What are the benefits of human growth hormone (HGH) in older men with symptoms like decreased muscle mass and bone density loss?

Benefits of Human Growth Hormone in Older Men: Limited Evidence and Significant Risks

Human growth hormone (HGH) therapy is not recommended for older men due to limited evidence of clinically significant benefits and substantial risks of adverse effects. 1, 2

Current Evidence on Benefits

The potential benefits of HGH in older men include:

• Body Composition Changes:

  • Modest decrease in fat mass (approximately 2.1 kg)
  • Modest increase in lean body mass (approximately 2.1 kg) 2
  • These changes occur without significant weight change

• Potential Metabolic Effects:

  • Small decrease in total cholesterol levels, though this effect may not be significant when adjusted for body composition changes 2

• Symptom Improvement:

  • May address some symptoms that older men find bothersome, such as decreased energy (90%), decreased strength/endurance (86%), and deterioration in work performance (52%) 3

Significant Limitations and Risks

Limited Evidence for Functional Benefits

• Despite changes in body composition, there is no convincing evidence of improvements in:

  • Physical function or strength
  • Quality of life
  • Cognitive function
  • Mortality 3, 2

• The American College of Physicians clinical guideline notes that evidence on long-term benefits is lacking due to limited follow-up in existing studies 3

Adverse Effects

HGH therapy is associated with significant side effects:

• Common adverse effects:

  • Soft tissue edema
  • Arthralgias (joint pain)
  • Carpal tunnel syndrome
  • Gynecomastia 2

• Metabolic effects:

  • Increased risk of diabetes mellitus
  • Impaired fasting glucose/insulin resistance 3, 2

• Other potential concerns:

  • Fluid retention
  • Joint pain 1
  • Possible increased cancer risk (though evidence is limited) 4

FDA Status and Legal Considerations

• HGH is not FDA-approved for anti-aging purposes 1
• Distribution of HGH as an anti-aging agent is illegal in the United States 2

Alternative Approaches for Older Men

For older men concerned about muscle mass and bone density:

1. Strength training: Recommended by the American College of Sports Medicine as an effective method for increasing muscle strength and mass with high-quality evidence 1

2. Testosterone replacement therapy (TRT): May be considered for men with documented low testosterone levels (<230 ng/dL) and symptoms 3

   • TRT has been shown to improve lean body mass, reduce fat mass, and potentially improve bone mineral density 3
   • However, TRT should be used cautiously and only after careful discussion of risks and benefits

3. Bone health management: For men with osteoporosis or at risk of fractures, consider calcium (1200 mg daily) and vitamin D3 (800-1000 IU daily) supplementation 3

Conclusion

Based on current evidence, HGH therapy cannot be recommended for older men seeking to prevent or reverse age-related changes. The modest benefits in body composition do not translate to meaningful functional improvements, while the risks of adverse effects are substantial. Strength training and appropriate management of documented hormonal deficiencies represent safer and more evidence-based approaches.