105.HGH for Adults

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105.HGH for Adults




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List of contributors page ix

Preface xv

Foreword xvii

Niels E. Skakkebæk

Part I Introduction

1 Physiological regulators of growth hormone secretion 3

Mark L. Hartman

2 Insulin-like growth factors (IGF) and IGF-binding proteins: their use for 54

diagnosis of growth hormone deficiency

Werner F. Blum

3 Growth hormone and IGF-I effects on in vivo substrate metabolism 87

in humans

Niels Møller

4 Determination of growth hormone (GH) and GH binding proteins in serum 104

Sanne Fisker and Hans Ørskov

Part II Diagnostic and Clinical aspects

5 The syndrome of growth hormone deficiency in adults 125

Ross C. Cuneo, Franco Salomon and Peter H. Sönksen

6 The diagnosis of growth hormone deficiency in adults 153

David M. Hoffman and Ken K. Y. Ho

7 Monitoring growth hormone replacement therapy 173

Andrew A. Toogood, Simon J. Howell and Stephen M. Shalet


Part III Growth hormone replacement therapy in adults with growth

hormone deficiency

8 The effect of growth hormone on protein metabolism 191

David L. Russell-Jones and Margot Umpleby

9 Growth hormone deficiency, insulin resistance and glucose metabolism 204

  1. L. Hew, M. C. Christopher and F. P. Alford

10 Growth hormone and body composition 222

Jens Sandahl Christiansen and Nina Vahl

11 Effects of growth hormone on human fluid homeostasis 233

Jens Møller

12 Growth hormone and cardiac function 251

Antonio Cittadini, Salvatore Longobardi, Serafino Fazio and Luigi Saccà

13 Growth hormone and cardiovascular risk factors 265

Thord Rosén

14 Growth hormone (GH), exercise performance, muscle strength and 281

sweat production in healthy subjects and in adults with GH deficiency

Anders Juul, Katharina Main and Niels E. Skakkebæk

15 Growth hormone and bone and mineral metabolism 301

Jean-Marc Kaufman and Mark Vandeweghe

16 Growth hormone and thyroid function and energy expenditure 333

Jens Otto Lunde Jørgensen, Troels Wolthers and Jørgen Weeke

17 Growth hormone and psychosocial and central nervous effects 349

Jan-Ove Johansson, Lena Wirén and Bengt-Åke Bengtsson

18 Impact of gender and age on growth hormone responsiveness 373

Pia Burman and Gudmundur Johannsson

vi Contents

Part IV Growth hormone, growth-hormone releasing peptides

and ageing

19 Growth hormone and ageing 399

Kieran G. O’Connor and Marc R. Blackman

20 Growth hormone releasing substances – basic aspects 441

Karen Kulju McKee, Andrew D. Howard, Scott D. Feighner, Sheng-Shung Pong

and Roy G. Smith

21 Clinical uses of growth hormone releasing peptides (GHRPs) and 463

GHRP analogues in adults

Ian M. Chapman and Michael O. Thorner

Index 485


HGH for Adults

Growth hormone fuels childhood growth and helps maintain tissues and organs throughout life. It’s produced by the pea-sized pituitary gland — located at the base of the brain. Beginning in middle age, however, the pituitary gland slowly reduces the amount of growth hormone it produces.
This natural slowdown has triggered an interest in using synthetic human growth hormone (HGH) as a way to stave off some of the changes linked to aging, such as decreased muscle and bone mass.
If you’re skeptical, good. There’s little evidence to suggest HGH can help otherwise healthy adults regain youth and vitality. Alternatively, HGH treatments may increase the risk of other medical conditions. Experts recommend against using HGH to treat aging or age-related conditions.

Do some adults need HGH treatment?
Adults who have a growth hormone deficiency — not the expected decline in growth hormone due to aging — might be prescribed synthetic HGH by their doctors.

