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Questions About Steroids
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An intelligent discussion of Anabolic Steroids. Discussion of anything and everything that deals with Anabolic Enhancement.

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Default GH - (ed verses eod)

posted by BMF2 on Qualitymuscle


GH - (ed verses eod)


A very thorough well controlled 4 year study published on
The Journal of Clinical Endocrinology & Metabolism Vol. 87, No.8 3573-3577
clearly shows every other day (EOD)HGH injections to be much more beneficial in
the long run to everyday injections. Everyday injections seems to drastically lower
your body's sensitivity to it's own GH secretion. The study included children with idiopathic
short stature, but can be ever casting on us, normal non-deficient hGH individuals who
may use hGH periodically for bodybuilding, sports and health purposes.

The 38 children were divided into 2 groups:
Group I received daily hGH injections.
Group II received alternate day hGH injections.

It is important to note that the total weekly dosage of hGH
was the same for both groups.

Both groups received the hGH therapy contiguously for 2 years.
Their natural growth was followed for an additional 2 years after hGH therapy ended.
They were all measured at 3-month intervals during the 4 years period (2 years
with hGH therapy and 2 years after). Their Serum GH was measured by double antibody RIA kit.

During hGH therapy, both groups accelerated their growth substantially.
Group I receiving the daily hGH injections first & second year velocity was 3.4 and 2.3 SD
Group II receiving the alternate hGH inj. had 3.0 and 2.0 SD for first and second year respectively.

Over the initial 6 months after withdrawal of therapy, growth velocity decelerated to a low nadir -3.9 SD score
for the daily therapy group, whereas it decelerated in the alternate day group to only -0.2 SD score.

During the 2 years off therapy, the later group (taking EOD injections)
maintained growth rates of -0.2 to -1.2 SD score, which is similar to their SD score prior to the hGH treatment.
The daily group also recovered but very slowly, on the fourth semiannual evaluation off therapy.
The cumulative 4-year growth velocity (2yrs on and 2 yrs off therapy) of the alternate day group was greater
than that of the daily therapy group (mean, 0.9 vs. 0.3 SD score).

At the end of the 4-yr therapy period, the adult height prediction of the alternate day group was greater
than that of the daily group by a mea of 6.5cm (that's over 2.5" in height, quite a lot of difference)

In even simpler English, to translate what it may mean to us is that using hGH everyday will only
negligibly give better short-term results. Yet using alternate day hGH will give radically better long-term
results and much better recovery. As the body may get back to homeostasis much faster.

Remember the two groups got the same weekly total hGH dosage,
so your every other day hGH injections would be twice as if you used
it every day.

The researchers said, the dose was of less impotency than the schedule of the injections.
Daily hGH therapy for 3 years caused subnormal growth persisting for 1.5 years (very bad)

It may be that the problem is not enough hGH or IGF-1 secretion but rather
the body's decreased sensitivity to it. The interesting part is that the serum GH levels
and serum IGF-I and IGF-binding protein remained unaffected or relatively mutely affected.
Even your body's endogenous pulsatile secretion of GH resumes within just days
even after long-term hGH therapy.

The researchers hypothesis is that the tolerance may be in the "GH signal transduction in
selective target organs in response to the disappearance of the unique pulsatile
pattern of serum GH during GH therapy". You see, hGH taken via sc injections
do not imitate the your body's own GH secretion.
"Indeed, daily sc administration of GH results in an unphysiological serum GH profile, with peak
levels at 4 h and a slow decline over the course of the following 1224 h. This pattern can be
regarded as continuous administration, rather than the physiological GH pulses,
with a frequency of about eight per day."
"Assuming that the withdrawal syndrome is related to tolerance that might have developed toward
hGH or IGF-I, we tried to prevent it by alternate day treatment. Moreover, hGH doses used in
therapy often stimulate IGF-I to supraphysiological serum levels, suggesting that target
tissues IGF-I may also be higher than normal. The mechanism seems, therefore, to rest
with hGH and IGF-I action at their target tissues. We now show that alternate day therapy
with hGH in children with an intact GH-IGF-I axis prevents the withdrawal syndrome"

