Free Consultation

Human Growth Hormone (HGH)

Of all the interventions that anti-aging medicine has brought to patients who wish to slow the aging process, human growth hormone (HGH) is arguably the most profound and the most controversial. Human growth hormone, also known as somatotropin, is the most abundant hormone made by the pituitary gland in the brain. Cells in the pituitary, known as somatotropes, produce HGH and release it into the bloodstream, where it can have a direct effect by itself on tissues and organs, or it can be absorbed by the liver and converted into various other growth factors. HGH is released in pulses throughout the day, determined in large part by “circadian rhythms.” Most HGH release occurs during stages III and IV deep sleep.

Two hormones, GHRH and somatostatin, produced in the hypothalamus regulate HGH production through a feedback loop. Growth hormone-releasing hormone (GHRH) stimulates HGH production and somatostatin inhibits HGH production. Specific gastrointestinal cells produce third regulating hormone, grehlin, which works in synergy with GHRH to stimulate HGH production.

Human Growth Hormone obtained its name from the fact that HGH is necessary to make children grow in stature. At one time, this was believed to be essentially the only role played by HGH. We now know differently. It appears that nearly every organ in the body depends on HGH for proper growth and development. Growth hormone increases anabolic activity and lean body mass. It regulates the body’s metabolism of proteins, electrolytes, carbohydrates, and controls how the body uses fat.

The muscle building actions of growth hormone don’t come from growth hormone directly, but are mediated by conversion and release from the liver of a more potent and active form, called insulin-like growth factor 1 (IGF-1). HGH also causes the body to produce binding proteins that carry IGF-1 and act as hormones in their own right. The pituitary gland secretes growth hormone in brief spurts, and disappears from the blood very rapidly, making direct measurement next to impossible. Instead, IGF-1 levels do not fluctuate as rapidly, making it a surrogate marker of HGH levels.

HGH has been called a master hormone because of its ability to affect all the other hormones and organs throughout the body. It has repairing and restorative ability that can reverse damage, and facilitate re-growth of failing organs somewhat, something no other hormone can do. It is unclear, however, whether maintaining physiologic levels of HGH or IGF-1 equivalent to those of a 25-35 year-old person will extend the length of human life. But it is worth noting that the Journal of Clinical Endocrinology and Metabolism reported in 1997 that healthy centenarians have high serum IGF-1 concentrations.

HGH levels decline with age. After the age of 25, levels begin to decline at a rate of 10– 15% per decade. As the levels of growth hormone decrease with age, so do the levels of IGF-1, falling by nearly 50% after the age of 40. The decline in HGH is known as somatopause. Every hormone has a ‘pause’ and human growth hormone is no different.

Aging results in less (deep) sleep, diminishing opportunities for HGH secretion. Unfortunately, sleeping pills and the over-the-counter sleeping pills do not increase the length of stage III and IV sleep cycles, when HGH is secreted. Other factors can interfere with HGH secretion, including a sedentary lifestyle, other hormonal imbalances, chronic stress, and even extreme changes in diet.

Adult Growth Hormone Deficiency

Signs and symptoms associated with Adult Growth Hormone Deficiency (AGHD) include:

  • Decreased
  • Memory, mood, and well-being
  • Quality sleep o Muscle mass o Lung function
  • Strength and exercise capacity
  • Bone density
  • Immune function
  • Heart function with less cardiac output
  • Joint cartilage mobility and increased arthritis
  • Skin thickness
  • Rate of wound healing
  • Glucose stability
  • Nitric oxide levels
  • Thermoregulation
  • Increased
  • LDL cholesterol
  • Insulin resistance
  • Body fat and central adiposity
  • C-reactive protein and other inflammatory markers
  • Fibrinogen and plasminogen activator inhibitor-1
  • Premature atherosclerosis
  • Tone in the sympathetic nervous system
  • Depression

AGHD has been described as a model for aging, because the symptoms are essentially the same associated with aging. “Normal aging” results, in part, from an insufficiency of growth hormone, as opposed to a true deficiency. The HGH levels of a normal 50 or 60 year old may be as low as those found in an adult with a pathological deficiency from pituitary disease. Less than one-third of the older population is growth hormone deficient and may benefit from replacement therapy. HGH replacement therapy can treat or reverse many of the signs and symptoms in patients diagnosed with Adult Growth Hormone Deficiency.

