Human Growth Hormone "HGH" continues to be a hot-button with an incredible amount of misinformation put out in mainstream media. Recently on Anderson Cooper's show, Dr. Thomas Perls asserted that I got cancer due to taking HGH, when in fact I started taking it seven years after my cancer diagnosis. I think it's important to counter these attacks with information from experts on bioidentical hormones. This will give you an entirely different perspective on the risk/reward of HGH protocols. Frankly, I consider it one of the most important elements in my full complement of bioidentical hormones. Again, my levels are based on my blood work and I would never abuse the amounts, like some athletes have done. I take just what has been lost in the aging process to keep my system running optimally and protect against the diseases of aging. 

Ron Rothenberg MD, an authority on anti-aging, preventive and regenerative medicine discussed growth hormone in detail in my book Ageless and he has updated the information recently. 

 “Growth Hormone is one of the most studies compounds in medicine.  When growth hormone deficiency is present, growth hormone replacement therapy has widespread health benefits on quality of life, body composition, cognitive function, cardiovascular outcomes, bone density and exercise capacity.  Growth hormone replacement therapy has been studied with published results in major medical journals reporting on more than 100,000 patients.  All reports conclude that there is no increase in cancer risks either new cancers or recurrent cancers in patients with prior cancer.  There can be minor side effects of numbness in the extremities or achy joints or swelling but these can be reversed with decreasing the dose or stopping therapy.  Blood sugar can potentially become elevated if no lifestyle measures such as diet and exercise are included but with these lifestyle measures blood sugar and diabetes can actually improve.” 

Remember that knowledge is power! There is so much information at your fingertips, but to help you sift through the clutter.  Dr. Ron Rothenberg has compiled the facts on HGH along with an extensive reference list to back up the information:

GH is one of the most studied compounds in medicine with almost 100,000 journal references currently in Pubmed. We will review some key controversies relating to GH and provide an extensive list of references. 

• There is an exponential decline in GH release after 18-21 years of age and a 14% decline per decade after puberty.
• Low GH and its downstream hormone IGF-1 are associated with poor health and quality of life outcomes. When AGHD is treated with GH, there are usually increases in GH, IGF-1 and IGF Binding Protein 3 (IGFBP-3), which all have a role in clinical results. Although IGF-1 is pro-mitotic and taken out of context could promote cancer, IGFBP-3 is anti-cancer (Ingermann). The mechanism is explained by stimulation of anti-cancer gene p53. Teenagers with the highest GH and IGF-1 have low rates of cancer. When treating with GH a balance is produced between IGF-1 and IGFBP-3. (Scire) 

Below is a summary and review of GH and GHRT on different systems: 

• In women age 70-79, low IGFG-1 is associated with poor strength, difficulty walking and poor mobility – all contributing to poor quality of life. (Cappola)
• Low GH is associated with decreased longevity in humans, with more that 20 years decreased lifespan with low GH. (Beeson)
• Older men with higher IGF-1 do not show the same decrease in lean body mass and increase in fat mass- “GH determines life’s potential.” (Ruiz-Torres)
• Childhood or adult GH deficiency is associated with 2-3 times increase in mortality. (Stochholm)
• GH and IFG-1 have profound effects on the Central Nervous System and improve cognitive capabilities. (Nyberg)
• Higher IGF-1 is correlated with better cognitive function. (Aleman)
• GH/IGF-1 reverses osteoporosis and treatment with GH improves outcome in hip fractures. (Hedstrom, Van der Lely, Baum)
• GHRT improves cardiovascular function and reverses atherosclerosis and improves cardiomyopathy and improves exercise capacity in patients with congestive heart failure. (Gibney, Colao, Perot, Fazio Pfeifer)
• The lower the IGF-1, the greater possibility of cardiovascular disease. (Laughlin)
• IGF-1 is correlated with fitness. (Nindl)
• Endothelial Progenitor Cells (EPC’s) are the stem cells that maintain and repair the cardiovascular system. The quantity and quality of EPC’s is perhaps the best biomarker of aging with higher counts correlating with improved health outcomes. Any intervention that improves EPC’s should be considered a major intervention to improve health. IGF-1 through GH improves the number and function of EPC’s. EPC senescence is improved, probably through increasing telomerase activity and lengthening the telomeres of these critical stem cells. (Thum, Devin) 
• GH/IGF-1 are necessary for immune system function and for the maturation of T and B cells. (Clark, Burgess)
• GHRT decreases fat mass especially the dangerous abdominal visceral fat and is especially effective when combined with diet and exercise. The potential side of effect of increasing glucose and insulin is not present when diet and exercise are combined with growth hormone. (Albert, Johannssen, Christiensen, Franco)
• A possible side effect of GHRT is increasing glucose and insulin and even inducing type 2 diabetes. As demonstrated above and by Nam, when combined with diet and exercise this does not occur. Even if diabetes were to be induced it would be a temporary phenomenon that would be reversed and disappear when GHRT was discontinued. Type 2 diabetes will actually be improved by GHRT treatment. See the quote below from Nam: “Low-dose GH treatment combined with dietary restriction resulted not only in a decrease of visceral fat but also in an increase of muscle mass with a consequent improvement of the insulin resistance observed in obese type 2 diabetic patients.”
• Several studies have demonstrated the improvement in Quality of Life with GHRT. (Gilchirst, Gibney)
• A central question in GHRT is “Does GHRT increase the risk of cancer?” Multiple studies and reviews have concluded that there is no increase in cancer risk compared to the general population
• Jenkins review is aptly titled, “Does Growth Hormone Cause Cancer?” and provides the conclusion: “Extensive studies of the outcome of GH replacement in childhood cancer survivors show no evidence of an excess of de novo cancers, and more recent surveillance of children and adults treated with GH has revealed no increase in observed cancer risk .”
• Moltich’s review has similar conclusions: “Although there has been some concern about an increased risk of cancer, reviews of existing, well-maintained databases of treated patients have shown this theoretical risk to be nonexistent”
• In children with brain tumors treated with GH there was no increased risk of tumor progression, recurrence or new CNS or non-CNS tumor or leukemia. (Bogarin). The recurrence rate of the brain tumor was significantly less in the children treated with GH.
• No studies have proven an association between GH and malignancy. Van Bunderen concludes, “Mortality due to malignancies was not elevated in adults receiving GH treatment.”
• Savendaal recently reported results of mortality in more than 2,500 patients treated with GH as children for various causes including short stature. There were more than 46,000 person-years of observation. The 21 deaths were mostly caused by accidents or suicide. The authors state, “Importantly, none of the patients died from cancer or from a cardiovascular disease”
• Bell studied safety of GH in Children and concludes:   “The current data now comprise 20 years of GH therapy, 54,996 patients, and a cumulative 192,345 patient-years of treatment. With the longer time and expanded patient numbers, we continue to see no increase in new malignancies or recurrences of CNS tumors in rhGH treated children without risk factors, consistent with other reports.”  

