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Growth Hormone for the Elderly?

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The decline in growth hormone secretion with increasing age has led many investigators to suggest that there is a cause effect relation between this decline and changes in body composition, increased adiposity and decreased muscle mass. This is an important issue, but is it an ethical one?

If the changes in body composition in older adults are not directly related to the decline in growth hormone secretion, then it is an ethical issue, since growth hormone would be given to healthy subjects. An analogous situation would be administering growth hormone to short children who do not have growth hormone deficiency, a practice that cannot be recommended. In addition, it is not clear whether a growth hormone induced increase in muscle mass of 10 percent or a 15 percent decrease in the mass of adipose tissue produces substantial improvement in muscle strength, mobility, or the quality of life.

The cost of long term treatment is also an obvious consideration. Currently, the cost of growth hormone therapy for a child with growth hormone deficiency ranges from $10,000 to $30,000 a year, depending on body weight. Treatment of a 70 kg adult with the regimen used by Rudman et al. would cost approximately $13,800 a year.

Thus, long term growth hormone treatment in elderly adults with diminished growth hormone secretion would require a considerable personal and financial investment.

Source:
content.nejm.org

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