Dr. Vance recently published an article by the above title. She concludes that antiaging therapy with human growth hormone (hGH) has not yet been proven safe or effective. Although not the first investigator to study GH in relation to body composition, Dr. Dan Rudman¹ in 1990 authored the first publication concerning the use of hGH in 12 elderly men.  Dr. Vance summarizes the data in that report; the administration of hGH at approximately twice the dose of hGH used in adult growth hormone deficiency (GHD) for six months resulted in a 4.7 kg increase in lean body mass, a 3.5 kg decrease in adipose tissue, and an increase of 0.02 gm/cm in lumbar spine density, and significant increases in BPs and in fasting glucose concentrations.  There were no assessments of exercise endurance, muscle strength, or quality of life.  Vance points out that the follow-up to this study does not include any substantiation that hGH in elderly men does more than confirm an increase in lean body mass and a reduction of body fat (with no change generally in total body weight).

Vance appropriately criticizes the proliferation of commercial “antiaging” clinics which promote the sale of inappropriate and ineffective agents such as arginine and other agents to release growth hormone and of hGH itself.  Vance chastises those who for monetary gain are so dishonest and potentially destructive of their customer’s health.

The use of long-term administration of hGH in adults with no established growth hormone deficiency is appropriately deprecated as it is not known whether the effect of long-term administration of hGH in the elderly is potentially harmful.  Cancer of various organs is of particular concern.  The work of Chan et al is cited.²  In 152 healthy men, the relative risk of the subsequent development of prostate cancer was increased by a factor of 4:3 among men who had serum concentrations of IGF-I in the highest quartile as compared with those men with concentrations in the lowest quartile.

The author’s complete conclusion is that there is no “current” magic bullet medication that retards or reverses aging.

 

Vance ML.  N Eng J Med 2003;348:779-780.

 

Editor’s Comment: This editor agrees with Dr. Vance’s conclusions.  I concur having initiated in 1982 the first study of the effect of hGH in elderly individuals.  I and four other male subjects over the age of 55 received native hGH daily for 2.0 - 2.5 years at a dose that raised IGF-I levels from GHD concentrations to levels above the 50th percentile for young adult males.  In myself there was an increase in lean body mass and decrease in free fat mass.  The same occurred in two other subjects but not in subjects 4 and 5.  Some element of hyperinsulinemia and glucose intolerance occurred but not overt diabetes mellitus.  No overt changes in gross body configuration occurred.  Subjectively there were no changes in self image, sense of well-being or libido and no changes in psychological mood.  There were no changes in hair color, the rate of hair or nail growth, or disappearance of wrinkles.   The study was stopped in 1985 when native hGH was no longer extracted from human pituitaries because of the development of Creutzfeldt Jakob disease in some GHD patients having received hGH.  On the basis of all reports in the literature and my scientific observations among the five normal elderly patients in the study cited, I agree with Dr. Vance and most other pediatric endocrinologists, “to give hGH for purposes of attempting to alter aging in individuals who secrete GH normally for age is unacceptable unless administered under a rigidly controlled double blind study”.

Reference to the role of IGF-I in shortening or lengthening life in animals is presented in the abstract immediately preceding this one (PDF page 42).  Theoretically longevity can be shortened by the indiscriminate use of GH in mammals.

 

Robert M. Blizzard, MD

 

References

1. Rudman D et al. N Engl J Med 1990;323:1-6.

2. Chan, et al. Science 1998;279:563-566.