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    Monday, December 23, 2002

    The Cure: Hormones are certainly getting a lot of attention lately. Almost as much attention as smallpox. First, The New York Times ran a story about the dangers of anabolic steroids (read: testosterone), then Andrew Sullivan reacted with accusations that the Times was on an anti-drug crusade. Then, Reason chimed in with a piece comparing their use by athletes to the use of batting helmets (?). Now, it's back to the Times with an article on hormones as a panacea for aging. At least the New York Times article is balanced. They present the views of steroid boosters and detractors. On the side of the proponents, there is this paper in The New England Journal of Medicine:

    ... he gave growth hormone to 12 elderly men for six months, reporting that they gained muscle and lost fat. Nine men who served as controls had no such body changes. In his paper, published on July 5, 1990, in The New England Journal of Medicine, Dr. Rudman concluded with this sentence: "The effects of six months of growth hormone on lean body mass and adipose-tissue mass were equivalent in magnitude to the changes incurred during 10 to 20 years of aging."

    The study was small and brief and only looked at lean body mass, fat mass, bone density, and skin thickness. It didn’t bother itself with adverse effects of the growth hormone, or with quantifying any functional gain from the changes in body mass.

    Then, as so often occurs with unproven therapies that cost a lot of money, there are the testimonials:

    Dr. Ron Livesey was fat, tired and out of shape. At 49, he felt that his best years were behind him.

    So one day seven years ago, on his way to a medical meeting, he stopped at a doctor's office in Palm Springs, Calif., for his first hormone injections.

    Early the next morning, Dr. Livesey was at the meeting, sitting in a darkened auditorium watching slides of technical data. To his surprise, he found himself alert, taking everything in. He continued the hormone treatments.


    Doctor Livesey now makes his living giving hormone treatments to others, at $1,000 a month, most likely paid for in cash -no insurance hassles, no Medicare hassles - since it’s unlikely to be covered by insurance.

    She was depressed, gaining weight, feeling old and fatigued. But, she said, when she began taking growth hormone, estrogen and progesterone, she noticed an immediate change in her mood and energy. It gave her the stamina and enthusiasm to start dieting and working out at a gym and she dropped 10 pounds. She said her libido returned, her hair grew, and even her bunions regressed so she could wear high heels again.

    Her bunions regressed? That’s extremely hard to believe. Bunions are bone deformities, usually caused by wearing tight-fitting shoes over a long period of time. The shoes press the big toes in toward the rest of the toes, and over time, the bones remold and the deformity becomes fixed. If anything, the regression of her bunions would make it harder to wear high heels since her foot would be wider at the toes. Sounds suspiciously like hype.

    On the other hand, the skeptics have studies like this, which included adverse effects, and objectively measured functional improvements:

    Dr. Papadakis set out to test growth hormone in 52 healthy men from 70 to 85. She designed the study so that the men did not know if they were taking the drug or a dummy medication.

    Reporting in 1996, she found that growth hormone slightly increased muscle mass and decreased body fat but, paradoxically, did not make the men stronger. People had claimed it improved their mental clarity, but she found no such effects; if anything, those taking growth hormone did slightly worse on memory tests. They also suffered swollen legs and feet and achy joints, making them so uncomfortable that a quarter taking growth hormone had their doses reduced during the study.

    Dr. Papadakis said her results were ignored by growth hormone enthusiasts. "They can't let go of the hypothesis because they like it," she said


    Then, there are the animal studies:

    "I agree that mice and rats are not people, but mice that don't make growth hormone live longer," Dr. Warner said. "Mice that overproduce growth hormone live shorter lives. The same principle applies in fruit flies and little worms called nematodes. It may be irrelevant, but it makes us wonder."

    In fact, people who overproduce growth hormone live shorter lives, too. The condition is called acromegaly. Left untreated, it results in diabetes, hypertension, heart disease, and colon polyps that can lead to colon cancer.

    As for testosterone, and other anabolic steroids they have their problems, too - especially when taken by growing adolescents. Excess testosterone closes the growth plates of bones prematurely, resulting in shorter stature. They suppress the growth of the testicles. Even adults can experience gonad shrinkage when they use them. They can cause hepatitis. In fact, Germany now compensates former East German athletes for the ill-health they’ve suffered as a consequence of forced anabolic steroid use under Communist rule.

    So, while the use of anabolic steroids and other hormones has its place in known deficiencies, and in some chronic wasting illnesses (like AIDS), it isn't a fountain of youth and strength.
     

    posted by Sydney on 12/23/2002 07:25:00 AM 0 comments

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