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hGH, Test and body pain

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guijr
(@guijr)
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This brand new article reveals that the administration of HGH alone may lead do bodily pain in older guys. Do you think it does really happen in real-world?

Giannoulis MG, Sonksen PH, Umpleby M, Breen L, Pentecost C, Whyte M, McMillan CV, Bradley C, Martin FC. The Effects of Growth Hormone and/or Testosterone in Healthy Elderly Men: A Randomized Controlled Trial. J Clin Endocrinol Metab. 2005 Dec 6; [Epub ahead of print].

ABSTRACT

Context: Declines of growth hormone (GH) and testosterone (Te) secretion may contribute to the detrimental aging changes of elderly men. Objective: To assess the effects of near physiological GH with/without Te administration on lean body mass (LBM), fat body mass (FBM), mid-thigh muscle cross-section area, muscle strength, aerobic capacity (VO2max), condition-specific quality of life (A-RHDQoL) and generic health status (SF-36) of older men. Design, settings, and participants: A six months randomized double blind, placebo controlled trial in eighty healthy community dwelling older men (age, 65-80 yr). Interventions: Participants were randomized to receive either (i) placebo GH or placebo Te (Pl), (ii) recombinant human GH (rhGH) and placebo Te (GH), (iii) Te and placebo rhGH (Te) or (iv) rhGH and Te (GHTe). GH doses were titrated over 8 weeks to produce IGF-I levels in the upper half of the age-specific reference range. Fixed dose Te (5 mg) was given by transdermal patches. Results: LBM increased with GHTe (P = 0.008) and with GH (P = 0.004), compared with placebo. FBM decreased with GHTe only (P = 0.02). Mid-thigh muscle (P = 0.006) and VO2max (P < 0.001) increased only after GHTe. Muscle strength changes were variable, one of six measures significantly increasing with GHTe. Significant treatment-group-by-time interactions indicated an improved A-RHDQoL score (P = 0.007) in the GH and GHTe groups. SF-36. Bodily Pain increased with GH alone (P = 0.003). There were no major adverse effects. Conclusion: Co-administration of low dose GH with Te resulted in beneficial changes being observed more often than with either GH or Te alone.

"The medals don't mean anything and the glory doesn't last. It's all about your happiness. The rewards are going to come, but my happiness is just loving the sport and having fun performing" ~ Jackie Joyner Kersee.


   
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jboldman
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i wonder what kind of pain, joint pain?

jb


   
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guijr
(@guijr)
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Posted by: jboldman
i wonder what kind of pain, joint pain? jb.


It was not specified in the article. I sent an e-mail to Dr. Martin asking about it, but no word from him yet. On the other hand, there are several articles linking hGH use and body pain: arthralgias and myalgias (localized or generalized), and only one that reported no side effects of joint pain due to growth hormone use, as we can read below:

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Engelson ES, Glesby MJ, Mendez D, Albu JB, Wang J, Heymsfield SB, Kotler DP. Effect of recombinant human growth hormone in the treatment of visceral fat accumulation in HIV infection. J Acquir Immune Defic Syndr. 2002;30(4):379-91.

