Growth Hormone Deficiency: The Physical Signs

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This blog begins a series of health-casts about the physical signs of the most important hormone deficiencies. We hope to help you develop your observational skills so you will notice the important physical characteristics of each hormone deficiency.

Click to view reference chart – Physical signs of Growth Hormone Deficiency

Most hormone deficiencies cause physical signs that are visible when looking at or engaging in a conversation with an affected patient. Doctors are not only taught to “see” these signs, but automatically register the whole cluster of signs that signify a particular hormone deficiency. This blog begins a series of health-casts about the physical signs of the most important hormone deficiencies. We hope to help you develop your observational skills so you will notice the important physical characteristics of each hormone deficiency. Remember many hormones affect other hormones so many symptoms may be the same, yet with a different hormone deficiencies that initiate the final physical sign. Today we will talk about Growth Hormone deficiencies and the physical changes a lack of this hormone displays.

Growth Hormone (GH) is one of the pituitary hormones that decrease with age after 35-40. GH begins to wane around age 40, parallel to the declining testosterone production. Growth Hormone provides adults with stimulation of cells to grow and multiply, with new cells replacing old ones, which is the way we repair our tissues that maintain our health. Our bodies exist in a constant state of balanced growth and breakdown. For example, osteoporosis or thinning of the bones that happens as we age occurs when our growth hormone and testosterone levels decrease, causing a slowdown in the bone growth phase, while the bone dissolves at the normal rate. This unequal growth that is exceeded by reabsorption of the bone causes an overall deficit of bone thickness, leading to thin bones or Osteoporosis. The trigger for bone loss is hormonal (loss of GH, Testosterone and eventually estrogen), but the outcome is thin and fragile bones as we age.

Throughout our young life our muscles grow under the stimulation of testosterone and growth hormone. These liquid communicators (GH, T) are both anabolic hormones, meaning they stimulate growth and renewal of the majority of tissues in the body, most notably our muscular system. As we age, our muscles deteriorate and ache. Once again this breakdown of muscle mass is due to a progressive loss of these two hormones. When testosterone and growth hormone are at critically low levels, blood flow is diverted from the muscles, cell division of muscle decreases, nutrition is diverted from the muscles, and the process of the growth and strength of muscle that occurs in our youth is lost. Similar to bone, the breakdown of muscle occurs at the same pace as young healthy people, muscle growth is stalled and slowed by the physiologic effects of GH and Testosterone. The physical signs that we observe as “clues” to the deficiency of GH in relation to muscle and bone strength appears as a person who stands bent forward, looks at the floor while walking, has a slow pace and looks like he is in pain just by walking. His shoulder muscles look bony and his clothes will appear too big except for the abdominal bulge of belly fat. We call this sign, when combined, frailty.

Loss of facial muscles that support our cheeks brows and jaw line is secondary to deficient GH and the loss of Testosterone’s effect on the facial muscles, giving us a look that is older than our years. This signs appears as jowls, saggy neck, thin eyebrows, and saggy eyelids.

Look at a subject’s hair and it will be very thin, grey and lifeless, his or her nails will have longitudinal lines on them, and all the veins and tendons of the hands are visible.

Look to the belly of a person you suspect of GH deficiency. If it is fat and droopy, and his or her back has “drapes” of skin that hang, arms that hang and waddle, and sagging thighs much like the drapes of the back.

Other characteristics of GH loss include thin lips, deep nasolabial folds, bags under the eyes, and a sagging chin. All the problems we women correct with lasers, fillers, retin-A and youth potions that we apply on our face! If we could catch our low growth hormone problem before all of these cosmetic problems occur, we would be fighting a battle we could win, or at least keep up.

Currently I treat low GH with testosterone in pellet form which does an excellent job of stimulating GH and alleviating these signs and symptoms. In some people, especially those with head injuries, or concussion syndrome, or those over 70, testosterone does not always stimulate GH. For these patients we give a stimulation to the hypothalamus which in turn stimulates the pituitary to produce GH. This compounded medication is Sermorelin. We do not prescribe GH because it is aggressively controlled by the US DEA and doctors who do use it frequently lose their licenses. It is treated like a narcotic when it is merely a hormone that is lost with aging and should be replaced.

Lawmakers don’t understand or care, that with GH we might live longer, and we would be happier and healthier if we were able to receive the GH we are missing when testosterone pellets and Sermorelin stop working to stimulate GH!

Some of us had low levels of growth hormone when we were children, secondary to genetic and developmental diseases. This results in a shorter height, with thinner bones when we reach maturity. Most people with conditions that cause low growth hormone are not as robust as those people who have plenty of growth hormone. This is the primary reason that we pick spouses with adequate height. It is a sign that our spouse is healthy and we are passing on strong healthy genes.

As adults our growth hormone stays relatively static and adequate until we hit age 40, and the end of our fertility. This gives us a period of time where we are young, healthy strong and sturdy. After 40 when testosterone and growth hormone fall, people of both sexes begin to display physical signs of aging and lack of health.

The following pictures are from patients who have deficient growth hormone.
They are outward signs of decline, but give us an idea of what we will find inside their bodies: waning immune systems, increasing inflammation, insulin resistance and obesity, with loss of muscle mass and firm skin.

Testosterone is from the ovaries and testes of fertile young people, and helps to stimulate the hypothalamus in the brain to make growth hormone. These two hormones produce a physical body that is youthful as long as the two hormones are maintained at a youthful level.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.

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