Researchers mark the analogy to another endocrine tolerance and withdrawal syndrome:
"alternate day therapy with glucocoricoids prevents tolerance to that hormone to a substantial degree,
"Interestingly, glucocoricoids withdrawal syndrome can also occur while the
hypothalamic-pituitary-adrenal axis is intact (, indicating that tolerance to glucocoricoids has developed
at the target organ level (9). "

An example of a good safe protocol to follow in my opinion could be

hGH taken for 4 months (16 weeks) or more at 8IU every other day,
split to 4IU three hours after waking up (say 11:00am)
and another 4IU taken 4 hours later (say 3:00pm).
This approach is quite conservative and may be optimal.

Obviously, you may extend past 4months, and take more IUs per day.
This approach goes with 8IU EOD, so it is equivalent to folks that would
otherwise go with 4IU ED, which is what most do.

There is some controversy as to how many of these IUs the body
can utilize at once

Obviously, there are lot of studies, some better conducted, some less.
Lots of opinions and doctrines in endocrinology, bodybuilding etc..
So you should make your own decision, I guess old individuals on
hGH for life would not mind, as no rebound would affect them. Professional
bodybuilders probably wouldn't mind as well.

I would rather follow a protocol like this. For most part due to the
nasty rebound that I could get after withdrawing from long-term ED hGH treatment.
Nothing worse then look awesome, stop hGH then after several months having:
Low body sensitivity to your own body's GH.
Slow recovery
Decline in resting cardiac output
Increase fat mass
Decrease in metabolic rate
Negative nitrogen balance, phosphorus, sodium and potassium.

Again, I said "could" not "would", because this study cannot absolutely manifest
our use of hGH. Moreso, we are not children, we are not idiopathic hGH deficient
and not aGHD. But since the weekly dosages do remain the same as well as the
duration of the hGH usage. Just changing to the EOD protocol from the well
hyped everyday inj protocol is worth in my honest opinion. It seems statistically
a better bet, with more chance to win, than loose as opposed to the ED protocol.

I just tried to summarize the findings of the study, which was by the way,
a pleasure to read as the study is well written and was prepared by
Dr Hochberg, MD, a renowned well respected figure in endocrinology.

You can read the full article with all the graphs and details here:
http://jcem.endojournals.org/cgi/content/full/87/8/3573
With references to 23 studies.

Here are some interesting graphs:

http://jcem.endojournals.org/conten...g0828721002.gif
This graph shows the difference growth velocity difference pre GH treatment, and at the
end of the trial, 4 years after (2 years after withdrawal from GH treatment)
The dark bar marks the alternate day injections. The light bar marks the every day injections,
note that the every day injections group saw worse long-term (4 yrs) results as opposed
to the alternate day group.

http://jcem.endojournals.org/conten...g0828721003.gif
This graph shows the annual bone age advancement in children treated with
alternate GH injections and daily injections.
The light bar marks the every day injections, the dark bar the alternate day injections.
In first two years (the years they were taking hGH), take a look at the relatively
small advantage ED injections gave over the EOD inj, as opposed to the 2 years
after withdrawal of the treatment.
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Default

I was doing 4iu ed and had to back off to 2 iu ed because of joint and water problems. His suggestion in my case would be 4iu eod. hmm, will have to see if there is any other supporting data.

jb
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Default

Quote:
Originally Posted by jboldman
I was doing 4iu ed and had to back off to 2 iu ed because of joint and water problems. His suggestion in my case would be 4iu eod. hmm, will have to see if there is any other supporting data.

