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Growth hormones
Here’s a quick look at the hysteria, quackery and professional sports
By Dr. John Crisler, DO, PLLC
In previous issues we have explored the hormonal optimization
(Interventional Endocrinology) of testosterone and thyroid. Now we are
going to move on to what many consider a much more controversial topic,
Growth Hormone Replacement Therapy (GHRT). You may have heard or read
numerous reports of both the benefits—and risks—of GHRT. Sports
enthusiasts have no doubt noticed all the current media hype about its
use by athletes (including arrests). More on that later. But what are
the facts?
First, what is Growth Hormone (GH)? It is a hormone (chemical
messenger) produced by the pituitary gland, which is situated at the
base of the brain.
GH is largely responsible for growth and development as our bodies
mature; this is why a shortage causes dwarfism.
But in adult life, GH also helps maintain health and vitality.
As we age, its production lessens, as does testosterone, DHEA, thyroid
and estrogen (in women); these deficiencies contribute to all manner of
illness. Such is the “Neuroendocrine Theory of Aging”, which states we
age because our hormones decline, not the other way around.
It makes sense to many, therefore, to supplement GH as we age, thereby
treating “Adult Onset Growth Hormone Deficiency”.
This is, or SHOULD, be no different than a physician replacing thyroid
hormone (see previous article in H&F) in those who are hypothyroid, or
insulin in those with insulin-dependent diabetes. All cases are merely
treating legitimate hormone deficiencies, where the deficiency is
well-proven to cause morbidity (illness).
Yet, for some reason, GHRT is treated with extreme bias, and, in my
professional opinion, to the detriment of the public health.
Studies published in the prestigious New England Journal of Medicine
show GHRT can help you:
Lose fat and gain muscle
Boost energy
Thicken skin (and therefore reduce wrinkles)
Improve Lipid Profile
Reduce inflammation
Improve sexual function
Increase bone density (prevent, even treat osteoporosis)
Improve immune function
Strip plaque from the arteries
Reduce cardiovascular disease
Reduce permanent damage of the heart after a heart attack
Restore memory and improve mental function
Improve mental outlook
Stave off Alzheimer’s Disease
Decrease healing time after injuries or surgery
Help repair ailing joints
Literally hundreds of scientific studies abundantly demonstrate GHRT
improves both the quality and the quantity of life, and without any
serious or permanent side effects. So what’s the problem?
Many in the conventional medical community insist upon ignoring the
restorative benefits of GHRT—while simultaneously greatly exaggerating
its risks. For instance, Dr. Schlomo Melmed, who claims to be one of
the world’s foremost authorities on hormonal supplementation (he
certainly possesses the credentials), recently stated “You can do
yourself a lot of harm with GHRT”. And Dr. Thomas Perls, who tries to
make similar claims regarding his expertise in this area, even goes so
far as to call GHRT “medical quackery”.
What evidence do these “experts” offer to substantiate their position?
A look at the scientific studies they argue, when evaluated in a
logical, reasonable manner, soon pale to mere examples of inappropriate
therapies, unjustifiable comparisons, even outright (and ridiculous)
misinformation. The public deserves the truth when medical experts are
indeed comparing apples to oranges. Especially given the glowing
reports of improvement in QOL (Quality of Life), and health, by those
patients who get GHRT.
For instance, studies conducted on mice that either produce no growth
hormone, or cannot use that which they do produce, are shown to live
longer. Their conclusion is, apparently, that GH is bad for you. If so,
why did God put it in us? If you actually read this study, you see they
are about a third the size of normal mice, and show little interest in
food. So why do GH-deficient mice live longer? Caloric restriction has
been shown to extend life in numerous species. But even if caloric
restriction allowed us to live to be 200 years old, in the words of Dr.
Ronald Rothenberg, “Who wants to be hungry for two centuries”?
And when we look at actual human studies (instead of rodents), those
who are GH deficient die at least 20 years before their siblings who
are not. A much better comparison, to be sure.
