Sunday, May 27, 2007

Fountain of youth or a false hope? - Backers, detractors battle over HGH

Fountain of youth or a false hope? - Backers, detractors battle over HGH
By Michael Martinez
Copyright © 2007, Chicago Tribune
Published May 27, 2007

BEVERLY HILLS, Calif. -- At age 48, Ann Hull was tired of being tired. So she came to Beverly Hills, a mecca for anti-aging treatment, and her physician put her on human growth hormone -- a drug she said made her feel younger.

"Just immediately, I noticed a difference," said Hull, a former model turned aspiring lawyer from Studio City, Calif., who began HGH treatments three months ago. "I feel better, my hair is better, my skin is better, my body fat has gotten down."

Scientists and some prosecutors, however, denounce HGH as a false fountain of youth. Hull was legitimately prescribed HGH injections for a hormone deficiency. Still, the drug is at the center of a growing medical and legal controversy.

Sales are up, anti-aging clinics have gone viral on the Internet, and celebrities including Sylvester Stallone use it. However, abuse has prompted New York authorities to indict more than 20 people, including five physicians in three states, for allegedly running HGH mills over the Internet. A New York congressman now wants stricter federal control over the drug.

Still, HGH has captured the imagination of Baby Boomers dispirited over aging, even though medical experts say growth hormone is a placebo for such uses. Those experts add that the exercise and nutritional regimens of patients are the real sources of rejuvenation.

Synthetic HGH is a prescription drug. In a natural state, HGH is a protein produced in the pituitary gland.

In short children, HGH stimulates growth. In adults, it has a stimulatory effect on muscle growth and reduces body fat, said Ruth Wood, a professor of cell and neurobiology at the University of Southern California.

The prescribed uses of HGH are typically for adults with rare hormone deficiencies and AIDS patients, authorities said.

However, the drug has also become an illicit health fad. And one New York district attorney compared the Internet distribution of HGH prescriptions, with patients not even seeing doctors, to "cartels that sell hard-core street drugs."

As advocates assert the revitalizing benefits of HGH -- despite scientific refutation -- HGH sales have almost doubled in five years, to more than $1 billion last year, according to IMS Health Inc., a health-care information firm.

Much of those sales come from rejuvenation clinics on the Internet portraying aging as if it were "a disease" that HGH can reverse, authorities said. Another popular "off label" use of HGH is for performance enhancement by bodybuilders and athletes because the drug is hard to trace, experts said.

Among its most aggressive advocates, the Chicago-based American Academy of Anti-Aging Medicine, with more than 20,000 members, says the drug's popularity is due to Baby Boomers being increasingly diagnosed with hormone deficiency, which HGH remedies by improving mobility, cognitive functions, immune functions, body composition and sleep, among other results, according to group officials.

Speakers at the group's conferences have drawn controversy for their promotion of HGH, which academy President Dr. Ronald Klatz called "the first medically proven age-reversal therapy" in his 1997 book.

In addition to their claims about reversing aging, Klatz and academy Chairman Dr. Robert Goldman have themselves been at the center of scrutiny when the Illinois Department of Financial and Professional Regulation fined each man $5,000 in 2000 for placing "MD" after their names. Neither has ever been a licensed medical doctor in the U.S., but both men have osteopathic degrees and graduated from an MD program in Belize.

Klatz disputes critics' charges that the drug is being abused. Growth hormone "is utilized by only less than 10 percent of the total anti-aging patient population for properly diagnosed adult growth hormone deficiency syndrome," Klatz said in an e-mailed statement through a spokeswoman.



Officials: Claims overblown

Pitchmen, however, make grand promises, authorities charge.

"It's the next carbohydrate diet. It's the new South Beach diet. It's the new fountain of youth," said Albany County, N.Y., District Atty. P. David Soares, who's leading an investigation against an Internet ring of rejuvenation clinics, doctors and a drugmaking pharmacy in which physicians allegedly wrote prescriptions without even seeing the patients.

"We have not had the legitimate need for human growth hormone that would be on pace with what you're seeing in prescription sales," Soares said. "What was traditionally a product that could be acquired in back alleys or at the HIV treatment centers is now being exchanged freely over the World Wide Web."

At the Rejuvalife Vitality Institute, the Beverly Hills clinic where Hull is being treated, the president, Dr. Andre Berger, said his practice doesn't portray HGH as a miracle cure-all and added that he conducts clinical exams along with tests to determine whether HGH is necessary. His Web site advertises "non-surgical cosmetic & anti-aging treatments," including "the dramatic, positive effects of ... human growth hormone."

"This is not a supermarket where a patient can get it off the shelf," Berger said in his office. "They have to have a diagnosis."

Berger described critics' accusations against clinics like his as "ridiculous."

"It's not a fountain of youth. It's an important hormone. If deficient and replaced, it can help health span, vitality and well-being, which is the essence of what people are looking for. It's not a clinical disease because aging is not a disease, but it helps to treat the symptoms, signs and negative aspects of aging. It's not a panacea," he said.



Legislating HGH

In the wake of Soares' inquiry, Sen. Charles Schumer (D-N.Y.) has introduced legislation that would make HGH, now a regular prescription, a schedule III controlled substance, which would tighten restrictions on its dispensing, allow tougher penalties for trafficking and ensure federal monitoring of the drug.

But advocates of anti-aging medical practices say the legislation is unneeded as the vast majority of doctors administer HGH legally. These practices exploded after Dr. Daniel Rudman of the Medical College of Wisconsin wrote a 1990 article in the New England Journal of Medicine stating HGH injections to a dozen men over age 60 produced lean muscle mass, denser bones, thicker skin and less fat. That article has been disputed by many scientists.

"You can't justifiably smear the anti-aging paradigm because of the actions of a few Internet-based rogue physicians," said Fintan Dunne, editor of MyLongLife.com and an advocate of anti-aging medicine.

But Dr. Stanley Korenman, professor of medicine at UCLA and associate dean of ethics, said no evidence exists that HGH prolongs life.

"And even in the people who need it, like the ones I treat who have proved to have growth hormone deficiency, it's very hard to prove benefits. Everyone feels better, but it may be a placebo effect and in fact I know it is a placebo effect," Korenman said. "The question is, how good is it really?"

Disagreement even exists within the anti-aging community about HGH injections versus over-the-counter products promoting natural HGH. For example, nurse Lisa Wells of Van Nuys, Calif., has a Web site selling homeopathic products she says stimulate the body to produce natural HGH, but anti-aging doctors often dismiss such products as a waste of money.

Meanwhile, Hull, the patient from Studio City who began HGH injections this year, says that renewed health helped her graduate from law school last weekend. She's even off medicine for high blood pressure and allergies. She spends $500 a month on HGH and supplements, she said.

"I'm sold," she added.

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mjmartinez@tribune.com

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