So we are going to grow old. That is certain. Is it also certain that we
will grow old in exactly the same way that human beings have since
prehistoric times? As the Romans did, and the Greeks? As medieval kings
did, and as millionaires have done in spite of their millions? You know
what I mean. Frail. Our steps more hesitant. And in our hearts a
well-founded fear that any little elevation in the pavement or dip in the
road will send us sprawling. Tired, oh, so tired.
In spite of efforts to propagandize for the golden years, old age has really not been that pretty. Not in the past, and not even today with all of our comforts. It has been said that youth is wasted on the young; well, experience and money are often wasted on the old because they don't have the energy to do anything with them.
Legal Status of HGH Adult Deficiency
HGH: The Body of Evidence
HGH: What You Should Know if You Plan to Take It
Cautions about so-called Generic HGH
An extensive list of scientific clinical studies
Growth Hormone Replacement Found Safe for Long Term Use
What we now know is that much of
what is called old age is a deficiency state, much like a vitamin
deficiency. As we age, we develop age-related hormonal deficiencies. As a
physician, it startles and saddens me to consider all the thousands of
elderly patients who have come to me over the years suffering from the utter
depletion of old age. I was able to help many of them, no doubt about it.
But if I had known then what I know now, I could have done more. Nowadays,
using hormone replacement of age-related deficiencies, I
can do much more to improve their quality of life.
Unfortunately there are probably no more than a thousand or so physicians in the United States at present who are routinely using HGH as part of their hormone replacement therapy—to rejuvenate the old by restoring normal levels of this deficient hormone that is essential to life.
Can there be some danger in taking hormones? Should caution be exercised in prescribing them? Yes, certainly. As you'll see, most of the hormones discussed in this book do have at least some potential for causing harm to at least some of the people who would otherwise be reasonable candidates for taking them. It wouldn't be the smartest of moves to take human growth hormone, or any other hormone without the guidance of a knowledgeable physician—which is why they require a prescription from a licensed health care practitioner. At the same time, when a prudent approach guided by lab tests is used, it strikes me that no great abundance of common sense is necessary to see that the danger for the average eighty-year-old of sinking toward senility and death—or, at least, the nursing home—is far more immediate and acute than the risk of side effects from the judicious replacement of deficient hormones. By that I mean only replacement of what is deficient, not pharmacological doses.
When Americans eventually come to realize that much of what we now call old age can be slowed, and is to some extent even reversible, will they stand by and allow it to remain unreversed? I wouldn't bet on it. They will want to maintain their quality of life for as long as possible. I tell my patients that we cannot stop the aging process, but we can slow it down and often reverse the ravages of aging to a significant extent.
As a private citizen, I certainly don't intend to allow old age to creep up on me any faster than absolutely necessary. As a doctor who has been watching the hormone revolution take its baby steps during the past two decades, I know that old age is not totally invincible. We have shot gaping holes in it. We can not only slow the process of aging but we can also delay the onset. I don't know whether Mother Nature approves, but even she is going to have to adapt.
The next three chapters will discuss the most startling, really awe-inspiring of all the replacement hormones: Human Growth Hormone (HGH). It is also the most expensive, the most difficult to use, and one of the most controversial. But very ordinary, healthy people are beginning to take it purely to fight off old age. Let's look at one of them.
Tim Wallace, a seventy-three-year-old businessman, is the managing partner supervising the building of two hundred houses on a hundred rolling acres in Virginia. When that enterprise began a year and a half previously, Tim wondered if he had bitten off more than he could chew. His energy level had been slowly sagging for about a decade. This would be his last big project. Would he have the strength for it?
Said Tim, "I was full of enthusiasm, but pretty soon I had to admit I wasn't the man I used to be. I'd work hard in the morning, but by afternoon I'd be exhausted. Often I'd have to lie down on the office couch for an hour or two and tell my secretary to hold my calls. I began to organize the job around my fatigue. And it only got worse. After a couple of months, I decided I was the most exhausted man alive."
