Written by DR. GEORGE TOULIATOS, MD
02 January 2020

 

 

Dr. Testosterone
By George Touliatos, MD

 

Growth Hormone

 

Growth hormone (HGH) or somatropin is a polypeptide composed of hundreds of amino acids (191). It is produced in infancy and adolescence by the anterior pituitary gland (adenohypophysis).

The synthetic form of HGH is produced in the laboratory by the method of recombinant DNA from E. coli. Until 1985, GH treatment using human pituitary growth hormones extracted from deceased individuals or chimpanzees had a significant risk of transmission of bovine spongiform encephalopathy (Creutzfeldt-Jakob disease).

The agents that promote HGH secretion are:

1) Fasting (low insulin – high glucagon)

2) L-arginine, L-ornithine, lysine, clonidine (against hypertension), L-Dopa (against Parkinson’s disease)

3) Multi-joint, free-weight exercises such as deadlifts, squats and night sleep 11:00 p.m.-7:00 a.m.

4) Lactate production during anaerobic activity

5) Estrogenic environment

HGH is also released during the REM (rapid eye movement) phase of night sleep (11:00 p.m.-7:00 a.m.)

Somatropin acts synergistically with testosterone, insulin, thyroxin and high caloric diets. The cells that constitute the 191 amino acids are activated by GHRH peptide in the hypothalamus. HGH in puberty has the ability to promote all cells and promote tissue growth through hyperplasia. However in adults, hypertrophic phenomena occur instead.

Somatropin’s hypertrophic effect is stimulated by somatomedin C (insulin growth factor or IGF-1), a hormone homologous to proinsulin. All organs seem to respond to it, except those that are in closed cavities and their expansion is impossible (eyeballs, brain). All visceral organs though, including soft tissues (lips, ears, tongue, gums) are overfed because of the remodeling – proliferation of cells (mitotic cellular divisions). Epidermis (skin) also gets thicker, while tendons, joints, articular capsules and cartilage are regenerated by the connective tissue collagen synthesis (chondroblastic activity). Effect on myocardial growth is evident, leading after chronic abuse to cardiomegaly, cardiomyopathy (HGH-induced), increased rate of cardiovascular disease and progressive heart failure.

Muscle hypertrophy caused by the use of HGH implies the hyperplasia of all tissues. The elbows and the chin protrude, the forehead grows, the jaw widens (dentures – braces), the hands and feet grow as well. It is the characteristic acromegaly after the end of puberty. This is, however, something that former chemist of BALCO and KetoSports, Patrick Arnold refuses. He supports that after the closure of epiphyseal plates, hyperplastic phenomena don’t occur, at least in skeletal-contractile-sriated muscle tissue. Unlike William Llewellyn, author of the book Anabolics and longtime columnist for Muscular Development, and Dave Palumbo, who both support the opposite.

 

r-HGH’s huge benefits involve anti-aging at low doses (2 IU daily) and the mobilization of fat at double dose (4 IU), while at doses of 8-16 IU, it is an excellent muscle growth agent. It contributes to positive nitrogen balance by the entry of amino acids into muscle cell, while it has an adverse effect on insulin. Therefore, it releases glucose in the circulation (gluconeogenesis in liver) and free fatty acids, contributing to the lipolysis of the subcutaneous tissue, which antagonizes the effect of insulin.

The indicated doses per kilogram of bodyweight concern only young children with hypopituitarism-dwarfism. In every product, quantities are measured in milligrams (mg). The ratio between mg and international units (IU) is 1:3. Therefore, 12mg of pharmaceutical recombinant somatropin is substantially 36 IU. The leading pharmaceutical growth hormones are Saizen, Genotropin, Norditropin, Serostim and Humatrope.

HGH has a half-life of 30 minutes, while the peak of its action is reached at 120 minutes. Within 36 hours, the metabolic activity is ceased. When it is administrated before sleep, we sabotage its natural secretion during the REM stage. It is better to be administrated twice a day, in the morning in a fasted state and post training. The ideal time to use r-HGH is when the stomach is empty and hunger is present (low insulin – high glucagon). After the use of r-HGH, one should not consume carbohydrates for at least half an hour, as long as the half-life of HGH exists. Otherwise, the insulin release from the pancreas will hinder its metabolic activity. In other words, using r-HGH requires hunger and not carbohydrates. This is possible in the early morning, first thing in the morning, when the serum glucose levels are low. Its subcutaneous use extends the absorption by one hour compared to the intramuscular, which gets instantly absorbed, as it enters directly into the bloodstream. However, we diminish the local fat oxidation effect.

Measuring IGF-1 and IGF1-BP3 are methods to verify r-HGH authenticity. With the exogenous use of the HGH, liver releases IGF1.