Medicine should always be a work in progress. If future data leads to different conclusions our treatments should be modified appropriately. Considering the widespread benefits of GHRT for AGHD and the low risks reported, this treatment can improve quality of life and improve cardiovascular risks and cognitive function, body composition and bone density.

A quote from Sonsken:

“Growth hormone is essential for normal adult life, and without it life expectancy is shortened, energy and vitality reduced and the quality of this life is impaired. The medical case for GH replacement is now proven beyond any reasonable medical and scientific doubt.”

References: 

Ingermann  A. Identification of a novel cell death receptor mediating IGFBP-3-induced anti-tumor effects in breast and prostate cancer.  J. Biol Chem.  2010 Sep 24;285(39):30233-46. 

Scire G et al.  Growth hormone therapy does not alter the insulin-like growth factor-I/insulin-like growth factor binding protein-3 molar ratio in growth hormone-deficient children. J Endocrinol Invest. 2008 Feb;31(2):15 

Cappola AR et al. Association of IGF-I levels with muscle strength and mobility in older women. J Clin Endocrinol Metab 2001 Sep;86 (9): 4139-46 

Besson A et al. Reduced longevity in untreated patients with isolated growth hormone deficiency. J Clin Endocrinol Metab. 2003 Aug;88 (8):3664-7.  

Ruiz-Torres A et al. Ageing and longevity are related to growth hormone/insulin-like growth factor-1 secretion. Gerontology. 2002 Nov-Dec;48(6):401-7.  

Stochholm, K et al. Mortality and GH Deficiency a Nationwide Study. European Journal of Endocrinology. (2007)157 9-18 

Nyberg F. Growth Hormone in the Brain: Characteristics of Specific Brain Targets for the Hormone and Their Functional Significance. Front Neuroendocrinol 2000 Oct;21(4):330-348 

Aleman A et al. Insulin-Like Growth Factor-I and Cognitive Function in Healthy Older Men J Clin Endocrinol Metab 84:471–475, 1999 

Logobardi, J Endocinol Invest, May 1999

Bone density significantly improved with GH therapy 

H. Oxlund,  et al Growth Hormone and Mild Exercise in Combination Markedly Enhance   Cortical Bone Formation and Strength in Old Rats   Endocrinology, April 1998, p. 1899-1904 Vol. 139, No 4 

Colao A. Bone loss is correlated to the severity of growth hormone deficiency in    adult patients with hypopituitarism.  J Clin Endocrinol Metab 1999 Jun;84(6):1919-24 

Hedstrom M. Hip fracture patients, a group of frail elderly people with low bone mineral density, muscle mass and IGF-I levels. Acta Physiol Scand 1999 Dec;167(4):347-50 

Van Der Lely et al. Use of human GH in elderly patients with accidental hip fracture. Eur J Endocrinol 2000 Nov;143(5):585-592 

Baum HB et al.  Effects of physiologic growth hormone therapy on bone density and body composition in patients with adult-onset growth hormone deficiency. A randomized, placebo-controlled trial. Ann Intern Med 1996 Dec 1;125(11):883-90

