Dr. Andy

Reflections on medicine and biology among other things

Wednesday, November 09, 2005

Growth Hormone as an anti-aging treatment

is apparently not a good idea
Recombinant growth hormone (GH) is being inappropriately marketed as an anti-aging treatment, something I’d been previously unaware of. While it is true that growth hormone levels fall as you age, it is not clear that GH supplementation would prevent or reverse other manifestations of aging (e.g. your hair turns grey as you get older, but coloring it doesn’t help your knees any).
This article talks warns doctors against getting involved in this, for a variety of reasons

First, it apparently doesn’t work and may even hurt:
Transgenic mice that produce supraphysiological levels of GH for their age have markedly reduced life spans and experience premature onset of age-related cognitive changes….Growth hormone–resistant and GH-deficient mutant mice experience substantially increased life spans.
Of course theses studies aren’t exactly analogous to use in aging humans; we really need a study of Gh replacement in older mice, but these data certainly don’t support use of GH for aging.

In addition, off-label use of GH is illegal. For most medications, once they are approved licensed physicians can prescribe them as they see fit (which is not an ideal system), but not so for GH:
off-label distribution or marketingof GH to treat aging or aging-related conditions is illegal. Unlike most FDA-approved medications, GH can only be distributed for indications specifically authorized by the Secretary of Health and Human Services—aging and its related disorders are not among such indications.
Apparently penalties can be quite stiff, $250,000 fine per incident, although the article doesn't note any physician who has actually been charged, and I'd be surprised if they go after anyone. I also think the GH manufacturers have some responsibility to ensure their product is being used appropriately, although all their incentives are to have it used as widely (and inappropriately) as possible. Of course one $100 million judgement for someone who took it inappropriately and had a heart attack could wipe out all those profits (ed- are you defending all those malpractice lawyers? Just saying, incentives are incentives)

The article is a bit one-sided and I knew nothing about the issue coming in, but it does sound like a bit of a scam. For an example of misleading claims see here:
Dr. Di Pasquali's work is . . . often referenced by Exercise & Nutrition periodicals
Wow, it must be true if it is Exercise and Nutrition periodicals.

I would say if I wanted to make easy money, going after the vanity of aging baby boomers would be a good strategy, they aren't going to go gracefully.

UPDATE: this article also contains the weirdest disclosure I've ever seen:
Drs Perls and Olshansky report that they are defendants in a lawsuit brought against them by the American Academy of Anti-Aging Medicine and others.
More details are here and it sounds like an attempt to intimidate criticism of GH use. When what is at heart a scientific dispute gets dragged into court, I'd bet against the party who initiated the lawsuit.


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