
AMERICAN ASSOCIATION OF CLINICAL ENDCRINOLOGISTS (AACE) ANNUAL MEETING HIGHLIGHTS
SEATTLE, April 16 -- Human growth hormone is useful in adult patients for correction of endocrine deficiencies but not as a fountain of youth, reported investigators here.
Action Points
Explain to interested patients that human growth hormone can be beneficial in adults with endocrine deficiencies, but there is no reliable evidence to show that it is a safe or effective anti-aging therapy.
This study was published presented orally at a conference. These data and conclusions should be considered to be preliminary as they have not yet been reviewed and published in a peer-reviewed publication.
Recombinant human growth hormone (rHGH) is actually underused in transition patients -- those who were treated for endocrine disorders in childhood but are now on the cusp of adulthood, said David Cook, M.D., of the Oregon Health Sciences University in Portland.
But when the patient is an otherwise healthy adult who sees rHGH as a magic shield against the ravages of time, the evidence just isn't there, while evidence of potential harm is abundant, noted George Merriam, M.D., of the University of Washington here.
Dr. Cook and Dr. Merriam discussed the practical applications and pitfalls of human growth hormone in adults at a general session of the American Association for Clinical Endocrinologists meeting here.
Whether to stop rHGH or when is unclear, Dr. Cook said, but the rule of thumb is that treatment should continue until patients reach their final adult heights, and at that point they should be reassessed to determine whether there is persistence of the natural growth hormone deficiency.
Although some investigators have suggested that transition patients could be put on hiatus from growth hormone therapy for up to two years, patients often experience a gain in body fat and a loss of bone mineral density in the interim, Dr. Cook noted.
"Soft tissue density body composition deteriorates rapidly after growth hormone is discontinued," he said, "and bone mineral density probably can coast a little bit for a while -- 18 to 24 months after you've kick-started it. But we worry about accrual and whether you've lost that period of growth."
Young adult patients generally need growth hormone replacement therapy throughout the accrual phase of bone mineral deposition, which peaks at ages 25 to 30 (later in men than in women).
Growth hormone in transition patients can also protect against cardiovascular risks, especially a decrease in ejection fraction, that can occur when supplemental therapy is stopped, according to Dr. Cook.
And although the use of human growth hormone in early clinical studies was thought to increase the risk for certain malignancies based on in vitro studies and associated with increased risk for some malignancies, including colorectal, breast, and prostate cancer cell lines, and lymphoma, those studies were mixed and were based on experience with hormone derived from human pituitary extracts, and not the recombinant hormone in use today, Dr. Merriam noted.
"Probably the most rigorous single study in the United States is the childhood cancer survivor study, funded by the National Cancer Institute," Dr. Merriam said. "There was no recurrence in the recurrence rate of leukemia in the growth-hormone treated patients, and for all diagnoses there was no tumor recurrence. In fact, for certain categories of tumors, including CNS tumors and medulloblastoma, the recurrence rate is actually reduced in the growth-hormone treated patients."
Current consensus is to withhold growth hormone from patients with active malignancies and those in whom cancer status is not clear, Dr. Merriam said.
As for the use of growth hormone to keep youth a little longer or to enhance athletic performance, the most widespread off-label uses of the substance, Dr. Merriam noted that in these applications patients are starting from a physiologically normal base and adding more synthetic HGH into the mix.
"Remember, going above normal is a condition called acromegaly," he said.
He also noted that the study that kicked off the human growth hormone craze, published in the New England Journal of Medicine in 1990, was uncontrolled, involved only 21 men from the ages of 61 to 81, and lasted for only six months. That study, by Daniel Rudman, M.D., of the Medical College of Wisconsin in Milwaukee, and colleagues, purported to show that human growth hormone in older men was associated with a decrease in body fat, increase in lean muscle mass, and a 1.6% increase in average lumbar vertebral bone density.
"Remarkably, after only six months of therapy he saw an increase in vertebral bone density, and those of you who have looked at growth hormone and bone know that 12 to 18 months is the least you can treat for in order to be able to see increases in bone density," Dr. Merriam said. "He also reported no significant side effects, and everybody who has tried to replicate these findings with the same doses has run into severe side effects and has had to cut doses by a half to a third."
The Diagnosis of Partial Growth Hormone Deficiency in Adults with a Putative Insult to the Hypothalamo-Pituitary Axis
Robert D. Murray, Martin Bidlingmaier, Christian J. Strasburger and Stephen M. Shalet
Department of Endocrinology (R.D.M., S.M.S.), Christie Hospital, Manchester M20 4BX, United Kingdom; St. James’s University Hospital (R.D.M.), Leeds LS9 7TF, United Kingdom; Medizinische Klinik-Innenstadt (M.B.), Ludwig-Maximilians Universitat, D-80336 Munich, Germany; and Charite Universitatsmedizin (C.J.S.), D-10117 Berlin, Germany
Address all correspondence and requests for reprints to: Professor S. M. Shalet, Department of Endocrinology, Christie Hospital National Health Service Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom. E-mail: stephen.m.shalet@man.ac.uk
.
