Hormone injection's promise of youth comes with risks

CHICAGO -- Injecting himself with human growth hormone six times a week and swallowing a handful of dietary supplements each day doesn't seem weird or excessive to 44-year-old Richard Weisman of Las Vegas.

"I have young children. I do it for them," said Weisman, the owner of a luxury and sports car dealership at Caesar's Palace. "I want to be healthy as I get older."

Not only that, he said, he also feels an increase in energy, muscle mass and libido. "My wife loves it and is going to start the program herself," he said.

Weisman isn't alone. Other ordinary non-athletic Americans are injecting themselves with human growth hormone as part of a regimen prescribed by fringe doctors and a multimillion-dollar anti-aging industry that -- depending on who's talking -- is either solidly based on science or mostly hucksterism and quackery.

Much of anti-aging medicine, or as it's more often called in recent years "age-management" medicine, relies on dietary supplements, nutrition counseling and exercise programs.

But a portion of patients also get blood tests that detect supposedly low levels of a marker for human growth hormone. Those patients often go home with a prescription for injectable HGH and a $500 monthly hormone bill that insurance doesn't touch.

Human growth hormone is produced naturally by the pituitary gland and contributes to normal growth in children. In studies, HGH has been shown to increase muscle mass and reduce fat in men and women, with notable side effects, including diabetes.

A pharmaceutical version is approved for treating children who fail to grow for various reasons, for AIDS patients with muscle wasting syndrome and for adults with legitimate growth hormone deficiency caused, for example, by surgery or radiation.

Other uses are illegal, including to turn back the clock on aging. The FDA says it is investigating violations of the law -- the Food, Drug and Cosmetic Act as amended in 1988 and 1990 -- and has sent warning letters to companies selling HGH over the Internet for other uses.

University of Illinois-Chicago epidemiologist Jay Olshansky, who co-authored a paper published last year in the Journal of the American Medical Association on legal issues surrounding HGH, said anti-aging doctors were surprised to learn they were on shaky legal ground.

They now are changing tactics by redefining growth hormone deficiency and making questionable diagnoses of their patients, Olshansky said.

"They've been administering growth hormone as an anti-aging intervention for a long time. They haven't been hiding it at all," Olshansky said. "Now they're trying to redefine it as a treatment for growth hormone deficiency."

Most prescriptions for HGH should go to children, according to Dr. Thomas Perls of Boston Medical Center, but 74 percent in 2004 went to people age 20 and older.

"In my opinion, that suggests a large amount of illegal distribution," said Perls, a co-author with Olshansky of the JAMA paper and director of a project that studies people who live to age 100.

Sales of HGH in 2004 totaled $622 million for legitimate and non-legitimate uses.

Weisman, the Las Vegas car dealer, said he pays $1,000 a month for supplements and hormones, and a twice-yearly blood test costs him $650 each time. Plus, he paid $2,000 for an initial evaluation with Cenegenics Medical Institute in Las Vegas, the clinic that designed his program and was featured recently in GQ magazine.

"Some people might think it's expensive, but how do you put a value on health?" Weisman asked.

Whether HGH enhances health in already healthy adults remains uncertain, but small, short-term studies have shown benefits and risks.

In 2003, a placebo-controlled, randomized study of people 65 and older found that growth hormone increased lean body mass and decreased fat mass, but the study subjects experienced frequent side effects including diabetes and glucose intolerance.

Other studies have linked HGH to raised cholesterol levels, heightened blood pressure, joint problems, swelling and carpal tunnel syndrome.

Weisman said he's never experienced side effects, although his doctor informed him about them. Doctors interviewed for this article who prescribe HGH said side effects can be avoided by initial low doses or by giving smaller doses if side effects occur. These doctors insist they prescribe HGH only to patients whose blood tests show a deficiency.

Dr. Evan Hadley of the National Institute on Aging said legitimate research on growth hormone has been blown out of proportion by wishful thinkers and marketers.

"Science doesn't have immediate answers for people who want to know what the fountain of youth is today," Hadley said.

But age-management doctors said their work focuses on disease prevention, and so is an affront to the disease-oriented medical establishment.

"Many of my colleagues have criticized the work I do," said Dr. Geoffrey Jones, who practices in Oak Brook, Ill., and puts about 15 percent of his patients on growth hormone. "I don't blame them. I was in the same shoes they're in. When I heard about it, I was critical of it. It's the old saying: If you're not up on it, you're down on it."

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On the Net:

National Institute on Aging fact sheet on hormones and aging: http://www.niapublications.org/tipsheets/pills.asp

Cenegenics Medical Institute: http://www.cenegenics.com