Or how about studies conducted on mice which produce many times the
normal output of GH, which is clearly unhealthy in all species. This is
comparable to acromegaly (gigantism), which is caused by extremely high
natural production of GH, or taking GH at very high doses (like
bodybuilders). It’s just not fair, or legitimate, to use the negative
effects caused by taking many times the recommended dosages of a drug
as evidence that ALL use is detrimental. This is analogous to claiming
you should never take two aspirin because taking a whole bottle may
kill you.
Another study used to “prove” GHRT is dangerous is one which shows
IGF-1 levels (a hormone produced by the liver under GH stimulation) are
elevated in men with increased risk of prostate cancer. There is an
unwarranted leap in logic in assuming this means GHRT increases the
risk of same in the first place. Further, the study shows these men,
all into middle age or older, have IGF-1 levels at 500 or higher. I
have seen IGF-1 tests on literally hundreds of men that age, and have
yet to see a single IGF-1 test that high. Other studies contradict the
previously mentioned; indeed, the majority show those with lower levels
of IGF-1 (and therefore less GH production) get more cancer.
So the biggest reason offered to NOT administer GHRT is the claim it
will increase the risk of cancer. In fact, not one shred of evidence
exists to suggest GHRT either causes cancer, or tumor reoccurrence in
those previously treated for cancer. Still, the package insert for GH
includes this caveat, even though several prestigious physician groups
have recommended it be removed due to the totality of evidence to the
contrary.
Actually, in GH deficient adults, refusing GHRT is associated with a
doubling of cancer risk, and they are four times more likely to die of
cancer than the general population. Pretty hard to argue GHRT is a
cancer cause then, isn’t it?
The simple fact is there are no substantial adverse effects associated
with appropriate GH replacement. But what are the TRUE possible
negative side effects of appropriate GHRT? Some may develop tingling or
numbness in their fingers or toes (parasthesias). Others may hold a bit
of edema (water retention). A few will complain of aching joints.
Finally, blood sugar levels may rise a bit. In all cases, the negative
side effects go away when treatment is halted. Usually just reducing
the dose a bit is all it takes. Therefore absolutely none of the side
effects of appropriate GHRT are serious.
On the other hand, many, many commonly prescribed drugs cause side
effects MUCH worse than these—even risk killing the patient--yet are
still routinely, and chronically, administered. In all cases, it’s a
matter of the risks versus the benefits. But let’s make sure we are
comparing similar fruits.
A twenty year old with pituitary disease would certainly be treated
with GH. However, a 60 year old with the same level of GH is not. Why
should that be? Opponents of GHRT cast dispersions because of the “side
effects” of GHRT. So why, then, would they automatically provide it for
the 20 year old? Hmmm…
And why would so called “experts”, such as Drs. Melmed and Perls, go to
such extraordinary lengths to impugn legitimate GHRT, in the face of
these simple and undeniable facts?
In a future article we will look at the use of GH—at high doses--in
sports. In particular, the cases of pitcher Jason Grimsley, of the
Arizona Diamondbacks, recently busted when a search of his home yielded
a large stash of GH; David Segui, who claims high dose GH Therapy
restored his life following an injury-plagued fifteen year professional
baseball career; and Jose Canseco, who purports a desire to serve as an
“ambassador” for the use of steroids and GH for sports injury
rehabilitation (frankly, most of us in my field would probably prefer
to NOT be associated with the likes of Mr. Canseco). The future of GH
Therapy for rehabilitating injuries is indeed bright—but what are the
REAL dangers of such high dose therapies, and what effects will same
have not only on the sports community in particular, but our society as
a whole? We’ll also include an interview I did of my friend and
colleague Dr. Mark Gordon (recently featured on the July 3, 2006
episode of ESPN’s “Outside the Lines”), a legitimate expert in GH
Therapy, about GH uses in both Anti-Aging and Sports Medicine. Stay
tuned!
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