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How to avoid diabetes on GH
- Thread starter Zss
- Start date
I have never heard of that, man... diabetes occurs when white blood cells attack the pancreas & destroy it as though it were some type of virus or bacteria. That is my limited understanding. I could understand this happening if you take slin with the GH... as the pancreas is responsible for insulin production and if you shut that down with exogenous slin then you would essentially be a diabetic. But I will bump it for you until somebody can give you a more detailed answer.
I'd be more worried about looking like a Neanderthal...
I'd be more worried about looking like a Neanderthal...
Baby Gorilla
New member
Huh?
Diabetes can also be a genetic thing where your body doesn't make enough or doesn't release it right.
Bodybuilding can make you diabetic if you give it up without gradually going back to a normal diet. You drop the exercise and change diet but your body still releases lots of insulin based on what it's used to.
If anything, exercise helps regulate diabetes so its not a problem.
Diabetes can also be a genetic thing where your body doesn't make enough or doesn't release it right.
Bodybuilding can make you diabetic if you give it up without gradually going back to a normal diet. You drop the exercise and change diet but your body still releases lots of insulin based on what it's used to.
If anything, exercise helps regulate diabetes so its not a problem.
TommyGunns
New member
bump 
Never Enough
New member
Zyg, I didn't see any references listed. I copied the article for everyone because I think you have to be a member to view their articles.
Growth Hormone Changed Older Bodies, for Better and Worse
By GINA KOLATA
Over the past few years, hundreds of clinics have sprung up, providing human growth hormone to thousands of elderly people looking for a fountain of youth. Athletes, would-be athletes and bodybuilders also take it, often in huge amounts, hoping to build muscle. But there has been almost no objective evidence on whether it works.
Now, in one of the largest and most careful studies so far of human growth hormone in healthy older people, researchers find that it can markedly transform older people's bodies. The effects were potent. Those who took the drug gained lean body mass, much of which is likely to be muscle, and lost fat as if they had been working out in a gym, lifting weights and doing aerobic exercise. Some men gained 10 pounds of lean body mass and lost an equivalent amount of fat. Yet the subjects, who ranged in age from their mid-60's to their late 80's, were sedentary and did not exercise or change their diets.
But the investigators caution that these gains were accompanied by serious adverse side effects in nearly half the subjects, who developed pre-diabetes or diabetes, aching joints and swollen tissues.
The findings, the scientists said, give them hope, but much work remains. The study lasted just six months, and there is concern that growth hormone may have terrible long-term effects — in animals it can actually speed aging and reduce the life span, and scientists fear it could promote the growth of cancers. In people, growth hormone can cause arthritis, and some experts worry that the joint pains that plagued many in the study might lead to arthritis if the drug were continued.
"This is a fascinating area for further research," said Dr. Marc Blackman, a director of the new study, which is being published today in The Journal of the American Medical Association. But, Dr. Blackman cautioned, "we don't think this is ready for prime time yet."
Growth hormone therapy should not be used outside a controlled clinical trial, said Dr. Blackman, who directs the laboratory of clinical investigation at the National Center for Complementary and Alternative Medicine.
The researchers were asking whether growth hormone and, possibly, sex hormones might be a key to the debilitating changes that occur with aging. Starting about age 30, growth hormone levels start to decline. By age 60, people can have half as much as they did at 30. Testosterone, in men, declines, too, and, in women, estrogen levels plummet after menopause. The hypothesis was that the effects of aging — shriveling muscles, thinning bones, increased body fat, especially in the abdomen, a loss of energy and enthusiasm, might be linked to hormone deficiencies, and, in particular, a lack of growth hormone.
People who lack growth hormone — for example, patients with a genetic defect or a tumor of the pituitary gland that prevents the hormone from being made — have all these signs and symptoms of aging, and they are reversed when they take growth hormone injections.