Gibney et al.  The effects of 10 years of GH in adult GH deficient patients

J Endocrin Metab 1999 August 

Colao A et al. Beginning to end: Cardiovascular implications of growth hormone (GH) deficiency and GH therapy. Growth Horm IGF Res. 2006 May 9 

Perrot, A. et al. Growth Hormone Treatment in Dilated Cardiomyopathy J Card. Surg 2001;16:127-131 

Fazio, S et al. Effects of Growth Hormone on Exercise Capacity and Cardiopulmonary Performance in Patients with Chronic Heart Failure. J Clin Endocrinol Metab. 2007 Aug 14 

Pfeifer M et al. Growth Hormone (GH) Treatment Reverses Early atherosclerotic Changes in GH-Deficient Adults J Clin Endocrinol Metab 84: 453–457, 1999 

Borson-Chazot F. et al. Decrease in Carotid Intima-Media Thickness after One Year Growth Hormone (GH) Treatment in Adults with GH Deficiency J Clin Endocrinol Metab 84: 1329–1333, 1999 

Thum, T et al. Age-Dependent Impairment of Endothelial Progenitor Cells Is Corrected by Growth Hormone Mediated Increase of Insulin-Like Growth Factor-1. Circulation Research February 16, 2007 

Devin JK et al. The effects of growth hormone and insulin-like growth factor-1 on the aging cardiovascular system and its progenitor cells. Curr Opin Investig Drugs. 2008 Sep; 9(9):983-92. 

Nindl BC et al. Circulating IGF-I is associated with fitness and health outcomes in a population of 846 young healthy men. Growth Horm IGF Res. 2011 Jun;21(3):124-8

Laughlin GA et al. The prospective association of serum insulin-like growth factor I (IGF-I) and IGF-binding protein-1 levels with all cause and cardiovascular disease mortality in older adults: the Rancho Bernardo Study. J Clin Endocrinol Metab. 2004 Jan;89(1):114-20.  

Clark  R. The somatogenic hormones and insulin-like growth factor-1: stimulators of lymphopoiesis and immune function. Endocr Rev. 1997 Apr;18(2):157-7 

Burgess W et al. The immune-endocrine loop during aging: role of growth hormone and insulin-like growth factor-I.  Neuroimmunomodulation 1999 Jan-Apr;6(1-2):56-68 

Christiansen, J. Effects of GH upon body composition.. Growth Hormone in Adults , 1996, Cambridge University Press

 Johannsson G et al.  GH treatment of abdominally obese men reduces abdominal fat mass, improves glusoce and lipoprotein metabolism and reduces diastolic BP. J Clin Endocinol Metab 1997;82:727-734

 Albert SG et al. Low-dose recombinant human growth hormone as adjuvant therapy to lifestyle modifications in the management of obesity.Clin Endocrinol Metab. 2004 Feb;89(2):695-701. 

 Franco C et al. Growth hormone treatment reduces abdominal visceral fat in postmenopausal women with abdominal obesity: a 12-month placebo-controlled trial. J Clin Endocrinol Metab. 2005 Mar;90(3):1466-74 

Nam SY et al. Low-dose growth hormone treatment combined with diet restriction decreases insulin resistance by reducing visceral fat and increasing muscle mass in obese type 2 diabetic patients.
Int J Obes Relat Metab Disord 2001 Aug;25(8):1101-7 

Gilchrist FJ  et al. The effect of long-term untreated growth hormone deficiency (GHD) and 9 years of GH replacement on the quality of life (QoL) of GH-deficient adults. Clin Endocrinol (Oxf) 2002 Sep;57(3):363-70 

Gibney et al.  The effects of 10 years of GH in adult GH deficient patients J Endocrin Metab 1999 August 

Jenkins PJ et al. Does growth hormone cause cancer? Clin Endocrinol (Oxf). 2006 Feb;64(2):115-21.   

Molitch ME. Diagnosis of GH deficiency in adults--how good do the criteria need to be? J Clin Endocrinol Metab 2002 Feb;87(2):473-6 

Bogarin R et al. Growth hormone treatment and risk of recurrence or progression of brain tumors in children: a review. Childs Nerv Syst. 2009 Jan 14 

 Van Bunderen C et al Does growth hormone replacement therapy reduce mortality in adults with growth hormone deficiency? Data from the Dutch National Registry of Growth Hormone Treatment in adults.

.J Clin Endocrinol Metab. 2011 Oct;96(10):3151-9. Epub 2011 Aug 17. 

Sävendahl L,

Long-term mortality and causes of death in isolated GHD, ISS, and SGA patients treated with recombinant growth hormone during childhood in Belgium, The Netherlands, and Sweden: preliminary report of 3 countries participating in the EU SAGhE study.

]J Clin Endocrinol Metab. 2012 Feb;97(2):E213-7. 

Bell J, Long-term safety of recombinant human growth hormone in children. J Clin Endocrinol Metab. 2010 Jan;95(1):167-77. Epub 2009 Nov 11. 

Sonksen, P . The journal of growth hormone and igf research, 1998, 8, 275–276

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