This is the second article on hormones that are important for good health. In the first instalment (Hormones for health, Fit4life, Feb 17), I wrote about insulin, testosterone, oestrogen and progesterone. I also explained about bio-identical hormones.
Today, I will share about the most important hormone in anti-ageing (maintaining our health and youthfulness) - human growth hormone (HGH).
HGH, DHEA (dihydroepiandrosterone) and pregnenolone are hormones and pro-hormones (ie hormone precursors) which maintain the health of many organ systems, and also act as biomarkers of ageing.
Their levels in the blood peak in early adulthood (around age 20-25 years) and then decline steadily as we age. The current level and rate of decline influences our overall health, as they influence many organs.
The level and rate of decline may be determined by genetic factors, lifestyle, diet, exercise and weight. They can further be modified by supplementation and medical therapy. I call them the "youth hormones".
Of these, HGH is the most important.
The sex hormones are also youth hormones. Testosterone is a reliable bio-marker for men (if the blood sample is taken in the morning), but estradiol is not a reliable bio-marker due to its marked (menstrual) cyclical variation, although the trend (if tests are done on the same day of the cycle, usually at the end of the third week, in a woman with regular cycles) may be useful. After menopause, when there is no menstrual cycle, the level becomes a reliable indicator.
For post-menopausal women out there: most of you probably do not know that your estradiol (the main oestrogen) level is probably even lower than that of the average man of the same age who is not fit and healthy (and most men above 50 are in this category).
These men tend to have higher estradiol levels than they should (which is not good for them), in contrast to menopausal women who have lower levels required for good health.
If your estradiol level is even lower than a man's, how can you expect to be healthy, feminine and sexy?
Human growth hormone
HGH is the "master" hormone of the body. As the name implies, it is crucial for growth in children. Children who are HGH-deficient will become stunted, while those who have excess HGH (usually due to a pituitary gland tumour) will become "giants".
All the world's tallest men and women recorded in the Guinness Book of World Records were likely to have suffered from this problem (acromegaly). They have a myriad of health problems and do not live long.
What we are concerned here is the role of HGH in healthy ageing. After age 25, HGH levels decline by about 13 per cent every decade in the average person (more in the unhealthy, and less in the fit and healthy).
This means that you will have about 50 per cent left by the age of 60.
Since HGH, as the master hormone, directly or indirectly (through increasing the production of many growth factors) influences all the organ systems, its decline is responsible for most of the signs and symptoms of ageing.
The decline in the level of oestrogen after menopause only accelerates the ageing process, which has been going on for at least three decades previously (mainly due to the HGH decline).
The different tissues and organs age at different rates. For example, while most women are wary of their bones becoming brittle (osteopenia/osteoporosis) after menopause, the bone density (and strength) actually starts to decline from about age 35 onwards, about 15 years before menopause, while their hearts usually become unhealthy only after 50 (because oestrogens are excellent protectors of the heart).
Since many men enter andropause even earlier than age 50 (if low testosterone levels are used as the criteria), their accelerated ageing also starts earlier.
In 1990, the New England Journal of Medicine published a landmark study by Rudman and colleagues on the effects of HGH (injection therapy) on men above 60 years old (NEJM July 5, 1990). They reported improvements in body composition (less fat, more muscle), strength, exercise tolerance and wellbeing in the subjects tested.
Although it was a small study, this in fact started the anti-ageing revolution. Since then, there have been over 20,000 studies on HGH. Some of the benefits of having healthy levels of HGH shown in these studies include slower senescence (ageing), reduced adiposity (body fat composition), improved blood lipids, reduced blood homocysteine (a marker of inflammation and heart disease risk), reduced atherosclerosis, improved heart function, improved diabetes, increased lean body mass, improved exercise tolerance, improved immune system, better quality of life, better sleep, less fatigue, better sexual function, improvement from depression and anxiety, improved memory, improvement from memory loss in Alzheimer's, improved rheumatism and fibromyalgia, improved osteoporosis, and many other benefits (references available on request).
However, there are some controversies. Naturally high IGF1 (insulin-like growth factor 1, which is the marker for HGH in the blood) has been associated with some cancers (eg breast and prostate), but a causal relationship has not been established.
The higher IGF1 levels have not been shown to be the cause of the cancers, and instead, could be due to the cancer, as cancer cells are known to produce many growth factors to sustain their growth and spread.
In people with acromegaly, HGH production is 10-100 times more than normal. Yet, overall they do not have more cancers (although they have slightly more colon cancers than others). So it is more likely that in cancer patients, the high IGF1 levels is due to the cancer itself.
Another controversy is that HGH can worsen diabetes. IGF1 levels increase with HGH. Insulin-like growth factors have glucose-lowering effects like insulin, and improve insulin-sensitivity. Thus, more studies show improvement in diabetes rather than worsening.
The controversy arises because diabetes occurs more in HGH-treated children, and in those with acromegaly. There are other explanations for these.
There is no doubt that having healthy levels of HGH means better health, and those with severely low levels need treatment. What is controversial is whether those with lower levels within the "normal" range when tested (and have any of the parameters mentioned above which can be improved by HGH) should be interfered at all; and whether high HGH levels predispose to cancer (see above).
The answer is simple - if you want better health and you have low HGH, you can try to improve its level and feel the benefits yourself. Make sure your doctor explains to you all the pros and cons, including possible side-effects (eg edema, which only happens if you take excess doses in the injection form).
If you don't get any benefit after three to six months, then you can stop. If you are convinced of the benefits (especially if there are measurable improvements in your weight, body composition, and obvious improvements in your skin texture), then you can continue.
How to improve HGH levels
There are natural ways to improve your HGH level. The best ways are:
● Make sure you have sufficient deep sleep (six to seven hours of good sleep), and go to sleep not later than midnight because the HGH is released in spurts at about 2-3am (peak spurt) and again at about 5am, provided you are in deep sleep. Those who are chronically sleep-deprived, and those who work shifts, therefore miss on these spurts.
● Have a healthy nutrient-dense, high-protein, low-calorie diet. HGH is a peptide hormone and requires amino-acids for its production. Avoid caffeinated and milk products, alcohol and the empty calories in cakes and cookies.
● Intense exercise, which must include muscle-building (weights and/or resistance) training.
● Maintain a lean body (body fat below 20 per cent for men and below 25 per cent for women).
There are also supplements that can improve natural HGH secretion. These are called "secretagogues" and contain the component amino-acids which also act as HGH secretion-boosters. They are available in powder form (most effective) or tablet/capsules.
There are also sublingual sprays which contain homeopathic formulas or even HGH encapsulated in patented "delivery systems" to allow for its absorption (HGH is a large peptide which cannot be absorbed when taken orally). However, the effectiveness of these formulations has not been scientifically validated.
Then there are also supplements which provide the growth factors (including IGF1) directly instead of inducing HGH secretion, which then increase the growth factors production in the body.
Medical therapy by HGH injection is given only to children and older people with proven deficiencies after appropriate tests are done. These patients must be strictly monitored by their doctors.
The older patients may first try supplementation, and switch to injections only if these fail. For the majority, injections are not necessary.
The dangers and side-effects of overdosing only apply to those getting HGH injections. You need not worry about getting any side-effects if you are taking supplements to improve your HGH levels, which is why you can continue these for as long as you like if you get the benefits, while your doctor monitors your IGF1 level at suitable intervals.