Duncan Crow
Wholistic Consultant
http://members.shaw.ca/SomaLife-gHP/HGH_FM_Medline.html
HGH Deficiency in Fibromyalgia (FM)
Robert
Bennett's web site is www.myalgia.com
____________________________________
Human Growth
Hormone is the Treatment that Does the Most!
Bennett RM,
Clark SC, Walczyk J. A randomized, double-blind, placebo-controlled study of
growth hormone in the treatment of fibromyalgia. Am J Med 1998
Mar;104(3):227-31 Department of Medicine, Oregon Health Sciences University,
Portland 97201, USA.
PURPOSE: The
cause of fibromyalgia (FM) is not known. Low levels of insulin-like growth
factor 1 (IGF-1), a surrogate marker for low growth hormone (GH) secretion,
occur in about one third of patients who have many clinical features of growth
hormone deficiency, such as diminished energy, dysphoria, impaired cognition,
poor general health, reduced exercise capacity, muscle weakness, and cold
intolerance. To determine whether suboptimal growth hormone production could be
relevant to the symptomatology of fibromyalgia, we assessed the clinical
effects of treatment with growth hormone.
CONCLUSIONS: Women with fibromyalgia and low IGF-1 levels experienced an
improvement in their overall symptomatology and number of tender points after 9
months of daily growth hormone therapy. This suggests that a secondary growth
hormone deficiency may be responsible for some of the symptoms of fibromyalgia.
_______________________________________
Fibromyalgia
patients have dysfunctional Growth Hormone Release!
Bennett RM,
Cook DM, Clark SR, Burckhardt CS, Campbell SM. Department of Medicine, Oregon
Health Sciences University, Portland 97201, USA.
Hypothalamic-pituitary-insulin-like growth factor-I axis dysfunction in
patients with fibromyalgia. J Rheumatolo 1997 Jul; 24(7): 1384-9
OBJECTIVE:
To investigate the serum levels of insulin-like growth factor-I (IGF-I) in
patients with fibromyalgia (FM) compared to healthy controls and patients with
other rheumatic diseases, and to explore possible etiologic mechanisms of low
IGF-I levels inpatients with FM.
CONCLUSION:
Many, but not all, patients with FM have low levels of IGF-I that cannot be
explained by clinical associations. These results suggest that low IGF-I levels
in patients with FM are a secondary phenomenon due to hypothalamic-pituitary-GH
axis dysfunction.
__________________________________
Disordered
growth hormone secretion in fibromyalgia: a review of recent findings and a
hypothesized etiology.
AUTHORS: Bennett
RM
AUTHOR
AFFILIATION: Dept. Medicine (L329A), Oregon Health Sciences University,
Portland 97201, USA.
SOURCE: Z
Rheumatol 1998;57 Suppl 2:72-6
CITATION
IDS: PMID: 10025088 UI: 99149227
Growth
hormone (GH) deficiency occurs in about 30% of fibromyalgia patients. Treatment
of GH deficient fibromyalgia patients with recombinant growth hormone improves
several clinical features, including the tender point count. Defective GH
secretion in these patients appears to be due to increased somatostatin tone in
the hypothalamus. An hypothesis is presented which relates dysfunctional GH
secretion to the effects of intermittent hypercortisolemia on upregulating the
density of beta-adrenergic receptors in the hypothalamus. The resulting
augmentation of beta-adrenergic tone stimulates the release of somatostatin,
thus, impairing GH secretion.
_______________________________________
The Growth
Hormone (GH)-Releasing Hormone - GH - Insulin-like Growth Factor-1 Axis in
Patients with Fibromyalgia Syndrome*
A. Leal-Cerro,
J. Povedano, R. Astorga, M. Gonzalez, H. Silva, F. Garcia-Pesquera, F. F.
Casanueva, and C. Dieguez
Department
of Endocrinology (A.L.-C., R.A., H.S., F.G.-P.) and Reumatology (J.P., M.G.),
Hospital Universitario "Virgen del Rocio", 15700 Sevilla; and
Departments of Medicine (F.F.C.) and Physiology (C.D.), Complejo Hospitalario
Universitario and Faculty of Medicine, University of Santiago, 15700 Santiago
de Compostela Spain
Received September 30, 1998. Revised May
24, 1999. Accepted June 1, 1999.
