Human Growth Hormone (HGH)
I wrote this article in 2007 since when I have tried several patients on hGH. I have not been impressed by the results, so no longer recommend this treatment. My guess is that low levels of hGH is a symptom of CFS and correcting the underlying caues of CFS will result in hGH levels returning to normal. I am often asked about hGH - so the information is as follows:
We know that patients with chronic fatigue syndrome have a generalised suppression of the hypothalamic pituitary adrenal axis and that many of them can be improved by taking physiological doses of hormones such as thyroxine, DHEA, cortisol and melatonin. Another important pituitary hormone is hGH. This idea has already been used by Dr Teitelbaum, a doctor in America who also specialises in Environmental Medicine, to good effect. He uses human growth hormone in the treatment of CFS to good effect, but it is very expensive.
What is hGH?
hGH is the most abundant hormone produced by the pituitary gland and is the most important anti-ageing hormone. Levels are at their highest during teenage years, then they drop to about a third of this level during one's twenties and slowly decline thereon with time. hGH is converted in the liver to insulin-like growth factor 1 (IGF-1) known as somatomedin and this promotes glucose transfer through cell membranes as a source of fuel for cells. Declining levels of the growth hormone are thought to be responsible for many of the symptoms of ageing such as wrinkles, grey hair, decreased energy, increased body fat, cardio-vascular disease, osteoporosis and so on. Metabolic effects of growth hormone deficiency include less muscle and more fat, poor muscle strength and stamina, osteoporosis, hypoglycaemia, slow metabolic rate, poor conversion of T4 to T3, thin skin, poor heart function, poor kidney function, reduced sweating, depression and foggy brain. Obviously, many of these symptoms occur in chronic fatigue syndrome.
There are some lifestyle changes which have been well recognised to improve production of hGH. The first of these is sleep. Most secretion of hGH occurs during the hours of sleep before midnight. This may explain the old wives' tale that one hour of sleep before midnight is worth two hours after. It squares with the fact that many CFSs are owls rather than larks.
The second factor which affects hGH production is diet. Insulin blocks hGH production, so anything that can be done to keep insulin levels low will be very helpful. Again, this may explain why the low carbohydrate, high protein, high fat Stone Age Diet benefits so many of my CFS sufferers. In fact, more often I now prescribe the ketogenic diet - please see Ketogenic diet - the practical details and My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds.
Further points about diet are that the total amount of food eaten is critical. Broadly speaking, people eating restricted diets live longer than people eating food ad lib. This has also been well proven in studies on rats. What this means in practical reality is that we should be eating small amounts of the best quality food of low GI index that we can find. The third aspect of eating is that food after 6pm inhibits hGH production so perhaps the Chinese proverb you should breakfast like an emperor, lunch like a king and supper like a pauper has a scientific founding! So breakfast should be a protein and fat meal such as bacon and eggs, lunch should be protein and vegetables or salad, i.e. meat, fish, eggs, green vegetables, salad and salad dressing, nuts and seeds should be one's main snack and the evening meal should be a light carbohydrate meal with vegetables, salad, root vegetables, pulses, fruit and so on.
Micronutrients are essential in the production of hGH. Deficiencies of calcium, magnesium, potassium, zinc, chromium and vanadium can all inhibit production of hGH. These minerals are all present in adequate amounts in my Mineral Mix (except vanadium, which is not permitted).
Finally, exercise stimulates production of hGH, but this has to be done with great care in CFS because this is what makes sufferers ill. However, the ideal time to exercise is first thing in the morning on rising when one should do whatever is possible without causing muscle weakness or delayed fatigue. Interestingly the best exercise for optimal hGH production is weight training. Once a week one should go to one's maximal lift capacity - the maximum amount of weight that can be lifted once on one occasion to optimise results. Again, this must be done with great care in CFS.
The idea behind using hGH
The rationale for trying this was based on a clinical paper produced in July 1990 by Dr Daniel Rudman. He was using it to investigate its potential as an anti-ageing substance and this study showed major improvements in lean body mass (8.8%), reduction in adipose tissue (14.4%), increase in skin thickness (7.1%) as well as improved energy levels, restoration of thinning hair and hair colour, improvements in lipid profiles, hypertension, cardiac output, liver function, immune function, sexual function and sleep patterns. In his paper he stated that these patients became approximately 15 years younger biologically within three months both clinically and seriologically.
Further work showed that the pituitary gland normally produces youthful levels of human growth hormone until extreme old age, but it is sequested within the confines of the pituitary gland by the action of hypothalamic hormones. That is to say the hormone is present, but for some reason is not being released. There has since been a discovery that certain nutrients, called secretogogues, which contain all natural ingredients can do everything that human growth hormone injections can do at a fraction of the cost by stimulating the release of these natural hormones. It is actually a mixture of certain amino acids combined with saccharrides (stevia), which regulate blood sugar and insulin and unblock receptor sites for releasing hGH, which presumably have become blocked by poor diet and environmental toxins. The pharmacologist John Jameson further discovered that carbonation of the nutrients and the use of chaperone molecules enhance their delivery and he has compounded this into a product called Symbiotropin. I wonder if this combination could be produced by a high protein diet (amino acids), magnesium carbonate, sleep and detoxing!
Secretogogues - hGH mimics
The most attractive part of secretogogue treatment is that the clinical improvement is caused by the patient's own growth hormone. This makes this treatment extremely safe with no potential for overdosing.
Secretogogues have not only been used for anti-ageing and in chronic fatigue syndrome, but they also have profound effects on cardiac disease, diabetes and neuro-degenerative conditions.
Dosage and treatment
The dose of Symbiotropin is two tablets taken at night, three hours after an evening meal, it should be taken in a fizzy drink (the tablets are effervescent). The idea is not to exhaust the pituitary gland or get tachyphylaxis and so the treatment is not given continuously. The suggested regime is five days in every seven (i.e. take it on Monday, Tuesday, Wednesday, Thursday and Friday, but do not take it on Saturday or Sunday), then take it for two months in every three.
I am trying Symbiotropin on some of my CFS patients (but I have to say without much succes!) and the cost is approximately £30 for 40 tablets, so three months supply costs £60. I do not supply this - buy on-line and shop around!
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