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The average person thinks of the damage of aging as an
inevitable process of wear and tear. However, if wear and
tear were the primary cause of aging in humans, a 60
year-old should have only twice the signs of aging as a 30
year-old.
Why do most 30-year-olds show few effects of aging, while
the effects of aging are so obvious in a 60 year-old person?
If wear and tear were the major cause of aging, a
90-year-old person would only have 3 times as much aging
damage as a 30-year-old.
At the age of 30, people have spent most of their lives with
fairly high levels of human growth hormone (HGH). HGH is
responsible for growth during childhood -- and for the
repair and regeneration of human tissue throughout our
lives. By the time we reach the age of 30, our HGH levels
are only about 20 percent of their peak levels during
childhood, and after the age of 30, they continue to decline
at about 12 to 15 percent per decade, and often much more.
By the time most of us are 30 years old, our bodies no
longer produce enough HGH to repair all of the damage that
is occurring in our bodies. As our HGH levels continue to
decline, the damage that we call aging continues to
accelerate.
The decline in HGH is not the only cause of the
manifestations of aging. Even if our HGH levels remained at
the level of a 25 year-old, we would continue to experience
the effects of aging, but those effects would be greatly
reduced until we reached a very advanced age. HGH does not
affect the root cause of aging, as measured by maximum
lifespan, but it can certainly affect many of the
manifestations of aging.
By increasing the levels of HGH in our bodies, we can slow,
or even reverse, many of the manifestations of aging. It
must be done carefully, though, and under medical
supervision. Ideally, this HGH replacement should begin at
about the age of 30 years, but HGH replacement can be
beneficial at any age above 30. In fact, for older people,
HGH therapy can reverse the manifestations of aging by 5 to
15 years or more. There is no other single therapy currently
available that can have the impact on the aging body that
HGH can have.
What HGH therapy can do:
*Reduce excess body fat, especially abdominal fat. (The
reduction of abdominal fat is the single most profound
effect of HGH replacement in many people.)
*Increase muscle mass (and physical strength if combined
with moderate exercise).
*Reduce wrinkling of the skin and some other effects of skin
aging.
*Re-grow certain internal organs that have atrophied with
age.
*Increase bone density.
*Strengthen the immune system.
*Reverse cognitive decline.
*Stimulate production of the bone marrow cells that produce
red blood cells.
*Reduce the probability that you will spend the last years
of your life in a nursing home.
- HGH slows the
progression of cardiovascular disease, and reduces the risk
of death from cardiovascular disease, in individuals with
natural growth hormone levels that are below average for the
age of the individual. HGH can also slow the progression of
cardiovascular disease by improving one's cholesterol
profile. There is increasing evidence over the past year or
two that maintaining healthy growth hormone levels results
in a stronger heart. Individuals with low growth hormone
levels have an overall increased risk of death due to
cardiovascular disease. Low growth hormone levels cause a
particularly large increase in the risk of stroke as
compared with individuals receiving growth hormone
replacement.
What HGH cannot do:
*It cannot eliminate the effects of oxidation damage,
although it may alleviate some of it.
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*HGH
cannot eliminate the effects of the reduction of other
hormones. In fact, a deficiency of certain other hormones
will decrease the beneficial effects of HGH.
*It cannot significantly reverse the damage to human
proteins caused by glucose, although it may reverse a little
of this damage.
*Although it helps skin to look younger, it cannot eliminate
all of the damage cause by sunlight and other ultraviolet
sources.
*It cannot increase maximum lifespan. For many people with
HGH or IGF-1 genetic defects, however, it can significantly
extend life expectancy.
HGH is produced by the
pituitary gland. The ability of the pituitary gland to produce
HGH declines very little with aging in most people. The decline
with aging occurs one step back from the actual secretion of HGH
by the pituitary. There are at least 3 substances which control
HGH secretion:
1. Growth hormone releasing hormone (GHRH), a substance
which declines with age. Increasing levels of GHRH causes the
pituitary to increase its output of HGH.
2. Growth hormone releasing peptide (GHRP) is another
substance that declines with age. Increasing levels of GHRP also
causes the pituitary to increase its output of HGH.
3. Somatostatin is a hormone that blocks the release of
HGH by the pituitary gland. The natural production of
somatostatin increases with age, and causes a corresponding
decrease in HGH production by the pituitary gland.
The production of HGH
is controlled by GHRH, GHRP, somatostatin, and other substances
in the body. The degree to which changes in the levels of each
of these substances is responsible for the decline in human
growth hormone varies from individual to individual, and is
somewhat gender-dependent.