The measuring of IGF-1 should be made in half an hour (half-life). Normally, we should observe hyperglycemia, as HGH releases glucose in circulation from liver (gluconeogenesis). Aching of bones and joints is evidence that the effect is active.14162 647017841989335 1241365847 n 1

HGH tends to reduce the natural production of thyroxin. This occurs because it favors conversion of thyroxine to triodothyronine (T4=>T3). As a result of this, it is advised that it be combined with the smallest dose of T4 (25mg thyroxin) as long as the treatment lasts.

 

Chronic abuse of somatropin causes hypothyroidism (increase of the TSH, or thyroid- stimulating hormone). Hypothyroidism also appears in the form of nodular goiter in patients with pituitary adenoma, acromegaly and gigantism. In other words, a patient with anterior pituitary adenoma has similar symptoms to a chronic r-HGH abuser. Apparently, administration of T4 is necessary in both cases. In pituitary adenoma and gigantism, nodular goiter, abnormal glucose tolerance and diabetes mellitus type 2 (DM2) may coexist.

GH increases insulin resistance and consequently insulin action is reduced in both hepatic and extra hepatic tissues. So, the incidence of DM2 can be explained by the direct hyperglycaemic effects of excess HGH. As a counterweight, a small dose of insulin could be administrated, or metformin (<4 IU).

Other common symptoms that are observed along with r-HGH abuse and pituitary adenoma are acromegaly and arthritis. The latter is due to the friction of long bones epiphysis, as they grow.

Tibia and femur are the sites of epiphyseal plates from where a teenager grows. Bones that are also affected are humerus (brachium), radius and ulna (forearm) and the bones of wrist and ankle.

The braces that some athletes wear on their teeth suggest the deformation of the maxilla (upper jaw) and the thinning of front teeth, due to r-HGH use.

We often hear about athletes getting injured by the infamous “fatigue fractures.” These take place as a result of chronic abuse of somatropin. The explanation is that as the muscles grow along the bones (tibia or fibula), they pull them. Consequently, periosteum of bones cracks, since it can’t stand the forced pressure. This is something that occurs in combination with AAS abuse and repeated cushions (long jump, triple jump and high jump).  

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Carpal tunnel syndrome is another side effect. The wrist tendons get thicker due to fluid retention, which causes compression phenomena in the median nerve. Numbing of the thumb and hand is a typical clinical syndrome. It can be treated surgically, by the incision and decompression of the carpal ligament.

Chronic abuse of somatropin has been implicated in neoplastic lesions, leukemia in particular. This happens because with doses >8 IU/24h, there is a release of IGF-1 from the liver.

The fundamental basis of tumor growth and carcinogenesis is the excessive proliferation of cells. HGH may stimulate tumor genes that undergo mutations and in combination with other factors, could lead to tumor genesis. Those who have a family history of cancer should first check their tumor markers (CEA, CA, 19-9, AFP). That is the reason why large doses of somatropin lead to tissue and muscle development, through the growth factor of insulin. In contrast, smaller doses <4 IU/24h, deal with lipolysis in particular.

Over time, somatropin users develop thickening of the upper airways (pharynx, larynx and glottis), resulting in partial obstruction and creation of sleep apnea. This is accompanied by snoring and awakening during sleep. This is reinforced by the cervical muscles being overdeveloped. Subjects often complain about waking up with headache, poor concentration and memory, dysthymia-moodiness, derived from hypercapnia (CO2 elevation). This is the result of hypoventilation and low oxygenation in brain.

Super heavyweight bodybuilders and strongmen have developed a neck circumference (> 45cm). The majority of them show the effect of obstructive sleep apnea, during which they snore in their sleep and wake up violently-abruptly. This phenomenon is due to the fact that the pharynx-upper respiratory tract has undergone hypertrophy from:

 

1) Development of soft tissues, by r-HGH abuse

 

2) The strong muscular development of the cervical (trapezoid) and side cervical muscles (sternocleidomastoids).

Moreover, epiglottis relaxes during bedtime, due to the action of parasympathetic nervous system, thus resulting in that phenomenon.

 

George Touliatos, MD is an author, lecturer, champion competitive bodybuilder and expert in medical prevention regarding PED use in sports. Dr. Touliatos specializes in medical biopathology and is the medical associate of Orthobiotiki.gr and Medihall.gr, Age Management and Preventive Clinics in Athens, Greece. Heis the author of four Greek books on bodybuilding, has extensively developed articles for www.anabolic.org and is the medical associate for the book Anabolics, 11th Edition (2017). Dr. Touliatos has been a columnist for the Greek editions of MuscleMag and Muscular Development magazines, and has participated in several seminars across Greece and Cyprus, making numerous TV and radio appearances, doing interviews in print and online. His personal website is https://gtoul.com/

 

 

 

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