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Growth Hormone for the Elderly?

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What is the optimal dose and frequency of administration? The doses of growth hormone used in these studies raised IGF-I production to levels similar to those found in healthy young adults (and some healthy older adults); however, thrice weekly or even daily administration is not physiologic, since growth hormone secretion is pulsatile throughout the day and night.

Although the doses of growth hormone used by Rudman et al. and other investigators raised serum IGF-I concentrations to those of young adults, the doses had to be increased or decreased in some subjects because the IGF-I response was suboptimal or because there were indications of excessive growth hormone action, including an increase in blood pressure, edema, and arthralgia. Although an optimal dose of growth hormone can be readily established, it is possible that the pulsatile administration of growth hormone, which would require the use of a portable infusion device, would have additional benefits, fewer side effects, or both.

An alternative method to increase endogenous growth hormone secretion is the long term administration of growth hormone releasing hormone, which produces normal pulsatile and diurnal growth hormone release. An analogue of a long acting growth hormone releasing hormone or a depot preparation would be needed to make this practical. Are there ethical issues relating to the administration of growth hormone to healthy older adults? Since the risk benefit ratio has not been established, the answer to this question is a straightforward yes.

Source:
content.nejm.org

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