The
only naturally-occuring growth hormone releasing peptide appears
to be ghrelin. Ghrelin is a hormone with many other effects,
including being a powerful appetite stimulant. When given to
laboratory animals, the animals eat huge amounts of food. The
weight gain induced by overeating completely overwhelms the fat
burning caused by the growth hormone release, and the animals
become obese. Pharmaceutical companies have produced synthetic
growth hormone releasing peptides, such as GHRP-6 and GHRP-2,
which stimulate HGH in humans, but do not increase appetite
significantly. These substances are not on the market yet, and
probably won't be for many years, if ever.
Pharmaceutical
companies have produced a number of other promising analogs of
ghrelin that restore the normal pulsatile release of growth
hormone without the other unwanted effects of ghrelin. These
substances include:
*Hexarelin
*MK-0677 (ibutamoren mesylate, developed by Merck)
*Capromorelin (developed by Pfizer)
*Tabimorelin
*SM-130686 (Sumitomo Pharmaceuticals)
*Ipamorelin (Novo Nordisk)
*NN703 (Novo Nordisk. Similar to ipamorelin, but more selective)
Many of the above
growth hormone releasing analogs of ghrelin are effective when
taken orally. None of them are on the market anywhere in the
world. Hexarelin is a peptide that is fairly easy to synthesize,
and it is sometimes used outside of legitimate medical channels.
The other substances on the above list are only available in
rare clinical trials.
The effects of HGH in the human body have been studied
intensively for decades, but the factors that affect HGH
production remain rather complex and mysterious. Part of the
reason for this is that the quantities of these substances
produced by the body are on the order of a milligram per day in
adults. Most people only produce about a teaspoonful of these
substances during their entire adult lives.
To make the HGH situation even more complex, HGH is normally
released in pulses or bursts throughout the day. There are
usually 10 to 20 surges of HGH release, with the largest release
occurring shortly after you fall asleep. Is there any advantage
to having HGH released in pulses? Or is this simply the body's
most efficient way of producing HGH? Nobody knows the answer to
this important question, although there seems to be some
evidence that the pulsatile release of HGH is important for
human health.
There are indications, however, that some of the ghrelin
analogs or the GHRH analogs may be superior to ordinary HGH
replacement. Ordinary HGH therapy does not increase insulin
sensitivity or decrease glucose levels, although it logically
should be expected to -- since it increases the level of IGF-1
(insulin-like growth factor number 1). IGF-1 decreases glucose
levels, so there is something about the continuous presence of
growth hormone that is offsetting this IGF-1 related decrease in
blood glucose. When youthful pulsatile release of growth
hormone is restored, often (most notably with Tesamorelin) the IGF-1
related decreasein blood glucose is seen in most people, as
would be expected. With some people, however, blood glucose
levels increase (at least in short-term studies).
There are three basic ways for increasing HGH:
- Taking a substance that increases the natural secretion
of HGH by the pituitary gland.
Using an injectable human growth hormone releasing hormone (GHRH).
- Using injectable human growth hormone.
With current technology and available substances, taking a
substance that increases the natural secretion of HGH generally
works best for those between the ages of roughly 30 to 45 years.
For most people over 45, injectable HGH is most effective --
and usually the only effective -- of the currently available
options (although sermorelin works for some people).
Tesamorelin looks very promising, but it is not known how widely
available it will become. But let's look at these three methods
in greater detail.
There are a number of substances that increase the natural
secretion of HGH. Some of them are amino acids. The
relationship of certain amino acids to growth hormone is complex
and varies greatly among
different individuals and among individuals of
different
ages. All absolute and universal statements made about this
subject are clearly false.
The most effective and economical way of causing this HGH
release for many people seems to be taking 2 grams of the amino
acid L-glutamine in the morning and taking 10 to 30 grams of the
amino acid L-arginine before bedtime. Both of these amino acids
must be taken on an empty stomach. Amino acids are generally not very
effective in people over the age of about 40 to 45. In fact,
for people over about the age of about 40 to 45, HGH increases
due to amino acids may only be barely measurable on laboratory
tests, and may have no real practical effect.
There has been only one scientific study showing that
L-glutamine causes HGH release, but there is a large body of
anecdotal evidence from non-traditional physicians and their
patients that L-glutamine is actually effective in most persons
under about age 45.
There is a large body of scientific study on the effects of
L-arginine on growth hormone release. In fact, the
administration of a large dose of L-arginine is a standard test
for the ability of the pituitary to release growth hormone.
(Another test using insulin is actually more effective, but it
is not accepted as the standard test by the U.S. Food and Drug
Administration.) Most scientists believe that L-arginine
promotes HGH release by inhibiting somatostatin, and this has
been demonstrated in at least one scientific study. L-arginine
has many other benefits in addition to being a growth hormone
releaser. See the chapter of this manual on Arginine for
additional information about using arginine as a growth hormone
releaser and for safety warnings about the use of arginine.
