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Human growth hormone: Miracle or snake oil?

By Walter Armstrong

They clog your e-mailbox and swamp the Internet, all those tacky ads for products with names like LifeForce and Neugenesis and Pro Blen HGH Velvet. Google "HGH," or "human growth hormone," and 7.5 million results spring up, a clue to the gold-rush mania driving the performance-enhancing drug and supplement industry. A warning to consumers: Sucker, beware!

Click on one link, and you get George Hamilton and Cathy Rigby testifying to seniors about "the miracle of the Renuva Anti-Aging System" at $99.99 a month. Another site, another demographic, another D-list celeb: MetabolanGH pitchman (and gay porn star) Colton Ford, identified here as "41-year-old acting/recording artist." Puffing out his bare chest, Ford says, "In my industry, you have to be physically on top of your game every day. Not only does MetabolanGH keeps [misspellings, a sure sign of credibility] me constantly hard, but my skin is as soft as it was in my teens! MetabolanGH is truly the juice of youth."

These ads are worse than just tacky, however. They're such an outrageous example of health fraud that Jeffrey M. Drazen, MD, the editor in chief of The New England Journal of Medicine (NEJM), our nation's most trusted name in medical information, posted a rare warning on NEJM's website. Because the ads "cite a study reported in the Journal in 1990 by Rudman et al...sending readers to our website" and because that "the article...receives as many 'hits' in a week as other 1990 articles do in a year," he explains that "although the findings of the study were biologically interesting," Rudman's six-month study of HGH in a mere 12 men over the age of 60 was too short to prove either effectiveness or safety, let alone "to serve as a basis for treatment."

So much for the "scientifically proven" claims trumpeted in the ads.

As for the products themselves, Drazen pointed out that they contain "not human growth hormone [available by prescription only] but, rather, a mixture of substances that is claimed only to stimulate the body to release human growth hormone. There are no data...that support this claim or prove that the substance has no harmful side effects."

In his ongoing crusade to impose accountability on the unregulated marketing of dietary supplements, Drazen also got two states to open investigations into certain companies pushing these pills. That was in March 2003. Today, there are more products—and profits—than ever.

The 911 on Rx HGH
Nothing is more seductive than a fountain of youth, and that's exactly the status its enthusiasts claim for human growth hormone. Prior to Rudman's 1990 study, the feds had approved injections of synthetic HGH solely to promote bone growth in undersize kids or to anyone with a serious growth-hormone deficiency. In such cases, HGH replacement has worked wonders. As Shlomo Melmed, MD, of Los Angeles' Cedars-Sinai Hospital put it plainly to WorlHealth.net, "Growth hormone stimulates the bones and other organs to grow. It also regulates how cells utilize glucose and fat, and stimulates the liver to manufacture another hormone, called Insulin-like Growth Factor 1, or IGF-1." But, as with many potent meds, long-term high-dose use carries predictable risks, including, Melmed warns, enlarged jaw and facial features; high blood sugar, cholesterol, and triglycerides; insulin resistance and mild diabetes; high blood pressure; fluid retention; muscle cramps; and joint pain and arthritis."

What Rudman did in his 1990 study was to give a dozen healthy old men injections of growth hormone. They had no HGH deficiency—they simply didn't have the high levels of HGH that they had once had. And this was perfectly normal: Your body's peak production of growth hormone generally occurs at age 18—when you need it most—after which begins a long, slow, relentless decline not only of HGH levels but of many other bodily functions. This is known as aging, and until recently was viewed as an eternal law of nature, like gravity.

Rudman showed that in a dozen healthy old men, HGH "treatment"—what critics such as Memed slam as "excess HGH"—caused a small increase in muscle and bone growth and a smaller decrease in fat. However, he didn't measure whether these guys were actually stronger or fitter, able to lift more or exercise longer. On the downside, he found higher blood pressure and blood-sugar levels.

Still, that single study helped spawn an anti-aging empire of clinics and publications, products and ads, for baby-boomers crashing into their twilight years, and by the time Drazen issued his alarm, one in three scripts for the $15,000-a-year drug was for such "off-label"—cosmetic—uses as fat loss, muscle gain, even smoother, younger-looking skin.

Meantime, black-market concoctions of HGH were rampant in professional sports. In fact, American football great, Lyle Alzado, reported that as many as 80 percent of his fellow players, including himself, has shot up the pricey potion—not least because, unlike steroids, testosterone and other so-called performance enhancers, one trick this anabolic, muscle-making agent can perform is remaining invisible to increasingly stringent drug testing. Alzado, by the way, died in 1992 at age 43 from a brain tumor he attributed to his chronic use of steroids and other performance-enhancing drugs.

The Gay Angle
The only gay men under 65 likely to get a piece of this alleged Miracle-Gro muscle action were, ironically, those whose need for lean muscle mass was in no way cosmetic but a matter of life and death. Makers of synthetic HGH hit pay dirt in the pre-protease '90s when HIV-related wasting syndrome was a leading killer of PWAs, and it's interesting that AIDS treatment activists have pioneered efforts to define the actual clinical benefits and risks of hormone-replacement therapy.