Excess Growth Hormone

Excess growth hormone secretion causes a condition known as acromegaly, and is associated with an increase in soft tissues, edema and joint pain. Supraphysiologic growth hormone levels also decrease apoptosis, the protective process of finding abnormally growing cells or early tumors. Since high levels of growth hormone can inhibit apoptosis and because it is an anabolic hormone which makes tissues grow (including cancer cells, potentially), questions have been raised about HGH replacement therapy as a cause of cancer. Individuals with acromegaly have supra- physiologic levels of HGH, and they have an increased risk for colon cancer. However, acromegaly confers an all-cancer risk of just 0.76.

The New England Journal of Medicine, October 1999, concluded, “There is no evidence that HGH replacement therapy affects the risk of cancer or cardiovascular disease.” Much higher-than-normal levels of HGH in conjunction with low levels of another protein known as IGF-1-BP-3 (IGF binding proteins) may have a role in cancer risk development (prostate, breast and colo-rectal), according to the Lancet, April 2004.

IGF-1-BP-3 appears to have an inhibitory effect on cell growth, helping protect one from cancer by promoting programmed cell death, called apoptosis. IGFBP-3 inhibits mitogenesis by sequestering IGF-1 from the type 1 IGF receptor. It also modulates retinoid receptors, interacts with TGF-beta, and blocks cell division at G2/M. The journal Cancer reported in 2005 that “IGF-1 was not associated positively with the risk of prostate carcinoma; however an increase in the IGFBP-3 level was associated with a modest decrease.” Appropriate HGH replacement therapy tends to produce a greater rise in IGF-BP3 then IGF-1. Close monitoring of IGF-1 and IGF-BP3 levels during replacement therapy is essential to avoid exceeding optimal and physiologic ranges.

Abnormally high levels of growth hormone are also associated with increased production of various inflammatory agents such as leukotrienes and cytokines. Any overproduction of inflammatory compounds resulting in an imbalance of the ratio of inflammatory to anti-inflammatory compounds causes silent inflammation, which is at the root of most aging-related diseases. Therefore, any HGH replacement program must avoid causing supraphysiologic growth hormone levels and should be balanced with other lifestyle interventions known to prevent and treat silent inflammation.

“Insulin-Like Growth Factor-1 is a Vascular Protective Factor,” an article published in a 2004 issue of the American Heart Association journal, Circulation is one of many shedding light on the importance of maintaining optimal levels of growth hormone and other hormones for keeping our physiology functioning at its highest level. The following quote, from the first paragraph, of the article states the message clearly: “Recent advancements in cardiology have focused on proliferation and regeneration as a potential cardiovascular defense mechanism. Within this framework, growth factors are acquiring increasing importance; insulin-like growth factor-1 (IGF-1) emerges among them for its versatile pleiotropic actions.” The authors concluded with the following statements:

• “Increasing evidence indicates…that IGF-1 protects against endothelial dysfunction, atherosclerotic plaque development, the metabolic syndrome, clinical instability, and ischemic myocardial damage.”

• “Measurement of circulating IGF-1 may add valuable information to the current assessment of cardiovascular risk. Individuals with traditional cardiovascular risk factors but normal or elevated IGF-1 may be protected, at least in part, against disease. With reduced IGF-1 levels, instead, vascular risk factors may fully exert their detrimental effects, through unopposed endothelial dysfunction, endothelial apoptosis, and development of unstable plaques. Those with markedly reduced IGF-1 might develop disease even in the absence of traditional risk factors. It is worth noting that healthy centenarians have high serum IGF-1 concentrations.”

Initial HGH Corrective Measures

Improvements in growth hormone levels generally can be accomplished through a balanced approach to diet, exercise, stress management and optimization of other hormone levels. It may require significant efforts in all the following ways for 6 months or more before noting improvement in IGF-1 levels and symptoms of somatopause

  • Mediterranean-type, calorie-restricted (reduced as much as 10-25%), low glycemic diet
  • Lose excessive body fat
  • Regular, vigorous exercise, especially weight training
  • Effective stress management skills
  • Correct other hormone insufficiency (e.g., thyroid, DHEA, estrogen, progesterone, testosterone)
  • Omega-3 (fish oil), anti-inflammatory and anti-oxidant supplements
  • Modest increases in growth hormone levels (rarely by more than 20%) can be accomplished in some patients with oral precursors for HGH (called Secretagogues). If you chooses to try this approach, ask your doctor for appropriate doses of the following secretagogues
  1. Arginine
  2. Ornithine
  3. Glutamine
  4. TMG-Betaine
  5. Linoleic acid (Conjugated FA)
Contraindications to HGH Replacement Therapy
  • Any evidence of neoplastic activity
  • Intracranial lesions must be inactive and antitumor therapy complete prior to institution of therapy
  • Intracranial hypertension
  • Proliferative diabetic retinopathy
  • Pulmonary fibrosis
  •  Recent coronary angioplasty
  • HGH should be discontinued if there is evidence of tumor growth
  • It should not be initiated to treat acute critical illness due to complications following open heart or abdominal surgery, multiple accidental traumas, or if you are experiencing acute respiratory failure
  • Caution is required when HGH is administered to patients with diabetes mellitus, as insulin dosage may need to be adjusted.
HGH Replacement Therapy

