Human Growth Hormone 101

What is a hormone?

A hormone is one of the many chemical messengers of the body. Hormones are comprised of proteins that form peptide chains and direct the functions of our body. One of the most vital of these chemical messengers is Human Growth Hormone.

We here at Bio-Identical Hormone Replacement Therapy MD, the Conscious Evolution Medical Institute, want to do everything we can to help you make an informed decision about Hormone Replacement Therapy. Therefore, we have compiled this information about the history, benefits, pros, and cons of growth hormone imbalance treatment.

GH (Growth Hormone), also known as STH (somatotropin) is a hormonal protein that stirs growth and also the reproduction of cells in people and many animals. It's a lone chain of one hundred ninety-one amino type acids that makes up a hormone of the polypeptide variety. It is manufactured, secreted, and stored by somatotrophic cells inside the lateral wings of the anterior pituitary gland.

The following information about the physiology of Growth Hormone also reviews briefly diseases caused by a deficiency of Human Growth Hormone as well as excessive Growth Hormone (gigantism and pituitary acromegaly). It also discusses treatment that features Human Growth Hormone. To learn more about a commonly used growth hormone that is often given to cattle, look up bovine somatotropin.

Terms

Recombinant HGH Human Growth Hormone is called somatotropin as well (In Britain: Somatotrophin)

HGH is an acronym for Human Growth Hormone. This hormone, HGH, is released from or extracted in a measured fashion from the pituitary gland of human beings.

In the 1980s, Human Growth Hormone of biosynthetic form replaced Human Growth Hormone that was derived from the pituitary in bio hormone replacement therapy from cadavers (they harvested HGH from the pituitary glands of dead folks) used in the United States and other locations. Now HGH is created through genetic engineering.

Previously, Human Growth Hormone was gathered from processed pituitary glands. Biosynthetic HGH, also referred to as Recombinant Human Growth Hormone, is known as Somatropin and the abbreviation rhGH is used.

From the middle of the 1980s, the HGH abbreviation started to carry connotations that were paradoxical. It now quite rarely is used in reference to Human Growth Hormone for the purposes that are indicated.

Gene and Structure of an HGH molecule

The HGH genes are located at region q22-24 of the the17th chromosome (GH1). They happen to be related closely to hCS (human chorionic somatomammotropin, known also as lactogen of the placenta) genes. Human Growth Hormone, PRL (prolactin), and hCS (chorionic somatomammotropin) make up a group of similar hormones that promote growth and activity that is lactogenic.

The predominant isoform that comprises Human Growth Hormone is a one hundred ninety-one amino acid protein chain that has a molecular weight that is twenty-two thousand daltons. The configuration has four helixes that are needed for interaction that is functional with the Growth Hormone Receptor.

Growth Hormone is believed to be evolutionarily and is structurally similar to chorionic somatomammotropin and prolactin. Even though there are real similarities within the structure that correlate Human Growth Hormone with that of other species, only the HGH from primates and humans has a significant effect on people.

Secretion of Growth Hormone

Many molecular configurations of growth hormones move through the body. A large portion of the HGH circulating through the body is attached to a particular protein called growth hormone-binding protein, or GHBP. The protein is manufactured by the Growth Hormone receptor.

Hormone Regulation

The hypothalamus releases peptides from the neurosecretory nuclei and those peptides enter the veins around the pituitary gland. These peptides are significant in that they stimulate the secretion of Growth Hormone by the body's somatotropes.  But, even though a balance of the inhibiting and stimulating peptides controls the release of growth hormone, the balance is also affected by numerous physiological inhibitors and stimulators of Growth Hormone Secretion.

Stimulators of Growth Hormone Secretion include:

GHRH (Growth Hormone Releasing Hormone) originates from the arcuate nucleus.

Sleep

Ghrelin (the hunger-stimulating hormone)

Exercise

Dietary protein estradiol

Low levels of blood sugar (hypoglycemia)

Arginine (decreases blood pressure and enhances injury recovery)

Growth Hormone secretion inhibitors include:

Somatostatin that originates in the periventricular nucleus

Glucocorticoids (carbohydrates of a dietary variety)

Levels of Insulin-Like Growth Factor-1 and Growth Hormone circulation concentration (the body reacts negatively to this feedback)

Secretion of Growth Hormones is stimulated in non-endogenous therapies as well. There are a significant number of exogenic compounds known as xenobiotics that have been proven to stimulate and inhibit the function and secretion of Growth Hormones. This highlights the theory that the axis of Insulin-Like Growth Factor-1 and Growth Hormone is proving to be a vital target for particular chemicals that disrupt the endocrine system (referred to as endocrine disruptors).

