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New information and access to information are characteristics of the first part of the 21st century. Medical science produces thousands of articles and bits of information, regularly making it nearly impossible to keep abreast of new clinical findings and scientific discoveries. New uses of medications and therapies expand the scope of a physician’s ability to intervene and improve on the quality of the life of individuals. Therefore, periodic updates on certain subjects are required. Human Growth Hormone (HGH), originally taken from the human brain, was very costly to obtain, was in limited supply and had significant infectious disease potential, producing severe brain disease in some recipients. In the ’80s, the ability to produce synthetic growth hormone from recombinant DNA was achieved, changing the availability of the hormone as well as its safety. This availability, coupled with society’s expectation that any human deficiency, including lack of height and size, should be treated, has produced great interest in expanded use of HGH. The potential for increased pharmaceutical profits and the desire for a more perfect expression of one’s own genetics has only fueled the fire. The adult obsession and demand for the perfect body can be seen every day in the workplace, on television and in the operating room. This perspective cannot help but influence children and their own physical expectations. Where does heightened awareness and knowledge go from reasonable intervention to obsession? When does the cost outweigh the benefits? When is enough, enough? The development of growth hormone, as has the synthesis of insulin also done, has given people the opportunity to replace what does not exist, normalizing and extending life. Who are candidates for this therapy and who should say no to treatment? Replacement therapy in children has been an accepted intervention for decades and will continue to be. In addition, adult replacement therapy, frequently from a deficiency produced by tumor or surgical intervention, has become conventional treatment. Certain genetic diseases that are accompanied by short stature are well-accepted opportunities for intervention. New research has demonstrated that administration of growth hormone in infants who were small at birth (small for gestational age-SGA) produced normalization of height and other measurements including head circumference in contrast to untreated SGA infants. Although the long-term results of this research are not evident, head circumference normalization indicating enhanced brain growth and function can be hypothesized, effecting lifelong function and intelligence. Further research in the area of HIV and burn victims demonstrates improved muscle mass and growth when treated with growth hormone. Now that the kids are taken care of, what about you, the parent, the adult? Will growth hormone become the fountain of youth? There is potential that growth hormone can enhance continued muscle mass and strength as we age. Cellulite may disappear! Obesity and wrinkles can be things of the past. Growth hormone begins to decrease in most people around the age of 30 and the theory behind growth hormone supplements is that restoring hormone levels to what they were when people were younger will restore youth. A study in the New England Journal of Medicine followed participants over the age of 60 who improved lean body mass, bone density and skin thickness while decreasing fat mass when they were injected three times per week. However, the results only persisted as long as the growth hormone was being injected. Therefore, long-term results would probably not be sustained without regular injections at around $30-40,000 per year. Other side effects such as hypertension and diabetes can result from prolonged treatment with HGH. So what may appear wonderful on the surface can become a problem in the long run. The availability of HGH has changed and improved many lives, but beware of lurking devils. Be skeptical of ads that promise too much. Anything that appears too good to be true usually is and maybe we should not tamper too much with Mother Nature! Dr. Clyde Wesp is a pediatrician with Southern Orange County Pediatric Associates with offices in Lake Forest, Laguna Hills, Rancho Santa Margarita, Ladera Ranch and San Clemente (Talega) and is affiliated with Saddleback Memorial Medical Center, Mission Hospital and Children’s Hospital of Orange County. He is a member of the American Academy of Pediatrics and the Memorial Care Physician Society. If you have any questions or comments for Dr. Wesp you can email him at askdrwesp@netscape.net. For Letters: ocfamily.com |
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