jb


I seen a similiar read awhile back based on a shorter study, I'll see if I can locate it.
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I swear by this method now, I remember when the study was first posted hear so I changed from 3iu's ED to 6iu's EOD and after a few weeks I dropped all the excess water and no longer got any of limb numbness.
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Professional sprinters use 2.5iu EOD.
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quote:
Professional sprinters use 2.5iu EOD.


mathematitian bastard mode /on:

used at least untill 2000 when someone gave uo the program.
now its most likely different with igf and ngf and stuff...

and they used it synergisticaly with insulin after morning weights to be able to pull off speed at the evening
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Quote:
Originally Posted by Wicked Design
I swear by this method now, I remember when the study was first posted hear so I changed from 3iu's ED to 6iu's EOD and after a few weeks I dropped all the excess water and no longer got any of limb numbness.
Interesting. Anyone else experiment with this protocol, and what were the results - mainly in terms of body composition?

I wonder if a lower dosage eod would be just as efficient, though - such as 6IUs eod instead of 4IUs ed.
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Lot of BB's I know use eod GH, they say it works better, and I am sure they have not read that study.
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But better in terms of what? This study was on growth rate in children, didn't say anything about fat loss.

I'd be interested in hearing results and dosages in terms of fat loss, where 3-4IUs per day (so in this case 6-8IUs eod) seems to give the best cost:benefit ratio.
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I found these studies supporting the eod dosing:

J Endocrinol Invest. 2003 May;26(5):420-8.

Three weekly injections (TWI) of low-dose growth hormone (GH) restore low normal circulating IGF-I concentrations and reverse cardiac abnormalities associated with adult onset GH deficiency (GHD).

Pincelli AI, Bragato R, Scacchi M, Branzi G, Osculati G, Viarengo R, Leonetti G, Cavagnini F.

University of Milan, IRCCS San Luca Hospital, Italian Auxologic Institute, Milan, Italy.

GH replacement therapy given 3 times weekly (TWI) and adjusted to allow serum IGF-I concentrations in the mid-normal range for sex and age has been shown to be as effective as the daily regimen in improving lipid profile, body composition, bone mass and turnover in adult GH deficient (GHD) patients. Only one study has investigated so far the short-term (6 months) effect of a fixed weight-based TWI dosing schedule on heart structure and function in childhood onset (CO) GHD patients, whereas such a schedule in adult onset (AO) GHD patients has not been studied as yet. Aim of this study was to investigate whether a 1-yr low-dose titrated TWI GH-replacement regimen aimed at achieving and maintaining IGF-I levels within the low normal limits for age and sex is able to affect cardiovascular and heart parameters in a group of AO GHD patients. Eight adult patients (4 women and 4 men, age 35.8 +/- 3.37 yr, body mass index, BMI, 28.7 +/- 2.62 kg/m2) with AO GHD were included in the study, along with 10 healthy subjects, matched for age, sex, BMI and physical activity (6 women and 4 men, age 35.2 +/- 4.05 yr, BMI 28.4 +/- 2.34 kg/m2). M- and B- mode ecocardiography and pulsed doppler examination of transmitral flow were performed in GHD patients at baseline and after 3 and 12 months of GH therapy (mean GH dose 6.7 +/- 0.8 microg/kg/day given thrice a week), while normal subjects were studied once. Treatment with GH for 1 yr induced a significant increase in left ventricular (LV) diastolic and systolic volumes (+11.1 and +16.5%, respectively). Systolic LV posterior wall thickness and LV mass were increased (+10.2 and +7.7%, respectively) by GH administration. Systemic vascular resistance was significantly decreased by 1-yr GH therapy (-13.8% after 1 yr), while stroke volume, cardiac output and cardiac index were increased (+9.4, +11.6 and + 11.9%, respectively). LV end-systolic stress was decreased at the end of GH therapy (-11.2%). E and A wave, significantly reduced at baseline, were increased by 1 yr of GH therapy (+23.3% and +28.1%, respectively); likewise, the abnormally high E peak deceleration time was partially reversed by GH administration (-10.7%). Our study, though conducted in a small sample size, demonstrates that a TWI GH treatment schedule is able to reverse the cardiovascular abnormalities in AO GHD patients and to improve body composition and lipid profile. The maintenance of circulating IGF-I concentrations within the low normal range allows to avoid most of the side-effects reported with higher GH doses while being cost-effective and improving the patient's compliance.