In most people, growth hormone deficiency is caused by a benign tumor on the pituitary gland (pituitary adenoma) or by treatment of an adenoma with surgery or radiotherapy.
For adults who have a growth hormone deficiency, injections of HGH can:
• Increase exercise capacity
• Increase bone density
• Increase muscle mass
• Decrease body fat
HGH treatment is also approved to treat adults with AIDS- or HIV-related growth hormone deficiency that causes irregular distribution of body fat.

How does HGH treatment affect healthy older adults?
Studies of healthy adults taking human growth hormone are limited and contradictory. Although it appears that human growth hormone can increase muscle mass and reduce the amount of body fat in healthy older adults, the increase in muscle doesn’t translate into increased strength. It isn’t clear if human growth hormone provides other benefits to healthy adults.

What are the risks of HGH treatment?
HGH treatment might cause a number of side effects for healthy adults, including:
• Carpal tunnel syndrome
• Increased insulin resistance
• Type 2 diabetes
• Swelling in the arms and legs (edema)
• Joint and muscle pain
• For men, enlargement of breast tissue (gynecomastia)
• Increased risk of certain cancers
Clinical studies of HGH treatment in healthy older adults have been relatively small and short in duration, so there’s little to no information about the long-term effects of HGH treatment.

Does HGH come in pill form?
HGH treatment is approved in the United States only for treatment of growth hormone deficiency — and related problems associated with HIV infection. HGH is only effective if administered as an injection.
There’s no pill form of human growth hormone available. Some dietary supplements that claim to boost levels of HGH come in pill form, but research doesn’t show a benefit.

HGH is considered a controlled substance by the Food and Drug Administration. Using HGH for a condition that isn’t approved, such as building muscle or as an anti-aging treatment in older adults, is illegal.

What’s the bottom line?
If you have specific concerns about aging, ask your doctor about proven ways to improve your health. Remember, healthy lifestyle choices — such as eating a healthy diet and including physical activity in your daily routine — can help you feel your best as you get older.

Several glands in the body produce hormones, but health experts consider the pituitary to be the master control gland. Not only does it control other glands, but it also makes the hormone that triggers growth.
The pituitary gland is in the brain below the hypothalamus. It secretes hormones in response to chemical messages from the hypothalamus.

The human growth hormone (HGH) helps to influence height, as well as build bones and muscles in the body. It is crucial for processes involved in normal human growth and development.
Genetic factors can lead to a lack of growth hormone in children. Damage to the pituitary gland is a common cause of a deficiency in adults.

In this article, we look at the reasons to use HGH, the function of growth hormones, and possible side effects.
HGH is essential to growth, especially in children, but it is also involved in many other processes in the body, including bone density, muscle mass, and mood.

Different hormones control various body functions and processes, including growth and development, metabolism, sexual function and reproduction, and mood.

It helps process protein and increases fat breakdown to help provide the energy needed for tissue growth.
Growth hormone levels can change through the day, and physical activity plays a part.
Exercise and similar activities can cause the levels to rise naturally. Sleep, stress, and low blood sugar levels also increase growth hormone levels.

