Three years ago a snowstorm forced me to spend an unexpected night in a small Montana town. The TV in the little motel only received 3 channels due to the storm. Scanning the 3 stations, I came upon a fellow making some health claims that really got my attention. It turned out to be an infomercial. I tuned in just in time to hear him say:

• Gray hair turning dark
• Disappearing bald spots
• Reduced skin wrinkles
• Fading age spots
• Better mood
• Sharper memory
• Greater concentration
• Improved sex
• Lower cholesterol
• Clearer vision (the picture flashed to a happy senior throwing away his reading glasses)
• Loss of body fat without diet or exercise
• Strength and muscle gains, again sans exercise
• Better digestion and elimination
• Reversal of hearing loss
• Prevention of bone loss
• Greater stamina and endurance
• Deeper sleep
• Reduced joint pain
• Faster wound healing
• Much more energy
• Reverses the bio marker of aging by 10-20 years And it is all done with zero side effects.

When they said the cost could be $500 to $1000 a month or more, I knew they were speaking of recombinant human growth hormone (hGH). I also knew that 1) to the layperson, this advertisement looked very impressive and would generate huge sales ($80 million for one company alone) and 2) the claims were so over the top I wondered if they would ever be challenged.

Every company selling supplements designed to boost hGH mentions research. One study by Daniel Rudman, et al.,¹ is constantly referenced and often referred to as a "landmark study." I found it at www.nejm.org. When I clicked on it, there was a surprise. An editorial explaining that this article receives more hits in a week than most 1990 pieces do in a year was posted. The editors' felt it has been so misused, they provided the entire article (rather than just the abstract) free of charge or registration. Also posted were full text commentaries, including one from 1990 discussing the original research and a 2003 followup by the same author.^2,3

HUMAN GROWTH HORMONE
HGH is produced by the anterior pituitary gland. Production declines with age (see chart).

EFFECTS
Real hGH has been shown to 1) increase protein synthesis in almost every cell 2) increase mobilization of fatty acids from adipose tissue resulting in a greater amount of fat metabolized for fuel, and reduce the rate of glucose utilization. 3) HGH also improves skin elasticity and skin thickness, and 4) can reduce or even reverse bone demineralization.^1,4 Note: if a person has a frank deficiency, they may notice other changes as well.

SIDE EFFECTS
Unfortunately, hGH has side effects. In a study of 131 men and women aged 65 to 88 who had a 30 mcg/kg/bw injection 3 times a week and continued with 3 weekly injections of 20 mcg/kg/bw, they had the following problems.⁵

THE LANDMARK STUDY
As mentioned above, in 1990 a study was published in the New England Journal of Medicine regarding growth hormone. The results of 6 months of growth hormone therapy were increase in lean body mass (8.8%), bone density (1.6%), and skin thickness (7.1%). There was 14.4% loss of adipose tissue. The muscle gain and fat loss were accomplished without diet or exercise.

Dr. Rudman's study was done with 21 men aged 61 to 81. They were tested and divided into 2 groups based on IGF levels. 12 subjects had IGF levels below 350 U/L indicating a growth hormone deficiency. The other 9 had IGF levels above 350 U/L. The 12 males with low levels of IGF-1 ranged in age from 61 to 73, while the 9 controls were 65-81 years old. (Ninety-five percent of men 20 to 40 have more than 350 U/L of IGF-1. Seventy percent of men over 60 have more than 350 U/L of IGF-1.) In this study, 6 months of hGH therapy in the form of recombinant growth hormone delivered by 3 weekly injections of 0.03 mg/kg/bw reversed the biomarkers of aging by 10 to 20 years. (according to the authors). This statement was based on the increases in lean body mass and skin thickness along with reduction in body fat. Everyone selling hGH nutritional supplements uses the biomarker quote. Rudman, et.al. further stated, "Our findings cannot be generalized to the approximately two-thirds of men over age 60 who have plasma IGF-1 over 350 U/L." Strangely, no one selling hGH supplements uses this statement. There is nothing in Dr. Rudman's paper to indicate that hGH given to persons under 60 years of age with normal levels of IGF-1 will have similar responses to those over 60 with deficiencies. There is also nothing in the study to indicate that amino acids, herbs, vitamins, and minerals will have effects similar to hGH injections. And, while it is true that various types of nutritional supplements have been shown (in laboratory conditions) to slightly elevate growth hormone, none of them come close to the rise following strenuous exercise or the first few hours of deep sleep.

FTC ACTION
So, how amazing are these legal, over-the-counter, hGH products? Well, they set a record for the highest amount of money ever awarded in a health fraud case by the Federal Trade Commission (FTC). In June of 2005 a $6.5 million dollar initial payment with an FTC-run complaint program titled "Consumer Redress"⁶ capped at $13.5 million set the $20 million dollar record. The defendants in this case - Great American Products (GAP) and Physicians Choice Incorporated (PCI), manufactured and marketed the products Ultimate HGH, Super HGH, Master HGH, and Super HGH Booster and agreed to the settlement. In addition to the cash payouts, they had to cease false or unsubstantiated claims regarding their products. The FTC sent letters to at least 90 Internet marketing companies selling natural hGH precursors, stimulators, or secretagogs warning them that deceptive or misleading advertising can result in legal jeopardy. After looking at some of the hGH websites six months later (in December, 2005) it does not appear many companies (chose one) either received, reviewed, or read the warning.

CONCLUSION
I wish there was a product that was 100% safe and could do 25% of makers of so-called natural human growth hormone precursors claim. I encourage anyone who sells and markets these products to fund no-strings-attached research. In the meantime, it appears that those who feel a benefit from these pricey products most likely have a placebo response.

References
¹Rudman, D., Feller, A.G., Nagraj, H.S., et al. Effects of Human Growth Hormone in Men Over 60 Years Old. N.Engl.J.Med. 1993; 23: 1-6.
²Vance, M.L. Growth Hormone for the Elderly. N.Engl.J.Med. 1990; 323: 52-54.
³Vance, M.L. Can Growth Hormone Prevent Aging? N.Engl.J.Med. 2003; 348: 779-780.
⁴Harman, S.M., and Blackman, M.R. Use of Growth Hormone for Prevention or Treatment of the Effects of Aging. J Gerontol A Biol Sci Med Sci. 2004; 59: 652-658.
⁵Black, M.R., Sorkin, J.D., et al. Growth Hormone and Sex Steroid Administration in Healthy-Aged Women and Men: A Randomized Controlled Trial. JAMA. 2002; 288: 2282-2292.
⁶FTC Targets Bogus Anti-Aging Claims for Pills and Sprays Promising Human Growth Hormone Benefits. www.ftc.gov/opa/2005/06/greatamerican.htm.

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