Sex hormones may also play a role, Dr. Blackman said. "Sex steroids stimulate the growth hormone system," he said. "At least in younger people, when one is awry, the other one goes down."
In their study, the researchers tried to recreate in older people the hormone levels of a 20- or 30-year-old. They recruited 57 women and 74 men, with ages from 65 to 88, giving them hormones or dummy medications.
The most striking results were in the men who took both growth hormone and testosterone. They gained almost 10 pounds of lean body mass and lost a corresponding amount of fat. They also increased their cardiovascular endurance, a measure of their ability to exercise. Men who took growth hormone alone gained seven pounds of lean body mass and lost a similar amount of fat but their endurance did not change.
The women who took growth hormone, with or without estrogen and progesterone, gained a few pounds of lean body mass and lost five pounds of fat. In both men and women, sex hormones alone did not significantly change their body composition. Growth hormone appeared to be the major factor.
Growth Hormone Changed Older Bodies, for Better and Worse
By GINA KOLATA
Over the past few years, hundreds of clinics have sprung up, providing human growth hormone to thousands of elderly people looking for a fountain of youth. Athletes, would-be athletes and bodybuilders also take it, often in huge amounts, hoping to build muscle. But there has been almost no objective evidence on whether it works.
Now, in one of the largest and most careful studies so far of human growth hormone in healthy older people, researchers find that it can markedly transform older people's bodies. The effects were potent. Those who took the drug gained lean body mass, much of which is likely to be muscle, and lost fat as if they had been working out in a gym, lifting weights and doing aerobic exercise. Some men gained 10 pounds of lean body mass and lost an equivalent amount of fat. Yet the subjects, who ranged in age from their mid-60's to their late 80's, were sedentary and did not exercise or change their diets.
But the investigators caution that these gains were accompanied by serious adverse side effects in nearly half the subjects, who developed pre-diabetes or diabetes, aching joints and swollen tissues.
The findings, the scientists said, give them hope, but much work remains. The study lasted just six months, and there is concern that growth hormone may have terrible long-term effects — in animals it can actually speed aging and reduce the life span, and scientists fear it could promote the growth of cancers. In people, growth hormone can cause arthritis, and some experts worry that the joint pains that plagued many in the study might lead to arthritis if the drug were continued.
"This is a fascinating area for further research," said Dr. Marc Blackman, a director of the new study, which is being published today in The Journal of the American Medical Association. But, Dr. Blackman cautioned, "we don't think this is ready for prime time yet."
Growth hormone therapy should not be used outside a controlled clinical trial, said Dr. Blackman, who directs the laboratory of clinical investigation at the National Center for Complementary and Alternative Medicine.
The researchers were asking whether growth hormone and, possibly, sex hormones might be a key to the debilitating changes that occur with aging. Starting about age 30, growth hormone levels start to decline. By age 60, people can have half as much as they did at 30. Testosterone, in men, declines, too, and, in women, estrogen levels plummet after menopause. The hypothesis was that the effects of aging — shriveling muscles, thinning bones, increased body fat, especially in the abdomen, a loss of energy and enthusiasm, might be linked to hormone deficiencies, and, in particular, a lack of growth hormone.
People who lack growth hormone — for example, patients with a genetic defect or a tumor of the pituitary gland that prevents the hormone from being made — have all these signs and symptoms of aging, and they are reversed when they take growth hormone injections.
Sex hormones may also play a role, Dr. Blackman said. "Sex steroids stimulate the growth hormone system," he said. "At least in younger people, when one is awry, the other one goes down."
In their study, the researchers tried to recreate in older people the hormone levels of a 20- or 30-year-old. They recruited 57 women and 74 men, with ages from 65 to 88, giving them hormones or dummy medications.
The most striking results were in the men who took both growth hormone and testosterone. They gained almost 10 pounds of lean body mass and lost a corresponding amount of fat. They also increased their cardiovascular endurance, a measure of their ability to exercise. Men who took growth hormone alone gained seven pounds of lean body mass and lost a similar amount of fat but their endurance did not change.
