The Youth Hormone

A “special report” in the back of a women’s magazine caught my eye.  It was about the “Youth Hormone” and had a photo of a heavily botoxed woman with the words, “What’s her secret?  It’s not just the occasional Botox, peel or filler, or even her assortment of skin creams…”. It goes on to proclaim the benefits of growth hormone as an anti-aging remedy.

This “report” is actually an ad disguised as an article.  The ad doesn’t actually lie, but manipulates the truth so skillfully that even I had to read it twice to see what was really being said.

For starters, notice that the ad doesn’t deny the woman is using Botox, peels, fillers, and the like.  In fact, it admits that she does.  Later in the ad they quote Dr. Oz as saying, “I have been searching for this from the day we started the show.  I’ve been looking for ways of increasing growth hormone naturally because I don’t like getting the injections.”  It’s important to realize that this out-of-context quote doesn’t actually say that he recommends this treatment to anybody or that he uses it himself.  It merely says that he would like to see a way to ‘increase growth hormone naturally.” 

On the second page of the ad, we finally learn about the product itself.  SeroVital is a blend of amino acids that supposedly cause growth hormone production to spike.  I looked up their website and found more of the same smoke and mirrors I found in the ad.  I looked up growth hormone in the medical literature and its therapeutic uses are the same as I remember from my endocrinology fellowship: growth of children with genetic or chromosomal problems, small stature, and more recently, in adults with short bowel syndrome and burn victims.  Growth hormone is probably effective as an athletic performance enhancer,and so is not legal in most sporting competitions.  The risks of growth hormone are that it can mimic a condition called acromegaly, and for a clear idea of this, look at a picture of Arnold Schwarzenegger, who exhibits many features of a GH abuser. (Note I didn’t say he took GH; I can do smoke and mirrors too.)  I did not find any true anti-aging benefits in the medical literature. 

Forget the cost of growth hormone, and the risks, the fact it needs to be injected to work, and even whether or not it is effective as an anti-aging treatment.  SeroVital is not growth hormone. It’s a blend of amino acids that are said to boost GH production that you could buy in the vitamin shop for a lot less than the $100 per month SeroVital charges .  I’m sorry, but their claim doesn’t even make sense.  Individual  amino acids are the building blocks of proteins like growth hormone but they are assembled according to genetic instructions and this assembly is carried out by other proteins called enzymes.  The whole machinery needs to be in place to make growth hormone.  Just adding the raw materials and expecting GH to increase is like dumping a pile of lumber on the ground and expecting a house to form.  As far as their claims that SeroVital increases GH production, a good resource on this is here: http://www.consumervaluereports.org/serovital-hgh/

There is also a major assumption here.  GH decreases naturally with age.  That is a fact.  But is it a bad thing?  It might be that way for a reason we don’t understand yet.  What if a natural decline in GH is necessary for longevity?  We don’t know the answer to this.  But these marketers are making a huge leap assuming that  if something is higher in youth than in age, it’s better. 

At the end of the ad is this: “To me, anything that may reduce wrinkles, tighten saggy skin, decrease body fat, increase lean muscle mass, strengthen bones, and boost mood, while giving you plenty of energy and improving sex drive, is a no-brainer.  However, make no mistake about it, the “established” medical community (and of course they know everything) would say its benefits are largely anecdotal, and based on research that’s preliminary.”

There is so much wrong with this little statement I don’t know where to start.

Notice that they don’t claim their product does these things but that it “may” do these things.

Second, I would say that the words “no-brainer” really don’t belong in a discussion of medical therapy, where you would hope people are using their brains to make your life better.

Third, discrediting the entire medical community by using the word “established” in quotes, gives the false sense of “us versus them” without ever telling you who “us” is.  No doctor or scientist involved with the development and testing of the product is quoted.  If you read a medical paper, the authors are listed.  They tell you who they tested, when they did the testing, where the testing was done, and the strengths and weaknesses of their work.  Medical researchers are expected to self-critique their research in their papers, which are then reviewed for free by experts in the field before the paper can be published.  If the researchers stand to make money for their work, or if their research was supported by outside funding, it must be disclosed. On top of that, researchers must get their studies approved by an internal review board which is a committee that determines if the study is ethical and safe.  Finally, any new drug that is studied must be approved for use by the FDA and tested and retested according to rigorous guidelines before it can be advertised and sold for that purpose.  SeroVital and similar supplements don’t have to adhere to any of these guidelines because they are supplements.  There is no safety data, no study you can look up and read, no doctor you can call about his methods. No IRB approved these clinical trials and the FDA has not reviewed this compound to see if it is safe or if it works.

