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Risks associated with growth hormone in elderly outweighed benefits
‘Elixir of life’ does not result in beneficial changes in key clinical outcomes.
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Despite its growing popularity as an “age reverser,” human growth hormone was associated with minimal changes in body composition and increased rates of potentially serious adverse events when taken by healthy elderly individuals, according to findings of a new study.
Hau Liu, MD, MBA, research fellow in the division of endocrinology and Center for Primary Care and Outcomes Research at Stanford University, and colleagues conducted a systematic review of randomized, controlled trials of growth hormone in healthy elderly patients.
“The evidence we found suggested minimal benefit, but the real potential for some adverse events. On top of that, you add that the distribution of growth hormone for antiaging purposes is illegal in the United States. It’s also been reported that people are spending anywhere from hundreds of thousands of dollars for this drug, however they obtain it,” Liu said in an interview with Endocrine Today. “Put it all together and it strongly suggests that growth hormone should not be used for antiaging purposes.”
More risks than benefit
Growth hormone in healthy elderly patients has not been extensively studied.
The researchers’ search turned up 31 articles describing 18 unique study populations and a total of 220 participants who received growth hormone (mean age, 69 years). Initial growth hormone dose (mean, 14 ug/kg of body weight) and treatment duration (mean, 27 weeks) varied.
They found that the adverse events outweighed the benefits of growth hormone in this cohort. Adverse events were reported in 17 of the 18 included studies.
Patients who received growth hormone had increased rates of soft tissue edema, arthralgias, carpal-tunnel-like syndromes and a trend toward increased rates of diabetes and prediabetes.
Changes in body composition
Growth hormone had little effect on body composition and weight gain in this population.
Weight loss did not differ between those that received growth hormone and those that didn’t. Fat mass decreased slightly (change of –2.08 kg; 95% CI, –2.80 to 1.35 kg) and lean body mass increased (change of 2.13 kg; 95% CI, 1.32-2.94 kg) in the growth-hormone–treated group vs. placebo group.
There was also a slight decrease in cholesterol levels of 0.29 mmol/L in the growth hormone group (95% CI, –0.49 to 0.08 mmol/L), but this effect was not robust in sensitivity analyses, according to the researchers.
None of these changes were significant enough to signal any substantial benefits of growth hormone in healthy elderly people, the researchers wrote.
Women appeared to respond to growth hormone differently than men, which the researchers said was because women may require higher doses of growth hormone for longer periods than men to achieve physiologic replacement levels. Women did not have increased lean body mass and had smaller decreases in fat mass than men. Rates of adverse events were similar between men and women.
“Although growth hormone-induced body composition changes in the healthy elderly are similar to those reported in individuals who are growth-hormone deficient, we find no evidence that growth hormone replacement in the healthy elderly improves other clinically important outcomes, such as maximal oxygen consumption, bone mineral density, lipid levels and fasting glucose and insulin levels,” the researchers wrote.
No evidence
On the basis of these data, growth hormone cannot be recommended for use in the healthy elderly, the researchers concluded. “Although growth hormone has been widely publicized as an antiaging therapy and initial studies suggested that it might be clinically beneficial and safe in the healthy elderly, we find little evidence to support these claims,” they wrote.
In 2004, approximately 20,000 to 30,000 people used growth hormone and annual sales are upward of $1.5 billion. The FDA has not approved growth hormone for use in antiaging therapy.
Liu said there are several problems with growth hormone used in antiaging. “First, it’s distribution as an anti-aging therapy is illegal in the United States and, second, there’s limited benefit and the potential for serious side effects. The minimal improvements in body composition could likely be achieved if the hundreds to thousands of dollars per month people are reported to be spending on growth hormones were applied to other interventions, say, gym membership or hiring a trainer.
“Growth hormone obviously has very important uses for growth hormone-deficient populations or in children with certain illnesses. However, in the healthy elderly population and in those interested in using it for antiaging purposes, our findings strongly suggest that it is not the magic bullet or the elixir of youth that people think it is,” Liu said.
He recommended the things people are told by their clinicians on a regular basis: engaging in regular exercise, eating a healthy and balanced diet, and quitting smoking. –by Katie Kalvaitis
For more information:
- Liu H, Bravata DM, Olkin I, et al. Systematic review: the safety and efficacy of growth hormone in the healthy elderly. Ann Int Med. 2007;146:104-115.