HGH Treatments & Therapies...

There are different classes of hGH therapies to restore or raise IGF-I levels. Each has their own benefits and purposes. Listed below are three of the better known treatments and the pros and cons of each.

Daily hGH Injections The FDA has approved the use of synthetic or recombinant human growth hormone for the treatment of Adult Onset Growth Hormone Deficiency, as well as dwarfism due to growth hormone deficiency, Turner=s syndrome and wasting due to AIDS. Treatment protocols vary from daily doses of 0.05 -0.5 units when combined with other replacement hormones such as thyroid, testosterone, estrogens and DHEA 1(these hormones may potentiate growth hormone when given simultaneously). Other regimens include 16.5 units/week given in divided doses 3 days a week2 and a method which is designed to resemble the bodies physiological secretion, a so-called high frequency /low dose technique of 4-8 units /week given twice daily before sleep and immediately upon awakening.3 These regimens raise IGF-I values to youthful levels in 1-2 months, with improvements in muscle strength, exercise endurance, and an increase in the lean body mass. The other laboratory parameters also revert to youthful levels.2 The long-term administration of hGH is very expensive, although the cost is decreasing with competition between the producers of the drug. It also requires daily injection, and if the treatment is going to be successful, these injections will be for a long time period. An oral substitute for hGH would be a major breakthrough, but to date there are no known substitutes or delivery systems for oral hGH. Oral Amino Acids (hGH Releasers) Oral amino acids is an exciting approach to stimulate the production and release of hGH from the pituitary, a fact used in the investigation of pituitary function in the young child and adult. A mixture of arginine, (2g) lysine(1g), ornithine(2g), and glutamine(1g), has been recommended as a supplement to induce hGH release and consequently increase the IGF-1 levels4. The product GHR15 contains this mixture of amino acids to induce production of hGH. There are many studies in young people showing that these amino acids will produce an increase in the plasma levels of IGF-1, and also reports of success using this regime in the elderly, there has been, to date, no published scientific study showing that indeed these four amino acids will cause an appropriate increase in the levels of hGH and consequently IGF-1 following long term therapy.

This combination of amino acids has been put together as supplement mixtures such as GHR-15 which includes other supplements as well as the four amino acids. Studies have been conducted by laboratories on the efficacy of oral amino acids, either as amino acids, or as a prepared nutritional supplement.

Oral Sprays & Peptides (Homeopathic hGH)

Another approach is the use of oral preparations of hGH releasing factor. Unfortunately hGH releasing factor is a peptide and as such is metabolized to amino acids prior to absorption by the small intestine.

The development of so-called synthetic "small molecules" called peptidometric growth hormone secretogogues which can be taken by mouth offers an alternative to the amino acid approach. One of these, MK0677 (GHSs), has been shown to increase pulsatile hGH responses and IGF-1 levels to the range seen in young adults⁵. This is a pharmaceutical preparation and has not reached the physician as yet. In fact it may take several years for FDA approval and to date is not available to the general public. When it does, it will only be available by prescription only.

Other "all natural compounds" are already on the market, one such compound claims to increase the IGF-1 levels by an average of 44%. This substance, an "all natural secretogogue", is provided as an effervescent drink which is taken before retiring to stimulate the nocturnal pulsation of hGH release. There are numerous anecdotal reports about the use of this product, but again, no published study on its ability to increase hGH secretion and consequently IGF-1 levels in the elderly.

  IGF-1 Relationships to Cancer & Obesity

IGF-1 and Cancer

Insulin like growth factors are mitogens for breast and prostate epithelial cells, therefore the inevitable question must be what is the relationship between cancer of these organs and the level of IGF-1 in the blood? Does the stimulation of growth hormone production induce malignancy? The answer to these questions are not known.

What is reported in the literature is the following. A controlled prospective study of 152 patients with prostatic cancer and controls from the Physicians Health Study showed that the patients had higher IGF-1 levels than the controls (Chan JM et al Plasma insulin like growth factor 1 and prostate cancer risk: a prospective study. Science 1998; 279:563-6). An earlier study of patients from Athens showed that increased values of IGF-1 were associated with an increased risk or prostate cancer, with some associated evidence of interaction with high levels of testosterone. (Mantozoros C.S. et al Insulin like growth factor-1 in relation to prostate cancer and benign prostatic hypertrophy Br J Cancer 1997, 76:1115-8).

Therefore male patients receiving growth hormone stimulates or hGH itself should be monitored with regular IGF-1, free testosterone, and PSA, and the level of IGF-1 targets should be conservative.

So far breast cancer studies have yield conflicting data, other than showing indeed that invitro IGF-1 is a powerful stimulator, and is indeed expressed in high levels by cancer cells. A report from Sweden showed that in premenopausal women high levels of IGF-1 in the follicular phase were significantly correlated to breast cancer (Olsson, & Borg A, Reduced testosterone, 17 beta estradiol, sex hormone binding proteins, and increased IGF-1 concentration in healthy first degree relatives to breast cancer patients, Eur J Cancer Prev. 1997;6:330-40). There is no doubt that estrogen therapy in conjunction with growth hormone stimulation must be performed with caution and carefully monitored, with IGF-1, estradiol, estrone, and estrone measurements and perhaps mammography.

IGF-1 and Obesity

The literature contains numerous recent publications on this topic. IGF-1 levels in obesity are high in the presence of low hGH production and high peripheral insulin levels. The levels of IGF-1 fall during low caloric intake and this is accompanied by loss of both muscle and fat. This increase of IGF-1 is a non growth hormone dependent function and is related to insulin concentration. Obese patients should perhaps be treated with a low caloric intake, growth hormone stimulation and exercise to maintain muscle mass.

References for hGH Therapies

1.  Hertoghe T.  Growth hormone therapy in aging adults 4^th Annual meeting of the American Academy of anti-aging Medicine, Las Vegas December 1996.
2. Jansen YJ, Frolich M, Roelfsema F.  A low starting dose of genotropin in growth hormone deficient adults. J Clin  Endocrinol Metab 1997; 82 (1): 129-35.
3. Terry CL. Human growth hormone replacement therapy in adults 4^th Annual meeting of the American Academy of anti-aging Medicine, Las Vegas December 1996.
4. Klatz R, MD Grow Young with hGH  Harper Collins New York, NY 1997.
5. Smith R. A new receptor involved in the control of growth hormone secretion 4^th annual meeting American academy of anti-aging medicine Las Vegas 1996.

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