ImmInst.org Forums: Olshansky vs HGH - ImmInst.org Forums

HGH doesn't reach the level of scientific backing I'd want to chance on. It appears to be helpful for some people under some circumstances, but no-one can say whether you're one of them. Yet. Too much like rolling the dice considering the potential downsides and side effects.

That said, I'm libertarian on the right to do what you like with your own body. Equally libertarian on whether lying about the effectiveness or capabilities of a product constitutes fraud. So both sides look just as bad for entirely different reasons.

A major caveat would be that mice deficient in any component of the growth hormone pathway (GH, GHR/BP, IGF-1R) are weaker and smaller, but live a good deal healthier and longer [1]. Recent data would seem to suggest that some of this may be true in humans, too [2].

If you want to feel like a young human you need the hormonal profile of a young human. This is the feeling that many HGH users describe while taking it. HGH also makes people look younger. There is no doubt it has a strong effect on the body. Youth, strength, and vitality are all things that we desire and HGH is the only susbstance in use today that can bring it in short order. CR, meditation, exercise, and supplementation are all helpful in slowing the rate of aging but none of them come close to the age reversing effects of HGH.

Like Reason, I do not discourage anyone from using HGH. I do not use it myself, because I do not know anyone personally who takes it and because I have not researched the supposed downsides extensively.

Still I don't see the need for the near religious opposition shown by Olshansky.

Dear Prometheus: Actually, I don't have a religious opposition to the use of GH -- I'm not sure what would motivate this belief. Indeed, I have stated repeatedly [including a statement to that effect during a UPI interview just published] that perhaps there is a place for GH as a treatment for aging-related conditions in the future, but that future should wait the completion of clinical trials that evaluate the hormone for safety and efficacy. Regardless, the use of GH as an anti-aging treatment is illegal in the U.S. (even under off-label use) -- we demonstrate this definitively in our article published yesterday in JAMA.
United Press International
http://www.upi.com/HealthBusiness/view.php...25-034430-2759r
Forbes
http://www.forbes.com/home/sciencesandmedi...025hormone.html

S. Jay Olshansky

dear mr. olshansky,

are you against hgh secretagogue use also?

one of the most dramatic aging accelerators is stress mainly due to injury and lower quality of life. if GH can reverse or prevent it, than its secondary effects are not to be underestimated. I'm with "GH at any age" group.

Quote

Thanks for clearing that up.

Quote

(see John's original post for references)

The observations of extended lifespan in GH axis downmodulation are likely to have to do with altered insulin signaling and should not be extrapolated to support the suggestion that decreasing GH levels are beneficial. On the contrary, the overall endocrine deficiency we observe in the aged is part of systemic downmodulation in the expression of many genes and the deterioration of endocrine tissue supporting stem cell niches.

Don't forget that one of the benefits of CR is an increase in GH secretion. Another beneficial activity - exercise - also results in an increase in GH secretion. Whilst I have not come across a study that measures the endogenous GH levels of supercentenerians in the last 30 years of their life I would bet that their GH levels at the ages of 70, 80 and 90 would be measurably higher than those who passed on at or around those ages.

I do not believe that supplementing declining GH levels such that they are brought to the endogenous levels of healthy 25-30 years olds would present any significant adverse effects.

Consequently when Jay O. suggests that we should

Quote

I think it is an impediment for those who stand to benefit from GH supplementation. There are no studies that I have come across that suggest that GH supplementation to bring declining levels back to a more youthful range present a safety issue (and this is why I call Jay O a 'crusader' - show me the supporting evidence).

The treatment for an adult who has been diagnosed with hypopituitarism includes GH supplementation. Why is there such a difficulty in accepting that an increasing degree of hypopituitarism starting from slight to moderate is a consequence of aging and should be treated as such?

Quote

Speculations about the mechanism do not make the demonstrable life-extendig effect of downmodulating GH signaling go away.

Quote

True, but they also result in many other things than increased GH. I think it is currently not possible to reconcile the data from the different types of experiments we cited. More work is definitely required here as elsewhere in the field of GH supplementation.

If an informed human wishes to take HGH based on these inconclusive data, they should definitely be free to do so and I would not consider it irrational. Aging is not fun. It is worth taking moderate risks to alleviate it and that is what the current regulatory system completely ignores.