HGH replacement therapy is never a first-line therapy for aging-related problems. Growth hormone replacement therapy is not indicated for “anti-aging” purposes. Low growth hormone levels must first be addressed with proper nutrition, nutritional supplementation, exercise, appropriate replacement of other hormones, and stress management. Growth hormone replacement therapy is limited to treating Adult Growth Hormone Deficiency, a diagnosis made after careful review of the clinical picture, a complete medical history, thorough physical examination, and review of laboratory findings that are consistent with a diagnosis of AGHD. It should be used with moderation and appropriate laboratory monitoring .

HGH is a relatively large molecule, which is one reason why it cannot be taken by mouth or absorbed topically. The only current effective route for HGH is by injection. HGH is released in pulses throughout the day, determined in large by “circadian rhythms.” Most HGH release occurs during deep sleep, which is known as stage III and IV sleep.

Even though most studies on HGH replacement therapy have shown decreased insulin resistance with HGH, there can be an increase in insulin resistance in some individuals. This situation usually can be prevented by decreasing the dose of HGH or by following a hormonally balanced diet as described in this manual. In men, when testosterone is used along with HGH, the complications of increased insulin resistance are frequently avoided. At any rate, close monitoring for these possible side effects is essential, with HGH dosages adjusted accordingly. Intracranial hypertension with papilledema, visual changes, headache, nausea and/or vomiting has been reported in a small number of patients treated with HGH.

Side Effects of HGH Replacement
  • Intracranial hypertension with papilledema, visual changes, headache, nausea and/or vomiting has been reported in a small number of patients treated with HGH.
  • Edema (swelling) of the hands and ankles. Excess doses usually result in fluid retention in the hands and feet. If this develops, discontinue the HGH until the fluid disappears (possibly 2-5 days), and call the doctor. Check blood pressure any time fluid retention develops to be sure blood pressure is not increasing as well. Continued fluid retention may lead to headaches and/or joint pain, and possibly carpal tunnel syndrome, increased blood pressure or insulin resistance.
  •  Parethesias (numbness and tingling in the hands)
  • Arthralgias (joint aching)
  • Slight bruising at the injection site
  • Glucose intolerance, hyperglycemia, and/or increases serum insulin levels, at least initially. In several studies, HGH therapy resulted in small increases in fasting glucose, fasting insulin levels, and HgbA1c levels. Even though most studies on HGH replacement therapy have shown decreased insulin resistance with HGH, there can be an increase in insulin resistance in some individuals. This situation usually can be prevented by decreasing the dose of HGH or by following a properly balanced diet, low in high-glycemic carbohydrates. In men, when testosterone is administered in patients receiving HGH, the complications of increased insulin resistance are frequently avoided. At any rate, close monitoring for these possible side effects is warranted, and HGH doses are adjusted accordingly.
  • In the past, HGH was extracted from the pituitary glands of human cadavers, raising the concern for possible spread of Creutzfeldt-Jakob (Mad Cow) disease. For this reason, recipients of human cadaver-derived HGH are not permitted to donate blood. Today, HGH is manufactured using the recombinant DNA technique, the same technique used to manufacture human insulin. There is no danger of Creutzfeldt-Jakob (Mad Cow) disease from modern recombinant HGH.
Side Effects of HGH Replacement

Careful monitoring is essential with HGH replacement therapy, which may include:

  • IGF-1 levels, fasting glucose, fasting insulin and hemoglobin A1C are measured
  • 4-8 weeks after initial replacement and are repeated every 2-6 months thereafter
  • PSA is measured every 6 months in men
  • Other hormone levels are monitored, as well as other blood tests appropriate for treatment
  • Physical assessment for side effects are assessed 4-8 weeks after initial replacement and are repeated every 2-6 months thereafter
  • Annually
  • Physical examination
  • Baseline blood testing
  • Women are required to have annual pap smears and mammograms
  • All patients are urged to have a colonoscopy every 3 years over age 50
Begin Your Journey to Wellness! – Call 307-733-2950

Our Clinic is the ideal place for women, men or children to secure an integrative, holistic and personalized approach to health care.  We partner with each patient to focus on the root cause of their illness, support their recovery, and help them maintain good health.

Contact us for a free consultation