I saw Tim in my office in June 1995 and suggested that he might want to try human growth hormone (or HGH, as we'll often abbreviate it.) He had already begun taking DHEA, which had produced some improvement—but not enough. Now, I measured his blood levels of IGF-1 (Insulin-Like Growth Factor-1 is abbreviated as IGF-1), a byproduct of growth hormone and the only practical laboratory test to use as an indicator of growth hormone (HGH) secretion. Tim's level at 110 ng/ml, although extremely low by the standards of a young adult, was not surprising in a man his age. Soon after the tests were done, Tim began taking self-administered injections one unit of of HGH four days each week. Two months passed, and he noticed he had more energy. After he'd been on growth hormone replacement therapy for four months he simply wasn't fatigued anymore. "It's pretty amazing," Tim remarked some time later. "I have more muscle strength, in my legs especially, and my body fat is shrinking. Now that I've been on growth hormone for eight months, I find that when I squeeze the fat around my abdomen, I can't get a handful. I need less sleep. But the greatest change is simply what I suppose you'd call general vitality—I'm much stronger, much more alive, I've got more energy now than I've had since my forties. People who meet me for the first time can't believe it when I tell them my age.
"You know, I don't think I'm going to retire after all."
I marvel at Tim's appearance, his energy, his youthful delight in what's happening to him, and I marvel as well because I know I'm seeing a phenomenon new to the human race: the years rolling backward. Tim has bought himself extra years of vital life.
A SORT OF MIRACLE
Let's look again at the study conducted by Dr. Daniel Rudman at the Medical College of Wisconsin, which I mentioned previously. Dr. Rudman had been investigating HGH, which is the only hormone discussed in this book that must be injected—a minor inconvenience in light of its benefits. The needle is quite tiny (27 gauge), and an injection under the skin of the abdomen or thigh is not particularly painful.
Dr. Rudman had been investigating human growth hormone for some years and was already prominent in the field. He was about to become a bit of a legend. He was aware of a number of medical studies showing that children, rodents, and human adults who suffer from a deficiency in growth hormone secretion tended to experience loss of lean body mass (muscle) and expansion of adipose tissue (fat). They were weaker and fatter than they ought to be. But when given replacement doses of growth hormone, these alterations in body composition were readily reversed—in children, in rats, and in full- grown, older men and women. More importantly, their overall quality of life improved in many different areas.
Surely, Dr. Rudman reasoned, it could not be coincidence that these are also the effects naturally produced by aging and in more or less direct proportion to the decline of growth hormone that is simultaneously occurring. Increasing fatigue, increased fat deposition, thinner skin, and—invisible but crucial—shrinkage and decreasing functionality of major internal organs all occur in the second half of life. In most people they only occur progressively and to a significant extent after the age of forty, which is just when HGH production begins to taper off more sharply. An average woman's body is 35 percent fat at age thirty and 53 percent by the time she's eighty. Similar changes occur in men, and in both sexes there's a corresponding decline in muscle and overall vitality. It would be quite surprising if there were not a causal connection between these changes and the decline of growth hormone, since one thing that studies have definitely shown is that growth hormone causes the breakdown of fat and promotes the synthesis of protein, our bodies' major building block.
The building up of healthy tissue, especially lean tissue, is called anabolism, and its destruction and eventual disintegration is called catabolism. (The combination of anabolism and catabolism, along with all the other chemical processes in the body, is called metabolism.) It is a medical truism to say that the first half of life is anabolic and the second half catabolic. What if a leading cause of this process was an abundance of HGH from childhood until early adulthood and a progressive deficiency from then on?
Rudman and his associates decided to take twenty-one healthy men from sixty-one to eighty-one years of age with IGF-1 concentrations in the lower 30 percent of what's normal for a young adult and divide them into two groups. Twelve men received three injections of growth hormone per week for six months, and nine men received no treatment. Total weekly doses of HGH were in a physiologic replacement range, approximately equal to what a young adult produces normally. All the men remained healthy. Nonetheless, the differences between the treated and untreated groups after six months was startling. The twelve men on HGH increased the amount lean tissue on their bodies by 8.8 percent and decreased their total amount of fat by 14.4 percent. Their skin thickness increased 7.1 percent and their vertebral bone density improved by 1.6 percent. The untreated men showed no significant changes.
