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07/29/2010 (4:36 am)

growth hormone Best answer on the web

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  • i am 21 and i take genetropin .6 injections because my igf-1 was 200 at 20 years old! my igf-1 now is 330. i am worried about acromeglia(when ur face start to look like a giant)! are there any blood tests to show if i am ok or is 330 a good level to have??


  • Hello anonymous - a week ago you wrote:
    "for an extra 50$ can you explain these 4 points in detail
    1. does growth hormes increase testosterone
    2. does it increase estrogen
    3. does it promote hair re growth
    4. does it cause hair loss?"

    Can I elaborate any more on these points? Please let me know if there is any more detail you require.
    Thanks,
    Kevin, M.D.


  • Thank you for the rating and generous tip. Please contact me should you have further medically-related research in the future.
    Thanks,
    Kevin, M.D.


  • Hello,
    Thanks for asking for clarification.

    "So i should be ok with a igf-1 of 330?"
    Currently, your IGF-1 level of 330 falls within the normal range of IGF-1 (280-400).
    "Explain the other blood test to me in detail please."

    1) Serum GH concentration
    Measurement of serum growth hormone is indicated in patients with equivocal serum IGF-I values, or in those with elevated serum IGF-I values in whom further biochemical confirmation is required. GH secretion in normal subjects is pulsatile, diurnal, and stimulated by a variety of factors, including short-term fasting, exercise, stress, and sleep. As a result, serum GH concentrations fluctuate widely, ranging from less than 0.5 to 1 ng/mL (less than 0.1 ng/mL using very sensitive assays) during most of the day, to 2 to 5 ng/mL before the next meal or after exercise, to as high as 20 or 30 ng/mL at night or after vigorous exercise. Serum GH concentrations also may be high in patients with uncontrolled diabetes mellitus, liver disease, and malnutrition.
    All patients with acromegaly have increased GH secretion. However, the serum GH concentration is often in the range of 2 to 10 ng/mL during much of the day, values that can be found in normal subjects. Unlike normal subjects, the patient's serum GH concentrations change little during the day or night, and in most patients do not change in response to stimuli such as food or exercise. Nevertheless, because of the variations in serum GH that occur in normal subjects and in patients with other disorders, a high value cannot be interpreted without knowing when the blood sample was obtained and something about the patient. To obviate these problems it is best not to obtain random measurements of serum GH.
    The most specific dynamic test for establishing the diagnosis of acromegaly is an oral glucose tolerance test. In normal subjects, serum GH concentrations fall to 2 ng/mL or less within two hours after ingestion of 50 to 100 g glucose. In contrast, the post-glucose values are greater than 2 ng/mL in over 85 percent of patients with acromegaly.
    2) Serum IGFBP-3 concentration
    Because IGFBP-3 secretion is GH-dependent (as is IGF-I), serum IGFBP-3 concentrations are elevated in patients with acromegaly. There is, however, considerable overlap of these values with those in normal persons, thereby limiting the utility of this measurement.
    Based on this, it would seem that the serum growth hormone (GH) and the IGF-1 are the two more important tests in diagnosing acromegaly.
    Thanks,
    Kevin, M.D.


  • one clarifaication, does growth hormone "possiably" or "definitly" increase testosterone and estrogen? do you know how likly or how much of a possablity and increase? thanks


  • for an extra 50$ can you explain these 4 points in detail
    1. does growth hormes increase testosterone
    2. does it increase estrogen
    3. does it promote hair re growth
    4. does it cause hair loss?


  • ill pay more if need be!


  • Hello - you asked the following.
    "Does growth hormone "possiably" or "definitly" increase testosterone and estrogen?"
    In theory, growth hormone increases both testosterone and estrogen. However, it may not increase it enough to make a physiological effect on your body. If the GH/IGF-1 levels are normal, it should not affect the estrogen/testosterone levels in your body.
    Growth hormone increases the level of IGF-1. IGF-I stimulates specialized functions in endocrine tissues, including enhancement of the effects of FSH and LH. Enhancing the FSH and LH levels in your body will stimulate production of both estrogen and testosterone.
    Hope this helps,
    Kevin, M.D.