The women who took growth hormone, with or without estrogen and progesterone, gained a few pounds of lean body mass and lost five pounds of fat. In both men and women, sex hormones alone did not significantly change their body composition. Growth hormone appeared to be the major factor.
Never Enough
New member
Here's the rest,
(Page 2 of 2)
The side effects, however, were serious, afflicting 24 percent to 46 percent of the men and women taking growth hormone and including swollen feet and ankles, joint pain and carpal tunnel syndrome, which is caused by a swelling of a tendon sheath over a nerve in the wrist. It, and the joint pain, might be caused by the drug's tendency to increase water retention, Dr. Blackman said.
But Dr. S. Mitchell Harman, an author of the new study and director of the Kronos Longevity Research Institute, a nonprofit center that does research on aging, said it might be a result of growth hormone's effects in increasing tissue growth.
In addition, half the men who took growth hormone also had impaired abilities to use glucose, developing either diabetes or a prediabetic condition. But all these adverse effects disappeared when the study ended and the men and women stopped using the drugs.
Participants in the study did not grow stronger, even though they gained muscle, but it is possible that that might change if the treatment continues longer, said Dr. Harman, who also helped direct the study. Dr. Harman noted that when the hormone was given to people with rare medical conditions who lacked it, "you see very little increase in muscle strength until a year."
Dr. Blackman was cautious. "I personally believe these data are quite exciting," he said. "But there are two issues that are the bottom line. One is that we are uncertain about the possible effects and their functional relevance — getting out of a car, being able to bathe. The other is that there needs to be a lot more research with larger numbers of people and a reduction of these adverse effects."
Dr. Michael Thorner, chairman of the department of medicine at the University of Virginia School of Medicine, said the recent fall from grace of hormone therapy in menopause should give people pause. "If you just advocate that growth hormone be used because it might help," Dr. Thorner said, "the next thing you know, the whole world is on it. I think in medicine one should tailor therapies based on evidence."
The marketing of growth hormone took off in 1990 with the publication of one preliminary study of 12 men, indicating that they had lost fat and gained muscle. Soon afterward, researchers said, anti-aging clinics sprang up to offer the drug, at a cost of $1,000 or more a month, to people looking for a way to turn back the clock.
Growth hormone, made by Genentech, Eli Lilly & Company and others, is approved for use by children and adults with rare medical conditions that make them lack it. But once a drug is on the market, doctors can prescribe it at their discretion.
In just the last four years, according to IMS Health, a company that tracks drug sales, prescriptions for growth hormone made by Genentech and Eli Lilly have more than tripled, rising to 21,000 in 2001 from 6,000 in 1997.
While some prescriptions are for legitimate uses, medical experts say, many others are not. For example, growth hormone is also used by athletes and bodybuilders, with magazines directed toward these groups advertising its availability. The current issue of Men's Fitness, for example, has three ads for growth hormone, providing telephone numbers that people can call for a list of doctors who will prescribe the drug.
"There are plenty of doctors who will prescribe it," said Dr. Harman said. "It's a tremendous scam."
(Page 2 of 2)
The side effects, however, were serious, afflicting 24 percent to 46 percent of the men and women taking growth hormone and including swollen feet and ankles, joint pain and carpal tunnel syndrome, which is caused by a swelling of a tendon sheath over a nerve in the wrist. It, and the joint pain, might be caused by the drug's tendency to increase water retention, Dr. Blackman said.
But Dr. S. Mitchell Harman, an author of the new study and director of the Kronos Longevity Research Institute, a nonprofit center that does research on aging, said it might be a result of growth hormone's effects in increasing tissue growth.
In addition, half the men who took growth hormone also had impaired abilities to use glucose, developing either diabetes or a prediabetic condition. But all these adverse effects disappeared when the study ended and the men and women stopped using the drugs.
