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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.
The effects of GH on the body are indirect as GH actually stimulates the liver to produce another hormone, Insulin-like growth factor or IGF-1, which actually produces all of the known effects of GH. Doctors actually measure IGF-! Levels as a surrogate marker for GH secretion rates. IGF-1 is also known as Somatomedin C.
Vital for bone and organ growth in our youth, in adulthood, GH is essential for many other important functions. It increases the size and amount of brain, muscle, hair, and bone and all other tissues and organs. GH renews, replenishes and preserves these tissues as cells die off and are regenerated.
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:
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.
Dr. Terlinsky can correct your growth hormone deficiency, alleviate your symptoms, and help you live a better, happier life.
Arguments Against Use of GH for the Aging Population.
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.
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.
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:
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.
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.
The best way to evaluate what Nu-Living program is most appropriate for you is to have a short phone conversation about your current state of health. So give us a call at (703) 379-7110. Or if you prefer, fill out our getting started form and we'll get in touch.
Board certified in Internal Medicine and Nephrology, Dr. Terlinsky has over 25 years of active clinical experience. »
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