GH therapy and possible applications to connective tissue/joint degeneration in active populations.
A common issue for athletes and other active populations (e.g. SWAT, SOF, etc.) is joint and connective tissue pain with various causes and diagnosis such as tendonitis, bursitis, cartilage degeneration, to name a few.
The use of various anti-inflammatory drugs, as well as nutritional supplements (e.g., Glucosamine, fish oils, etc,), and other therapeutic modalities are of value, but are far from a cure at this point.
A topic I have been researching for some time is the use of GH and other growth factors as a possible treatment for joint/connective tissue degeneration.
The causes of joint pain are multi factorial, but in active populations are often training related: over training, lack of proper warm up, loading and exercise choices, and other variables.
That’s the first place people should look when having chronic joint issues, but not everyone has a choice in the matter as to how much exercise they do and or the types of exercise they perform; various athletes, special operations soldiers, SWAT operators, etc.
I have written in prior articles that I think the use of GH and other growth factors (IGF-1, etc) was a promising way to treat connective tissue/joint problems, and studies are starting to support that conclusion.
There have been impressive developments recently in the use of growth factors for accelerated healing of sports related injuries, overuse syndromes, improved healing after some plastic surgery procedures, as well as studies finding success in the area of orthopedics.
More controversial, my hypothesis has also been that many people who suffer from chronic connective tissue problems and chronic back problems are often found to have low IGF-1, and reversing that state of low IGF-1 as a treatment for these pathologies is a viable treatment. It appears the former concept – using growth factors to treat joint pathology – is getting greater attention with the scientific/medical community. The latter concept – that a deficiency in these growth factors may be the cause of their joint related problems – a much more controversial idea.
But hey, I don’t mind being ahead of the curve and waiting for the scientific and medical community to catch up to me! Remember, Growth factors (e.g., IGF-1, bFGF, PDGF, EGF, and others) are the mediators that control the biological processes necessary for repair of soft tissues. After hitting the gym or the road with 60-80lbs of stuff on your back, and having muscles and joints in need of repair from micro trauma caused by those activities – or in the case of traumatic injury to muscles, tendons and ligaments – these growth factors are responsible for healing the injuries, with animal studies showing clear benefits in terms of accelerated healing and repair.
Regarding research on the issue of using growth factors to treat sports related injuries, a recent review in the British Journal of Sports Medicine entitled “Growth Factor Delivery Methods in the Management of Sports Injuries: The State of Play” examined the issue. The review covered a wide range of topics that examined the use of growth factors for treating various sports medicine related injuries. However, the report also noted,
“The use of growth factors in Sports Medicine is restricted under the terms of the WADA* anti-doping code, particularly because of concerns regarding the IGF-1 content of such preparations, and the potential for abuse as performance-enhancing agents.”
So, as hormones such as growth hormone (GH), IGF-1, as well as others may have performance benefits in athletes, they are banned by the International Olympic Committee (IOC) and are on the WADA list of agents.
It’s important to note that this review is talking mostly about directly delivering, via injection, the growth factor in question into the injured joint, which results in a much higher concentration to the injured area while reducing whole body/systemic exposure.
The IOC and WADA are concerned with athletes taking these hormones for performance enhancement vs. treating an injury. However, WADA has what they refer to as a “Therapeutic Use Exemption” which states:
“Athletes, like all others, may have illnesses or conditions that require them to take particular medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the Prohibited List, a Therapeutic Use Exemption may give that athlete the authorization to take the needed medicine.”
There are various ways of delivering higher doses of growth factors to injured tissue, but each has in a reliance on the release of the aforementioned growth factors which are released upon injection at the site of an injury. This means you get a high therapeutic dose at the site of the injury with a low whole body/systemic exposure of these growth factors.
So what about athletes and other active populations using GH who are not subject to IOC or WADA rules? Many athletes using low dose GH report improved joint function and less pain from GH therapy. Of course, not injecting it into the joint (and that should NEVER be attempted without medical supervision), which is how most athletes use GH, means a greater whole body effect and a lower concentration at the site of injury, which opens up additional areas of concern.
Regardless, it still appears to help with joint problems. I also recommend people who have chronic joint problems have their IGF-1 levels checked via blood tests. Healthy young people who have adequate diets and protein intakes don’t generally suffer from low IGF-1 levels, though I find it’s more common than some might realize, and not uncommon in older adults.
Finally, the use of GH for joint problems has to be done in the context of legality. I do not recommend people use illegally obtained GH for this use and need to find a medical doctor willing to work with them on their medical/joint related problems, but physicians using GH for this use is becoming more common as additional research and clinical feedback becomes available.
Creaney L, Hamilton B.
Growth Factor Delivery Methods in the Management of Sports Injuries:The State of Play. Br J Sports Med. 2007 Nov 5
* = The World Anti-Doping Agency