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.