Human Growth Hormone and The Business of Immortality

Last week, James Forsythe, a prominent doctor in Reno, Nevada was acquitted by a federal jury after going to trial on allegations that he trafficked in human growth hormone (HGH). The decision came as a relief to the American Academy of Anti-Aging Medicine (A4M), because among other allegations, the doctor was accused of selling HGH as an anti-aging treatment, which is illegal in the U.S. A4M has a history of pushing for HGH-driven anti-aging treatments.

So what’s so special about HGH when it comes to aging? Beginning in your 40s, the pituitary gland slowly reduces the amount of hormone it produces, a fact that some feel is both responsible for the frailty of age and reversible through the introduction of synthetic growth hormones.

But there is little, if any, reliable scientific evidence about the anti-aging benefits of HGH. In fact, there are no double-blind placebo-controlled studies for most of the anti-aging miracle cures out there. Yet we do know for a fact that HGH can increase the risk of cancer—not to mention edema (retention of fluids), arthralgia (joint pain), carpal tunnel syndrome, diabetes, and gynecomastia (enlarged mammary glands in males).  Oh, and it might actually shorten life.

Even though selling HGH for anti-aging purposes is illegal, a 2005 JAMA study estimated that as much as 30 percent of commercial activity around HGH is outside the law. In September of this year the New York Times provided a salient example of extralegal HGH trade when it revealed the chief executive of a leading Chinese pharmaceutical company illegally distributed millions of dollars worth of HGH in the U.S. Boston news outlets also recently reported that a local company is being investigated for promoting HGH as an anti-aging treatment. This October, in Brooklyn, NY $8 million worth of HGH and steroids was seized from a pharmacy by law enforcement agents.

Blue chip drug companies have done little to discourage the proliferation of HGH as a miracle cure. Last year a whistleblower alleged  that “Pharmacia, a company Pfizer acquired in 2003, improperly promoted its drug Genotropin to doctors who intended to use it as an anti-aging treatment.” Pfizer made things worse last summer by trying to block memos relevant to the case. And until very recently, Merck and Pfizer were both running experiments to see how HGH affects older people. Pfizer claims (somewhat suspiciously, after the Pharmacia controversy) that it’s stopped because “tests showed its drug wasn’t effective.” But “Merck wouldn’t comment on why it halted development,” according to The Boston Globe.

It’s not surprising that drug companies want in on the anti-aging action. According to a 2006 BusinessWeek article, the anti-aging industry pulls in $56 billion a year, with that number expected to swell to $79 billion by 2009. A lot of this money comes from the sheer expensiveness of anti-aging treatments. According to BusinessWeek, the price of an anti-aging treatment under the director of A4m includes a complete health assessment that costs $2,500 or more, “a shopping list of diet supplements and natural hormones that can run $250 a month,” and HGH, which can “set patients back by as much as $2,000 a month.”

With so much to be made of HGH and anti-aging, A4M has been less than subtle in its push to fuel hopes of living a supernatural life. This much is clear from the current stories on the A4M website, which features:

•    A genetically modified “supermouse” that can “run for hours at 20 metres per minute without getting tired. It lives longer, has more sex, and eats more without gaining weight. Could the science that created this supermouse be applied to humans?” wonders A4M.

•    A perhaps unexpected ray of hope for those seeking the fountain of youth, courtesy of worms: “Nematode worms treated with lithium that show a 46 percent increase in lifespan, raising the tantalizing question of whether humans taking the mood affecting drug are also taking an anti-aging medication.”

•    Last but not least, the question that we were all wondering about: “Genetic Advances to Pioneer Super-Human Elite?”

To some this may all seem ridiculous, but over the last eleven years almost 2,000 doctors in the US have sought board certification as anti-aging specialists. A4M currently claims 19,000 members in 90 countries, and the organization has nearly doubled in size over the past five years.

Part of the appeal is that these anti-aging “experts” make going backward in time a pleasant experience. One told CNN earlier this year that "Your typical internist may have 4,000 patients. I've decided to limit myself to 400. Before, I would see a patient for maybe 10 minutes at a time. Now, I usually know as much about them as they know about themselves." It’s easy to make anti-aging treatment feel good. After all, the essence of the work is self-affirming.

The notion that “you deserve to live forever” is particularly appealing to the mindset of the baby boomers that are now beginning to gray. Take for example amenity-driven anti-aging treatments like medical spas. The International Spa Association (ISA) reports that the medical-spa industry is the fastest growing US spa industry, growing four times as fast as the spa industry as a whole. Earlier this year ISA pinpointed trends that were propelling the industry, and noted that an important development in the growth of spas is the notion that “spa visits are necessary and an entitlement,” which “is particularly true among baby boomers. They feel entitled to spa experiences rather than viewing them as a treat or only reserved for special occasions.”

Over recent years, media outlets again and again report on the key role that boomers play in fueling the anti-aging “skin trade” (as one article put it last year). The boomers themselves seem unapologetic about their obsession with immortality, authoring books like “The Baby Boomer’s Guide to Living Forever” (published by the aptly-named Hubristic Press) and producing news magazine covers that celebrate their own birthdays.

With this mindset—not to mention the unprecedented degree of discretionary income that baby boomers possess—it’s hard to see how the anti-aging industry can be scaled down. Many people will jump at the chance, no matter how risky, to live forever. Last year feds raided Signature Pharmacy, a company in Florida, for selling HGH as an anti-aging cure, a move which grew the company’s sales from $550,000 in gross annual sales in 2000 to more than $36 million in 2006.

The only thing likely to stem the tide of harmful anti-aging fads like HGH is coherent regulatory action on the part of the FDA, which to date has been very hands-off on the matter, save for the occasional sting. I don’t say this to beat the “big government” drum without reason; the truth is that we just can’t trust consumers to choose anti-aging treatments responsibly. After all, the very premise of living forever could be said to be both irresponsible and irrational. The fact is that there’s no “reasonable” way to guarantee immortality. The baby boomer consumer is too desperate, the anti-aging expert too obsequious and comforting, and the potential pay-off—no matter how implausible—too momentous for the anti-aging industry to operate rationally.

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Very informative post. Thanks for posting this.