Fibromyalgia
(FM) is a painful syndrome of nonarticular origin, characterized by fatigue and
widespread musculoskeletal pain, tiredness, and sleep disturbances, without any
other objective findings on examination. Interestingly, some of the clinical
features of FM resemble the ones described in the adult GH-deficiency syndrome.
Furthermore, insulin-like growth factor (IGF)-1 levels are frequently reduced
in patients with FM.
CONCLUSION: our data show that patients with FM exhibited a marked decrease in
spontaneous GH secretion, but normal pituitary responsiveness to exogenously
administered GHRH, thus suggesting the existence of an alteration at the
hypothalamic level in the neuroendocrine control of GH in these patients. Furthermore,
our finding of increased IGF-1 and IGFBP-3 levels after GH treatment, over 4
days, opens up the possibility of testing the therapeutic potential of hGH in
patients with FM. (The Journal of Clinical Endocrinology & Metabolism 84:
3378-3381, 1999)
__________________________________
Secretion of
growth hormone in patients with chronic fatigue
syndrome.
Growth Horm
IGF Res 1998 Apr;8 Suppl B:127-9
Berwaerts J,
Moorkens G, Abs R
Department
of Endocrinology, Middelheim Hospital, Antwerp,
Belgium.
PMID:
10990147, UI: 20443554
Decreased
serum levels of insulin-like growth factor I (IGF-I) are
common in patients with fibromyalgia, which is
frequently associated with chronic fatigue syndrome
(CFS).
Twenty
patients with CFS (7 men, 13 women; age range, 30-60 years)
and age- and sex-matched controls were tested for
peak GH responses to insulin-induced hypoglycaemia
and arginine administration. Nocturnal secretion of
GH and serum levels of IGF-I were also measured.
Serum IGF-I SDS (+/- SD) was significantly lower in
patients with CFS than in controls (SDS, -0.39 +/-
1.07 vs 0.33 +/- 0.84; P = 0.02).
Patients
with CFS also tended to have reduced nocturnal
secretion of GH (area under the curve, 32.4 +/- 18.3 vs
62.7 +/- 43.7 microg/l/15 minutes; P= 0.06), but
peak GH responses to insulin-induced hypoglycaemia
and arginine administration did not differ
significantly between the two groups. It is not
clear whether the tendency for impaired spontaneous
nocturnal GH secretion in patients with CFS is a
cause or an effect of the condition.
_____________________________________________
Growth
Hormone Eases Fibromyalgia PainImproves
Stiffness, Reduces Number of Tender Points
June 27,
2002 -- For anyone with fibromyalgia, effective treatment is
elusive and the quest is frustrating. Research has shown that
the illness may be due to low levels of growth hormone. And
now, new research shows that growth hormone injections
can relieve the pain and stiffness that comes with fibromyalgia.
Fibromyalgia
is a chronic disorder that causes pain all over the body with
muscle and joint stiffness. If affects mostly women and is
diagnosed by identifying specific tender points on the body. These
areas are particularly tender to touch - even to light touch. Although the
definite cause of fibromyalgia is unknown, one theory is
that it may be caused by below-normal levels of growth
hormone. Growth hormone deficiency has been associated
with low energy, muscle weakness, sensitivity to cold,
weakened ability to remember and think, and other problems -
many of which are seen in people with fibromyalgia.
This illness
definitely has a hormone component, Alfonso Leal-Cerro,
MD, tells WebMD. Leal-Cerro presented new findings at
the annual meeting of The Endocrine Society. He is a professor
of endocrinology at the Hospital Universitario Virgen del
Rocio in Seville, Spain. "We had
previously found that a high number of patients with fibromyalgia
have low levels of insulin-like growth factor 1," he says. Growth
hormone increases the level of insulin-like growth factor 1
(IGF-1) in the body. So
Leal-Cerro and colleagues set out to see if giving growth hormone
could help people suffering from fibromyalgia. Giving growth
hormone should increase the levels of IGF-1.