There are several problems with the use of arginine and other
amino acids as HGH releasers. Their effectiveness generally
diminishes with age, and with continued use. This has led some
people to the opinion that amino acids such as L-arginine are
weak or ineffective HGH releasers. This can be a dangerous
assumption. In some young people, L-arginine may actually
cause dangerously high levels of HGH release. Many young
people use L-arginine, but it should not be used by anyone until
at least 5 years after they have completed their long bone
growth (unless they are under close medical supervision).
In order for your body to naturally produce HGH, or to
produce HGH in response to certain amino acids, the following
things must NOT be
present:
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*Anti-cholinergic
medicines. This includes most medicines that make you
drowsy or dehydrated. The most common of these medicines are the
antihistamines that make you drowsy, including Benadryl (or
any other brand of diphenhydramine), Sominex, Nytol,
Tylenol-PM, and Zyrtec. (Claritin, Clarinex and Allegra
probably do not affect the HGH-releasing effect of amino
acids or natural HGH release.)
- *Alcohol, in any appreciable quantity, blunts the HGH-releasing
effect of amino acids and also suppresses natural HGH
release. An ounce or less of alcohol two or three hours
before taking a HGH releaser will have little effect on HGH
release, but using alcohol to get to sleep can dramatically
suppress your natural HGH release during sleep.
- *Eating protein or carbohydrate within 3 hours before
(or one hour after) taking an amino-acid HGH releaser will
significantly blunt the growth hormone release induced by
these amino acids.
Theratechnologies of Canada has developed what appears to be
a much better form of GHRH. Tesamorelin contains
the same number of amino acids (44) as natural growth
hormone releasing hormone, but it has been modified to last
longer in the human body. It avoids the short half-life
problem of sermorelin, and tesamorelin appears to be much
more effective. Tesamorelin was approved by the FDA in the
United States on November 10, 2010 for HIV-related fat
accumulation. Tesamorelin will be marketed in the United
States under the brand name Egrifta.
It is also currently under investigation for the reduction
of abdominal fat in otherwise normal adults with reduced
levels of growth hormone. Tesamorelin is also being
investigated for mild cognitive impairment.
Tesamorelin has produced many encouraging results, including
a small improvement in glucose levels in most patients.
Human growth hormone often produces a temporary increase in
insulin resistance when it is first started, especially in
high doses. Tesamorelin seems to have the opposite
effect. (However, under certain conditions, such as when
Tesamorelin is discontinued after a short period of time,
insulin resistance actually may get worse. This is not
surprising from what is known about lipolysis and insulin
resistance.)
Another long-acting analog of GHRH that looks very promising
is CJC-1295, but that product is at least 3 years away from
approval by government agencies. CJC-1295 maintains a much
longer half-life in the human body by partially binding to
albumin, an important protein that is prevalent in the human
bloodstream.
The one that has consistently worked the best is MK-0677 (ibutamoren
mesylate), which is very effective in restoring HGH release in
middle-aged and "normally-aging" elderly individuals to the
levels of much younger people. MK-0677 is an oral medicine
that restores the release of HGH in the pulsatile fashion
characteristic of HGH release in young people. Unfortunately,
it was not very effective in restoring HGH in the frail elderly,
which was its original target market. It appears, in fact,
that any form of HGH supplementation in the very frail elderly,
and in the critically-ill elderly, is actually quite harmful.
A considerable amount of research has been done on HGH
releasers by the pharmaceutical companies, and some very
promising substances have been developed, but there is no sign
that any of them will be on the market anytime soon. MK-0677 (ibutamoren
mesylate) is a substance, though, that seems to be too good to
go away. It still appears in successful clinical trials from
time to time. It recently completed another successful medical
test in normally aging adults, and has been undergoing clinical
trials for use in fibromyalgia.
In
a free market, MK-0677 (ibutamoren mesylate) would likely have
had a revolutionary impact on the health of most people over
40. In fact, it is possible that MK-0677 could have
revolutionized health care, prevented great human suffering, and
literally saved trillions of dollars in health care. Since a
free market in pharmaceuticals does not exist, MK-0677 will
probably remain a laboratory curiosity more many years.
Because of the news stories about athletes using excessive
doses of HGH, and of bodybuilders who use high doses of HGH in
an highly-experimental and
medically-uncontrolled environment, governments at the state and
federal levels in the U.S. have cracked down on many physicians
who write too many HGH prescriptions. This has scared many
physicians away from prescribing HGH for new patients and has
made finding a physician much more
difficult in the past four years. Lawmakers
at all levels of government in the United States believe that it
is more important to prevent athletes from cheating than it is
to keep ordinary adults healthy and out of nursing homes.
In addition, a number of
prominent and powerful individuals have attacked all forms of
anti-aging medicine in recent years. If you would like to see
the kind of future that these people want for you, visit a local
nursing home. A nursing home for the elderly contains the
largest concentration of severely growth-hormone-deficient
people that you will find anywhere.
Jerry Emanuelson
For the complete version of this
article you can visit
Future Science.
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