In other words, it’s just 21st century snake oil.

I didn’t write about this just to pick on SeroVital but to illustrate how to read amazing claims and interpret them.  If you can’t find out where it was tested, if it was FDA-approved, or what the safety profile is, ask your doctor what they can find out.  In my electronic patient chart, I can click on an icon called Micromedex and find out if there is any medical information on a supplement. It takes me about 4 seconds.   If it’s not listed, it’s not real.  Save your $100 per month and instead invest your time in the one thing that actually can “reduce wrinkles, tighten saggy skin, decrease body fat, increase lean muscle mass, strengthen bones, and boost mood, while giving you plenty of energy and improving sex drive”.  This magic bullet has been extensively studied and there are thousands of papers of reputable research backing up these claims.  It’s exercise.

hans and franz

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Not on the Same Page

During the course of my practice, I’ve seen many couples struggle to make difficult treatment decisions.  Should they do in vitro? Donor egg?  Donor sperm?  Take out a second mortgage?  Do insemination in spite of what the priest says?  Reduce a triplet pregnancy down to twins?  It’s bad enough that we can’t guarantee outcomes.  It’s bad enough that treatments are expensive.  It’s bad enough that there may be ethical, religious, or moral implications to these decisions. 

It’s worse when they can’t agree between themselves.

It’s not only couples with infertility who have trouble agreeing on a course of action.  I would say nearly all married couples reach a point where one is ready to move forward with a decision and the other is hanging back.  This usually seems to happen with high stakes decisions that have very unpleasant outcomes if they go wrong, and iffy outcomes at best if they go right.  We are facing a decision like this right now.  We moved from the East Coast to the Midwest for work.  We sold our house, but kept our vacation home in Vermont.  This place was always more home to us than any daily house.  Our Christmases, Easters, summer vacations, winter breaks, dog’s birthdays were spent in this house.  Most of our best memories are linked to this peaceful and beautiful place.  We hoped eventually to retire there, maybe keep a horse, take daily walks on the dirt road, write, garden, ski in the middle of the week.  We hoped to host Christmases with our grown children and grandkids.

For a couple of years after we moved, we managed to hold on to the house, maintain it, and travel to Vermont during school breaks to use it.  But it has become clear that the expense and difficulty of maintaining the house are beyond our capabilites, and it is time to let it go.

Well anyway, it has become clear to me.  To my husband, not so much.

So we are not on the same page about this.  And as we have struggled each to sway the other to our point of view, I began to wonder why it has to be this way.  And I began to wonder why my patients have to struggle through this discordance as well.

And I think I’ve figured it out.  This was an epiphany to me, but maybe everyone else already knows it.  Maybe there is even a psychological term for it that I never caught because I slept through the lecture.  (Let’s be honest, I slept through a lot of lectures.  Once the lights were out, so was I.)

The reason we aren’t on the same page is that we need to be on different pages.  Take the example of the couple who is deciding to do in vitro.  Other treatments have been tried and haven’t worked. It’s time to make a decision.  On person is ready to move on.  Often this is the woman, because she is the one who has to do all the treatments and she’s sick of it already.  The other is not ready yet.  The reason they need to be different is that the one who is moving forward is in crisis.  She is devastated that she need to take this step to have a baby.  She has been hopeful for a long time, and hope has run out.  She is emotionally running on fumes.  He is in denial.  This is actually a good thing, because it allows him to remain cheerful and optimistic, which has helped her get through this crisis so that she can now consider IVF, unthinkable until now.  But now that she’s able to be optimistic and hopeful, the reality of their situation is sinking into him.  He is beginning to realize that having a baby “the normal way” may not happen.  He is beginning to lose hope.  He needs her optimism and resolve.  So the couple passes hope back and forth like a hot potato.  It’s necessary, but on the surface, it just looks like they disagree.  Once I realized this, and was able to think of my own marriage in this way, it opened up reserves of patience and gratitude toward my husband that I would never have tapped otherwise.  This doesn’t mean that we are now magically in agreement.  But at least now, I think I can see why it’s not so bad that we’re not.

 

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