ABSTRACT

HIV-associated lipodystrophy often includes excess accumulation of visceral fat. Recombinant human growth hormone (rhGH) is a potential treatment for the excess visceral fat. Prospective, open-label trials of 24 weeks of rhGH 6 mg/d and 24 weeks of 4 mg every other day were conducted with an intervening washout period of 12 weeks. Thirty HIV-positive participants (26 men and 4 women) with visceral adiposity were enrolled. The main outcome measure was change in visceral adipose tissue (VAT) on whole-body magnetic resonance imaging scan. Changes in whole-body subcutaneous adipose tissue and skeletal muscle, glucose metabolism, serum lipids, and quality of life were also assessed. Despite stable body weight, VAT decreased in evaluable subjects an average of 42% with rhGH 6 mg/d (n = 24; p <.001) and 15% with 4 mg every other day (n = 10; p <.01) after 12 weeks, with trends toward further decreases after an additional 12 weeks at each dose. Subcutaneous adipose tissue also decreased, but proportionately less and not significantly on the lower dose. Skeletal muscle increased. Body composition rebounded to or near baseline after the washout period. Effects on lipids were inconsistent. Total cholesterol levels fell on the higher dose only, whereas high-density lipoprotein cholesterol levels increased on the lower dose only, and there was no effect on triglyceride levels. Joint pain was the most common adverse event, and was reflected in subjective quality of life measurements as an increase in bodily pain. Insulin sensitivity fell, and 4 participants developed diabetes. Other adverse events included cancer of unknown relationship to treatment in 3 participants. Levels of distress decreased after 24 weeks on the higher dose. In conclusion, rhGH effectively reduces the excess visceral adipose tissue often associated with HIV fat redistribution/lipodystrophy. However, frequent adverse effects warrant controlled studies and careful patient monitoring, especially regarding glucose tolerance.

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Lo JC, Mulligan K, Noor MA, Schwarz JM, Halvorsen RA, Grunfeld C, Schambelan M. The Effects of Recombinant Human Growth Hormone on Body Composition and Glucose Metabolism in HIV-Infected Patients with Fat Accumulation. J Clin Endocrinol Metab. 2001;86(8):3480-7.

FROM FULL TEXT

The most common complaints were arthralgias and nonpitting edema in the extremities that tended to improve during the course of the study. Patient 3 had persistent arthralgias that necessitated a reduction in the dose of GH to 1.5 mg/d at month 2 and for the remainder of the study, with improvement in symptoms.

In conclusion, treatment with GH at 3 mg/d resulted in a decrease in total body fat and an increase in lean body mass in this open-label trial. The most common side effects seen during the study were arthralgias and edema, probably reflecting the pharmacologic dose of GH used and the resultant supraphysiologic levels of IGF-I.

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Johannsson G, Marin P, Lonn L, Ottosson M, Stenlof K, Bjorntorp P, Sjostrom L, Bengtsson BA. Growth hormone treatment of abdominally obese men reduces abdominal fat mass, improves glucose and lipoprotein metabolism, and reduces diastolic blood pressure. J Clin Endocrinol Metab. 1997;82(3):727-34.

FROM FULL TEXT

Five had peripheral edema, two subjects experienced muscle stiffness and arthralgia, one developed mild carpal tunnel syndrome, and one subject experienced increased perspiration. These side effects appeared during the first 6 weeks of treatment and subsided in four patients in response to a reduction in dose implemented within 4 months after the start of treatment; in three patients, the side effects subsided spontaneously.

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Kotler DP, Muurahainen N, Grunfeld C, Wanke C, Thompson M, Saag M, Bock D, Simons G, Gertner JM; Serostim in Adipose Redistribution Syndrome Study Group. Effects of growth hormone on abnormal visceral adipose tissue accumulation and dyslipidemia in HIV-infected patients. J Acquir Immune Defic Syndr. 2004;35(3):239-52.

FROM FULL TEXT

The largest differences in frequencies of adverse events between PL and r-hGH groups were for arthralgia, swelling, limb pain, hypoesthesia, paresthesia, and elevated blood glucose, which are all events known to be associated with r-hGH administration in other study populations.

In DD, however, 1 serious event (severe hyperglycemia not requiring hospitalization) was reported as probably related to study drug and 5 adverse events were reported as possibly related (carpal tunnel syndrome, left ventricular hypertrophy, upper abdominal pain, a suicide attempt, and a death [cause unknown and not clarified despite a coroner investigation]).

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Schambelan M, Mulligan K, Grunfeld C, Daar ES, LaMarca A, Kotler DP, Wang J, Bozzette SA, Breitmeyer JB. Recombinant human growth hormone in patients with HIV-associated wasting. A randomized, placebo-controlled trial. Serostim Study Group. Ann Intern Med. 1996;125(11):873-82.

