Sermorelin - the "new" HGH

[wworkmd]

I am an anti-aging physician in Fresno, CA, and I use a lot of different hormones for replacement of deficiencies. I do not believe in supra-physiologic doses of any hormone but I use the guideline that all men and women over 30 years old should have the hormones at the optimal level of a 30 year old (which means the upper quartile).

I used to Rx HGH but the Feds came down on the State Medical Board and I decided to stop writing it, even though, when properly dosed, it is as safe as mother's milk.

I now use and Rx Sermorelin, which is a HGH analog that is injected nightly like HGH. I am interested if anyone has tried it and what is their experiences with it? I know that it isn't as strong as HGH but there are no side effects and no concern for type II diabetes or carpal tunnel syndrome that you can get with HGH use.

Dr. Work

 

[splash]

No experience with sermorelin, sorry. I'd worry a bit, though, that GHRH analogs might wear out my pituitary. I'm 57 and would feel more comfortable sticking with gh - growth hormone (somatropin) - , could I get it.

But I wish you were my anti-aging doctor, as your guidelines for hormone replacement to optimal levels for a 30 yo are my personal preferences.

I'm so sorry to hear the FDA came down on the CA state medical board making you, and other docs, too, Im sure, afraid to continue RXing GH. In anti-aging doses it cures or at least delays so many illnesses otherwise often accompanying aging in our society it makes you wonder who and how many in the FDA and other areas of politics are in bed with the drug companies, who of course mostly sell products to mask symptoms and not cure anything.

Osteoporosis finally got me off my butt 6 months ago and back to taking care of my physical self as a top priority--and led to an interest in body building.

For an old gal I'm starting to look pretty good

And it feels criminal that I can't easily get human growth hormone - somatropin - therapy in the US, and covered by insurance even to help rebuild my bones.

My research tells me that along with exercise, good nutrition, and a few specific bone-building supps, GH could insure I regain my former great-quality dense bones.

 

[wworkmd]

No need to worry about "wearing out" the pituitary since it is a therapeutic dose and the negative feedback system is in place with somatostatin to tampen down any excess analog that you may inject. You see, you can't even overdose on the stuff...you would literally waste it.

It is sorry to see what the FDA has done but they are only enforcing the laws set forth by Congress. Congress got stupid (ever seen them act wisely?????) back in the 1970s and threw HGH in with the anabolic steroids when they started outlawing everything. We didn't know all of the health benefits for HGH back then...but I don't see Congress reversing themselves any time soon.

Dr. Work

 

[thefantom1]

Hey Doc... you should take some Clomid and grow a set of balls..... Don't cave in to what Congress thinks...they are idiots.. and not trained in medicine... you are. It is your job to make things right in the human body...what would happen if insulin became the next "bad boy" drug???? You going to prescribe sugar tablets?? NO... we need more Doctors to stand up and say enough is enough... Leave the Medicine business out of Congress...... You took the oath Doc.... now do the right thing and prescribe HGH to those that need it.... Don't let your patients suffer because of some jackass Congressmen want to get re-elected.

 

[wworkmd]

Actually HCG - human chorionic gonadotropin - works better in the ball growing business...

All kidding aside...you must be joking! What is good medicine and what is legal are sometimes two separate things. So if "I" decide to do what is "right" for my patient, who has not suffered a traumatic brain injury or suffered from panhypopituitarism, and prescribe human growth hormone - somatropin - , then "I" would have the distinct privilege of possibly losing my license. Sorry, I would rather concede the battle that I know I will lose so that I can fight another day. I learned that in ninjutsu.

Only an idiot doc would just prescribe HGH to anyone who wants some is a fool and can actually do prison time. See what happens when they "stood up" to Congress? However, those docs were "virtual" and had no office and therefore I think they should be strung up. REAL physicians actually examine a patient, take a history, do a physical and then draw the appropriate labs. You cannot duplicate a "good faith" exam over the Internet and only a money-hungry MD would be greedy enough and stupid enough to prescribe HGH/Test/whatever over the Internet. Those guys should lose their license to practice and cool their jets with "3 hots and a cot"...just MHO.

Finally, why not use Sermorelin instead? Negative feedback loop is still present so you can't overdose on the stuff and so it is quite safe...unless YOU want to juice up on supraphysiologic levels...then YOU are being the stupid one.

Dr. Work

 

[thefantom1]

Doc... my point was that if you feel after proper bloodwork and exams, that someone has low levels of growth hormone, testosterone or any other level..you shouldn't feel intimidated by the Government when you bring the levels back up to the norm.. and I agree that none of these things should be given to someone just because the want them... and they should never be prescribed in supraphysiologic levels...


What exactly did the Feds do with State Medical Board???


Ps... also keep us up to date on how the Sermorelin is working for your patients...

 

[wworkmd]

Excellent idea about if the hormone levels are low, then correct them. Testosterone is easy. Just test the total testosterone, the sex hormone binding globulin and the albumin, plug the values into the calculator and...voila! presto chango! you have the bioavailable testosterone and NOONE can dispute the value. Docs may disagree as to what is the actual level when replacement begins, but we would all agree WHAT the bioavailable testosterone value represents.

