Adult
Growth Hormone Therapy-Clinical Perspectives
Quality
of Life Improves with GH Therapy
By Ron
Rothenberg, MD
| Ron
Rothenberg, M.D. is Clinical Professor in
Preventive and Family Medicine at the University
of California, San Diego, School of Medicine. Dr.
Rothenberg maintains a private practice at
California Heathspan Institute in Encinatas, CA
USA. Dr. Rothenberg may be contacted by telephone
at (760) 635-1996, or by e-mail at info@eHealthSpan.com |
In my anti-aging practice,
I have about 160 patients being treated with growth
hormone therapy (GHRT) for normal aging. One parameter
which is often missing from evaluations of medical
treatments is "quality of life" . Many factors
come together to produce a good quality of life or more
simply feeling good or feeling great. Just about every
week a patient tells me something like, "This is the
best I've felt in as long as I remember." Of course,
I'm not just treating them with GHRT. Lifestyle comes
first: nutrition, exercise, stress reduction. Beyond
lifestyle, GHRT takes my patients to a different level of
wellness and quality of life. There are consistent
benefits mentioned by my patients.
My patients
report improved memory and cognition, a more positive
attitude and less depression. Discontinuing prescribed
antidepressants is not uncommon. Many patients simply tell
me that they feel happier. At times I have been told about
an increased esthetic awareness of the beauty of the
world. Body composition improves with more lean body mass
and less fat mass. This is observed even when patients
already had optimized diet and exercise programs before
beginning GHRT. More rapid recovery from minor sports
injuries is typical. Exercise performance increases.
Patients report that they are told they look better, look
healthier with better skin and often with reversal of hair
loss. Combining GHRT and lifestyle in motivated patients
often lead to objective lab values improving. Insulin
sensitivity and cardiovascular risk factors including
lipid profile and C-reactive protein are optimized. Other
benefits mentioned in the medical literature such as
reversal of atherosclerosis and improved immune function
are difficult for patients to observe one way or the
other.
Growth hormone
is not a "fountain of youth" or a guarantee of
immortality. Patients on GHRT are still prey to illnesses
and injuries like anyone else. They are just operating on
a younger, stronger, healthier physiological level.
One patient, a
52 year old attorney, explains it this way: When you are
in your twenties, you don't get up in the morning and
pound your chest and exclaim: I'm twenty and I feel great
and I recovered quickly from that basketball game and I'm
not gaining fat and sex is great! You just live your life
and go with the ups and downs. After being on GHRT for a
while that is what it is like. You don t marvel at the
effects every day, you just live on a better level.
As anti-aging
physicians, our goal is to rectangularize the
functionality curve of the human lifespan, helping our
patients to stay strong and vigorous as long as possible
without gradual and protracted deterioration. We know GHRT
is a proven defense against frailty and when added to
lifestyle this is our chance to stay stronger and more
functional. If we were to stay perfect, why intervene? But
since we don't, this is one route to maintaining function
while we await the genetic and biochemical therapies that
will be available in the near future. Patients treated
with GHRT are happier and healthier. Just ask one.
AAMN
Editorial Note:
There are several recent studies that document the
positive effects of GH therapy in adults on quality of
life measurements. These include:
NOVEMBER
2001 (KIGS/KIMS Outcomes
Research, Pharmacia AB, Stockholm, Sweden): Data
concerning visits to the doctor, number of days in
hospital, and amount of sick leave were obtained from
patients included in KIMS (Pharmacia International
Metabolic Database), a large pharmacoepidemiological
survey of hypopituitary adults with GH deficiency. Of the
304 patients surveyed, visits to the doctor, number of
days in hospital, and amount of sick leave decreased
significantly after 12 months of GH therapy. Patients also
needed less assistance with daily activities, although
this was significant only for the men. After 12 months of
GH treatment, Quality of Life (assessed by the
QoLAssessment of GHD in Adults questionnaire) improved, as
did both the amount of physical activity and the patients'
satisfaction with their level of physical activity. Dr.
Hernberg and colleagues thus conclude that "GH
replacement therapy, in previously untreated adults with
growth hormone deficiency, produces significant decreases
in the use of healthcare resources, which are correlated
with improvements in quality of life."
SEPTEMBER
2001 (Universitat Munchen,
Munich, Germany): Dr. Herschbach and colleagues from the
Institut und Poliklinik fur Psychosomatische Medizin found
scores across numerous psychometric markers improved
progressively in adults administered GH replacement
therapy.
JUNE
2001 (Royal Liverpool University
Hospital, United Kingdom): Dr. Ahmad and team found that
weight-based GH replacement resulted in significant
improvements in both body composition and quality of life
as early as one month after the initiation of treatment,
and persisted at three months. Noting that "most
importantly, these changes occur in the absence of
side-effects," the researchers "therefore
suggest the use of low-dose GH therapy, maintaining IGF-I
between the median and upper end of the age-related
reference range, for the treatment of adult growth hormone
deficiency."
During normal
aging, men and women experience a decrease of growth
hormone secretion of up to 60%. As our abstracts review
and Dr. Rothenberg's insights suggest, determination of an
individual s suitability for GH replacement therapy must
be based on a complete clinical evaluation that identifies
declining physical, cognitive, or psychological parameters
- either or both of which may cause a decrease in the
individual's quality of life. As Dr. Delgado points out, a
regimen of low-dose GH treatment coupled with supporting
hormones and nutrients can achieve impressive age-reversal
results.
Admittingly,
the discussion over the long-term efficacy of GH
replacement will undoubtedly continue. As an evolving
science, it is likely that vacillations of study findings
will continue for quite some time, and they reinforce the
fact that GH therapy in adults for any reason - including
specific disease treatment as well anti-aging purposes -
must be conducted judiciously by a physician trained in
this treatment.
In closing, we
cite one of the newest studies reaffirming the safety of
prudent GH therapy. In May 2002, Dr. Kehely and colleagues
in the United Kingdom published findings on their two-tier
parallel study. In one group of GH deficient adults, they
administered a low dose regimen (3 mcg/kg/day for 3
months, increasing to 6 mcg/kg/day for 3 more months)
versus conventional dose (6 mcg/kg/day, increasing to 12
mcg/kg/day for 3 more months). The proportion of patients
completing low-dose therapy was greater than for the
conventional dose group. While both dose groups showed
significant increases in lean body mass and decreases in
fat mass for all time points, subjects in the low-dose
group were better able to maintain the gain in lean body
mass for the six-month study period. There also were fewer
reports of adverse events (arthralgia) with the low-dose
therapy. The lower starting dose with dose titration
appeared more favorable, but researchers note that
individual variability also requires consideration.
When
supervised by a qualified anti-aging physician, evidence
to-date indicates that GH replacement therapy is valuable
in maintaining both physical fitness and mental acuity in
adult men and women.
RESOURCES
Delgado N.
Grow Young and Slim 2nd Edn: #1 Way to Fitness. HWS (Las
Vegas Nevada), in-publication (anticipated publication
date 2003).
Grow Young and Slim, at www.growyoungandslim.com
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An
original article as appeared in Anti-Aging Medical News,
Summer-Fall 2002, published by the A4M.