FROM FULL TEXT

Two patients in the growth hormone group withdrew because of adverse events (one for edema and pain and one for arthralgias). Five patients (one in the growth hormone group and four in the placebo group) were withdrawn because of new or progressive Kaposi sarcoma; progressive Kaposi sarcoma was noted at week 12 in another patient treated with growth hormone. Eight patients (four in each group) had Kaposi sarcoma at baseline that did not progress during the study.

Among commonly reported side effects, only swelling or puffiness, arthralgia or myalgia, and diarrhea differed significantly between groups. These events were usually mild to moderate in severity and resolved with treatment. Eighteen patients (15 in the growth hormone group and 3 in the placebo group) required a reduction in dose. Three patients who were receiving growth hormone developed the carpal tunnel syndrome. The syndrome resolved in 2 of the patients after a single dose reduction and in 1 despite continued treatment.

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On the other hand, the next article shows that there wasn't reported any joint pain (arthralgia).

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Andersen O, Haugaard SB, Flyvbjerg A, Andersen UB, Orskov H, Madsbad S, Nielsen JO, Iversen J. Low-dose growth hormone and human immunodeficiency virus-associated lipodystrophy syndrome: a pilot study. Eur J Clin Invest. 2004;34(8):561-8.

ABSTRACT

BACKGROUND: Treatment with high doses (2-6 mg day(-1)) of human growth hormone (hGH) in patients with human immunodeficiency virus (HIV)-associated lipodystrophy syndrome (HALS) has been shown to increase concentrations of total insulin-like growth-factor-I (IGF-I) more than twofold greater than the normal upper range and is accompanied by adverse effects such as joint pain and glucose intolerance.

MATERIALS AND METHODS: We performed a 16-week open-labelled prospective pilot study in six male HALS patients using a s.c. low-dose hGH, 0.7 mg day(-1), aiming to examine the impact on total and free IGF-I and fat distribution. Glucose metabolism was examined by oral glucose tolerance tests and hyperinsulinaemic euglycaemic clamps.

RESULTS: Total IGF-I increased twofold (P < 0.01) and free IGF-I increased 2.5-fold (P < 0.01) to the level of the normal upper range. HDL-cholesterol increased (P = 0.01). Patients reported improvements of lipodystrophy, which was supported by a decreased waist-to-thigh ratio (P = 0.01), and waist-to-hip ratio (P = 0.06). Ratio of peripheral to trunk soft tissue mass increased (P = 0.01, measured by dual-energy X-ray absorptiometry scans) and a trend towards reduction in percentage of trunk fat was suggested (P = 0.12). Total fat mass, exercise capacity, glucose tolerance, glucose disposal rate and immune status, respectively, did not change (all P > 0.5). The patients did not complain of arthralgia or other known GH-related side-effects.

CONCLUSIONS: Sixteen weeks' treatment of lipodystrophic HIV-infected patients with hGH, 0.7 mg day(-1), increased total and free IGF-I twofold and appeared safe and tolerable. The potential of low-dose hGH in the treatment of HIV-lipodystrophy awaits examination by placebo-controlled, randomized trials.

"The medals don't mean anything and the glory doesn't last. It's all about your happiness. The rewards are going to come, but my happiness is just loving the sport and having fun performing" ~ Jackie Joyner Kersee.


   
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liftsiron
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Each time that I use hgh I notice a mark increase in wrist and forearm pain also my shins seem far more sensitive than normal.

liftsiron is a fictional character and should be taken as such.


   
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guijr
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Posted by: guijr
It was not specified in the article. I sent an e-mail to Dr. Martin asking about it, but no word from him yet.


Yesterday, I got a reply from Dr. Martin, he said that the subjects had "joint pain, but not much".

"The medals don't mean anything and the glory doesn't last. It's all about your happiness. The rewards are going to come, but my happiness is just loving the sport and having fun performing" ~ Jackie Joyner Kersee.


   
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