What had happened to these twelve men on growth hormone was also visible to the naked eye. Physically, as best anyone could tell, these men had become younger. I know that's a crude, seat-of-the-pants method of estimating age. But isn't it what we all do when we first meet someone?
Standing in a bathing suit on the edge of the sea, many of the subjects of Rudman's experiment now looked five to ten years younger than they had six months before. Much of their flab was gone, their body contours were better defined, they were altogether harder, leaner, younger looking specimens and their skin was smoother and less wrinkled. Achieving this had required no exercise at all, which is a clear contradiction of the normal route to good conditioning. They had simply changed. Age had run effortlessly backward for them, just as, in the normal process of life, age runs effortlessly forward.
Rudman published his results in July 1990 in the New England Journal of Medicine, and like a time bomb, the possibility of a genuine reversal of the aging process began to form in the minds of hundreds of scientists around the globe. What was going on here?
We now know that these changes are not merely in outward appearance. Overall quality of life improves, with faster healing of any type of injury, fracture, or wound. Immunity and resistance to infection improve. Brain function, memory retention and cognitive function improve. Heart and kidney function improve. Depression and fatigue are reduced. Sex function improves. And quality of sleep improves.
JUST WHAT IS GROWTH HORMONE?
Created in the anterior (frontal) portion of the pituitary gland, growth hormone (HGH) is a small protein-like hormone (peptide) with a known sequence of 191 amino acids. It is chemically rather similar to insulin, although twice as large. Secreted periodically in very brief pulses, especially during the early hours of sleep, growth hormone remains in the circulatory system for only a few minutes and is therefore difficult to measure directly. HGH is quickly attracted to receptor sites on cells throughout the body. Some of it is taken into the liver and converts some into IGF-1, another small peptide hormone formerly referred to as "Somatomedin-C." IGF-1 is responsible for some of the activity of growth hormone in the body. Moreover, since IGF-1 remains fairly constant in the circulatory system for twenty- four to thirty-six hours and is more stable than growth hormone, a laboratory test for its levels in the blood gives a more reliable indication of total growth hormone production by the pituitary gland.
A normal level of IGF-1 in a young adult is approximately 300 nanograms per milliliter or higher, abbreviated ng/ml—some laboratories use different units of measurement such as "units.". Men and women older than fifty often have levels ranging from 150 down to as low as 30 or less. Depending on body size and also on how low their initial level was, one unit of growth hormone injected on four days per weekly—one unit each time-taken on different days—will usually bring those levels up to between 160 and 250. In older adults, when levels stabilize close to 200 or more, patients report noticeable alleviation of many of the "symptoms" of aging.
Having said that, I must confess that, in practice, the interpretation of IGF-1 measurements has had severe limitations. I always take a baseline measurement to find out if pretreatment levels are acceptable or low. I advise the occasional older patient whose levels are still adequate that HGH replacement will not be worth the effort and expense. With the person whose levels are very low, I have come to expect more rapid and dramatic clinical improvement. However, I have found that follow-up measurements of IGF-1 often do not correlate well with the clinical benefit received.
Frequently, patients who report great improvements on HGH do not show much increase in IGF-1 levels. And not uncommonly, patients whose IGF-1 levels increase substantially do not seem to experience correspondingly benefits. This is probably because HGH has direct action on cells independently of IGF-1 production. In some people, injected HGH does not seem to increase IGF-1 as much as the frequent small pulses released internally by the pituitary gland. Consequently, I no longer fully rely on routine follow-up testing of IGF-1 after therapy has begun. Its effectiveness as a guide to therapy is not nearly as great as a close and accurate observation of actual physical and symptomatic improvements in the individual man or woman being treated. The "gold standard" is response to a trial of therapy.