  • Hello,
    Thanks for asking your question. You asked the following:
    "i am worried about acromeglia(when ur face start to look like a giant)! are there any blood tests to show if i am ok or is 330 a good level to have??"
    Here are a few words about IGF-1 testing from the Anti-Aging Institute: "IGF-1 is Insulin-Like Growth Factor that is formed by liver cells when they are stimulated by Human Growth Hormone (HGH). It is the compound that is responsible for the effects we see from HGH supplementation. It is also known as Somatomedin-C.
    The ideal target for IGF-1 should be 280-400 mcg/ml (slightly higher in females). Normally, this is the value for 20-25 year olds. We find there is a wide variety of levels based on life-style and diet. Generally the normal values drop about 10% per decade." http://www.anti-aging.org/igf.html

    Your level of 330 falls within the normal range of IGF-1 (280-400). If you are on hormone therapy, you should check your level every 3-6 months. The obvious side effect of an increased IGF level are the effects associated with acromegaly.
    Acromegaly results from persistent hypersecretion of growth hormone (GH). The excess GH stimulates the hepatic secretion of insulin-like growth factor-I (IGF-I), which causes most of the clinical manifestations of acromegaly.
    Both serum GH concentrations and IGF-I concentrations are increased in virtually all patients with acromegaly.
    From UptoDate:
    "The best single test for acromegaly is measurement of serum IGF-I. Unlike growth hormone, serum IGF-I concentrations do not vary from hour to hour according to food intake, exercise or sleep, but instead reflect integrated GH secretion during the preceding day or longer. Serum IGF-I concentrations are elevated in virtually all patients with acromegaly and provide excellent discrimination from normal individuals.
    The results must be interpreted, however, according to the patient's age. In normal subjects, serum IGF-I concentrations are highest during puberty and decline gradually thereafter. Values are significantly lower in adults over the age of 60 than in younger subjects. Thus, an apparently "normal" value in a patient aged 70 years may in fact be elevated." (1)
    I will now briefly discuss some features of an increased IGF-1/growth hormone level, so you can be on the lookout for these symptoms while on hormone therapy.
    The clinical features of acromegaly are attributable to high serum concentrations of both GH and insulin-like growth factor-I (IGF-I), which is GH-dependent. Excess GH and IGF-I have both somatic and metabolic effects. The onset of acromegaly is insidious, and its progression is usually very slow. The interval from the onset of symptoms until diagnosis is about 12 years.
    The characteristic findings are an enlarged jaw (macrognathia) and enlarged, swollen hands and feet, which result in increasing shoe and glove size and the need to enlarge rings. The facial features become coarse, with enlargement of the nose and frontal bones as well as the jaw, and the teeth become spread apart. Joint symptoms are a common presenting feature of the disease, and back pain (and kyphosis) is common. Cardiovascular abnormalities include hypertension, left ventricular hypertrophy, and cardiomyopathy. The skin thickens, making it hard to puncture, and skin tags may appear. Manifestations of soft tissue overgrowth include macroglossia, deepening of the voice, and paresthesias of the hands (eg, carpal tunnel syndrome in around 20 percent).
    Acromegaly is associated with an increased risk of uterine leiomyomata and perhaps also colonic polyps. An increased incidence of several kinds of cancer has been suspected in acromegaly, but most studies have been uncontrolled. Approximately 10 percent of acromegalic patients develop malignant tumors, including adenocarcinomas of the colon, stomach, and esophagus, and melanoma (2). Many visceral organs are enlarged in acromegaly, including the thyroid, heart, liver, kidneys, and prostate. The thyroid enlargement may be diffuse or multinodular. Fatigue and weakness can be prominent symptoms. They may result from sleep apnea, cardiovascular dysfunction, neuropathy, hypogonadism, hyperglycemia, or some combination of these factors.
    The mortality rate of patients with acromegaly is two to three times the expected rate, mostly from cardiovascular diseases and cancer (3).
    It is good to see that you are concerned about the IGF-1 level. Currently you level of 330 falls within the normal range (280-400). As you can see, having a chronically elevated IGF-1 level is hazardous to your health - I have described many of these effects above. You should continue to monitor your IGF-1 level periodically.
    "Are there any blood tests to show if i am ok?"

    There are several blood tests to determine a diagnosis of acromegaly. This can be confirmed by measurement of both serum GH concentration after a glucose load and GH-dependent circulating molecules, such as IGF-I and IGFBP-3.
    I stress that this answer is not intended as and does not substitute for medical advice - please see your primary care physician for
    further evaluation of your individual case.

    Please use the answer clarification to ask any questions before rating this answer. I will be happy to explain any issue.

    Thanks,
    Kevin, M.D.

    Search strategy:
    No internet search engine was used in this answer. All sources are
    from objective, physician-written, peer-reviewed resources.

    Bibliography:
    1) Melmed. Diagnosis of acromegaly. UptoDate, 2002.
    2) Ron, E, Gridley, G, Hrubec, Z, et al. Acromegaly and gastrointestinal cancer. Cancer 1991; 68:1673. 3) Wright, AD, Hill, DM, Lowy, C, et al. Mortality in acromegaly. Q J Med 1970; 39:1. 4) Melmed. Clinical manifestations of acromegaly. UptoDate, 2002.

