Perils of Growth Hormone for ‘Antiaging’

Perils of Growth Hormone for ‘Antiaging’

Is growth hormone the magic elixir that can stop the aging processverbial “Fountain of Youth?”

Not according to the scientific literature. In fact, when misused for this purpose, clinical data indicate that the risks far outweigh any minimal potential benefits. For this reason, the US Food and Drug Administration (FDA) has approved growth hormone for a narrow indication — for children and adults who are truly deficient in it, as determined by strict diagnostic tests.

Yet “antiaging” clinics and websites that promise renewed vitality from “growth hormone replacement therapy” abound. And every so often, a physician is caught inappropriately prescribing growth hormone — possibly to patients that he or she has not seen or to professional athletes seeking a performance boost — which hits the headlines.

Let me be clear: this is not a “fun” therapy to try!  This is bad medicine!

In March of this year, for example, Andrew D. Pauli, MD, a Washington-state psychiatrist and medical director of the Elan Vital Longevity Institute, admitted to unprofessional conduct related to 5 patients whom he treated with human growth hormone (HGH).

Dr. Pauli confessed to not properly diagnosing a deficiency in growth hormone, for which he agreed to pay an $8000 fine, attend a 2-day ethics course, and be put on probation for up to 4 years, during which time he can practice medicine but can’t dispense growth hormone.

Appropriate vs Inappropriate Use

There are proper uses of this therapy. “There is good evidence that adults with growth-hormone deficiency when supplemented with growth hormone feel more energetic and have slightly better lean-body-mass to fat-body-mass ratio,” said endocrinologist Ronald Tamler, MD, from Mount Sinai Diabetes Center, New York.

However, “growth-hormone supplementation [in adults with no deficiency] has not been associated with improvements in longevity or any other relevant benefit,” he asserted.

The decline in levels of growth hormone that accompany normal aging can in no way be considered a “deficiency.”

The FDA approval for the use of  HGH is limited to a few conditions: as well as children with a growth-hormone deficiency and adults with growth-hormone deficiency due to rare pituitary tumors, there are just 2 other legal indications: HIV/AIDS muscle-wasting disease and short bowel syndrome.

And Section 333e of the Food and Drug Cosmetic Act states that HGH is authorized for these specific medical conditions, “but not for use for antiaging, body building, or athletic enhancement.”

Merely determining that an adult has low levels of insulinlike growth factor-1 (IGF-1) is not sufficient — unless the patient has deficiencies in multiple other pituitary hormones or had childhood growth-hormone deficiency. To be diagnosed with HGH deficiency, a patient must also have a subnormal response — a peak HGH level below 5 ng/mL — in a growth-hormone stimulation test.

Some devious doctors might do a stimulation test but use a test that is less sensitive or specific to show that a patient has a deficiency“It’s fairly common [for unscrupulous individuals] to come up with a diagnosis of adult growth-hormone deficiency using [tests] that are not appropriate,” agreed S. Jay Olshansky, PhD, from the School of Public Health, University of Illinois at Chicago. Dr. Olshansky has a special interest in aging research.

Since growth hormone is legally available, “many unscrupulous prescribers in Canada and the US have taken advantage of [this] to prescribe it off label,” said endocrinologist Shereen Ezzat, MD, from the University Health Network and University of Toronto, Ontario.

He says that antiaging clinics — also called wellness, longevity, or life-extension centers — appeal to 3 types of customers: “relatively young men seeking drugs to enhance body building, professional athletes who try to get an edge, and finally middle-aged individuals who are falling for the scam that these drugs stop or reverse aging.”

But none of the scientific evidence supports the myriad of claims made by antiaging clinics for the benefits of HGH.

Another concern is that growth hormone may promote the growth of malignancies – there are many pathologies that feed off of high levels of the medicines used in “antiaging.”

And ironically, growth hormone can actually accelerate aging, Dr. Olshansky noted.

Individuals are paying up to $12,000 a year for growth hormone, said Dr. Perls. Cost is therefore a major factor why many discontinue it after a few months. Others include a lack of tangible benefit and presence of unpleasant side effects, he said.

There is an urgent need for adequate resources to investigate and prosecute offenders, Dr. Perls added. However, he’s not certain the political will exists: “In the US, we have some pretty good laws, but the [Drug Enforcement Administration] DEA and the FDA are overwhelmed with more serious violent crimes.”

It is an important issue that unsuspecting consumers often do not realize is that “antiaging” or “age management” is not recognized as a specialty by the American Board of Medical Specialties.

If people think that they have a problem with their hormones, they should seek out a board-certified endocrinologist.

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