Way back in 1999, for example, Michael Mooney, a longtime Los Angeles advocate who operates the nonprofit Medibolics.com web site, discovered data in HGH studies suggesting that "the growth hormone does not increase the portion of the lean body mass (LBM) that is known as muscle, even though growth hormone does increase 'lean body mass.' Note that LBM describes several compartments of tissue that include muscle, connective tissue, bone, organs, and water, too. These studies found that the increase in LBM with growth hormone in HIV negative subjects consists of tissue other than muscle. Actually the increase in LBM appears to be mostly water."

So, while increasing the amount of H2O in your LBM will certainly add size and definition, your strength or endurance gains could be zip. Mooney's finding may help explain why only those HGH studies that added actual physical workouts—in particular, resistance or weight training—the chemical injections resulted in measurable enhanced performance.

Could this megamillion-buck fountain of youth be, as Mooney suggests, just another water cooler? That may be taking healthy skepticism about HGH's benefits too far, but there's no question that the treatment's risks far outweigh those of water. In 2002, one of the largest HGH studies concluded that while injected HGH built muscle and bone mass in healthy seniors and helped them drop pounds, some 40 percent of the 131 men and women developed some of the serious side effects mentioned by Melmed. These side effects stopped when the treatment did.

Way, Way Over the Counter
With HGH scripts hard to come by, amateur jocks and gym bunnies are left, like Renuva's George Hamilton and MetabolanGH's Colton Ford, with a glut of untested knockoffs. You can find viable growth hormone on the label of these products, but only in their names—Ultimate HGH, Super HGH, Replaceable HGH, Ultra HGH, Vital HGH, and so on—not in their ingredients. These over-the-counter products generally contain some of the amino acids that make up the actual HGH protein, possibly other amino acids that make up Insulin-like Growth Factor-1 and possibly even tiny amounts of "herbal" or "homeopathic" HGH.

These products are all dietary supplements that can be sold legally only to address nutritional deficiencies. But because a "dietary supplement" hardly seems or sounds sufficiently powerful to produce miracle-of-modern-science effects ("Experts in the NEJM report that Human Growth Hormone therapy makes you look and feel 20 YEARS YOUNGER!" shrieks MetabolanGH's web site) or, for that matter, carry a hefty price tag, companies have gussied-up the terminology. These amino-acid blends are referred to as HGH "precursors," "releasers," "enhancers," or "stimulators" because, on paper at least, they provide some of building blocks for creating human growth hormone. Many medical experts, such as Stephen Barrett, MD, who operates the nonprofit Quackwatch.com, dismiss them categorically as frauds, either because taking them orally is utterly ineffective or because the amount of actual growth hormone they help produce is too small to be beneficial. "Many amino acid products were claimed to cause overnight weight loss by increasing the release of growth hormone," he wrote in his "Growth Hormone Scams" posting. "So-called growth-hormone releasers were also marketed to bodybuilders with claims that they would help build muscle. Such claims are unfounded because amino acids taken by mouth do not stimulate growth hormone release. These formulations are based mainly on misinterpreted studies of intravenous arginine, which can increase HGH blood levels for an hour or so. Taking it by mouth has no such effect. The Federal Trade Commission and the New York City Department of Consumer Affairs attacked some companies making 'growth-hormone release' claims, but these actions had very little effect on the overall marketplace."

Mary Lee Vance, MD, a leading hormone-replacement researcher, agrees. "These amino acids taken orally are not known to do anything except waste money," she told WebMD.com. "They are not anywhere similar to the injected growth hormones. But people are misunderstanding this in their effort to find a magic bullet that will make them feel and look better." At its best, Vance wrote in a NEJM editorial accompanying Drazen's warning, their effect is "akin to eating a steak."

Certain companies have marketed HGH "releasers" as a nasal spray in an effort to offer—or to appear to offer—a more effective method of getting intact building blocks into your blood. But even if that worked, the chemical process that assembles 191 amino acids into the large, fragile protein that is HGH, is believed to be too complicated to be set in motion by these dietary supplements. That's why injections of the real thing are necessary.

In her NEJM editorial, Vance rolls up her lab-coat sleeves to take a few good jabs at the HGH-product juggernaut. "Not mentioned on the 'anti-aging' websites," she writes, "is a study of 18 healthy men, 65 to 82 years of age, who underwent progressive strength training for 14 weeks, followed by an additional 10 weeks of strength training plus either growth hormone or placebo. In that study, resistance exercise training increased muscle strength significantly; the addition of growth hormone did not result in any further improvement. Going to the gym is beneficial and certainly cheaper than growth hormone."

In fact, many bodybuilders and some researchers believe that anaerobic workouts—weight-lifting, sprinting, or any other short but intense exercise that doesn't burn oxygen for energy—stimulate the pituitary gland's production of growth hormone. Regular anaerobic exercise, they claim, can serve as a kind of self-induced, all-natural HGH treatment. Whether or not this is wishful thinking, one thing everyone agrees on is that regular exercise, ideally combining both anaerobic and aerobic, is the best self-treatment—body, mind, and soul. If it can't reverse the aging process, it can do something many of us would prefer: help us live longer and feel better. By the way, a month's supply of MetabolanGH costs $79.95—the monthly fee at a good-quality gym or health club.

Walter Armstrong is a freelance writer and editor in New York who served as the editor-in-chief of POZ magazine for six years. Armstrong has also worked at Rolling Stone, Men's Journal, Us, GQ, OutWeek and numerous other magazines.