Context: Similar to patients with severe GH deficiency (GHD),those with a more moderate impairment of GH secretion [GH insufficiency(GHI)] have abnormal body composition, dyslipidemia, and insulinresistance. Given the inherent problems in the diagnosis ofsevere GHD, the situation is likely to be even more difficultin individuals with GHI.
Objective: The objective of the study was to examine the utilityof GH stimulation tests and GH-dependent proteins in the diagnosisof GHI.
Design: The study was a cross-sectional, case-controlled study.
Patients: The study included 31 patients with GHD, 23 with GHI[peak GH 3–7 µg/liter (9–21 mU/liter)], and30 age- and sex-matched controls.
Main Outcome Measures: Demographic and biochemical markers ofGH status were measured.
Results: Nineteen of the patients with GHI (83%) had no additionalanterior pituitary hormone deficits. Ten GHI patients showeddiscordant GH status based on the two GH stimulation tests performed.GH status was defined by the highest peak GH value achieved;in four this was to the insulin tolerance test (ITT), four thearginine test, and two the GHRH-arginine test. In five of thesix patients in whom GH status was not defined by the ITT, peakGH levels to the ITT were in the range 2.4–2.9 µg/liter.IGF-I values for the GHI adults were significantly lower thanthe control subjects (121 ± 48 vs. 162 ± 75 µg/liter;P < 0.05); however, only six (26%) had values below the 10thpercentile of levels seen in the control group. IGF bindingprotein-3 and acid labile subunit levels of the GHI adults werenot significantly different from the controls.
Conclusion: The diagnosis of GHI in an individual is extremelydifficult because the patients rarely exhibit additional pituitaryhormone deficits, and levels of GH-dependent proteins are normalin the majority. Diagnosis relies heavily on GH stimulationtests and requires two tests in all patients to define GHI;obesity when present is potentially a major confounder.
Does growth hormone prevent aging? An article by Rudman et al.that appeared in the Journal in 1990
1 reported the effect onbody composition of administering human growth hormone for sixmonths to 12 older men. This article incited a proliferationof "antiaging" clinics and lay publications, such as "Grow Youngwith HGH," extolling the benefits of growth hormone in reversingor preventing aging. There are several Web sites that attemptto sell various oral and inhaled formulations of growth hormone;none of these formulations have been shown to be efficacious.In fact, since growth hormone is a peptide subject to degradationby gastric acid, oral preparations would not be expected tobe effective. Other Web sites are selling oral formulations(branched-chain amino acids) that are claimed to release growthhormone. These oral formulations are based on studies of intravenousarginine. Intravenous arginine increases serum concentrationsof growth hormone transiently (for less than one hour). Theeffect of oral branched-chain amino acids is akin to that ofeating a steak. Clinical medicine is practiced on the basisof established evidence regarding outcomes. What is the evidencesupporting the use of growth hormone to prevent aging?
First, it is necessary to recall exactly what the study by Rudmanet al. demonstrated. Twelve healthy men, 61 to 81 years of age,who had serum concentrations of insulin-like growth factor Ibelow those found in normal young men received growth hormonefor six months. (Insulin-like growth factor I mediates the actionof growth hormone, and its concentration reflects the circulatingconcentration of growth hormone.) The weekly dose of growthhormone was approximately twice as high as the dose used inadult men with a growth hormone deficiency.
The administration of growth hormone in older men resulted ina 4.7-kg increase in lean body mass, a 3.5-kg decrease in adiposemass, and an increase of 0.02 g per square centimeter in lumbar-spinedensity; systolic blood pressure and the fasting glucose concentrationincreased significantly. The study was not double-blind (therewas a control group consisting of nine men who received no treatment);there were no assessments of muscle strength, exercise endurance,or quality of life. This study is the basis for claims thatgrowth hormone reverses aging. My editorial accompanying thearticle by Rudman et al.2 concluded that such studies in olderadults "should be viewed as an important beginning," with theimplication that subsequent studies would determine the benefitsand risks of growth hormone treatment in older adults.
A recent double-blind, placebo-controlled study involving 27women and 34 men, 68 to 88 years of age, who were given growthhormone or placebo for 6.5 months confirmed the effects of growthhormone on body composition; there was no change in muscle strengthor maximal oxygen uptake during exercise in either group.3 Thisstudy corroborated the findings of a study by Papadakis et al.involving 52 healthy men, 70 to 85 years of age, who were givenplacebo or growth hormone for six months.4 Not mentioned onthe "antiaging" Web sites is a study of 18 healthy men, 65 to82 years of age, who underwent progressive strength trainingfor 14 weeks, followed by an additional 10 weeks of strengthtraining plus either growth hormone or placebo.5 In that study,resistance exercise training increased muscle strength significantly;the addition of growth hormone did not result in any furtherimprovement. Going to the gym is beneficial and certainly cheaperthan growth hormone.
The second consideration is the effect of long-term administrationof growth hormone. It is not known whether long-term administrationof growth hormone in the elderly is potentially harmful —particularly with regard to the risk of cancer, given that olderage is associated with an increased incidence of cancer. In152 healthy men, the relative risk of the subsequent developmentof prostate cancer was increased by a factor of 4.3 among menwho had serum concentrations of insulin-like growth factor Iin the highest quartile, as compared with those whose concentrationswere in the lowest quartile.6 This finding does not demonstratecausality by growth hormone or insulin-like growth factor I,but it does raise concern about giving older men growth hormone,which increases serum concentrations of insulin-like growthfactor I.
