Feb. 13, 2008— -- Dr. Richard Hellman, the president of the board of directors of the American Association of Clinical Endocrinologists (AACE), answered our viewers' questions about human growth hormone. Read his answers below and thank you for your questions.
Hellman is also a member of the executive committee of the AACE and chairs its patient safety committee. He is a Fellow of the American College of Endocrinology (ACE), and a Fellow of the American College of Physicians.
Question: What are the major side-effects of taking growth hormone? Do you know of any heart or muscle or joint problems? And if so, is there any time frame or dosing issues that affect them?
Gary from San Antonio, Texas
Hellman:When growth hormone is given to replace the growth hormone that is lacking, such as when a child or adult is proven to be without the capability to make their own growth hormone, if the growth hormone replacement is given in the appropriate dosage, the side effects are minimal.
In contrast, when growth hormone is given in excess, to someone who already makes adequate amounts of growth hormone, the excessive and inappropriate growth hormone may have many different and unpleasant side effects, dependent upon the age of the person, their health, and the amount of excess of growth hormone given. In this case, arthritis, due to joint overgrowth, entrapment of nerves, such as carpal tunnel syndrome, excessive sweating, elevated blood sugars or overt diabetes, and edema, may all occur. The longer the exposure to the excess, the greater the problem, and the older the person, the more vulnerable they are to some of the side effects noted above.
Question: Are there any natural proven ways to increase HGH output? Maybe certain exercises or diet? Can your body turn its natural HGH production down or off if it is injected for a period of time (like steroids)? Thanks for your help!
Greg from New York
Hellman: The question is whether there are any natural proven ways to increase HGH output. The counter question is why someone thinks it may be a good idea. Since HGH is essential for normal growth, and without it we remain much shorter than we should be, it is not a surprise that the levels gradually diminish as we get older, after HGH helps us grow in height to our full adult height and helps strengthen our bones to their full density, that we should have less of a need for the hormone. In general, the body does better regarding aging when people are active physically and mentally, and not overweight, and with a lower chronic stress level. Interestingly, when people are physically active and less obese, their HGH levels and responsiveness are better, but this may well be a result, rather than a cause.
Question: The HGH which is administered to children for the purpose of growing, does it also enhance athletic ability as in professional athletes? How safe are they and when are children taken off this drug? I know people who I am concerned about who is giving their kids this and I am curious about answers.
Lynn from Coram, New York
Hellman: When children are found to be growth-hormone deficient, they almost always are shorter than their peers, and less able to perform well athletically. When they are given appropriate replacement of growth hormone, together with improved growth and height will often come an improved athletic ability, but they often still have difficulty catching up with their peers athletically. Although some professional athletes as adults have taken growth hormone to improve their athletic performance, careful scientific studies show that the effect of the growth hormone on improving their muscle strength is relatively small and much less important than their training regimen.
Question: I have a 14-year-old son who is small for his age. He stands 4'10 and weighs about 85 lbs. We are seeing a specialist and are wondering about growth hormone treatments that are available for him. We are interested in side effects.
Pat from Jennings, Louisiana
Hellman: Your 14-year-old son who is small for his age should be evaluated by a pediatrician or pediatric endocrinologist to see why he is smaller than his peers. There are many reasons why he may be smaller at this time, and an expert can usually distinguish what the reason is, and whether he needs specific treatment, or merely more time to grow properly. In the event that he is found to have a deficiency of growth hormone, I would like to reassure you that since treatment is merely replacing the missing growth hormone, there are only minimal side effects. Even the injections are no problem for most children, and are well tolerated. I would not hesitate in finding out what you need to know about his height, and beginning with his pediatrician or going to a pediatric endocrinologist would be a good way to start.
Question: I am worried about my bf, he has been taking it for at least two yrs now, he says there is nothing wrong with taking it, he has a awful temper, he is up and down in moods, always has to stay busy never relaxes, even in the morning he will jump outta bed ready to work out, I'm very concerned with the temper part, he just gets outraged out of little simple things!! maybe it's just him, but i have a feeling this drug has something to so with it! please help!
Stephanie from Seekonk, Massachusetts
Hellman: Dear "worried about your boy friend." When a healthy adult male takes growth hormone either to improve athletic performance, or to improve muscle building, or to prevent aging, he is always making a mistake and wasting his money. There have been many reports of people with excess amounts of growth hormone having behavior changes, and anger problems would be not uncommon. In addition, many people may be taking multiple medications such as androgens, and they are often unaware of all that they are getting from their provider of the illicit medications. There is little benefit from these substances, and unlimited risk.
Question: I saw this segment on World News tonight and I started to think about my son. He is 10 diagnosed with ADHD and has been on Concerta for five years now. This medication has stunted his growth a lot. His little brother is three years younger and an inch shorter. Can this type of HGH be considered on a 10-year-old with this type of problem and on this medication?
Blenda from Weslaco, Texas
Hellman: The question as to whether medications that are commonly given for ADHD can cause growth problems is one that has been studied carefully worldwide. It appears that the effect of methylphenidate and related medications on height is relatively small, but there are many reasons other than the medication itself that may have influenced your son's growth. I would encourage you to discuss with the health care team that is caring for your son, and particularly a pediatrician or pediatric endocrinologist, who can help clarify what the best steps to take for your son would be.
Question: The presence of this topic in the media fuels ever more hype and sensationalism. I have searched JAMA and the NEJM, finding only the references to the studies performed on a small population of elderly men in the 90s. Since that study, there has been a proliferation of clinics organized by physicians promoting anti-aging via cocktails of HGH and other hormone replacements. These clinics make claims which I cannot find any supportive scientific evidence for. More disturbing, however, is the fact that there is no evidence to refute these claims.
Besides the initial studies which showed a small increases in muscle mass and in lean body mass, are there well-designed, peer-reviewed studies which demonstrate any positive effects for HGH? Do people feel better, are there effects on skin and connective tissues? On the negative side, can there be conditions brought about by the use of HGH? There are so many questions out there without answers, the truth is unknown and the public is gullible, they will follow the hype. I could go on but I think you understand my question.
Groh D.D.S. from Oak Brook, Illinois
Hellman: Dr. Groh makes the excellent point that the studies that have been done on the use of HGH have shown relatively modest increases in muscle mass and in lean body mass, but nothing like the extravagant claims made by those who claim anti-aging benefits, and the quality of life claims made by many others.
While it is true that a person who is proven by testing to be deficient in Human Growth Hormone feels much better when they receive adequate replacement, there is also evidence that the risks outweigh the benefit for those who take large amounts of HGH when they already have growth hormone production in their body. It is hard to avoid being moved by people who genuinely believe that growth hormone treatment can help many people who do not feel 100 percent, but the fact is that the scientific evidence overwhelmingly shows that growth hormone therapy is safe and effective for those already proven to be deficient, and in a few other medical settings, but for most of us, it is unwise to use, disappointing in the results, and a waste of time and money.