There is much in the news these days about growth hormone… promises about it being a fountain of youth, reversing wrinkles, melting fat, and increasing muscle mass. Is it all hype? Is it safe? If it’s so fabulous why isn’t everyone on it?
First of all growth hormone is a hormone which naturally occurs in our bodies. It is made by the pituitary, a gland located beneath the brain. The pituitary is considered the master gland of the entire endocrine system and it regulates the production of all the hormones in the body. Growth hormone gets its name from the fact that it is responsible for a child growing to become a full sized adult. It has been safely used for this purpose in children since 1983. Growth hormone has been FDA approved for use in adults who are deficient in growth hormone since 1996.
WHAT ARE THE SYMPTOMS OF GROWTH HORMONE DEFICIENCY?
Symptoms of growth hormone deficiency can be somewhat generalized and vague and include fatigue, depression, insomnia, loss of muscle tone and increased fat around the waistline. That’s why it can often be dismissed as “just getting old”. However, adults who are deficient in growth hormone have a two to three fold increase in premature heart disease and an increased incidence of diabetes, hypertension, strokes and osteoporosis.
HOW IS GROWTH HORMONE DEFICIENCY DIAGNOSED?
Growth hormone deficiency is diagnosed by having a person undergo a growth hormone stimulation test and documenting that their pituitary is unable to produce growth hormone on its own. This is the person who will benefit from growth hormone therapy. Individuals who obtain growth hormone therapy by ordering it through the Internet or without proper medical supervision are more likely to incur serious side effects.
GROWTH HORMONE DECLINES WITH AGING
There is a natural decline in growth hormone that occurs with each decade of life and this does not necessarily indicate a need for growth hormone. Loss of muscle mass called sarcopenia has been directly associated with decreased health and vitality in older individuals. Since growth hormone directly affects the maintenance of muscle mass, some researchers have suggested that it should be regarded as a biomarker of aging. Vigorous physical activity in older individuals may slow down the typical decline of aging.
THE COST OF GROWTH HORMONE
In the past, growth hormone has cost over $1000. per month. The price is now down to about $500 to $600. per month depending on the dosage. Men tend to require lower doses than women. Importantly, however, if the patient has been properly diagnosed, insurance will often cover the entire treatment. However, even if the cost is not covered, one needs to consider the fact that there is a real “cost” to not treating growth hormone deficiency–that is, the cost that goes along with the development and treatment of such chronic diseases as diabetes, high blood pressure, heart disease, strokes and osteoporosis.
DOES GROWTH HORMONE DECREASE BODY FAT AND INCREASE MUSCLE MASS?
Starting on growth hormone therapy does reduce body fat around the waistline and internal organs and increases lean muscle mass. When a person is deficient, giving growth hormone also increases the size and strength of the heart. There is also improvement in cholesterol and triglycerides. However, growth hormone should not be regarded as a panacea for obesity. Individuals with significant obesity often have other metabolic issues accounting for their obesity.
DOES GROWTH HORMONE REALLY DECREASE WRINKLING AND HAIR LOSS?
There are often many other medical indications for giving growth hormone to a deficient individual. However, a nice side benefit is that growth hormone also increases the thickness of the skin. Many patients report tightening of the skin, which results in fewer wrinkles and less sagging of facial muscles. Some patients also experience an increase in hair growth. Rarely, a patient will report that their hair color has become less gray. If an individual is planning cosmetic surgery, the surgery will achieve better results and last longer if they first undergo endocrine evaluation to ensure that all their hormones including growth hormone are in proper balance.
OTHER COEXISTING HORMONE DEFICIENCIES
Patients who are deficient in growth hormone may also be deficient in testosterone, estrogen, progesterone, cortisol, or DHEA and must be carefully evaluated for the presence of other deficiencies. Studies show that 80% of patients deficient in one or two hormones were also deficient in growth hormone. In those deficient in three or four hormones, virtually 100% of those patients were deficient in growth hormone. Effectiveness of the growth hormone therapy is affected by the skillful management of these other coexisting hormone deficiencies. Patients who previously took growth hormone and did not achieve good results are usually those who had other hormone deficiencies that were not appropriately managed.
WHAT ARE THE SIDE EFFECTS ASSOCIATED WITH GROWTH HORMONE THERAPY?