Participants in the study did not grow stronger, even though they gained muscle, but it is possible that that might change if the treatment continues longer, said Dr. Harman, who also helped direct the study. Dr. Harman noted that when the hormone was given to people with rare medical conditions who lacked it, "you see very little increase in muscle strength until a year."
Dr. Blackman was cautious. "I personally believe these data are quite exciting," he said. "But there are two issues that are the bottom line. One is that we are uncertain about the possible effects and their functional relevance — getting out of a car, being able to bathe. The other is that there needs to be a lot more research with larger numbers of people and a reduction of these adverse effects."
Dr. Michael Thorner, chairman of the department of medicine at the University of Virginia School of Medicine, said the recent fall from grace of hormone therapy in menopause should give people pause. "If you just advocate that growth hormone be used because it might help," Dr. Thorner said, "the next thing you know, the whole world is on it. I think in medicine one should tailor therapies based on evidence."
The marketing of growth hormone took off in 1990 with the publication of one preliminary study of 12 men, indicating that they had lost fat and gained muscle. Soon afterward, researchers said, anti-aging clinics sprang up to offer the drug, at a cost of $1,000 or more a month, to people looking for a way to turn back the clock.
Growth hormone, made by Genentech, Eli Lilly & Company and others, is approved for use by children and adults with rare medical conditions that make them lack it. But once a drug is on the market, doctors can prescribe it at their discretion.
In just the last four years, according to IMS Health, a company that tracks drug sales, prescriptions for growth hormone made by Genentech and Eli Lilly have more than tripled, rising to 21,000 in 2001 from 6,000 in 1997.
While some prescriptions are for legitimate uses, medical experts say, many others are not. For example, growth hormone is also used by athletes and bodybuilders, with magazines directed toward these groups advertising its availability. The current issue of Men's Fitness, for example, has three ads for growth hormone, providing telephone numbers that people can call for a list of doctors who will prescribe the drug.
"There are plenty of doctors who will prescribe it," said Dr. Harman said. "It's a tremendous scam."
Never Enough, thanks for cut/pasting. The thing I hate about these types of articles is that they are so vague as one can not even use the info, its basically wothless. What dose where these people taking? How long were they taking it? Did these people who suffered problems have any disposition or family history of diabetis? The list goes on and on and I hate to say it but writers who post these "half stories" should be strung up.
Never Enough
New member
No problem Zyg. I agree with you 100%. I mean they make statements without giving references. In the 2nd paragraph they talk about this study as being the largest and most carfeul study done on HGH but yet the article is so vague. The author could of at least gave a link to they study. I guess we should just take the authors word for it. 
macrophage69alpha
New member
Use of GH can reduce insulin effectiveness... GH and Insulin essentially work in opposition.. thus with older people who are already insulin resistant.. this may necessitate lower doses or supps to increase insulin secretion (or better sensitivity.. such are r-ala, GLA, and perhaps CLA)
I would think that the slin would be more of a risk for getting diabetes then using gh
I know people that use humalin r with the GH injections daily for months at a time.. to me that is just way to much slin to use
are there any studies out there that deal with long term insulin use and the risk it poses at becoming diabetic.
Thanks
I know people that use humalin r with the GH injections daily for months at a time.. to me that is just way to much slin to use
are there any studies out there that deal with long term insulin use and the risk it poses at becoming diabetic.
Thanks
The article dose pose some points of interest but none of them should be new to anyone who has considered GH and done some homework. As for diabetis, they did state the people in the study did not change diets nor did they exercise. As we all know most people eat a very high carb diet to begin with and over the years this causes insensitivity, combine that with GH and as Macro pointed out you end up with a recipe for disaster.
GH is a growth factor and just like it causes proliferation of tissue this can also cause cancers to grow as well. Once again, nothing new but it would still be nice to have some specifics.