The third matter of concern is the potential misuse of healthcare resources. Growth hormone replacement in growth hormone–deficientadults with pituitary disease is expensive, costing between$7,500 and $10,000 yearly. It is not known precisely how muchgrowth hormone is prescribed for "off label" uses, but estimatessuggest that one third of prescriptions for growth hormone inthe United States are for indications for which it is not approvedby the Food and Drug Administration. How many of these prescriptionsare reimbursed inappropriately by third-party payers? It isoften difficult to obtain third-party payment for growth hormonereplacement for adults with documented hypopituitarism and growthhormone deficiency — hence the concern about the inappropriateallocation of resources and denial of reimbursement for appropriatepatients in whom growth hormone replacement is beneficial.
Studies that have followed the 1990 report by Rudman et al.confirm the effects of growth hormone on body composition butdo not show improvement in function. In contrast, resistancetraining improves muscle strength and function, indicating thatreal effort is beneficial. There is no current "magic-bullet"medication that retards or reverses aging. It remains to bedetermined whether growth hormone secretagogues that consistentlyincrease endogenous production of growth hormone are beneficialin the elderly. Antiaging therapy with growth hormone has notyet been proved effective according to objective outcome criteria.
Dr. Vance has reported receiving grant support and consultingfees from Pharmacia and grant support from Eli Lilly and Genentech.
Systematic Review: The Safety and Efficacy of Growth Hormone in the Healthy Elderly
ANNALS OF INTERNAL MEDICINE: 16 January 2007 | Volume 146 Issue 2 | Pages 104-115
Background: Human growth hormone (GH) is widely used as anantiaging therapy, although its use for this purpose has notbeen approved by the U.S. Food and Drug Administration and itsdistribution as an antiaging agent is illegal in the UnitedStates.
Purpose: To evaluate the safety and efficacy of GH therapyin the healthy elderly.
Data Sources: The authors searched MEDLINE and EMBASE databasesfor English-language studies published through 21 November 2005by using such terms as growth hormone and aging.
Study Selection: The authors included randomized, controlledtrials that compared GH therapy with no GH therapy or GH andlifestyle interventions (exercise with or without diet) withlifestyle interventions alone. Included trials provided GH for2 weeks or more to community-dwelling participants with a meanage of 50 years or more and a body mass index of 35 kg/m2 orless. The authors excluded studies that evaluated GH as treatmentfor a specific illness.
Data Extraction: Two authors independently reviewed articlesand abstracted data.
Data Synthesis: 31 articles describing 18 unique study populationsmet the inclusion criteria. A total of 220 participants whoreceived GH (107 person-years) completed their respective studies.Study participants were elderly (mean age, 69 years [SD, 6])and overweight (mean body mass index, 28 kg/m2 [SD, 2]). Initialdaily GH dose (mean, 14 µg per kg of body weight [SD,7]) and treatment duration (mean, 27 weeks [SD, 16]) varied.In participants treated with GH compared with those not treatedwith GH, overall fat mass decreased (change in fat mass, –2.1kg [95% CI, –2.8 to –1.35] and overall lean bodymass increased (change in lean body mass, 2.1 kg [CI, 1.3 to2.9]) (P < 0.001), and their weight did not change significantly(change in weight, 0.1 kg [CI, –0.7 to 0.8]; P =0.87). Total cholesterol levels decreased (change in cholesterol,–0.29 mmol/L [–11.21 mg/dL]; P = 0.006), althoughnot significantly after adjustment for body composition changes.Other outcomes, including bone density and other serum lipidlevels, did not change. Persons treated with GH were significantlymore likely to experience soft tissue edema, arthralgias, carpaltunnel syndrome, and gynecomastia and were somewhat more likelyto experience the onset of diabetes mellitus and impaired fastingglucose.
Limitations: Some important outcomes were infrequently or heterogeneouslymeasured and could not be synthesized. Most included studieshad small sample sizes.
Conclusions: The literature published on randomized, controlledtrials evaluating GH therapy in the healthy elderly is limitedbut suggests that it is associated with small changes in bodycomposition and increased rates of adverse events. On the basisof this evidence, GH cannot be recommended as an antiaging therapy.
Editors' Notes
Context
Human growth hormone (GH) is widely sold and usedas an antiaging agent.
Contributions
The researchers reviewedall clinical trials of GH to determine if it is safe and effectivein the healthy elderly. They found that GH had no importanteffects on body composition but led to frequent adverse effects,most notably soft tissue edema and arthralgias.
Cautions
Clinicaltrials of GH have been small, and they may not have been ableto detect important differences.
Implications
Publisheddata about GH use in the elderly is limited, but available evidencesuggests that risks far outweigh benefits when it is used asan antiaging treatment in healthy older adults.
Source Information
From the Department of Medicine, University of Virginia Medical Center, Charlottesville.
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