Patterns of Secretion

The majority of physiologically vital secretion happens during a number of large peaks or pulses of growth hormone release every day. The concentration of growth hormone in blood plasma during one of these peaks can range from five to thirty-five ng/mL or even more. These peaks usually last a duration of ten to thirty minutes before they return to normal levels.

The most predictable and largest of the growth hormone peaks happen around an hour after one goes to sleep. Besides this particular time, there is a wide variety of Growth Hormone release patterns from person to person and even from day to day within a particular person.

Between peaks, base levels of growth hormone remain low, most often less than three ng/mL for most of the night and day.

Also, the pattern and amount of growth hormone that is secreted changes over the course of one's life. Base levels of Growth Hormone are at their highest at the beginning of childhood. The frequency and amplitude of peaks are at their greatest during the growth spurt of puberty.

Healthy adolescents and children average around eight peaks every 24 hours. Adults usually have around five peaks. The amplitude and frequency of peaks as well as base levels of Growth Hormone drop as one becomes older.

Growth Hormone Functions

The effect that Growth Hormone has on human tissue can most accurately be termed anabolic (meaning having a stimulative effect). Similar to the majority of other hormonal proteins, growth hormone functions through interaction with a particular receptor that is located on the outer surface of the cell.

Increases Height

The stimulation of growth in height during childhood is the most well-known effect of growth hormone action. It appears to be spurred by a minimum of 2 mechanisms.

Growth hormone stimulates the multiplication and division of the chondrocytes located in the cartilage. Chondrocytes are the main cells in the epiphyses (growing ends) of the long bones of a child's body (digits, arms, legs).

Growth hormone also encourages the manufacture of IGF-1(insulin-like growth factor 1, known previously as somatomedin C). IGF-1is a hormone that is similar to proinsulin. The creation of IGF-1 occurs primarily in the liver, and stimulation through Growth Hormone is necessary for this vital process to occur correctly.

IGF-1 also has stimulative growth effects on various types of tissue. IGF-1 is manufactured to a lesser extent inside the tissues that are targeted, which makes Insulin-Like Growth Factor-1 seemingly an endocrine hormone as well as a paracrine/autocrine hormone. Also, IGF
-1 has stimulative effects upon chondrocyte and osteoblast activity, leading to a promotion of the healthy growth of one's bones.

Other Functions of Growth Hormone

Though Growth Hormone's most well-known effect is the stimulation of height growth, it also stimulates a variety of other metabolic processes.

Below is a list of some of these processes:

• Increase in the retention of calcium, which increases bone mineralization and strengthens the bones as well Increase in muscle mass due to the genesis of new muscle cells (also known as hyperplasia, which differs significantly from hypertrophy).
• Promotion of lipolysis. This results in a loss of body fat, medically known as adipose tissue.
• Increase in the synthesis of proteins which stimulates growth and maintenance of every organ of the body, in exclusion of the brain.
• Role in the homeostasis of fuel production. Growth Hormone reduces the liver's intake of glucose, which opposes the hormone of insulin.
• Promotion of gluconeogenesis in the liver
• Contribution to the proper function and maintenance of the islets of the pancreas
• Stimulant of the immune system

Diseases that are a result of an excess of growth hormone

(acromegaly and pituitary gigantism)

The disease which is most common that results in an excess of growth hormone are a pituitary gland tumor comprised of somatotroph cells that normally reside in the anterior of the pituitary gland. These somatotropic adenomas are not cancer-causing and they grow very slowly, producing a greater and greater amount of growth hormone as they develop.

For many years, the main medical issue that arises from a somatotrophic adenoma is an excess of growth hormone. After many years, the adenoma can become so large that it begins to cause headaches and impair vision due to the pressure it creates upon the optical nerve. It can also create a deficiency of other hormones by displacing them on the pituitary gland.

Prolonged excess of growth hormone can lead to a thickening of the bones of the toes, fingers, and jaw. The jaw heaviness and digit thickness that occurs, as a result, are known as acromegaly. Problems that accompany acromegaly often include pressure upon the nerves (carpal tunnel among other conditions), weakness of the muscles, a reduction of sexual ability, and even possibly resistance to insulin, which can result in a rare kind of type-2 diabetes.

Tumors that secrete growth hormones are most often discovered during a patient's 50s. It is very uncommon for this type of tumor to develop during childhood or adolescence, but if it does develop, it can lead to an excess of growth hormone that can lead to excessive growth commonly called pituitary gigantism.