Anyone a member of the AMA? can ya get a hold of the study and post it or a link, it would be much appreciated.
GH is a growth factor and just like it causes proliferation of tissue this can also cause cancers to grow as well. Once again, nothing new but it would still be nice to have some specifics.
Anyone a member of the AMA? can ya get a hold of the study and post it or a link, it would be much appreciated.
Here is an abstract from the J of AMA
<http://jama.ama-assn.org/images/space.gif>
Growth Hormone and Sex Steroid Administration in Healthy Aged Women and Men
A Randomized Controlled Trial
[Author Information] Marc R. Blackman, MD; John D. Sorkin, MD, PhD; Thomas Münzer, MD; Michele F. Bellantoni, MD; Jan Busby-Whitehead, MD; Thomas E. Stevens, MD; Jocelyn Jayme, MD; Kieran G. O'Connor, MD; Colleen Christmas, MD; Jordan D. Tobin, MD; Kerry J. Stewart, EdD; Ernest Cottrell, BS; Carol St. Clair, MS; Katharine M. Pabst, CRNP, MPH; S. Mitchell Harman, MD, PhD
Context Hormone administration to elderly individuals can increase lean body mass (LBM) and decrease fat, but interactive effects of growth hormone (GH) and sex steroids and their influence on strength and endurance are unknown.
Objective To evaluate the effects of recombinant human GH and/or sex steroids on body composition, strength, endurance, and adverse outcomes in aged persons.
Design, Setting, and Participants A 26-week randomized, double-blind, placebo-controlled parallel-group trial in healthy, ambulatory, community-dwelling US women (n = 57) and men (n = 74) aged 65 to 88 years recruited between June 1992 and July 1998.
Interventions Participants were randomized to receive GH (starting dose, 30 µg/kg, reduced to 20 µg/kg, subcutaneously 3 times/wk) + sex steroids (women: transdermal estradiol, 100 µg/d, plus oral medroxyprogesterone acetate, 10 mg/d, during the last 10 days of each 28-day cycle [HRT]; men: testosterone enanthate, biweekly intramuscular injections of 100 mg) (n = 35); GH + placebo sex steroid (n = 30); sex steroid + placebo GH (n = 35); or placebo GH + placebo sex steroid (n = 31) in a 2 <http://jama.ama-assn.org/__chars/math/special/times/black/med/small/glyph.gif> 2 factorial design.
Main Outcome Measures Lean body mass, fat mass, muscle strength, maximum oxygen uptake ( [Vdot] O2max) during treadmill test, and adverse effects.
Results In women, LBM increased by 0.4 kg with placebo, 1.2 kg with HRT (P = .09), 1.0 kg with GH (P = .001), and 2.1 kg with GH + HRT (P<.001). Fat mass decreased significantly in the GH and GH + HRT groups. In men, LBM increased by 0.1 kg with placebo, 1.4 kg with testosterone (P = .06), 3.1 kg with GH (P<.001), and 4.3 kg with GH + testosterone (P<.001). Fat mass decreased significantly with GH and GH + testosterone. Women's strength decreased in the placebo group and increased nonsignificantly with HRT (P = .09), GH (P = .29), and GH + HRT (P = .14). Men's strength also did not increase significantly except for a marginally significant increase of 13.5 kg with GH + testosterone (P = .05). Women's [Vdot] O2max declined by 0.4 mL/min/kg in the placebo and HRT groups but increased with GH (P = .07) and GH + HRT (P = .06). Men's [Vdot] O2max declined by 1.2 mL/min/kg with placebo and by 0.4 mL/min/kg with testosterone (P = .49) but increased with GH (P = .11) and with GH + testosterone (P<.001). Changes in strength (r = 0.355; P<.001) and in [Vdot] O2max (r = 0.320; P = .002) were directly related to changes in LBM. Edema was significantly more common in women taking GH (39% vs 0%) and GH + HRT (38% vs 0%). Carpal tunnel symptoms were more common in men taking GH + testosterone (32% vs 0%) and arthralgias were more common in men taking GH (41% vs 0%). Diabetes or glucose intolerance occurred in 18 GH-treated men vs 7 not receiving GH (P = .006).