Because growth hormone is a hormone naturally present in the body, it tends to be well tolerated provided that the individual is given physiologic doses similar to those normally found in the body. Side effects can include swelling, fluid retention, carpal tunnel symptoms or symptoms related to blood sugar regulations. These are generally temporary and are resolved by cutting back the dose. Patients, who are growth hormone deficient and hesitant to start therapy, need to consider that there are side effects associated with not taking growth hormone. Untreated, growth hormone deficiency has a two to three fold increase in premature heart disease and an increase in diabetes, high blood pressure, osteoporosis and strokes.
GROWTH HORMONE DEFICIENCY CAN OCCUR AT ANY AGE
Just as a person can become deficient in thyroid hormone at any age, a person may become deficient in growth hormone at any age. When individuals younger than 50 become deficient in growth hormone they frequently go undiagnosed often with devastating consequences. Any circumstance, which causes traumatic or inflammatory injury to the head, has the potential to later cause deficiency in growth hormone and/or other pituitary hormones as well. Typical examples include head trauma from car accidents or sports injuries; history of radiation treatments to the head and neck; complications of pregnancy such as high blood pressure, or excessive post-partum bleeding and, of course, any kind of brain surgery.
TYPICAL PATIENTS WITH GROWTH HORMONE DEFICIENCY
George is a successful 50-year-old CEO and has always prided himself on taking good care of his health. Although he was feeling well, he came to see me because he wanted to maintain his good health as long as possible. He had seen his father suffer from Alzheimer’s and he was concerned about not going down that road himself. While George had not yet suffered any serious health problems, he was definitely “pushing the envelope” with his stressful lifestyle. He had noticed that he had gained a little weight around his middle. He was still playing golf twice a week but his swing just did not seem as strong as before. He was noticing that he was not sleeping as well as before. He was functioning at full capacity at his work but was pushing himself at the end of the day. George was tested and found to be totally deficient in growth hormone. After starting growth hormone, he lost the spare tire around his middle, started sleeping better, increased muscle mass, which improved his golf game immensely. He is back to feeling as alert and productive as he was in his 30’s. He has lost fat and increased muscle mass, which was documented on measurement of his body composition
Linda was a 38-year-old mother of 3 children who had a complicated pregnancy with high blood pressure and at the time of delivery lost a lot of blood and the doctors wanted to give her a transfusion. She refused because of her concerns about acquiring hepatitis or HIV and she finally regained a normal blood count but to her dismay, she never regained her former energy. She gained 50 pounds in the year after her delivery. Her hair was thinning and she felt as if she were aging before her eyes. She was exhausted and had no energy to care for herself or her family. Her body ached and she spent a lot of her time in bed. She was on antidepressants and sleeping pills but still felt badly. She was tested and found to be totally deficient in growth hormone. Her growth hormone deficient state most likely resulted from pituitary damage suffered at the time of her delivery. After restoring growth hormone levels to normal she began sleeping, regained her former vim and vigor and started losing weight. She is now able to keep up with the busy demands of her young family.
GROWTH HORMONE DEFICIENCY IS A MEDICAL PROBLEM
The general public should know that growth hormone deficiency is a medical problem — an endocrine disorder, not a cosmetic condition. It is essential that the patient be properly diagnosed. Growth hormone deficiency can be caused by a brain tumor which needs surgical treatment. Simply putting the patient on growth hormone therapy could prevent them from getting life-saving surgery. Or that person could have subtle symptoms of cortisol deficiency and giving that person growth hormone without first correcting cortisol could actually make them worse. Growth hormone deficiency, like other pituitary disorders, is best treated by an endocrinologist, a physician who has undergone specialty fellowship training to deal with complex endocrine problems, such as growth hormone deficiency. When growth hormone deficiency is properly diagnosed and managed by a qualified endocrinologist, many patients are fully reimbursed by their insurance companies for physician visits, lab tests and growth hormone therapy
DO YOU HAVE SIGNS OR SYMPTOMS OF GROWTH HORMONE DEFICIENCY?
If you have three or more of the below listed symptoms or conditions, you may be deficient in growth hormone. You should see a physician who is qualified to diagnose and manage growth hormone deficiency and other endocrine disorders.
* Increased Fat around the Waistline
* Loss of muscle mass or decreased strength
* Decreased mental concentration
* Poor Memory
* Decreased Sexual Function or Drive
* Depression or Mood Swings
* Thinning of Skin and premature wrinkling
* Currently receiving one or more other hormone preparations
* Head injury
* Complications of Pregnancy
* High blood pressure
* Heart disease
* History of stroke