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Older Americans taking shots of human growth hormone in an effort to turn back the clock will likely be disappointed.
As an anti-aging treatment, the hormones appear to offer few benefits but significant health risks, a review of the research finds.
Stanford University researchers came to this conclusion after analyzing 31 studies that included a total of more than 500 relatively healthy elderly people.
The only clearly positive effect found from taking the hormones was a slight improvement in lean body mass.
On the negative side, participants who took human growth hormones were significantly more likely to develop joint swelling and pain, and carpal tunnel syndrome.
There was also a suggestion of an increased risk of diabetes and prediabetes, but that association did not reach statistical significance.
Authors of the review say better studies are needed to understand the risks and benefits of human growth hormone as an anti-aging treatment.
But they say studies do not support the use of human growth hormones for this reason.
"If the benefits truly are minimal, and the risks are not, this is not a therapy that should be used for anti-aging purposes," Hau Liu, MD, MBA, MPH tells WebMD.
Use Growing Among Elderly
Growth hormone is naturally produced in the pituitary gland at the base of the brain, but its levels decline with age.
Promoters of synthetic growth hormone as an anti-aging treatment claim the hormones can do everything from firm sagging skin to boost a sagging libido.
According to government figures, between 25,000 and 30,000 Americans used growth hormones for aging purposes in 2004. That is a tenfold increase in about a decade, Thomas T. Perls, MD, tells WebMD.
"The cost of this treatment can be $12,000 a year or more, but even if you take the cost out of the equation, there is still a huge potential for causing harm," Perls says. "The people promoting this stuff have absolutely no idea what the long-term health effects are."
Because human growth hormone has not been approved for use as an anti-aging treatment by federal regulators, Perls argues that doctors who prescribe it for this purpose are breaking the law.
He first made that charge in a report published in The Journal of the American Medical Association in late 2005.
Perls' report prompted Liu and colleagues to conduct their review of the research on human growth hormone as an antiaging treatment.
No Fountain of Youth
The researchers limited their review to randomized, controlled clinical trials that included relatively healthy elderly people.
The participants used growth hormone for an average of about six months.
While growth hormone did appear to increase lean muscle mass and reduce body fat by an average of just over 4 pounds, it did not appear to have an effect on other measures of fitness, including bone density, cholesterol and lipid levels.
"From our review, there's not data to suggest that growth hormone prolongs life, and none of the studies make that claim," Liu says.
Liu tells WebMD he was surprised to find so little research has been done on the use of growth hormones in the elderly population—especially since so many claims have been made about the treatment's benefits.
But he says he understands why people believe the hype.
"Elderly people today are very health conscious and they are trying to do all they can to take care of themselves," Liu says. "But our conclusion is that growth hormone does not represent a magic bullet or the fountain of youth."
By Salynn Boyles, WebMD Medical News, January 16, 2007
"SunSafe in the Middle School Years" was a middle school research project conducted to improve awareness and educate teenagers about the prevention of skin cancer and the need for sun protection. The research study has been published in the January issue of Pediatrics.
The study provided a two-year follow-up period indicating that teens who participated in the program were much better about using sun protection devices than those teens who had not participated in the program.
The "SunSafe" project involved the cooperation of schools staff, recreational sports program coaches, parents and health care professionals. According to the study results, this may be the intervention needed to improve the behaviors of teens in protecting themselves better from the harmful ultraviolet rays of the sun.
The research took place within 10 communities in Vermont and New Hampshire. Funding was provided by the National Cancer Institute and was directed by pediatrician Ardis Olsen, MD and colleagues.
According to the "Primary Care Practice Manual" produced through the project, reducing sun exposure can eliminate 90 percent of skin cancers that currently occur in 1 of 5 Americans.
The middle school years were noted as being an especially important time to be sure that teenagers are given the important information regarding the risks and precautions of sun exposure. The project establishes that the teenage years are influential as a time when children begin to establish their own health habits. The hopes to influence these habits in a healthy way can prevent many individuals from having to suffer from future skin cancer.
Some of the findings from the study include that only about 30 percent of middle school students protect themselves from the sun. Seventy percent of the children surveyed had suffered from a sunburn during the previous summer.
