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Senior Citizen Alerts
Growth Hormone is Not the Anti-Aging Bullet for
Healthy Senior Citizens
Promoters of GH as an anti-aging therapy target the
healthy elderly
January 17, 2007 – Almost every senior citizen has
been tempted by advertising for products containing "GH." It stands for
"human growth hormone" and has been promoted as the ultimate in
anti-aging supplements. That's not true, says a new review of published
data on use GH by healthy elderly people. The study found that the
synthetic hormone was associated with small changes in body composition
but not in body weight or other clinically important outcomes.
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"There is certainly no data out there to suggest
that giving growth hormone to an otherwise healthy person will make him
or her live longer," said Hau Liu, MD, a research fellow in the division
of endocrinology and in the Center for Primary Care and Outcomes
Research at the Stanford University School of Medicine, and first author
of the review.
"We did find, however, that there was substantial
potential for adverse side effects."
People who took GH also had increased rates of
unhealthy side effects such as soft tissue swelling, joint pain, carpal
tunnel syndrome, and, in men, abnormal breast development. They were
also somewhat more likely to develop diabetes.
The review, "The Safety and Efficacy of Growth
Hormone in the Healthy Elderly," was published in the Jan. 16, 2007,
issue of Annals of Internal Medicine and is available on the Web at
www.annals.org on that day.
"Growth hormone has been widely promoted as an
anti-aging therapy," said Hau Liu.
"But the scant clinical experience of GH in the
healthy elderly suggests that although GH may minimally alter body
composition, it does not improve other clinically relevant outcomes such
as bone density, cholesterol levels, stamina, and longevity in this
population.
"And it's associated with high rates of adverse
events.
"So, on the basis of available evidence, we cannot
recommend growth hormone use for anti-aging in the healthy elderly."
Despite all the warnings, between 20,000 and 30,000
people in the United States used growth hormone as an anti-aging therapy
in 2004, a tenfold increase since the mid-1990s, according to the
authors of an unrelated study published in the Journal of the American
Medical Association in 2005.
This increase comes despite both the high cost of
such therapy - often more than $1,000 a month - and the illegality of
distributing growth hormone for anti-aging therapy in this country.
Those numbers prompted Liu and colleagues to see if the medical
literature provided any support for such therapy.
"These studies were designed to look at what
happens when you give growth hormone to a healthy elderly person," said
Liu. "For example, what happens to their bone density, to their exercise
levels and to their exercise capacity."
Growth hormone is naturally produced by the
pituitary gland, a pea-sized organ at the base of the brain. Production
is highest during childhood and the hormone-drenched adolescent years,
then typically starts tapering off around age 30, continuing to decline
into old age.
Growth hormone is critical to proper development in
children, particularly their height, and injections of growth hormone
are considered a legitimate treatment for short children and for adults
whose pituitary glands don't produce enough growth hormone to maintain
normal metabolism. But most promoters of growth hormone as an anti-aging
therapy target the healthy elderly.
In the United States, the FDA has approved the
drug, now produced synthetically, to treat children with short stature
and some other growth problems caused by childhood diseases.
The FDA has approved GH to treat adults with growth
hormone deficiency syndrome. Its use for anti-aging falls into a grey
area. The FDA prohibits drug companies from marketing GH for off-label
uses such as anti-aging.
Yet thousands of adults use GH as an anti-aging
drug. One estimate is that 20,000 to 30,000 adults used it for
anti-aging purposes in the United States in 2004.
The Web is replete with ads for all kinds of
products said to contain GH, from pills, sprays, injections,
secretagogues, homeopathic formations, and GH releasers and enhancers.
GH, often in conjunction with vitamins, testosterone and other hormones,
is said to increase muscle strength and mass, decrease body fat, improve
mood and motivation, increase exercise capacity, increase bone density
and (wink, wink) make wives and girlfriends happy.
Despite these enticing claims, careful review of
existing evidence does not support the prescription of GH for anti-aging
purposes.
Growth hormone is among the most expensive of all
hormones used for replacement therapy. One physician estimated that a
year's supply for an adult with GH-deficiency caused by pituitary
disease would cost between $7,500 and $10,000 per year. Estimates of the
cost of GH for anti-aging purposes range from $1,000 per month to $2,000
per month.
"Everyone is looking for the fountain of youth,"
Liu said. "We wanted to see if there is any validity behind some of the
claims made about growth hormone's anti-aging properties.
"Our biggest surprise was the general lack of
research that had been done in this area. When we reviewed the
scientific evidence, we found that there were really only about 500
patients involved in rigorous controlled trials. And only a few more
than 200 actually received growth hormone.
"Think about all the scientific claims made on
anti-aging Web sites based on this small population of patients. The FDA
typically doesn't approve a drug until it's been tested in thousands of
patients.
"In our review, we found that growth hormone
increased lean body mass or muscle mass by slightly more than two
kilograms (that's a little over four pounds) and decreased fat mass by
about two kilograms. But it had no other beneficial effects that we
could see.
"If you went to a gym pretty regularly, you might
get that change without breaking into too much of a sweat, and you
wouldn't spend $1,000 to $2,000 a month on something that appears to
have modest or minimal benefit and the probability of bad side effects,"
said Liu.
Editor's Notes
The researchers participating in this study were
supported by grants from the U.S. Agency for Healthcare Research and
Quality, the U.S. Department of Veterans Affairs and the National
Institute of Aging.
Other Stanford researchers participating in the
study were Dena Bravata, MD, senior research scientist in medicine;
Ingram Olkin, PhD, professor emeritus of statistics and of education;
Smita Nayak, MD, who is now an assistant professor of medicine at the
University of Pittsburgh; Brian Roberts, MD, research fellow in the
division of endocrinology; Alan Garber, MD, PhD, the Henry J. Kaiser Jr.
Professor, and Andrew Hoffman, MD, professor of medicine.
Stanford University Medical Center integrates
research, medical education and patient care at its three institutions -
Stanford University School of Medicine, Stanford Hospital & Clinics and
Lucile Packard Children's Hospital at Stanford. For more information,
please visit the Web site of the medical center's Office of
Communication & Public Affairs at
http://mednews.stanford.edu.
Annals of Internal Medicine (www.annals.org)
is one of the most widely cited peer-reviewed medical journals in the
world. The journal has been published for 80 years and accepts only 7
percent of the original research studies submitted for publication.
Annals of Internal Medicine is published by the
American College of Physicians (www.acponline.org),
the largest medical specialty organization and the second-largest
physician group in the United States.
ACP members include 120,000 internal medicine
physicians (internists), related subspecialists, and medical students.
Internists specialize in the prevention, detection, and treatment of
illness in adults.
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