Growth hormone-producing tumors are usually treated by means of surgical removal. In unique cases, focused blasts of radiation may be used. In other cases, a Growth Hormone antagonist like octreotide or bromocriptine may be administered to block the function of the growth hormone or cause the tumor to shrink.

Deficiency of Growth Hormone (GHD)

A deficiency of growth hormone can produce very different issues dependent upon the age at which the deficiency occurs. In young children, an inhibition of growth leading to short stature and size is the most common manifestation of Growth Hormone Deficiency.

For adults, however, effects that are caused by Growth Hormone deficiency are much more subtle. These effects can include weakness, lack of energy, reduction in bone mass in addition to a higher risk of cardiovascular complications.

There are numerous causes of Growth Hormone deficiency. These include genetic mutations, genetic defects of the pituitary and/or the hypothalamus, and also damage that occurs to the pituitary gland from disease, surgery, or injury.

A proper diagnosis of Growth Hormone Deficiency is a multi-step diagnostic procedure that usually culminates in growth hormone stimulation tests. In these tests, various stimuli are administered in an effort to spur the pituitary gland into releasing a pulse of Growth Hormone.

A deficiency in Growth Hormone is treated through bioidentical hormones therapy. All of the Growth Hormone that is currently used is of a biosynthetic variety created through technology derived from recombinant DNA.

Because Growth Hormone is a very large protein, It has to be administered by injection into the subcutaneous tissue to reach the bloodstream. Injections used to be administered into muscle mass until 1985 when the manufacture of synthetic Growth Hormone began.

If an individual has been long-suffering from the effects of Growth Hormone deficiency, treatment benefits are quite often gratifying and dramatic. Side effects are rare, as well. When Growth Hormone is used properly in children who have a deficiency, the end result is a more normal and average height in adulthood.

Growth Hormone Replacement Therapy is used as a treatment for adults that struggle with a Growth Hormone deficiency of adult-onset(which is usually caused by the development of a tumor on the pituitary gland) or childhood-onset (upon completion of the growth phase).

In these individuals, the benefits often include a reduction in body fat, an increase in lean muscle, stronger bones, improved cholesterol levels, fewer risk factors for cardiovascular complications, and an overall improvement in mental well-being.

Advantages of Hormone Replacement Therapy

Other uses for Growth Hormone and other indications of treatment

A number of other ailments other than Growth Hormone deficiency can lead to lackluster growth; however, the benefits of growth and height gain are very often poorer when not treated for Growth Hormone Deficiency as well.

Other examples of reduced stature that feature treatment regimens involving Growth Hormone include:

Chronic Renal Failure

Turner syndrome

Prader-Willi syndrome

In-utero growth complications

Severely small stature with no discernible cause

In conditions such as these, larger, pharmacological doses of Growth Hormone are needed to induce growth. The amount of Growth Hormone administered to the body by an HRT doctor in these instances is much higher than normal physiological levels. Luckily, treatment with these pharmacological doses rarely results in unwanted hormone side effects. Also, the Growth HRT side effects show little variation relative to the condition treated.

Often, Growth Hormone is utilized to attain benefits other than an increase in height. Growth Hormone Replacement Therapy leads to an increase in muscle strength and a modest reduction in body fat for those who suffer from Prader-Willi syndrome.

In those children who suffer from this condition, these two benefits are significantly more vital than simply growing in height. Growth Hormone has also proven to be useful to ward off the muscle atrophy and wasting caused by AIDS. Growth Hormone also can be administered to individuals suffering from short bowel syndrome so that their bodies are not dependent upon being fed totally intravenously.

Less Commonly Known benefits of Hormone replacement therapy include:

• Attempting to induce remission in those who suffer from Multiple Sclerosis
• Weight loss treatment for those with obesity
• Anti-aging treatment to reverse effects of
  the aging process (read more below)
• Combating fibromyalgia
• Relieving ulcerative colitis and Crohn's disease symptoms
• General treatment for being of small stature
• Administration to assist in physical enhancement for athletics or bodybuilding

Growth Hormone as an anti-aging therapy

The first claims of Growth Hormone as a valid treatment to combat the aging process dates back to the year 1990. The New England Journal of Medicine released a study in which Growth Hormone was implemented to treat twelve males over the age of sixty.

At the end of this study, every male was shown to have increases in lean body mass and bone density that were of statistical significance. The control set of males showed no such improvements. The scientists who conducted the research noted that reduction in bone density and an increase in lean body mass are among the changes that occur normally over a ten to a twenty-year period of aging.

Even though the authors did not claim that Growth Hormone reversed the process of aging, the results that they released were interpreted incorrectly, leading many to believe that Growth Hormone was effective as an agent to prevent and reverse aging.

