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Growth hormone has been documented to improve some measures of body composition, including increased muscle mass, reduced total body fat, improved skin elasticity, and reduced rate of bone demineralization, but without positive effects on strength, functional capacity, or metabolism.
Furthermore, the positive effects may be shortlived:
in a study of 148 patients with adult GHD (defined below), the modest beneficial effects on body composition
(eg, 5% increase in lean body mass) disappeared for most individuals after 24 months of treatment, and 38% of study participants dropped out because of lack of subjective improvement. In addition, the healthy lifestyle that patients who receive injectible GH are often encouraged to adopt, rather than the GH itself, may contribute to changes in body composition.
Growth hormone is associated with substantial side effects. In a clinical trial of healthy women (n=57) and men
(n=74) aged 65 to 88 years, GH administered subcutaneously at an initial dose of 30 µg/kg, 3 times per week, then
reduced to 20 µg/kg, was associated with carpal tunnel syndrome in 38% of women vs 7% of those taking placebo, and in 24% of men vs 0% taking placebo; edema in 39% of women (0% for placebo) and 30% of men (12% for placebo); and arthralgias in 46% of women (7% for placebo) and 41% of men (0% for placebo). Eighteen men treated with GH developed glucose intolerance or diabetes compared with 7 men in the nontreatment group.
In a placebo-controlled clinical trial of GH (0.1 mg/kg/d of GH) for AIDS wasting syndrome in 510 patients, the most common reasons for dose reduction and/or drug discontinuation were arthralgia, myalgia, edema, carpal tunnel syndrome, and elevated glucose and triglyceride levels, with 36% of individuals reporting arthralgias (vs 11% of those taking placebo), 30% reporting myalgias (12% for placebo), and 26% reporting peripheral edema (3% for placebo).21 Because of these high rates of adverse effects,22 nonsustained improvements in quality of life2and anabolic effects,and the drug’s high cost, even the treatment of AIDS wasting syndrome with GH has little support.2The doses used in these studies are similar to those suggested by antiaging Web sites selling GH.
Another concern is the possibility of an increased cancer risk with long-term GH treatment28 and the potentiating effects of insulin-like growth factors (IGFs) on cancer. Mukhina et al reported that autocrine production of GH
by mammary carcinoma cells facilitates cellular growth and suggested that such growth may be sufficient to cause breast carcinoma to become invasive and metastatic. To our knowledge, no studies have assessed long-term
efficacy or safety of GH administration as an antiaging intervention in humans.
2086 Journal of the American Medical association, October 26, 2005—Vol 294, No. 16
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