What is Growth Hormone?

Growth Hormone (sometimes referred to as GH, HGH, rhGH or Somatotropin) is a circular appearing hormone composed of 191 amino acids (see image). GH is a developmentally crucial, tissue-building hormone. GH is very plentiful from birth through puberty and late teens as we achieve adult body height and tissue composition.

GH release, which comes about by the pituitary gland secreting between 10 and 30 pulses of GH per day, peaks during the accelerated growth years of adolescence and teenage. Age related changes in GH secretion are a near universal phenomenon in humans decreasing over time. The greatest change in GH secretion occurs between the ages of 20 and 40 years. Age related decrease in GH secretion ranges from 15% in the first decade after adulthood to as much as 70% at middle age and beyond.

Children found to be GH deficient are aided in growth when they are given GH. It is of note that a 60-year-old man may have the same GH secretion rate as a 12-year-old growth deficient child receiving GH. There is no consensus on whether to consider the 60 year as ” normal for age” or GH deficient and in need of GH.

Do I Have Low Growth Hormone?

When we age there are significantly lowered levels of GH resulting in reduced renewal of tissues and organs. Lowered GH levels correlate with everything we commonly associate with aging including:

  • Loss of skeletal muscle causing the characteristic thinning of the arms, legs and trunk muscles.
  • Thinning of skin.
  • Loss of underlying collagen resulting in skin sagging and wrinkling.
  • Deposition of fat, especially in the abdomen and weight gain.
  • Increasing concentrations of blood glucose and resistance to insulin.
  • Accumulation of cholesterol and triglycerides that lead to clogging of arteries and heart attacks and strokes.
  • Increasing blood pressure.
  • Decay of immune function leading to increased vulnerability to cancer and infections.
  • Loss of secondary support for other endocrine functions such as the reproductive system, resulting in reduced production and sensitivity to sex hormone function.
  • Neurological and cognitive decline associated with memory loss and dementia
  • Osteoporosis (bone thinning), reduced height

Indeed, a GH deficient young person is susceptible to all of the above conditions associate with old age. These patients appear to be suffering from ‘premature aging.” Treatment with GH for the young GH deficient patient reverses this process, which is, has been the theoretical impetus to treat deteriorating elderly patient with GH in the first place.

The Solution: Dr. Terlinsky’s Bioidentical Hormone Replacement Therapy

Dr. Terlinsky can correct your growth hormone deficiency, alleviate your symptoms, and help you live a better, happier life.

A word of caution about GH use

Arguments Against Use of GH for the Aging Population.

  • Concern that GH will produce too many dangerous side effects.
  • Concern that GH will be expensive, risky and found to offer no real benefit.
  • Actually will cause harm, worsen the conditions associated with aging.
  • Be unethical as it is not part of present day mainstream medicine.

There are several small studies that can point to negative effects of GH, or the lack of benefit of GH or the risk of shortened lifespan. Please see the material below for a discussion of these issues.

Cautions: GH must not be used with cancer patients It is a FDA contraindication. Although most studies show no impact of GH on patients with cancer. All patients must have cancer screening prior to starting GH.

Can GH treatment cause cancer?

Most studies in fact show a reduction in overall cancer including breast and prostate cancer but not bowel cancer when IGF-1 levels were very high. In fact persons with hypopituitarism (almost absent GH) have increased cancer risk up to 5 times higher. This is back to less than normal, on GH replacement. Commonsense applies – on GH means regular health checkups.GH administration MUST be done under supervision of a trained doctor familiar with GH dosing, monitoring and effects.

Growth Hormone and the Law

It is also important to mention the highly regulated legal environment surrounding the use of GH in adults. It is the only FDA approved drug which is ILLEGAL to prescribe “off label’. Doctors risk fine, loss of medical license and prison for prescribing GH for any reason other than the two legal adult indications:

  • Adult GH Deficiency (AGHD)
  • Wasting state of HIV infection

It is prohibited by federal law to prescribe GH to adults for “anti-aging” purposes. The key is to use GH only when AGHD is properly diagnosed.

GH can at this point only be administered by daily subcutaneous injections. A pen using a small diabetic type painless needle is available from several manufactures. Some brands are Genotropin, Humatrope, Norditropin, Saizen, and Serostim. It is available only by prescription and by injection. Cost is very high and not a viable option for many patients. Other less expensive options are available using oral secretogogues and Growth Hormone Releasing Hormone. Please see discussion below.

Diagnosis of GH deficiency:

The proper way to make the diagnosis of AGHD is by a combination of clinical history, physical examination, and various blood and urine tests. There is much honest debate between many knowledgeable doctors and scientists on the exact findings and tests, which are needed to make the definitive diagnosis. It is by no means an exact science. A good place to start is with a GH deficiency questionnaire. Depending on your answers, you may be a candidate to consider a work-up for AGHD. Medical organizations like the Endocrine Society or the American Association of Clinical Endocrinologists have issued guidelines. All physicians acting in good faith to diagnose and treat their patients with GH for AGHD do not universally accept these guidelines. Many articles in mainstream peer reviewed endocrine journals put forth opposing points of view. Some doctors rely on IGF-1 levels and clinical status and history while others prefer to do various GH challenge or stimulation tests, which are expensive, and sometimes dangerous. Many physicians point to literature downplaying the accuracy, specificity and reproducibility of GH stimulation tests.

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