Statistics indicate that one or more blistering sunburn before 20 years of age doubles the risk of getting skin cancer.
Children have three times as much exposure to the sun as adults. Therefore, statistically, the majority of lifetime sun exposure occurs by the age of 18 years.
Health care providers should take part in the responsibility to discuss sun exposure with the teenagers as well as parents, teachers and coaches. However, this study found that only one-third of physicians had spoken to their patients about this subject.
Pediatricians who incorporated the "SunSafe" information message into their visits with their patients resulted in nearly a 10 percent increase of informed teenagers.
The approach of the SunSafe project was not to simply use classroom instruction, but to include poster contests, buttons and other means of promoting the sun-safety message. A medical device was also used to allow children to see skin changes that are not visible to the naked eye in normal light.
According to the researchers, public health efforts for the different approaches as used by SunSafe seem to show promise for establishing changes in adolescent behaviors in order to reduce skin cancer risks.
By Patricia Shehan, All Headline News, January 11, 2007
The U.S. Food and Drug Administration has approved a new treatment for moderate-to-severe frown lines, medically called nasolabial folds.
BioForm Medical issued a statement describing its Radiesse as a longer-lasting alternative to existing wrinkle fillers. The company said its calcium-based microsphere technology not only fills in facial folds and depressions, but also stimulates the body to produce collagen, the fibrous protein that gives the face its structure and fullness.
The drug was also newly approved to improve the appearance of people with AIDS-causing HIV who have significant facial fat loss (lipoatrophy), the San Mateo, Calif.-based company said.
Radiesse was first FDA approved in 2002 for use in facial reconstructive surgery.
HealthDay News, December 28, 2006
Giving infants "light therapy" to treat their jaundice may boost their risk of skin moles during childhood, French researchers report.
Some types of moles can raise risks for melanoma skin cancer, the team pointed out.
Jaundice affects between 45% and 60% of healthy newborns and as many as 80% of premature babies, according to background information in the article, which is published in the December Archives of Dermatology.
In this study, researchers at Saint-Antoine Hospital, Paris, examined 58 children, ages 8 or 9, for the presence of melanocytic nevi (moles). Eighteen of the children had phototherapy when they were newborns.
Overall, 37 of the children had moles that were 2 millimeters or larger, and there were an average of 2.08 moles per child. The children who'd had phototherapy (light therapy) had more moles than the other children (an average of 3.5 vs. 1.45). When the analysis was limited to moles between 2 millimeters and 5 millimeters, the association between phototherapy and moles was stronger, the study said.
Moles smaller than 2 millimeters in diameter "may represent more recent nevi, whereas those nevi due to early event should be larger," the researchers wrote. "Nevi larger than 5 millimeters probably are congenital nevi and are most probably associated with genetic predisposition."
"Higher numbers of acquired benign nevi are associated with increased risk of melanoma," the study authors concluded. "A detailed examination of the factors responsible for the development of nevi in children would be useful to identify high-risk groups to be targeted for prevention. The link between melanoma and phototherapy should be the focus of such a study."
HealthDay News, December 20, 2006
Laura Bush's skin cancer came with a classic symptom, a slow-healing sore.
That made it hard to ignore, a good thing: Remove skin cancer early, and it's easy to cure.
Better is preventing skin cancer, and key is protecting yourself—and your children, starting when they're tots—from the sun. Sunburns early in life are considered the most dangerous.
Too few heed that advice. Skin cancer strikes over 1 million Americans annually, and is on the rise.
The toll probably won't drop "until this generation that started using sunscreen in childhood grows up," predicts Dr. Clifford Perlis, a dermatologist at Fox Chase Cancer Center in Philadelphia.
Between 1 million and 1.2 million Americans are diagnosed each year with basal or squamous cell carcinoma, the most common and easy-to-treat skin cancers.
The first lady had a squamous cell carcinoma excised from her right shin in November.
Melanoma is the most lethal skin cancer, and strikes about 62,000 Americans a year. Of the 10,700 skin-cancer deaths annually, almost 8,000 are due to melanoma. Yet if caught before it has spread, even melanoma is survivable.