Conclusions In this study, GH with or without sex steroids in healthy, aged women and men increased LBM and decreased fat mass. Sex steroid + GH increased muscle strength marginally and [Vdot] O2max in men, but women had no significant change in strength or cardiovascular endurance. Because adverse effects were frequent (importantly, diabetes and glucose intolerance), GH interventions in the elderly should be confined to controlled studies.
JAMA. 2002;288:2282-2292
View Full Text
Author/Article Information
<http://jama.ama-assn.org/images/dot_lgray_999999.gif>
Author Affiliations: Divisions of Endocrinology and Metabolism (Drs Blackman and Jayme, Mr Cottrell, and Mss St. Clair and Pabst), Cardiology (Dr Stewart), and Geriatric Medicine and Gerontology (Drs Bellantoni, Busby-Whitehead, Stevens, O'Connor, and Christmas), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md; the Endocrine (Drs Münzer and Harman), Metabolism (Dr Sorkin), and Applied Physiology (Dr Tobin) Sections, Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, and National Center for Complementary and Alternative Medicine (Dr Blackman and Ms Pabst), National Institutes of Health, Bethesda, Md; Department of Medicine, University of Maryland School of Medicine, Baltimore (Dr Sorkin and Ms St. Clair); Burgerspital, St Gallen, Switzerland (Dr Münzer); Division of Geriatric Medicine, University of North Carolina School of Medicine, Chapel Hill (Dr Busby-Whitehead); Division of Geriatric Medicine, University of Southern Alabama School of Medicine, Mobile (Dr Stevens); Louth Hospital, County Louth, Ireland (Dr O'Connor); and Kronos Research Institute, Phoenix, Ariz (Dr Harman).
Corresponding Author and Reprints: Marc R. Blackman, MD, National Center for Complementary and Alternative Medicine, National Institutes of Health, 8 West Dr, Bldg 15 B-1, Bethesda, MD 20892 (e-mail: [email protected]).
Author Contributions: Study concept and design: Blackman, Bellantoni, Busby-Whitehead, Tobin, Stewart, Harman.
Acquisition of data: Blackman, Münzer, Bellantoni, Busby-Whitehead, Stevens, Jayme, O'Connor, Christmas, Tobin, Stewart, Cottrell, St. Clair, Pabst, Harman.
Analysis and interpretation of data: Blackman, Sorkin, Busby-Whitehead, Christmas, Tobin, Harman.
Drafting of the manuscript: Blackman, Münzer, Harman.
Critical revision of the manuscript for important intellectual content: Blackman, Sorkin, Bellantoni, Busby-Whitehead, Stevens, Jayme, O'Connor, Christmas, Tobin, Stewart, Cottrell, St. Clair, Pabst, Harman.
Statistical expertise: Sorkin, Tobin.
Obtained funding: Blackman.
Administrative, technical, or material support: Blackman, Bellantoni, Jayme, O'Connor, Christmas, Tobin, Stewart, St. Clair, Pabst, Harman.
Study supervision: Blackman, Busby-Whitehead, O'Connor, Tobin, Stewart, Harman.
Funding/Support: This work was supported in part by National Institutes of Health research grant RO-1 AG11005 (Dr Blackman) and General Clinical Research Center grant MO-1-RR-02719, from the National Center for Research Resources, National Institutes of Health, and by the Intramural Research Program, NIA. Genentech Inc provided the recombinant human GH and Novartis Pharmaceuticals provided the transdermal estradiol.