    Links:
    NIDDK - Acromegaly
    http://www.niddk.nih.gov/health/endo/pubs/acro/acro.htm#diagnosed

    The Anti-Aging Institute - Questions about IGF-1 Testing
    http://www.anti-aging.org/igf.html

    Lab Tests Online - Growth Hormone
    http://labtestsonline.org/understanding/analytes/growth_hormone/glance.html


  • so i should be ok with a igf-1 of 330? and explain the other blood test to me in detail please.


  • Hello - thanks for the opportunity to answer your further questions.

    1) does growth hormones increase testosterone?

    Yes - regarding IGF-1 specifically. As you know IGF-1 is a reflection of growth hormone. From UptoDate: "IGF-I stimulates specialized functions in endocrine tissues, including enhancement of the effects of FSH and LH on production of steroids by ovarian granulosa cells, testosterone secretion by Leydig cells, the effects of ACTH on adrenal cortical cell steroidogenesis, and the response of thyroid follicular cells to TSH." (1)
    2) does it increase estrogen?

    Yes. It was mentioned above that IGF-1 increases the effects of FSH (follicle stimulating hormone). An increased FSH increases estrogen level - this is more pronounced in women than in men. From the Center of Male Reproductive Medicine: "Since men with idiopathic infertility have normal testosterone levels, by definition, the increased FSH, LH and testosterone that result from clomiphene or tamoxifen treatment may boost testosterone and estrogen levels above normal levels." http://www.maleinfertility.org/new-therapy.html#anti

    For the next 2 questions, there are conflicting studies - there is no consensus. I will give studies that say IGF-1 both promotes hair growth and loss.
    3) does it promote hair growth?
    Possibly. In a study by Su et al. (1999), it is suggested that IGF-1 may stimulate hair follicle cells and has a role in anti-apoptosis (i.e. self-destruction): "IGF-1 may therefore be able to stimulate the proliferation of hair follicle cells through cellular signaling pathways of its receptors. Local infusion of IGF-1 into sheep has been reported to be capable of stimulating protein synthesis in the skin. It may also increase the production of wool keratin. The anti-apoptotic role of IGF-1 in hair follicles is also reviewed." (3)
    In another study by Philpott et al. (1994), he suggests that IGF-1 stimulates hair follicle growth: "Both IGF-I (0.01-100 ng/ml) and IGF-II (0.01-100 ng/ml) stimulated hair follicle growth in a dose-dependent manner." (4)
    4) does it promote hair loss?
    Possibly. A study by Signorello et al. (1999) suggests that a higher IGF-1 level doubles the incidence of vertex baldness: "BACKGROUND: Androgens are important in hair growth and patterning, whereas growth hormone substitution enhances their effect in growth hormone-deficient men. No previous study has jointly evaluated the function of sex steroids, sex hormone-binding globulin (SHBG), and insulin-like growth factor (IGF-1) in determining hair patterning in men. OBJECTIVE: We assessed the relationship between circulating hormone measurements and both head and chest hair patterning in a sample of elderly men. METHODS: Fifty-one apparently healthy men older than 65 years of age were studied cross-sectionally. Head and chest hair patterning was assessed by a trained interviewer. Morning blood samples from all subjects were used for measurements of testosterone, estradiol, dehydroepiandrosterone sulfate, SHBG, and IGF-1. RESULTS: Results were obtained from logistic regression models, adjusting simultaneously for all the measured hormones and age. Men with higher levels of testosterone were more likely to have vertex baldness (odds ratio = 2.5, 95% confidence interval per 194 ng/dL increment of testosterone). In addition, for each 59 ng/mL increase in IGF-1, the odds of having vertex baldness doubled (95% CI ). Those who were found to have higher circulating levels of SHBG were less likely to have dense hair on their chest (OR = 0.4, 95% CI per 24 nmol/L increment in SHBG]). CONCLUSION: Testosterone, SHBG, and IGF-1 may be important in determining hair patterning in men." (2)
    I hope that this information helps. Please feel free to contact me should you have any further questions.
    Thanks,
    Kevin, M.D.

    Bibliography:
    1) Clemmons. Physiology if IGF-1. UptoDate, 2002.
    2) Signorello LB, Wuu J, Hsieh C, Tzonou A, Trichopoulos D, Mantzoros CS. Hormones and hair patterning in men: a role for insulin-like growth factor 1? J Am Acad Dermatol. 1999 Feb;40(2 Pt 1):200-3.
    3) Su HY, Hickford JG, Bickerstaffe R, Palmer BR. Insulin-like growth factor 1 and hair growth. Dermatol Online J. 1999 Nov;5(2):1. 4) Philpott MP, Sanders DA, Kealey T. Effects of insulin and insulin-like growth factors on cultured human hair follicles: IGF-I at physiologic concentrations is an important regulator of hair follicle growth in vitro. J Invest Dermatol. 1994 Jun;102(6):857-61.









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