Most at risk for all skin cancers are people with fair skin, difficulty tanning, or a history of excessive sun exposure. For melanoma, major risk factors include a relative with the disease and having lots of moles.
Specialists urge all adults to examine their skin regularly for suspicious changes, such as a new growth or change in an old one.
Associated Press, December 20, 2006
Findings from a new study confirm that tea extracts applied to the skin promote the repair of damage from radiotherapy, and shed light on the mechanisms involved in the injury...
Scientists have long sought to learn whether and how stress can lead to skin problems. A new study in mice shows that a stress-triggered hormone could worsen or even cause skin disorders like psoriasis and eczema.
The scientists found that blocking the hormone called glucocorticoid—which increases in stressful times—resulted in better skin.
Understanding how glucocorticoids work could help scientists come up with ways to prevent human skin problems triggered by psychological stress, said lead researcher Kenneth Feingold of the Veterans Affairs Medical Center, San Francisco and the University of California at San Francisco.
"Here you have things going on in your mind that affect what's going on in your skin," Feingold told LiveScience.
The outermost layer of your skin, the epidermis, is composed of dead skin cells, which form a permeability barrier to prevent water loss. Every day tens of thousands of these dead cells slough off as tiny flakes. Typically, cells at the bottom of the epidermis grow, move to the surface and differentiate into skin cells to replace the lost flakes.
Previous research showed that psychological stress decreases cell growth and inhibits differentiation into skin cells.
In the new study, scientists subjected hairless mice to stress while either blocking the production of glucocorticoids or blocking the action of the hormone. Some mice weren't treated at all. The stress was created by placing the mice in small cages in constant light with a radio playing for 48 hours.
The two groups of mice treated with a type of glucocorticoid-blocker showed much better skin function compared with untreated and stressed mice.
While the researchers hope the study will lead to a way to treat people who suffer these skin conditions, there is still a long way to go. Besides needing to test the effect in people, blocking glucocorticoids could have negative side effects that are worse than exacerbations of skin disorders.
The research is detailed in the December issue of the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.
By Jeanna Bryner, LiveScience Staff Writer, December 7, 2006
By: Kirsten Sheridan
Discover the importance of a balanced internal and external pH in slowing the aging process.
Personal misuse of super-strength botulinum toxin caused a Florida osteopath, his girlfriend, and two of his patients to become paralyzed and hospitalized for months in 2004.
Details of the much-publicized incident—which ended in the practitioner being sentenced to three years in prison—are only now published in this week's issue of the Journal of the American Medical Association.
At the time of the incident, Bach McComb was an osteopathic physician who was continuing to practice in Oakland Park, Fla., after his license had been suspended. In the four cases described, McComb did not use a medical version of Allergan Inc.'s Botox.
Instead, he mistakenly gave himself and the three others four to six injections of a preparation of paralyzing botulinum toxin that was 2,800 times stronger than that typically used on patients, according to the authors of the JAMA article. This formulation was only intended for laboratory work.
The vial's labeling clearly marked the product as not being suitable for human use.
"The fact that clinical practitioners were using an unlicensed product was very disturbing," said Dr. Christopher R. Braden, a medical epidemiologist at the U.S. Centers for Disease Control and Prevention, and an author of the report. "It needed to be highlighted and the issue dealt with so that it does not recur."
"A 100-microgram vial of toxin taken from the same manufacturer's lot as the toxin administered to the case patients contained a toxin amount sufficient to kill approximately 14,286 adults if disseminated evenly," according to the JAMA report.
McComb, his two patients, Eric and Bonnie Kaplan, and McComb's girlfriend, Alma Hall, were each paralyzed by the time they were admitted to a hospital.
All of the patients eventually survived but were hospitalized for months and required assistance for basic functions such as breathing, speaking and walking. McComb was later sent to prison for three years.
The incident does not reflect on the safety of standard treatments of Botox, stressed Dr. John Canady, a professor of plastic surgery at the University of Iowa and vice president of the American Academy of Plastic Surgeons.
"This was clearly not Botox," Canady said. "More than 3 million people got Botox injections in 2005, which is the last year we have statistics on, and I don't believe any reaction such as this has been reported."