A survey of the clinical research conducted by the Stanford University School of Medicine released in 2007 revealed that GrowthHormone Replacement Therapy administered to older, yet healthy patients, led to an increase in muscle mass of around two kilograms. It also led to a reduction in body fat by two kilograms as well.

These effects, however, were the only positive effects that the survey revealed. Cholesterol levels, bone density, maximal aerobic capacity, and lipid profiles showed no change, nor did any other significant factor that would indicate an increase in general fitness.

The survey did not discover gains in muscle strength. They concluded that Growth Hormone merely allows the body to store greater amounts of water in muscle tissues, which would not lead to an increase in the actual growth of the muscles.

This also explains the improved lean body mass as well. Standardized administration of Growth Hormone did induce several negative issues like pain and swelling of the joints, carpal tunnel syndrome, and a higher risk of developing diabetes.

Complications and risks of Growth Hormone therapy: bio-identical hormone replacement therapy side effects

With Growth Hormone Replacement Therapy, some adults may experience the side effects of nerve compression, pain, swelling of the joints, and water retention.

Also, there is a concern that, theoretically, growth hormone treatment might raise the risk of developing cancer or diabetes, even more so in individuals who have other risk factors and take higher doses of Growth Hormone. It should be noted, though, that diabetes generally develops due to the accumulative effects of bad eating habits over the course of thirty or forty years.

The most probable cause for diabetes in those patients who undergo Growth Hormone replacement therapy is the lack of proper nutrition that the individual experienced throughout his or her life.

One particular survey of patients who were administered Growth Hormone that was collected from cadavers as children were shown to have a modestly higher risk of colon cancer as adults; however, cadaver Growth Hormone ceased to be used anywhere worldwide around 1985. Also, a link between the treatment and the incidence of colon cancer was not adequately established in the survey.

History

Choh Hao Li is associated with the discovery, refinement, and eventual synthesis of Growth Hormone. The history of the use of growth hormone from the initial extraction of the hormone from the human pituitary, to the minor catastrophe that resulted in a small group of patients acquiring Creutzfeldt-Jakob disease, to the eventual expansion of use and large expenses of synthetic Growth Hormone is explained in further detail in more detail elsewhere on Growth Hormone Treatment.

By the year 2005, the Growth Hormone of the synthetic variety was attainable in the U.S. by means of a number of manufacturers. Among these manufacturers are Genentech (Nutropin), Lilly (Humatrope), Pfizer (Genotropin), Novo (Norditropin), and Merck Serono (Saizen).

All of these products are almost identical in their composition, cost, and efficacy. They vary mainly through means of delivery and ultimate formulation.

Also in the year 2005, Teva, a company from Israel, began to offer Tev-Tropin in the United States for a cheaper price. In the year 2006, the United States FDA gave the go-ahead to a follow-up type of rhGH known as Omnitrope, released by Sandoz. Alkermes and Genentech developed a form of Growth Hormone that releases over time known as Nutropin Depot.

This treatment was FDA-approved in 1999 and it minimized the need for daily injections, requiring one injection every two to four weeks; however, this product became discontinued in the year 2004.

See also:

Human Growth hormone; Human Growth hormone treatment; Bodybuilding and Human Growth; Hormone Treatment; Human Growth Hormone controversies; Recombinant protein List; Insulin-LikeGrowth Factor-1

References

Alba-Roth, M'ller, Schopohl, vonWerder (Published 1988). Arginine can enhance Human Growth Hormone secretion through the suppression of the internal secretion of somatostatin. Journal of Clinical Endocrinology and Metabolism Volume 67 Issue 6: Pages 1186-9.PubMed 2903866.

Scarth. Controlling the HumanGrowth Hormone and-Insulin-Like Growth Factor axis by nutraceutical, environmental, and pharmaceutical xenobiotics: a new role for enzymes that metabolize xenobiotics and the factors which regulate their expression. A review". Xenobiotica Volume 36 (Issue 2-3): Pages 119-218. PubMedID16702112.

Takahashi, Kipnis, Daughaday (Published1968). Human Growth Hormone secretion during sleep". Journal of clinical Investigation Volume 47 Issue 9: Pages 2079-90. PubMed 5675428.

Actions of Ant. Pit. Growth Hormones.Med. Coll of Ga, 2007

King. Growth Hormone. Indiana 2006

The study finds no proof that Human Growth Hormone Therapy leads to a longer life.

British Broadcasting Company News. July 26, 2002. Human Growth Hormone therapy linked to cancer.

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