Growth Hormone in the Press Again

The past couple of weeks have seen a wave of articles on the "anti-aging" marketplace, with an emphasis on the use, abuse, risks and culture of human growth hormone. Frankly, it'd be nice to see it all go away in favor of a focus on the future of longevity research - but this is what you get when you have a geared-up anti-aging delivery infrastructure and no real, actual, working anti-aging medicine to be delivered.

The A4Ms of the world will no doubt be sterling allies once effective healthy life extension therapies have been developed - working technology will chase out snake oil, but that will be way past the point at which sterling allies will be needed. The real fight is here and now, in building the infrastructure and support for research and development.

But back to the growth hormone and an article typical of those of the past weeks. From where I stand, growth hormone therapies appear to be a legitimate old-school style therapy for some age-related and other conditions. As for most old-school medicine, it's a roll of the dice as to whether you'll benefit or suffer - no-one can say for sure what's really going on under the hood, or how your biochemistry will take it. Use is an educated risk assessment that people have to make for themselves - and caveat emptor is a very good rule of thumb when dealing with anything associated with the "anti-aging" marketplace. If you had to stick a pin in the map for anti-aging shyster central, human growth hormone would be it - a pity that the legitimate uses have been buried beneath a cartload of marketing.

Still, in a free society, you could stick whatever you liked into your body provided you were prepared to foot the bill for the consequences. Sadly, we do not live in a free society; insofar as medicine goes, we live in a highly regulated, paternalistic, socialist enclave. A commons has been created, and every potential tragedy leads to calls for further control and expansion rather than the much more sensible abolition of the commons. From the article:

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.

Olshansky and others have been sparring with the "anti-aging" marketplace for a while now, and over quite justifiable complaints, but I see resorting to "it's illegal" as lowering the bar for everyone. If you're going to attack, attack on the science - there's certainly enough to be going with there. FDA-defined legality, and in fact any defined legality of substances, is the tip of a large, cruel joke that wouldn't exist in a culture worth living in. Supporting these policies damages medical progress - and thus health and longevity - for everyone.

In summary: growth hormone therapies for general use are a big red lever on the slot machine, calorie restriction seems a far better bet, shysters are everywhere, and this is all a damaging distraction from the development of far better options for the future - but if you own the slot machine and are prepared to pay for the consequences, the decision to pull or wait, listen to shysters or not, should be all yours.

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We did address the science in our JAMA article, and since the publication of our 2005 article the science further supports our position.

Posted by: S. Jay Olshansky at December 20th, 2007 8:34 PM

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