In other words, I treat the patient, not the laboratory report. The pituitary gland of a young adult produces between 1½ and 2 units of HGH daily. Much more than 1½ unit of HGH daily would therefore exceed a normal physiologic replacement dose. When levels fall with age, the pituitary continues to release smaller amounts. Replacement with 1 unit of HGH (0.33 milligram), injected 4 days to 7 days per week now seems to make up for the lost amount and be a safe and effective dose. Side effects reported in the scientific literature are almost non-existent at this dose, and are related to excessive doses.
Effects of Growth Hormone
During adolescence, when growth is most rapid, production of growth hormone is also very high. However, once growth is complete, HGH must still be present throughout life at the lower maintenance levels, represented by the numbers above, to maintain physical and mental health and well-being. Tissue repair, cell replacement, healing, organ integrity, bone strength, brain function, enzyme production, immunity, resistance to infection, overall quality of life, and integrity of hair, nails, and skin all require the ongoing availability of adequate growth hormone. Without such a supply, these anabolic processes are crippled.
In childhood, growth hormone controls a major miracle— growth itself. Children with a pituitary deficiency of growth hormone are therefore incapable of normal growth. And until HGH became available—first in small amounts in the 1970s and then in unlimited quantities after 1985—such children inevitably reached adulthood as dwarfs.
Once we reach adulthood and our growth stops, the secretion of growth hormone begins to fall. For some decades, however, it remains at a level sufficient to maintain a healthy adult body. It cannot be emphasized too forcefully that the term "growth hormone" is misleading. Growth is only one of the hormone's functions; "growth" hormone is an all-purpose maintenance and repair hormone throughout life. It is absolutely essential for a high quality of life.
Unfortunately, its production declines inexorably as we age in almost everyone. Eventually we become flat-out deficient. No other word is appropriate. Averaged out over a lifetime, the declines will be about 10 to 15 percent per decade. By the age of sixty it is not uncommon to measure growth hormone decline of 75 percent or more from the abundant levels normally seen in twenty-five-year-olds. By causing a significant reversal of the weakness and frailty of age, Rudman's experiment—which has been repeated since by other investigators—seems to confirm logical expectations. Without HGH we cannot enjoy the physical strength of our earlier years; with it we are suddenly and startlingly reinvested with physical power and a sizable proportion of our youth-like vigor.
Won't Run on Empty
If the decline of growth hormone is so debilitating, what happens when
there's none at all? The most common cause of such a dead stop is a
pituitary tumor necessitating surgery.
In 1989, Douglas Harvill was a vigorous and relatively youthful sixty-three-year-old Virginia businessman. He had no apparent health problems until one day he was diagnosed with a malignant tumor on his pituitary gland. The cancer was excised, along with the pituitary gland itself. The operation was a success, and, following a short convalescence, Harvill resumed his life. He was given hormonal replacements for all the hormones for which the pituitary is responsible, with the exception of growth hormone. That is the normal protocol in a case like his. Growth hormone (largely through the efforts of the Food and Drug Administration) was then carefully restricted in its use to growth hormone deficient children. Doctors who wish to purchase HGH in the United States had been forced to falsify written case records to the manufacturer, naming a child to whom they allegedly intend to administer the hormone, and including growth charts and blood-test results to confirm dwarfism caused by growth hormone deficiency.
For Douglas Harvill, the result of this restriction by the FDA was that he suddenly discovered what a colossal obstacle fatigue can be.
"I had no strength at all. For the first time that I could ever remember, I hated to get up in the morning. I was sleeping an average of twelve hours a night and then two or three hours after I woke I'd get so exhausted that I had to go back to bed again. I was absolutely worthless. I'd always been physically very active, but now I found that no matter how much I forced myself to exercise I could build no muscle. Month by month and year by year I was growing weaker."