NOW, what about HGH? What value do you want to use? IGF-1? What level? Less than 100? Less than 200? What would be considered "Human Growth Hormone Deficiency Disorder"? Some would argue that the IGF-1 is worthless and that you need to do a "challenge" test to the pituitary to get the functioning of the anterior pituitary tested. But WHICH test? IV Arginine? Some experts say it is okay and others say it is not. ALL would agree that the insulin-hypoglycemic test is the "gold standard" but it requires hospitalization and it can actually be very dangerous to do...so the risks outweigh the benefits and no one wants to do the "gold standard" test. So, unlike testosterone (or thyroid or cortisol or estradiol or progesterone) testing, which is pretty cut and dried, the testing for HGH deficiency is ill-defined.

So what, you ask? If my doctor thinks I am low in HGH because of age, etc., and he/she thinks it is most beneficial that I get it, then he can prescribe it and all will be well with the world...and you would be WRONG. HGH is the ONLY medication on the US Pharmacopeia that cannot be written for "off label" and thus the diagnosis MUST be made of a deficiency (or you have AIDS wasting syndrome OR you are a pituitary dwarf OR you have complete pituitary failure, e.g., Sheehan's Syndrome) or the doc would be illegally prescribing it to you. Remember that YOU won't take the hit...the doc will. So those of you getting HGH from your doc and you aren't one of the cut and dried diagnoses, then eat, drink and be merry for sometime tomorrow you COULD be cut off of your HGH.

As to why the FEDS are involved...simple, Congress back in the 1970's classified HGH in the same category as steroids since it was being abused by bodybuilders (imagine that!) and athletes and docs did not have a real understanding of the importance of HGH replacement therapy at therapeutic levels (not the idiotic high doses of abusers). CONGRESS made docs jump through hoops for HGH. Thus the feds are involved.

Now for YEARS it was basically ignored/overlooked by the feds as long as it wasn't thrown in their faces or flaunted by yahoo doc trying to be a martyr and make a point. However, recently there have been a number of pharmacies being shut down and owners/pharmacists being indicted for distributing HGH to virtual docs who prescribe oodles of HGH without a good faith exam. I actually have worked with some of these pharmacies in the past for the small number of patients I had on HGH at the time. But they are now out of business and I now work with a compounding pharmacy in FL who does not sell/service virtual docs but only those who are "brick and mortar" docs, i.e., have offices that they actually see patients in (remember those kind?).

So as you know, fecal matter, like water, always wants to find its lowest poin and will thus roll down hill. So the Feds have started to notify state medical boards to start looking over and investigating docs who write for HGH. Remember that any scripts written by docs are monitored so they know when a doc is writing for it. The biggest question for the doc writing it is..."How big do I appear on the State Medical Board radar screen?" If they write for a lot of Rx of HGH then they are a big and juicy target but if they only have a few then it is unlikely to be a problem.

This is the reality of the situation and this is where "good" medicine and "legal" medicine part company. No amount of your justification of "well, my doc feels I need it so he is authorized to give it..." thinking will work unless you have had one of the verifiable tests. Now, if you are one of a FEW patients the doc has on HGH then he will probably not be bothered. However, if he is treating celebrities OR has a large number, then he will be spotted and he will get his pee pee whacked hard. Thus, Sermorelin is the obvious alternative that can be written for "off label" and maintains the negative feedback loop.

Hope this long-winded answer helps you understand the frustration that anti-aging docs go through everyday. I think I get more flak from my colleagues for starting people on adrenal replacement hormones vs HGH...but that's just me.

Dr. Work

Doc... my point was that if you feel after proper bloodwork and exams, that someone has low levels of growth hormone, testosterone or any other level..you shouldn't feel intimidated by the Government when you bring the levels back up to the norm.. and I agree that none of these things should be given to someone just because the want them... and they should never be prescribed in supraphysiologic levels...


What exactly did the Feds do with State Medical Board???


Ps... also keep us up to date on how the Sermorelin is working for your patients...

 

[shooting15]

Another way to avoid the legal problems is to direct your patients to a reliable source in someplace like Mexico. When my (California) doc told me he would no longer prescribe HCG because it is too high-profile, I made the shift to Mexico for all my hormone prescriptions. It is working out great, and I actually save money even after the travel expenses.

 

[wworkmd]

The only real problem with the "Mexico route" is making sure that you get quality stuff and not counterfeit. Mexico isn't exactly the best place for quality pharmaceuticals. In addition, what do you do? Take a trip down to Mexico, get the HGH, mix it up, slam it into your body and then go back to the good ole USA? Because if you bring it across the border and, again, don't have a legitimate prescription for it, you will not do well with Customs. If you declare it, some bonehead may let you through while the bright ones will confiscate it. If you don't declare it and they find it, then you are smuggling it across the border and I would rather not take anything than to be in a situation like that.

Again, what is the problem? Take Sermorelin (I am not selling it here...you have to be a patient of mine...so ask YOUR doc for it) and EVERYONE is happy...unless you like to juice up on supraphysiologic doses of HGH.

Dr. Work

 

[shooting15]

If you're going to Mexico, you get a doctor there to prescribe it, which is not really a problem, since any doctor can do it. Give them a copy of your bloodwork done in the states, so they have backup in the rare case that they should need it.