Multilevel marketing (MLM) is rampant in the fitness and health fields. It’s everywhere from promotion of supplements to exercise programs and more. While some of them are excellent as our reviews here reflect many if not most of them are dubious at best. That’s why it’s always a present surprise to find a study that affirms that an existing MLM product not only works but does so much more than the marketing people thought to mention.

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Last week the American Association of Clinical Endocrinologists released their revised guidelines for treatment of growth hormone deficiency. This revised document greatly updates the organization’s position on the use of Human Growth Hormone (hGH) and provides guidance for uses outside the traditional scope of rare metabolic diseases.

We’ve written about hGH before, and the recognition of hGH deficiency in patients that are outside the realm of strange endocrine tumors is a big step forward. Sadly, these guys aren’t the most compelling or bounciest writers. From time to time we have to cover the very dry scientific literature, this is one of those times. Let’s take a look at what the endocrinologists had to say.

There’s much pressure in the news lately on the “anti-aging industry” and doctors who “peddle growth hormone.” These accusations are not entirely without entirely without merit. In the above link you’ll note that Dr. Thomas Perls is at the center of the controversy. According to his bio, he is solidly part of the Ivory Tower of medical establishment. He’s also a highly recognized geriatrician and researcher. That does create certain biases on his part, though he is certainly an authority on aging. The problem is that he discounts legitimate growth hormone deficiency. He and his counterpart, S. Jay Olshansky, PhD, have written a commentary in this week’s Journal of the American Medical Association that paints all clinical use of hGH with a broad brush but ultimately issues the following somewhat loaded statement buried in the commentary:

Systematic reviews have found that hGH supplementation does not significantly increase muscle strength or aerobic exercise capacity in healthy individuals. Clinical evidence does support the therapeutic administration of hGH for children and adults with appropriate clinical indications. (unfortunately the full text isn’t available to the public)

JAMA has been a source of consternation for advocates of growth hormone therapies that are within the legitimate prescribing guidelines because of the kind of press coverage that JAMA commentaries receive, so much so that involved Universities pump the commentaries with press releases like this one. It’s hard for physicians practicing no matter how legitimately to overcome the media juggernaut that this creates.

I have specifically stated over and over that human growth hormone is not a panacea for all things that afflict the aging, though there is likely more legitimate growth hormone deficiency than is recognized by many physicians. Growth hormone replacement is a valid therapy when patients are deficient and requires regular monitoring often with repeated labs for patients that are on growth hormone. Any physician doing otherwise is doing so with at least a degree of wreckless abandon if not outright hazardous behavior.

Even the American Academy of Anti-Aging Medicine, a group that generates no small amount of controversy on their own, has taken a position of responsible management of growth hormone that does not involve unmonitored or unwarranted prescribing.

Why JAMA feels compelled to repeatedly come out and make blanket statements with commentaries like these that make it appear that there is no legitimate use for hGH to the casual reader is something that I have always been confused by. Are there doctors who prescribe illegitimately? Yes. Are there people who use hGH and other hormones for illegitimate or sporting uses? Yes. Are those people at risk for complications from their abuse? Yes. Can they get their drugs from non-US sources making at least some of the furor displaced? You bet, this guy did.

It’s long been thought that higher growth hormone(hGH) levels were associated with longer, higher quality lives as we age. Determining levels of hGH has always been the tough part. This paper in the Journal of Managed Care talks at length about what are the accepted mainstream medicine ways to diagnose hGH deficiency.

A quick read of the paper linked above shows that there are several tests to measure hGH levels and all of them are complicated. All of them take several hours. Basically, a substance is given to provoke the release of growth hormone from the pituitary gland. hGH levels are are drawn before the releasing agent is given and then at intervals over several hours. The reason this complicated approach is necessary is that hGH lasts for minutes after release so to accurately determine levels they have to be measure right after release. Clearly, this approach is complicated and inconvenient.

Anti-aging doctors have long been looking for a simpler way to measure and track hGH levels to make treatment with hGH more convenient. hGH causes a number of other hormones to be released in the body. One of these is insulin-like growth factor 1 (IGF-1). This compound is used as a proxy by many doctors to measure the levels of hGH. Low IGF-1 equals low hGH, or at least that’s the thinking. Unfortunately, this isn’t quite true.

Dutch researchers have announced some major findings. Tracking 376 otherwise healthy men between 73 and 94 years of age, they found that those with higher levels of hGH lived longer than those with lower levels of hGH. This was most significant in men at risk of cardiovascular problems. The study was simple: mortality versus hGH level. No looking into lean body mass. No looking at athletic performance. Just mortality.

The other piece of the study is that they used a new test for IGF-I that more accurately mirrors the effects of hGH on levels of this proxy hormone. Using this new study, the researchers found a much closer parallel to levels of the two hormones than available with traditional testing.

Hopefully the newer test will be available widely in the US soon.

An actual clinical trial of hGH (human growth hormone) was conducted and published here. The trial shows that patients with low IGF-I (the blood factor that we follow for growth hormone) and fibromyalgia saw improvement in their fibromyalgia pain with regular dosing of hGH. This shouldn’t come as a surprise since hGH and IGF-I both are involved in various enzyme cascades including those associated with inflammation. Also, for someone with low levels of hGH to do better when supplemented isn’t a surprise either.