The real Botox is carefully packaged by its manufacturer, Allergan, Canady explained. "Botox comes in a vial that does not have an excessive dose, and it is reconstituted in the same vial," he said. "None of these safeguards were in place" in the Florida case, Canady added.
Basic precautions against such misuse are obvious, Canady said.
"It is important to go to a board-certified plastic surgeon," he said. "You should feel free to ask that person what his track record has been in the use of Botox. Probably the biggest take-home message is that it is important to do your homework before any medical procedure, and that includes Botox."
In addition, "It's absolutely fair to ask what material is being injected into you personally," Canady said. "I don't think it's too much to ask to see the container or the material."
And Braden cautioned consumers about bargain-hunting.
The last time he looked at the Internet, he saw advertisements for "Botox-like" medications. "I would be very suspect of those kinds of products," Braden said.
By Ed Edelson, HealthDay Reporter, November 21, 2006
Marathon runners can be proud of their stamina, but all that time outdoors boosts their risk of skin cancer, including the potentially deadly malignant melanoma, according to a study in the Archives of Dermatology.
"We are the first to report this," researcher Christina M. Ambros-Rudolph, MD, tells WebMD in an e-mail interview.
Ambros-Rudolph is a consultant dermatologist at the Medical University of Graz, Austria.
She and her co-researchers, all runners, conducted the study after caring for eight ultra-marathon runners with malignant melanoma over the past decade.
Comparing Runners and Nonrunners
In the study, the researchers evaluated 210 marathon runners, men and women, aged 19 to 71.
They compared the runners' skin cancer risks with those of 210 men and women matched for age and gender who were not long-distance runners.
All participants underwent a skin cancer exam and answered questions about personal and family skin cancer history, as well as changes in skin lesions, sunburn history, sun sensitivity, and physical characteristics such as skin and eye color.
Even though more of the nonrunners had higher sun sensitivity, reflected by their light eyes and sensitive skin types, the runners had more atypical moles and more lesions called solar lentigines—often called "liver spots"—which are associated with a higher risk of malignant melanoma.
Not surprisingly, the more intense the training regimen, the more likely a marathon runner was to have the lesions and moles, Ambros-Rudolph found. While some runners logged about 25 miles a week, others put in more than 44 miles a week.
No lesions suggestive of malignant melanoma were found, but 24 marathoners and 14 from the control group were referred to dermatologists to evaluate growths that looked like nonmelanoma skin cancers (such as basal cell and squamous cell skin cancers).
What's behind the increased risk?
The study reflects what dermatologists see in practice, says Diane Madfes, MD, a New York City dermatologist and a spokeswoman for the Skin Cancer Foundation.
Among her patients who are long-distance runners, Madfes says she has seen many cases of abnormal moles as well as nonmelanoma cancers, though not much melanoma, she says.
Greater ultraviolet exposure, of course, is one explanation for the increased risk, say the Austrian researchers.
Nearly 97% of the runners studied said they wore running shorts and short-sleeved or sleeveless shirts.
Only 56% said they regularly use sunscreen; nearly 2% never do.
Also, long-term, high-intensity exercise suppresses the immune system, the Austrian researchers write. They note that patients who have undergone transplants and had immunosuppressive therapy have an increase in all types of skin cancers.
Reducing the Risk
Ambros-Rudolph advises runners to cover up, train when sunlight exposure is less intense, and slather on the sunscreen—in spray or lotion form. An SPF of 15 or higher is recommended.
The type of product preferred varies by gender, Ambros-Rudolph has observed. "Men usually hate using lotions, and sprays are quicker to apply and easier to apply on hairy skin, while women often suffer from dry skin and love lotions that moisturize at the same time."
Reapplying a water-resistant sunscreen every two hours is important, adds Madfes.
She suggests runners consider bicycling attire, especially the long-sleeved shirts made of newer wicking materials that draw away moisture from sweat.
About 62,000 new cases of malignant melanoma are expected this year in the U.S., along with more than a million nonmelanoma skin cancers, says the American Cancer Society.
About 8,000 are expected to die this year from malignant melanoma; nonmelanoma skin cancers will claim about 2,000 lives.
By Kathleen Doheny, WebMD Medical News, November 20, 2006