Even small changes in HGH levels affect the body.
Too little or too much growth hormone can cause significant growth problems. Too little HGH is one of the main causes of short stature and conditions such as dwarfism.
Some people use HGH because they believe it will build muscle, improve performance, or slow aging. However, the existing evidence does not support the use of HGH for these purposes.
In children
Children with low levels of lack of growth hormone may or may not be smaller at birth. Growth problems may appear in time, for example, if they are smaller than their classmates and growing less than 2 inches a year.
Some children are unable to produce growth hormone when they are born and continue to have low levels throughout their life.
Symptoms of growth hormone deficiency in children are:
• looking much younger than other children their age
• having a chubby body build
• impaired hair growth
• delayed puberty
• short stature
In some children, a lack of growth hormone is part of a genetic condition, but sometimes the cause of the deficiency is unknown.
In adults
In adults, a lack of growth hormone is often due to damage to the pituitary gland, which may be permanent. The damage could have occurred in childhood or adulthood.
Other causes include:
• radiation therapy
• a head injury
• infections, such as meningitis
Problems in the pituitary with producing growth hormone are commonly due to a pituitary tumor.
The pituitary can be damaged by the tumor itself or by treatment such as surgery and radiotherapy.
In adults, a lack of HGH can cause a number of different problems including:
• anxiety and depression
• increased fat around the waist
• increased risk of heart disease and stroke
• weak heart
• weak muscles and bones
• tiredness
• reduced ability to think
• other conditions
Growth hormone deficiency can also be a combination of one or more hormone deficiencies.
Some medical conditions may also benefit HGH treatment.
These include:
• Turner’s syndrome: Women with this condition generally have underdeveloped female sexual characteristics.
• Prader-Willi syndrome: A genetic disorder causes weak muscle tone, feeding difficulties, poor growth, and delayed development.
• Noonan syndrome: This genetic disorder interferes with the proper development of various part of the body.
• Chronic kidney disease
The most common treatment in both adults and children is growth hormone therapy using lab-developed HGH injections.

Doses occur several times per week or on a daily basis depending on how severe the deficiency is.Manufacturers designed the growth hormone to mimic the behavior of natural growth hormone in the body. It will be prescribed by a doctor.

HGH treatments can be self-administered or given by a doctor. Treatments are often given for several years. Patients will see their doctor every month or so to check their condition.
Blood tests will be carried out to see if extra growth hormone is needed and if treatments should be increased, decreased, or stopped. Cholesterol levels, blood sugar levels, and bone density will also be checked to see if they are healthy.

Taking growth hormone can affect the body’s response to insulin, which controls blood sugar levels. Growth hormone deficiency can also lead to high cholesterol and brittle bones if it is not treated.
Specific treatment for growth hormone deficiency depends on the person.
Doctors base this treatment on certain factors, such as:
• age
• overall health and medical history
• extent of the condition
• tolerance for specific treatment
• treatment expectations
• patient’s choice
The earlier the lack of growth hormone is treated in children, the better chance they have to grow to a near normal adult height.

Children can gain as many as 4 inches or more over the first 3 years of treatment. Another 3 inches or more can grow during the next 2 years.

Many adults have to take HGH treatment for the remainder of their life.
Anyone taking HGH will undergo regular monitoring to assess the safety and effectiveness of the hormone.
The goal of growth hormone treatments in adults and children is to restore energy, metabolism, and enhance body development or shape. It can help to reduce total body fat, especially around the belly.
HGH injections can also help to improve strength and exercise tolerance and reduce the risk of heart disease in those who lack growth hormone.

Many people experience an increase in overall quality of life.
Risks and side effects
Most people tolerate HGH injection treatments well with few problems.
However, possible side effects include:
• muscle aches
• joint discomfort
• headaches
• swelling of the hands and feet
Those who experience these symptoms or other problems should talk to their doctor. They can change the dose if necessary to help remedy the symptoms.
HGH injections are not recommended for people who have:
• tumors
• cancer
• serious illness
• severe breathing problems
• multiple injuries
• complications from open heart or abdominal surgery
HGH can affect insulin usage in the body, so people with diabetes should monitor their blood sugar levels carefully.

Other treatments may be required depending on the cause of the HGH deficiency.
Surgery or radiation may be necessary to treat a tumor in the pituitary. Pituitary hormones may also have to be taken to correct a gland that is not working properly.

Too much human growth hormone
If the levels of HGH are too high in adults, they may experience:
• muscle or joint pain
• fluid retention, leading to swelling
• carpal tunnel syndrome
Long-term use of HGH injections can cause a condition called acromegaly.
Adults cannot grow taller by using the synthetic growth hormone. High doses will thicken the person’s bones instead of lengthening them.

People with acromegaly will experience an overgrowth of bones, particularly in the hands, feet, and face.
The skin area can also be affected and may turn thick, coarse, and hairy. The excess HGH levels can also lead to high blood pressure and heart disease.



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