by decreasing the dose or in a few cases discontinuing the treatment. Significant side effects are rarely seen in clinical practice. Also, when the same total dose is divided daily over a week-long period (instead of administering 3 days a week) side effects are diminished or absent. If side effects do occur, it has been clinically demonstrated that they disappear with cessation of treatment.
The Clinical Anti-Aging Setting
Most traditional endocrinologists have had no intense training in treatment of testosterone and growth hormone deficiencies. They generally have excellent training in the treatment of diabetes, but lack of interest and expertise in how to treat testosterone and adult growth hormone deficiencies and some other hormone deficiencies that may accelerate aging. Because of this lack of knowledge, many of them have rejected these treatments and confused them with the improper use at excessive doses by sports athletes searching to improve their performance. The A4M, its numerous worldwide affiliated scientific and medical societies, and befriended organizations, do not approve the improper use of these substance in sports, but do point to the right of every patient who is suffering from one of these deficiencies to get relief from their complaints by the adequate hormone treatment.
Critics of the anti-aging medical science do acknowledge that HGH prescribing is perfectly legal in connection with (1) "treatment of a disease" or (2) an "other recognized medical condition" that has been authorized by FDA. At no time has Congress evinced any intent to restrict ethical physicians from prescribing HGH to mature or elderly adults for medical reasons within their sound judgment. Nothing in the statute dictates to physicians how to diagnose the indications for diseases which may be treated by HGH. Any inference that the statute was intended to prohibit physicians from prescribing HGH for hormone replacement purposes in GH-deficient adults is, in A4M's view, misplaced.
The therapeutic value of HGH was validated by a study83 conducted in Stockholm, Sweden. Data concerning visits to the doctor, number of days in hospital, and amount of sick leave were obtained from patients included in KIMS (Pharmacia International Metabolic Database), a large pharmacoepidemiological survey of hypopituitary adults with GHD, for 6 months before GH treatment and for 6-12 months after the start of treatment. Assistance required with normal daily activities was recorded at baseline and after 12 months of GH therapy. Quality of life (QoL) (assessed using a disease-specific questionnaire, QoL-Assessment of GHD in Adults) and satisfaction with physical activity during leisure time were also assessed. For the total group (n = 304), visits to the doctor, number of days in hospital, and amount of sick leave decreased significantly (P < 0.05) after 12 months of GH therapy. Patients also needed less assistance with daily activities, although this was significant (P < 0.01) only for the men. QoL improved after 12 months of GH treatment (P < 0.001), and both the amount of physical activity and the patients' satisfaction with their level of physical activity improved after 12 months (P < 0.001). In conclusion, GH replacement therapy, in previously untreated adults with GHD, produces significant decreases in the use of healthcare resources, which are correlated with improvements in QoL.
CONCLUDING REMARKS
Repeatedly since the genesis of the anti-aging medical movement in 1991, the media has sought to demonize the use of hormone replacement therapies in healthy but deficient adults. Relying on partisan – and often misinformed – critics, the media fuel and encourage hysteria among the public, which thereby results in a climate of misguided federal and state actions that seek to restrict these safe, proven, life-enhancing therapies.
Attempts to criminalize the practice of medicine where variations to State Board-favored traditional care threaten the continued advancement of innovative medicine. In these situations, there are no injured patients and no victims yet criminal proceedings are waged against progressive health professionals. State officials abuse their authority in recasting minor administrative issues as criminal acts; this is unjust and may be considered as criminal abuse of their publicly elected positions. Sensationalization by media confuses the public, with false allegations suggesting that HRT in clinically documented cases of adult deficiency syndromes equates to the abuse of performance-enhancing anabolic steroids.
The American Academy of Anti-Aging Medicine (A4M) is resolute in defending the rights of the patient working in conjunction with their physician in choosing any and all justifiable therapies, drugs and interventions which can be shown to improve either the quality or duration of the human lifespan or the form and function of the individual's physiology in order to achieve greater vitality and health at every age. It is in fact the physician's duty to act as an advocate for the patient's right to obtain the full lawful measure of scientific medical therapeutics necessary for optimum health and personal freedom of choice in healthcare.
The observation by George Orwell (1903-1950), English novelist, in the prognostic classic novel 1984, that: “War is peace. Freedom is slavery. Ignorance is strength” predicts that In a world where lies are supported by the establishment, to stand firm for truth is a dangerous and revolutionary action. Physicians of conscience and good will must unite to take back the future – or all freedoms, including freedom of choice in healthcare – will be lost forever.
APPENDIX A. LITERATURE REVIEW
This section presents a selection of published peer-reviewed studies that document the life-enhancing and/or life extending benefits of HRT in aging adults. For further references, see the A4M’s White Paper “Guidance for Physicians on Hormone Replacement Therapy”; A4M, May 2007; available at: http://www.worldhealth.net/white-papers-official-statements/
HGH
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Abs R. Update on the diagnosis of GH deficiency in adults. Eur J Endocrinol. 2003 Apr; 148 Suppl 2:S3-8.
Adamopoulos S et al. Growth hormone administration reduces circulating proinflammatory cytokines and soluble Fas/soluble Fas ligand system in patients with chronic heart failure secondary to idiopathic dilated cardiomyopathy. Am Heart J 2002 Aug;144(2):359-64
Aimaretti G et al. Diagnostic reliability of a single IGF-I measurement in 237 adults with total anterior hypopituitarism and severe GH deficiency.Clin Endocrinol (Oxf). 2003 Jul; 59(1):56-61
Albert SG et al. Low-dose recombinant human growth hormone as adjuvant therapy to lifestyle modifications in the management of obesity.Clin Endocrinol Metab. 2004 Feb; 89(2):695-701.
Aleman et al. Insulin-Like Growth Factor-I and Cognitive Function in Healthy Older Men J Clin Endocrinol Metab 84:471–475, 1999
Andreassen et al. Concentrations of the acute phase reactants high-sensitive C-reactive protein and YKL-40 and of interleukin-6 before and after treatment in patients with acromegaly and growth hormone deficiency. Clin Endocrinol (Oxf). 2007 Aug 28
Baffa R et al. Low serum insulin-like growth factor 1 (IGF-1): a significant association with prostate cancer. Tech Urol 2000 Sep; 6(3):236-239
Bartke A et al. Consequences of growth hormone (GH) overexpression and GH resistance. Neuropeptides 2002 Apr;36(2-3):201
Baum HB et al. Effects of physiologic growth hormone therapy on bone density and body composition in patients with adult-onset growth hormone deficiency. A randomized, placebo-controlled trial. Ann Intern Med 1996 Dec 1; 125(11):883-90
Bengtsson BA, Edén S, Lönn L, et al. Treatment of adults with growth hormone (GH) deficiency with recombinant