Pharmacia
donated the growth hormone that was used in the study, and
one of the co-authors, Angels Ulied, is a staff researcher
at Pharmacia in Barcelona, Spain. In this
small study, he and colleagues followed 20 women with both
fibromyalgia and low levels of IGF-1. Each woman received
injections of either growth hormone or placebo. For six months,
neither the women nor the researchers knew whether the
women were receiving growth hormone or the placebo. Then, for
the next 12 months, all the women were knowingly treated with
growth hormone.
After six
months of treatment, the women that received the growth
hormone injections had significantly less morning stiffness
and pain and fewer tender points than at the beginning of
treatment. The women continued to see these benefits at
12 months. The placebo
group had significantly less morning stiffness and fewer tender
points but had no significant reduction in pain. Leal-Cerro said
that he and colleagues are next planning to study
treating fibromyalgia with an oral drug that increases production
of growth hormone.
"Fibromyalgia
is a frustrating disease for people who live with it, and they
are desperate for effective treatment," Clifford J. Rosen, MD,
tells WebMD. He was not involved in the study. "The
people in the study were probably quite disabled with their
disease, because their IGF-1 levels were quite low, and there is a
body of literature that shows IGF-1 levels are lower in fibromyalgia
than in the general population. This deficiency may
contribute to the stiffness in fibromyalgia," says Rosen, staff
endocrinologist at the University of Maine and St. Joseph's
Hospital in Bangor, Maine. Rosen is the
president-elect of the American Society of Bone and Mineral
Research, and his research has focused on growth
hormone, IGF-1, and the relation of these substances to bone growth.
"However, I think it's too early to know if this is a feasible
approach."
____________________________________
(c) 2002
WebMD Inc.Hakkinen K,
Pakarinen A, Hannonen P, et al. Effects of strength training on
muscle strength, cross-sectional area, maximal electromyographic
activity, and serum hormones in premenopausal women with fibromyalgia.
J Rheumatol. 2002 Jun;29(6):1287-1295.
OBJECTIVE:
To examine the effects of strength training on basal concentrations
and acute responses of serum hormones, and their possible
interrelationships with training induced muscle hypertrophy and strength gains
of the knee extensor muscles in women with fibromyalgia(FM) and
healthy controls.
CONCLUSION: Both the magnitude and timecourse of
adaptations of the neuromuscular system to resistance training in women
with FM were completely comparable to those taking place in healthy
women. Basal levels of the anabolic hormones seem to be similar in women with
FM compared to age matched healthy women. Observations recorded during the
acute loading conditions might be considered an indication of the training
induced adaptation of the endocrine system, showing that the acute GH
response may become systematic after strength training in both women with
FM and controls.
_______________________________________
Characterization
of pituitary function with emphasis on GH secretion in the chronic fatigue
syndrome.
Clin
Endocrinol (Oxf). 2000 Jul;53(1):99-106.
PMID:
10931086 [PubMed - indexed for MEDLINE]
CONCLUSIONS:
We observed a significant impairment of GH response during insulin-induced
hypoglycaemia and a low nocturnal GH secretion in CFS patients. These changes
did, however, not lead to different concentrations in serum IGF-I. The clinical
expression of this inadequate GH secretion can thus be questioned, although the
alteration in body composition may be related to this relative GH deficiency.
Significantly increased prolactin and TSH levels were found when compared to
controls. These findings give support to the hypothesis of a decreased dopaminergic
tone in CFS. Further investigations are required in order to identify specific
adaptations within the neurotransmitter system in CFS and to determine the
clinical importance of the impaired GH homeostasis.
_________________________________________
ENDO:
Fibromyalgia Responds to Growth Hormone Treatment
By Paula
Moyer
Special to
DG News
SAN
FRANCISCO, CA -- June 20, 2002 -- Patients with fibromyalgia get relief from
many of their symptoms when they are treated with growth hormone therapy.
