Denver Rocky Mountain News

April 9, 2000, Sunday

SECTION: Home Front; Ed. Final; Pg. 6F

LENGTH: 1487 words

HEADLINE: PRESCRIPTION AGAINST AGING
SOME SEE FOUNTAIN OF YOUTH, OTHERS SEE THREAT TO HEALTH

BYLINE: By Michelle Andrews

BODY:
Dr. Ronald Livesey couldn't help but feel a little like an outlaw. Perhaps it was the syringe, the vial of clear liquid and the alcohol swipe wrapped in aluminum foil. Perhaps it was the fact that he was sitting in his underwear on a toilet in a strange hotel room.

Holding the syringe almost parallel to his thigh, Livesey, 54, felt a tiny prick of pain as he gently inserted it just under the skin. He thought to himself, "Now I know how a junkie must feel."

It wasn't heroin that Livesey was shooting up but something called human growth hormone. He spent the weekend playing tourist in Palm Springs, Calif., where the clinic he'd visited was located. On Sunday night he boarded a plane for San Francisco, where he was to attend a conference on internal medicine, his specialty.

By the time Livesey returned to work at Dartmouth Medical School's Hitchcock Clinic in Manchester, N.H., he was injecting himself twice a day. But he didn't tell his fellow doctors.

"I wanted to see if I would get a reaction," he says.

He did.

Within the first month, people started noticing: "You've sure got a spring in your step," they'd say, or, "You're really looking well these days."

At first Livesey wondered how much of this was due to the placebo effect. But time, he says, has proved otherwise. Three and a half years after his first visit to the clinic, Livesey has lost nearly 50 pounds, dropped four inches in his waist and built up 12 pounds of muscle in his upper body.

In fact, the doctor was so overwhelmed by the changes he saw in himself that he decided to move to New York and start a practice specializing in this new therapy that has changed his life: anti-aging medicine.

"He's made incredible progress," says his partner, Dr. Joseph Raffaele. " If you saw him from the neck down, you'd think he was 40 or 45."

Human growth hormone, or hGH, is fast growing in popularity. Even though the drug typically costs $1,000 a month, at least 10,000 people have begun taking it for anti-aging purposes, says Dr. Ronald Katz, president of the American Academy of Anti-Aging Medicine.

So what is this stuff? Produced by the pituitary gland, human growth hormone helps to maintain tissues and organs, build muscle mass and reduce fat, keep bones strong and enhance mood and mental acuity.

In most people, hGH levels start slacking off at about age 30. Anti-aging doctors believe that by returning hormone levels to those of a 25- or 30-year- old, the age when bodies function at their peak, we can slow and possibly reverse the effects of age.

Anti-aging doctors also prescribe sex hormones, adrenal-gland hormones, thyroid supplements and melatonin, if patients are "deficient" in those areas. The good ones generally recommend a diet and exercise regimen to complement the hormones, and many sell their own nutritional supplements, or " nutriceuticals."

The treatment is attracting all sorts of fans. Diane Gilman, 54, a New York fashion designer who sells her collections to Saks Fifth Avenue and Nordstrom as well as on the Home Shopping Network, injects herself with hGH twice a day. "I feel like I'm 30. I can get two to three hours of sleep and wake up feeling like a million bucks," she says.

Nick Maffei, 40, an abstract painter from Fishkill, N.Y., was worried that he'd run out of gas before he managed to really get his career off the ground. (He earns most of his income as a plasterer, but he was able to find a cheap hGH supplier on the Internet.)

"I don't want to be at Country Buffet, charging the steam table for food with all the other senior citizens," he says. "I don't want to be isolated with the blue-hair set."

Actors such as Nick Nolte and Dixie Carter admit to using hGH too.

. . .

There was a time when the chief candidates for human growth hormone replacement were children who had a growth-hormone deficiency and, more recently, AIDS patients.

Supplies were scarce - the drug had to be extracted from human cadavers - until Genentech introduced the first bioengineered human growth hormone in 1985. While not approved by the Food and Drug Administration for anti-aging purposes, doctors can prescribe it for anything they want.