Acknowledgment: We thank the study participants for their extraordinary and unselfish devotion to advancing knowledge of the aging process; the nursing staff of the GCRC for their invaluable assistance in the conduct of patient studies; Tracey A. Roy for her expert performance of the DXA assessments; and Derek LeRoith, MD, and Andrew Hoffman, MD, for their constructive critiques of the manuscript.
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Growth Hormone and Sex Steroid Administration in Healthy Aged Women and Men
A Randomized Controlled Trial
[Author Information] Marc R. Blackman, MD; John D. Sorkin, MD, PhD; Thomas Münzer, MD; Michele F. Bellantoni, MD; Jan Busby-Whitehead, MD; Thomas E. Stevens, MD; Jocelyn Jayme, MD; Kieran G. O'Connor, MD; Colleen Christmas, MD; Jordan D. Tobin, MD; Kerry J. Stewart, EdD; Ernest Cottrell, BS; Carol St. Clair, MS; Katharine M. Pabst, CRNP, MPH; S. Mitchell Harman, MD, PhD
Context Hormone administration to elderly individuals can increase lean body mass (LBM) and decrease fat, but interactive effects of growth hormone (GH) and sex steroids and their influence on strength and endurance are unknown.
Objective To evaluate the effects of recombinant human GH and/or sex steroids on body composition, strength, endurance, and adverse outcomes in aged persons.
Design, Setting, and Participants A 26-week randomized, double-blind, placebo-controlled parallel-group trial in healthy, ambulatory, community-dwelling US women (n = 57) and men (n = 74) aged 65 to 88 years recruited between June 1992 and July 1998.
Interventions Participants were randomized to receive GH (starting dose, 30 µg/kg, reduced to 20 µg/kg, subcutaneously 3 times/wk) + sex steroids (women: transdermal estradiol, 100 µg/d, plus oral medroxyprogesterone acetate, 10 mg/d, during the last 10 days of each 28-day cycle [HRT]; men: testosterone enanthate, biweekly intramuscular injections of 100 mg) (n = 35); GH + placebo sex steroid (n = 30); sex steroid + placebo GH (n = 35); or placebo GH + placebo sex steroid (n = 31) in a 2 <http://jama.ama-assn.org/__chars/math/special/times/black/med/small/glyph.gif> 2 factorial design.
Main Outcome Measures Lean body mass, fat mass, muscle strength, maximum oxygen uptake ( [Vdot] O2max) during treadmill test, and adverse effects.
Results In women, LBM increased by 0.4 kg with placebo, 1.2 kg with HRT (P = .09), 1.0 kg with GH (P = .001), and 2.1 kg with GH + HRT (P<.001). Fat mass decreased significantly in the GH and GH + HRT groups. In men, LBM increased by 0.1 kg with placebo, 1.4 kg with testosterone (P = .06), 3.1 kg with GH (P<.001), and 4.3 kg with GH + testosterone (P<.001). Fat mass decreased significantly with GH and GH + testosterone. Women's strength decreased in the placebo group and increased nonsignificantly with HRT (P = .09), GH (P = .29), and GH + HRT (P = .14). Men's strength also did not increase significantly except for a marginally significant increase of 13.5 kg with GH + testosterone (P = .05). Women's [Vdot] O2max declined by 0.4 mL/min/kg in the placebo and HRT groups but increased with GH (P = .07) and GH + HRT (P = .06). Men's [Vdot] O2max declined by 1.2 mL/min/kg with placebo and by 0.4 mL/min/kg with testosterone (P = .49) but increased with GH (P = .11) and with GH + testosterone (P<.001). Changes in strength (r = 0.355; P<.001) and in [Vdot] O2max (r = 0.320; P = .002) were directly related to changes in LBM. Edema was significantly more common in women taking GH (39% vs 0%) and GH + HRT (38% vs 0%). Carpal tunnel symptoms were more common in men taking GH + testosterone (32% vs 0%) and arthralgias were more common in men taking GH (41% vs 0%). Diabetes or glucose intolerance occurred in 18 GH-treated men vs 7 not receiving GH (P = .006).
