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MEDICINE

Pitching growth hormone as a fountain of youth

Risks get little mention, and often what's sold isn't real or effective.

November 14, 2005|Judy Foreman | Special to The Times

"Reverse age -- naturally."

"Restore your looks, health, energy and physical abilities."

Claims on "anti-aging" websites promise that human growth hormone will give aging adults better memory, better skin tone, better waistlines, a better sex drive. Not surprisingly, the benefits of the hormone -- whose U.S. sales exceeded $700 million last year -- are much more limited.

Its downsides are also greater than the ads let on, including, for men, an increased risk of diabetes. True, growth hormone can boost muscle and reduce body fat, but research shows that though you may look more buff, you may not actually be stronger.

Moreover, the hormone is effective only as a shot -- not as the commonly sold pills or sprays that can run from $500 to $1,000 a month. (It's also illegal to sell growth hormone, unless it's for very limited medical conditions.)

People who get injections of growth hormone as an anti-aging remedy are "performing an experiment on themselves," said Boston University geriatrician Dr. Thomas Perls.

In healthy children and young adults, growth hormone is made in the front part of the pituitary gland, just underneath the brain. Some extremely short children are deficient in growth hormone; for them, the hormone is safe and effective.

In adults, production of growth hormone naturally begins to decline at about age 30. But the only adults for whom doctors can legally prescribe it are those with pathological -- not moderate and age-related -- deficiencies, or for AIDS patients with wasting syndrome.

The growth hormone craze has been building since 1990, when a six-month study in 12 men older than 60 with low levels of growth hormone showed that injections of the drug resulted in a 10-pound gain in lean body mass and a nearly 8-pound loss of fat. The study, published in the New England Journal of Medicine, did not assess actual strength or exercise endurance, but it was a huckster's dream.

By February 2003, the growth hormone boom had become so "unnerving," as the New England Journal editor Dr. Jeffrey Drazen put it in an editorial, that the journal posted a disclaimer on its website alongside the 1990 study, warning readers about "potentially misleading e-mail advertisements" for the drug.

In the 15 years since the original study, medical researchers have also raised serious questions about the safety and efficacy of the hormone. For one thing, many websites sell the hormone in ineffective forms -- pills and sprays that supposedly contain growth hormone or stimulate the body to make it.

But the sprays don't work because the growth hormone molecule is too big to get into the bloodstream, and the pills don't work partly because they are destroyed in the stomach.

Moreover, a lot of what is sold is not even growth hormone. "It's totally useless," said Dr. Stanley Korenman, a UCLA professor of medicine and endocrinology.

One of the most careful studies addressing the effectiveness and safety of growth hormone involved 57 healthy women and 76 healthy men ages 65 to 88, all with normal age-related declines in growth hormone. Women got either thrice-weekly injections of growth hormone; two commonly used post-menopausal hormones, estrogen and Provera; both classes of hormone; or placebos of both. Men got analogous treatments, but received testosterone instead of the menopausal hormones.

The good news was that all the people who got growth hormone, whether alone or in combination with other hormones, had increases in lean body mass and decreases in fat, says Dr. Marc Blackman, a professor of medicine at the Johns Hopkins School of Medicine, who conducted the six-month study. But that didn't turn out to mean much in real life.

Despite the increase in muscle, the only people who got significantly stronger, as gauged by standard tests, were men who got both testosterone and growth hormone. For them, the strength increase was significant, about 13.5% -- a bit less than what could be achieved with a conventional weight-lifting program.

Similarly, the only people who improved their cardiac endurance were the men who got both testosterone and growth hormone. That increase was much less than what was achievable with aerobic exercise programs.

On the downside, growth hormone was associated with swelling, carpal tunnel syndrome and joint pain. Most worrisome was that half of the men on growth hormone (with or without testosterone) developed diabetes or glucose intolerance, a precursor of diabetes. All of these side effects disappeared when the drug was stopped. But the findings were still sobering, Blackman says. "I would not sanction the use of growth hormone to slow aging in any healthy person except as part of a randomized, clinical trial," he says.

Andrzej Bartke, a leading growth hormone researcher at the Southern Illinois University School of Medicine, says most researchers don't believe there is enough data to know whether human growth hormone is beneficial as an anti-aging remedy.

"At some time in the future, I wouldn't be surprised if it was worked out that some normally aging people would benefit from it," he says.

But we are definitely not there yet. Save your money.

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