At the forefront of the movement is the American Academy of Anti-Aging Medicine, or A4M, founded in Chicago in 1992. The group now has 8,400 members and has developed its own certification exam. To qualify, a doctor must be either an M.D. or a doctor of osteopathy and have five years of clinical practice.

A4M President Ronald Klatz says that it takes 2 1/2 years to complete the testing process and that 460 doctors have done so or are doing so.

Last year's annual A4M conference, held at the Tropicana Hotel in Las Vegas, attracted 5,040 attendees - a hundredfold increase since its first conference in 1993 - and 450 exhibitors.

Why such a crowd? There's a good chance it has a lot to do with money. Ten thousand baby boomers turn 50 every day, meaning that the market for anti- aging therapy may soon be extremely lucrative.

Alan Mintz, a board-certified radiologist, founded the Cenegenics Medical Institute in Las Vegas just two years ago. With close to 600 patients, it's probably the country's largest anti-aging clinic. They come from 40 states and eight countries to undergo an all-day medical evaluation and begin an anti-aging program that generally consists of hormone replacement, nutritional and other supplements, and diet and exercise counseling. The average fee? Between $500 and $600 a month.

"I see enormous economic opportunity in this," Mintz says. "Our goal is to do an IPO in three to four years."

In the past year the company has launched an ambitious "physician partner" program to extend the Cenegenics name and program to physicians across the country. (The partners use Cenegenics' medical protocols and its marketing and billing services; Cenegenics expands its patient base.) Fifty-eight doctors have signed up. Mintz believes most of the clinic's growth will come from this program.

But what if you want to invest in hGH without opening a clinic? There are five drug companies that sell hGH in the United States:

More energy. A more youthful body. The promise of an active old age. So what's the downside?

The side effects, for starters. They include joint pain and carpal tunnel syndrome, and in some cases diabetes and fluid retention in blood vessels, which can lead to high blood pressure and heart failure. Most of this can generally be controlled by changing the dosage.

Other things can't: Nadler has treated more than a few bodybuilders who, having used hGH to pump up, went way beyond the prescribed dosage.

"It's sort of like Cro-Magnon man," he reports. "Once you get up into that level, you get this frontal bossing. The forehead comes out. The jaw starts to grow. Even your internal organs start to grow. Once it occurs, it doesn't revert, even if you go off the growth hormone."

But for most users, there's a much bigger long-term concern: cancer. The fact is, human growth hormone makes things grow. Patients are carefully screened for existing cancers before beginning therapy, but what about pre- existing cancer cells that are undetectable by current diagnostics?

"There's evidence that growth hormone, whether given in the body or to the cells directly, can increase the propagation of pre-existing cancer cells," says Johns Hopkins's Marc Blackman. "It would be imprudent to recommend it at this point."

Dr. Tom Perls, an assistant professor at Harvard Medical School, thinks all of us have succumbed to negative hype.

"The people who are promoting this paint a terrible picture of aging," says the author of Living to 100, which examines why centenarians live to such an old age. (Good genes play the major role.) "It's as if aging and infirmity and death are all interchangeable. Anti-aging is really just anti- old people."

Then there's the question of cost - which is quite high. To patients who are worried about the steep price tag of human growth hormone, anti-aging doctors say reassuringly, "Wait until 2002, when the patents start to expire. Generics will flood the market, and the cost will really come down."

If only it were that simple. When generic competition comes, it will very likely lower prices. But the FDA must approve any generic drug sold in the United States, and there are no generic biologic drugs on the market at all.

For William Jones, it's more a question of the size of his estate. "One has to reapportion one's assets and income to cover this expense," the doctor says.

"But you can't take it with you. My kids are pretty much through their education. I could just keep salting it away and put it in a larger and larger estate. But for me, this is such a positive thing to do."

"I'd stick up a 7-Eleven to get the money if I had to."

NOTES:
Health & Nutrition Page

GRAPHIC: Photo
With a vial and a syringe like these, an estimated 10,000 people are giving themselves injections of human growth hormone for anti-aging purposes, says Dr. Ronald Katz, president of the American Academy of Anti- Aging Medicine.

LOAD-DATE: April 11, 2000