Douglas began reading up on growth hormone and discovered that there were European studies showing that average human survival after the removal of the pituitary gland was only ten years. In older people it could be considerably less with cardiovascular problems high amongst the causes of mortality. He was determined to obtain growth hormone, but the obstacles in his path at that time were considerable. Supplementation with HGH for adults, even adults who were chronically deficient—or, in his case, totally deprived—was not yet standard medical practice (and to some extent still isn't). It took Douglas Harvill over two years, with my help and the support of his endocrinologist, to get his supply of growth hormone.
The results for him were more dramatic than they would be for an ordinary person.
"Within ten days after my first injection, my strength and endurance had increased 50 percent. I could literally see myself recovering day by day. I went to my endocrinologist and said, ‘You're going to think I'm making this up.’ But he believed me. It only took a few months to gain back almost everything I had lost over two years. My coordination and balance dramatically improved. My muscles started coming back. All my energy and vitality came back. The difference was phenomenal.
This enormous improvement was achieved by administering just one unit of growth hormone four to seven days per week.
Douglas Harvill is now sixty-nine years old and enjoying a retirement that I suppose is not for everyone. Certainly it's different from our normal image of old age.
Douglas had always wanted to ride a motorcycle. He now owns three Harley-Davidsons and, in the cool of the morning, can more often than not be found roaring along the twisty Shenandoah Valley roads.
It's What Gives You Vitality!
One of the striking things about HGH is its ability to produce improvements in people who certainly haven't reached old age yet.
Consider Chad Strether, a Minnesota engineer who at fifty-six is still in the midst of an outstandingly vigorous and energetic life. Chad runs three or four times weekly and gets plenty of other forms of physical exercise. He's something of a computer buff, a lover of classical music, and a man whose wife still considers him a hunk. (So they both say.)
He should have no complaints, right? Well, he had a little one. Age was creeping up, and he was tracking it because, being an engineer, he was a man dedicated to precision, with a habit of keeping careful numerical records. He had noticed two things about his running: it wasn't nearly as much fun as it used to be, and he certainly wasn't doing it as well. His times on his two and three mile runs were going steadily down. He'd also noticed that now, when he ran two consecutive days, he did more poorly the second day. It used to be that he did better. And, though he watched his diet, slowly but surely, fifteen pounds of middle-aged spread had attached itself to his middle.
Chad also felt that mentally he wasn't quite as sharp as he used to be. Creative solutions didn't come as easily for engineering problems. He wasn't as quick at games. And he didn't like any of this. In January 1996, he found a doctor who prescribed him HGH. By the end of February, our meticulous, record-keeping engineer was observing changes.
He sensed that his balance and coordination had improved, and his running regimen was no longer torture for his muscles. His home exercise routine involves situps, pushups, and a series of rows on a rowing machine. Chad times it with a stopwatch. His best time in the previous year had been 7 minutes 26 seconds. After five weeks of HGH, he hit 7:05, then 6:54, 6:42. His weight fell eight pounds by April.
Chad also noticed that he played computer games more efficiently. (Yes, he times that, too.) At the same time, his intuitive impression—hard to measure exactly—was that he was becoming more creative in his work.
Chad was also excited by one other unexpected change. Classical music has always been a big part of his life. Now when he goes to concerts, which he does three or four times a month, he notices that, "I'm hearing high notes that I haven't heard in years."
I'm impressed by these changes. If they don't seem as extensive as the changes we've pointed out in older individuals that's because Chad was actually in tip-top physical and mental state.
Let's look at one other example, this time in an even younger, but very different man.
Ben Herzen, a New Jersey restaurateur and nightclub owner, started taking growth hormone at the age of fifty-three simply because he noticed he wasn't functioning any longer at the extraordinarily high level he was accustomed to. Ben owns nine nightclubs, is a city council member, a prominent figure in countless political organizations and charities, and a man who has worked hard and played hard since before he was old enough to vote. "How do you do it?" friends would ask him about his very active life. Ben would smile and shrug.