J Clin Endocrinol Metab. 2000 Oct;85(10):3720-5.

Recombinant growth hormone (GH) therapy in GH-deficient adults: a long-term controlled study on daily versus thrice weekly injections.

Amato G, Mazziotti G, Di Somma C, Lalli E, De Felice G, Conte M, Rotondi M, Pietrosante M, Lombardi G, Bellastella A, Carella C, Colao A.

Institute of Endocrinology, Seconda Universita of Naples, Italy. giovanni.amato@unina2.it

Currently, replacement recombinant GH (rGH) therapy in GH-deficient (GHD) adults is performed in daily injections. This modality of treatment is not complied with by the totality of GHD patients, who are supposed to receive life-long replacement. The aim of our study was to compare daily vs. thrice weekly (TIW) rGH injection effects on lipid profile, body composition, bone metabolism, and bone density in 34 GHD patients (13 women and 21 men; median age, 39 yr; range, 30-55 yr) randomly assigned to different therapeutic regimens. Group A included 18 patients receiving daily rGH injections, and group B included 16 patients receiving TIW injections of rGH. The starting dose of rGH was 10 microg/kg x day in both groups. Subsequently, the dose was adjusted to maintain serum insulin-like growth factor I (IGF-I) concentrations in the normal age-adjusted range. IGF-I levels were assessed before and after 1, 3, 6, and 12 months of rGH treatment, and lipid profile, body composition, bone metabolism, and bone density were evaluated before and after 6 and 12 months of treatment. Thirty-four healthy subjects served as controls. In the basal condition, lipid profile, body composition, bone metabolism, and bone density were significantly different in patients compared to controls. Conversely, patients included in groups A and B had similar serum IGF-I levels, lipid profile, body composition, bone metabolism, and bone density. After 3 months of rGH treatment, IGF-I levels were normalized in 15 of 18 patients (83.3%) in group A and in 7 of 16 patients (43.7%) in group B (chi2 = 4.21; P = 0.04). At this time point, serum IGF-I levels in patients in group A (202+/-57.5 microg/L) were significantly higher than those in patients in group B (155+/-45.1 microg/L; P = 0.001). After 6 months of therapy, serum IGF-I levels were normalized in all patients and were similar in both groups (223+/-35.2 vs. 212+/-41.4 microg/L, A vs. B, respectively). IGF-I levels remained normal until the 12-month follow-up. After 6 months of rGH replacement, total cholesterol, low density lipoprotein cholesterol, triglycerides, bioelectrical impedance, and body fat mass were significantly reduced, whereas high density lipoprotein cholesterol levels and lean body mass were significantly increased in both groups of patients, without any difference between them. No further change in lipid profile and body composition was observed after 12 months of treatment. Serum bone GLA protein and procollagen III levels were significantly increased after 6 months, and a downward trend was observed after 12 months of rGH replacement. However, a slight, but significant, increase in bone mineral density was observed in both groups only after 12 months (P = 0.0001). All patients in group B had good compliance to the TIW treatment, whereas 5 patients in group A had poor compliance to the treatment (chi2 = 3.2; P = 0.07). In conclusion, our randomized, prospective, and controlled study confirmed that rGH therapy with TIW injection regimen is effective in normalizing IGF-I levels and improving lipid profile, body composition, bone metabolism, and bone density. It also demonstrated that this efficacy is comparable to that observed in patients treated with daily rhGH therapy, with few side-effects and good compliance.



There's also these, where many studies use eod injections of GH: http://www.ncbi.nlm.nih.gov/entrez/...=ExternalSearch
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