Conclusions In this study, GH with or without sex steroids in healthy, aged women and men increased LBM and decreased fat mass. Sex steroid + GH increased muscle strength marginally and [Vdot] O2max in men, but women had no significant change in strength or cardiovascular endurance. Because adverse effects were frequent (importantly, diabetes and glucose intolerance), GH interventions in the elderly should be confined to controlled studies.
JAMA. 2002;288:2282-2292
View Full Text
Author/Article Information
<http://jama.ama-assn.org/images/dot_lgray_999999.gif>
Author Affiliations: Divisions of Endocrinology and Metabolism (Drs Blackman and Jayme, Mr Cottrell, and Mss St. Clair and Pabst), Cardiology (Dr Stewart), and Geriatric Medicine and Gerontology (Drs Bellantoni, Busby-Whitehead, Stevens, O'Connor, and Christmas), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md; the Endocrine (Drs Münzer and Harman), Metabolism (Dr Sorkin), and Applied Physiology (Dr Tobin) Sections, Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, and National Center for Complementary and Alternative Medicine (Dr Blackman and Ms Pabst), National Institutes of Health, Bethesda, Md; Department of Medicine, University of Maryland School of Medicine, Baltimore (Dr Sorkin and Ms St. Clair); Burgerspital, St Gallen, Switzerland (Dr Münzer); Division of Geriatric Medicine, University of North Carolina School of Medicine, Chapel Hill (Dr Busby-Whitehead); Division of Geriatric Medicine, University of Southern Alabama School of Medicine, Mobile (Dr Stevens); Louth Hospital, County Louth, Ireland (Dr O'Connor); and Kronos Research Institute, Phoenix, Ariz (Dr Harman).
Corresponding Author and Reprints: Marc R. Blackman, MD, National Center for Complementary and Alternative Medicine, National Institutes of Health, 8 West Dr, Bldg 15 B-1, Bethesda, MD 20892 (e-mail: [email protected]).
Author Contributions: Study concept and design: Blackman, Bellantoni, Busby-Whitehead, Tobin, Stewart, Harman.
Acquisition of data: Blackman, Münzer, Bellantoni, Busby-Whitehead, Stevens, Jayme, O'Connor, Christmas, Tobin, Stewart, Cottrell, St. Clair, Pabst, Harman.
Analysis and interpretation of data: Blackman, Sorkin, Busby-Whitehead, Christmas, Tobin, Harman.
Drafting of the manuscript: Blackman, Münzer, Harman.
Critical revision of the manuscript for important intellectual content: Blackman, Sorkin, Bellantoni, Busby-Whitehead, Stevens, Jayme, O'Connor, Christmas, Tobin, Stewart, Cottrell, St. Clair, Pabst, Harman.
Statistical expertise: Sorkin, Tobin.
Obtained funding: Blackman.
Administrative, technical, or material support: Blackman, Bellantoni, Jayme, O'Connor, Christmas, Tobin, Stewart, St. Clair, Pabst, Harman.
Study supervision: Blackman, Busby-Whitehead, O'Connor, Tobin, Stewart, Harman.
Funding/Support: This work was supported in part by National Institutes of Health research grant RO-1 AG11005 (Dr Blackman) and General Clinical Research Center grant MO-1-RR-02719, from the National Center for Research Resources, National Institutes of Health, and by the Intramural Research Program, NIA. Genentech Inc provided the recombinant human GH and Novartis Pharmaceuticals provided the transdermal estradiol.
Acknowledgment: We thank the study participants for their extraordinary and unselfish devotion to advancing knowledge of the aging process; the nursing staff of the GCRC for their invaluable assistance in the conduct of patient studies; Tracey A. Roy for her expert performance of the DXA assessments; and Derek LeRoith, MD, and Andrew Hoffman, MD, for their constructive critiques of the manuscript.
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