Now, however, he was beginning to notice the natural signs of middle age—the desire to sit at home with his feet up in front of the television set was suddenly becoming greater than the urge to go out to dinner or make it to that city council meeting. His hyperactive business life wasn't as easy to handle as it used to be. One night on television he saw a program that talked about human growth hormone and people who were going down to Mexico to get it. Intrigued, Ben spoke to his doctor, had his blood levels of IGF-1 checked, and eventually obtained a supply of HGH for his personal use in this country.
He started taking it in March of 1995, and by June noticed that he was starting to feel a little different. By September, he had no doubt at all that something had happened. Such a gradual, progressive improvement during the first six to twelve months of HGH therapy is not unusual.
Everything was just working better. It was as if something inside me was different. When I took a vacation in Mexico last year all I wanted to do was sit on the beach and read a book. This year I went out and swam for two hours. I had gotten fifteen years of energy back. "My legs and arms work better; I feel more coordinated; my muscles are hard again, and when I spent an afternoon at a friend's swimming pool, he asked me if I had joined a health club. I told him what I'd really done. I don't think growth hormone is a miracle drug. It's just replacing what I'd lost. But that's enough. I think everybody over fifty should be on growth hormone."
Should everyone over fifty be on growth hormone? In the present state of our knowledge, I would never suggest that, and, there are some people who do experience side effects. HGH is too potent to be taken incautiously, indiscriminately, or without a physician's guidance, as if it were some sort of an injectable aspirin. But I believe it's already clear that, taken under the supervision of a physician, HGH is going to be the most remarkable answer to aging that the human race has devised so far.
Are millions of people going to be taking it soon? The answer to that may have been given by Edward Chein, M.D., of the Life Extension Foundation, when he said to me that this was a "national security issue." By which he meant that the U.S. government couldn't afford to let it be known that growth hormone works for anything other than growth-deficient children. Twenty million elderly people taking growth hormone at a cost of more than $4,000 per person per annum represents $80 billion yearly added to the nation's Medicare bill. If the Food and Drug Administration is violently opposed to growth hormone use in adults, they have sound political reasons. It now seems that our national health-care policy has degenerated to the rationing of limited resources. At the moment, this country cannot afford the fountain of youth. Translation: people who want it are going to have to pay for it themselves.
THE WHOLE LINEUP
Okay, growth hormone is impressive, no doubt about it. Here are some of the things that carefully conducted medical studies−most of them conducted in the years since Dr. Daniel Rudman opened Pandora's box-have shown it can do:
● Increases muscle
● Decreases fat
● Increases skin thickness
● Smoothes out skin wrinkles
● Improves exercise tolerance
● Reverses heart failure
● Improves pulmonary function in people with chronic lung disorders
● Increases restorative REM sleep
● Increases energy and endurance
● Protects mental function and appears to help in the treatment of neurological and mental disorders such as Alzheimer's and Parkinson's diseases, and multiple sclerosis
● Enhances mental alertness and memory
● Increases the size of the thymus, the body's principal immune system gland
● Increases natural killer cell lymphocyte activity, a measure of immune system function
● Greatly increases longevity in animal studies
● Causes weight gain in frail elderly
● Causes some regrowth and regeneration of organs (liver, kidneys, and spleen) that have shrunk with age
● Normalizes serum cholesterol levels
● Causes hair and nails to improve in strength and appearance
● Speeds healing after surgery and trauma
● Greatly improves the quality of life in AIDS patients
These are the effects of this natural hormone given to people at doses calculated to replace age-related deficiency and maintain the body's supply at levels normally present during young adulthood. The quantities used are extraordinarily minute. A year's supply of growth hormone in concentrated form would be smaller than an average vitamin C tablet.
Growth hormone may not be as explosive as enriched uranium, but its potency within the human body is, I dare say, fully appropriate to the nuclear age.
HGH: The Body of Evidence
HGH: if Your Plan to Take It
Copyright © 2012 Elmer M. Cranton, M.D., all rights reserved