(Though the problem remains what to do with those many humans we would consider uninformed, but worth protecting from their uninformed choices)

Quote

Despite what we see in mice, humans with pituitary dwarfism do not show an extended lifespan or any reductions in age related pathology. Before you cite references on the infamous "little people of Krk", a geographically isolated population who as a consequence of interbreeding tend to carry numerous hereditary diseases including dwarfism, albinism, paralytic spasticity, cataracts and mental retardation, bear in mind that the longest lived Krk individual recorded was 91 years old - hardly extraordinary. Human dwarfism resulting from hypopitutiarism is associated with numerous endocrine complications that will contribute to decreasing lifespan.

If you have any evidence that lowered GH levels contribute to lifespan in humans let me know - similarly if you have any evidence that raising age related GH deficiency to more youthful levels contributes to any pathology.

Lely (1) writes, "it might even be dangerous to use excessive GH dosages in conditions in which the body has just decided to decrease GH actions". Firstly we are not talking about excessive but youthful levels and secondly, since when has medicine been at the mercy of the body's decisions?

Supposing we are able to increase neurotrasmitter function in the brain or immune function to youthful levels should we not do this because the body has "decided" to enter into an aging program that decreases these functions? Of course not - it would be absurd. Yet this is instrinsically the myopic rationale which is being promulgated.

Do we resign the cancer patient to death when he is diagnosed? No - we intervene by surgery, chemotherapy, radiotherapy and any other treatment available including experimental ones when the patient becomes terminal. Why should we not act similarly when it comes to aging?

Aging is at present an incurable disease. But it is a disease. We should not have to wait until the clinical manifestations of aging become gross to seek, at the very least, symptomatic relief. The inexorable processes of aging set in far sooner than the appearance of significant physical manifestations which makes the need for a procative rather than reactive interventional approach even more important.

from JAMA. 2005;294:2086-2090 said:

Olshanky's article (2), without suitable qualification to show that GH supplementation has serious side effects (many commonly prescribed anti-inflammatory agents have far more serious side effects than those cited above) is a grave loss for many patients who otherwise would have had the opportunity to be treated with GH. Considering the impact that such an article would have on an already lawsuit-fearful medical community I wonder if he fully recognises and is willing to take responsibility for the many patients who are going to miss out as a result of this dubious article.

from JAMA. 2005;294:2086-2090 said:

Rubbish. Thankfully, the reason for GH administration remains the prerogative of the medical practitioner.


(1) Justified and unjustified use of growth hormone
A J van der Lely
Postgraduate Medical Journal 2004;80:577-580

(2) Provision or Distribution of Growth Hormone for "Antiaging"
Thomas T. Perls, MD, MPH; Neal R. Reisman, MD, JD; S. Jay Olshansky, PhD
JAMA. 2005;294:2086-2090

Growth hormone is not poison. It is an essential part of a youthful healthy body. The high growth hormones that my body produced a few years back did not harm me, I can't see any obvious reasons why there would be harm now. I admit this is an extremely simplistic look at the situation, and GH administered to an aging body may have some unintended effects, I just haven't seen the need for such high alarm.

Carpal tunnel syndrome? A reason to ban GH? puhleeeeez. Give me a break.

Joint and muscle Pain (arthralgias)? Given that people on GH tend to feel like they can conquer the world, did they check to make sure these 65 to 88 year olds didn't just suddenly go on a Polka bonanza?

Edema? can be caused by Corticosteroids, Estrogen, Insulin, and Laxatives. I don't see anyone rushing to ban these substances.

Dear Prometheus and Mind:

I would recommend reading the following article for a detailed summary of the use of GH in humans and other species.

S. Mitchell Harman and Marc R. Blackman Hormones and Supplements: Do They Work?: Use of Growth Hormone for Prevention or Treatment of Effects of Aging
J Gerontol A Biol Sci Med Sci 2004 59: B652-B658.

The points you make Mind about the side effects of GH are interesting but irrelevant to the topic of our manuscript published in JAMA. There may very well be reason to question the existence of the law that prohibits the distribution of GH under off-label use as a treatment for aging and its related conditions (except when adult GHD has been properly established), but that does not change the fact that it is illegal. My guess is that there will soon be an effort to change the law should that be the target of those interested in this issue. I don't believe it is illegal because of the side effects. I think the Harman and Blackman article make a very strong case for why GH should not be used as a treatment for aging and its related conditions until it's studied more thoroughly. There is an inherent danger in assessing safety and efficacy on the backs of patients.
Hope this helps.
S. Jay Olshansky

Jay, I understand your position and concerns about patient's safety.

Besides the safety issues, do you think there is a cultural component involved in making GH illegal? People strongly lean toward the "natural is better" attitude, and GH gives users "unnatural" strength and vitality. Is it similar to the extreme reaction to steroids (or any performance enhancing supplement) in sports? I think so.