"This
illness definitely has an endocrine component," said Alfonso Leal-Cerro,
MD, who presented these findings at the 84th annual meeting of the Endocrine
Society.
"We had
previously found that a high number of patients with fibromyalgia have low
levels of insulin-like growth factor-1 [IGF-1]," explained Dr. Leal-Cerro,
lead investigator on the study and professor of endocrinology at the Hospital
Universitario Virgen del Rocio in Seville, Spain. "Therefore, we wanted to
see if growth hormone administration would be effective at
addressing their symptoms."
His team
randomised 20 women with both fibromyalgia and IGF-1 lower than 125 ng/mL to
injections of growth hormone (GH) or to placebo in a double-blind fashion.
After six months, they entered an open label phase for 12 months. The treatment
group received an initial GH dose of 0.13 mg/day (0.4 IU); the dose could be
titrated up to .66 mg (2 IU) daily. The women assessed their morning stiffness
and pain, andfibromyalgic tender points at baseline and at 3, 6, 9, and 12
months of treatment. Weight and waist-to-hip ratios were also obtained, and
patients responded to a general quality-of-life questionnaire.
The
treatment group had sustained elevations of IGF-1 levels throughout the study
and reported significantly less morning stiffness and pain at six months than
at baseline (p<0.02 and p<0.04, respectively). The treatment group also
had fewer fibromyalgic tender points than controls (p<0.04). These results
continued at 12 months (p<0.05 for stiffness, p<0.01 for pain, p<0.01
for tender points).
The placebo
group had significantly less morning stiffness and fewer fibromyalgic tender
points at six and 12 months than at baseline (p<0.05), but experienced no
significant reduction in pain. The groups had no differences in weight,
waist-to-hip ratios, or scores on the quality-of-life questionnaire.
The results
suggest that a secondary growth hormone deficiency may be responsible for some
symptoms of fibromyalgia, the investigators concluded. Dr. Leal-Cerro said that
he and colleagues are next planning to study the efficacy of treating
fibromyalgia with a GH secretagogue, which would be administered orally.
Pharmacia
donated the growth hormone that was used in the study, and one of the
co-authors, Angels Ulied, is a staff researcher at Pharmacia in Barcelona,
Spain.
_______________________________________
Laurie
Barclay, M.D.
NEW YORK
Source:
Arthritis Rheum. 2002;46(5):1344-1350. Reviewed by Gary D. Vogin, MD
(MedscapeWire) May 06 — Growth hormone (GH) response to maximal exercise is
impaired in patients with fibromyalgia, according to research reported in the
May issue of Arthritis & Rheumatism. Normalization with pyridostigmine
pretreatment suggests a defect in somatostatin tone, which may be related to
the exhaustive stage of chronic stress.
"The
results of this study indicate that GH deficiency is probably more common in
fibromyalgia patients than was originally reported," senior author Robert
Bennett, MD, MRCP, from Oregon Health Sciences University in Portland, says in
a news release.
Fibromyalgia
is thought to be a stress-related syndrome, linked to malfunctions of the
hypothalamic, pituitary, and adrenal hormones, including GH.
In this
study, 20 women with fibromyalgia and a control group of 10 healthy women
exercised to volitional exhaustion, reaching maximum respiratory and pulse rate
on a treadmill. One month later, testing was repeated 1 hour after pretreatment
with pyridostigmine, which inhibits somatostatin secretion.
Without
pyridostigmine pretreatment, 11 of the 20 patients with fibromyalgia had no
exercise-induced increase in GH levels. After the administration of
pyridostigmine, 19 of the 20 patients had a normal GH response to exercise.
The overall
increase in GH was 8 times higher than without pretreatment and was similar to
that seen in controls. Pyridostigmine alone did not stimulate GH secretion in
patients with fibromyalgia, nor did it affect GH levels in controls. Even those
fibromyalgia patients with normal insulin-like growth factor 1 levels had an
impaired GH response to exercise.
"Recognition
of defective GH secretion in fibromyalgia patients is of some practical
relevance because GH replacement therapy was shown to benefit fibromyalgia
patients in a 9-month placebo-controlled study," Bennett says.
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