Dear Mind
I don't think GH is illegal in this case because it was directly targeted as a questionable anti-aging treatment -- I think it inadvertenly fell into this category because of events that transpired since the law was written. Having said that, I don't really know what was in the minds of those involved. The natural is better attitude is interesting with regard to GH, for as I understand it the GH being produced today is "natural" -- it is virtually identical to that produced by our own pituitary. What is unnatural is reintroducing it into the body at later ages in quantities thought to exist at younger ages. One important problem is that no one knows what levels were really present in these patients when they were younger (because it wasn't measured), so they have to rely on cross-sectional population estimates of GH. There is also a question about its value in providing strength and vitality -- but those details are contained in the Harman/Blackman manuscript.
S. Jay Olshansky

All the physicians that I know who are willing to prescribe GH as an "anti-aging" treatment will firstly establish that GH levels are suboptimal through a barrage of diagnostics. Consequently the issue then becomes the definition of what constitutes adult GHD. Presently in the US these are the criteria:

Quote

We must be reminded that it was not too long ago that "normal" testosterone decline in the aging male was not recognised as an indication for testosterone supplementation, whereas today it is. In fact merely being 40 and over is an indication for Andriol (testosterone undecanoate) in males. Ironically, some of the more serious possible side effects of testosterone administration include liver cancer, prostate cancer, male breast cancer, etc. Despite these side effects doctors have no problem prescribing testosterone supplements for male patients at or around 40 who are presenting with the symptoms of reduced testosterone levels without the need for a blood assay (patient's blood pressure, however, is monitored every month and liver function every 6 months). Is the testosterone supplementation increasing lifespan - highly unlikely (even though there are studies that suggest lowered testosterone levels in the male contribute to myocardial infraction). However, the patient feels more robust and from a physiological perspective some of his functioning is as if he were younger.

If we consider GH supplementation we firstly see that the possible side effects are not as serious as those for testosterone and secondly that the benefits are more widespread and lasting (there are numerous references which one can search on Pubmed). From the article (1) that Jay O. is heavily drawing on and has directed us to on two ocassions now, we find that the authors are basing a substantive amount of their conclusions on the adverse effects of GH supplementation based on studies of acromegalic patients. Patients that suffer from acromegaly invariably secrete from childhood and until their demise or surgical intervention abnormaly high levels of GH due to the presence of a pituitary tumor. They tend to have a shortened lifespan and are plagued by cardiovascular and endocrine disease. The reality is that Harman et al (1) simply do not have sufficient data on GH supplementation to support their conclusions so they have had to extrapolate from the effects of lifelong, abnormally high GH secretion. Furthermore whilst they have chosen to include studies on the disease of acromegaly they have not included studies on usage of GH supplementation in children and athletes. This is far reaching at best and poor science at worst.

Anyone who takes the time to scrutinize these facts for themselves will conclude that Olshansky et al have not only failed to make their case that GH supplementation poses a risk when used in a professionaly monitored context but their representations to the medical community are counterproductive towards increasing the quality of life in the aging community.


(1) S. Mitchell Harman and Marc R. Blackman Hormones and Supplements: Do They Work?: Use of Growth Hormone for Prevention or Treatment of Effects of Aging
J Gerontol A Biol Sci Med Sci 2004 59 (7): 652-658

The Harman & Blackman (1) paper - note the impressive 110+ references yet amost nothing said on GH supplementation adverse affects aside from data on acromegalic patients.. Also note that the paper was accepted the date it was received (did anyone read it? - only kidding .. I think).

from the Conclusion said:

(1) S. Mitchell Harman and Marc R. Blackman Hormones and Supplements: Do They Work?: Use of Growth Hormone for Prevention or Treatment of Effects of Aging
J Gerontol A Biol Sci Med Sci 2004 59 (7): 652-658

boo I got an error message trying to DL this... can you email me this please at liorrh at yahoo.com

thanks

Sorry, liorrh. It appears the PDF didn't not port over when the new forums were instituted.

In any case, this is an interesting discussion that has not had any input in over 2 years. Just wondering if any new data regarding GH supplementation has popped up. I know that when Dr. Klatz was a guest on the Sunday Evening Update he was a big proponent of GH supplementation (and that was just a month ago), so I am just going to venture a guess that no serious side-effects have been seen with GH usage as of yet.

GH secretagogues such as GHRP-6 are becoming popular in some anti-aging circles. These cause the pituitary to release a more physiologically correct GH pulse, which some argue to be more beneficial than the steady levels obtained from exogenous HGH supplementation. These are much cheaper than rHGH, and some people appear to be very happy with the anti-aging benefits.