The Life Plan (65 page)

Sarcopenia

Sleep apnea

Sleep disturbance

Growth hormone is a protein-based polypeptide hormone. It stimulates growth, cell reproduction, and regeneration in humans. Somatotropin refers to the growth hormone produced naturally in humans, whereas the term somatropin refers to growth hormone created by recombinant DNA technology and is abbreviated “hGH.” Mounting evidence shows that adults with a somatotropin deficiency have impaired health, which then improves with hGH replacement therapy. When prescribed and monitored properly, this treatment is very safe and has the potential to greatly improve quality of life and reduce the incidence of morbidities associated with untreated growth hormone deficiency.

The following are diseases related to growth hormone deficiency:

Growth hormone protects against endothelial dysfunction, atherosclerotic plaque development, Metabolic Syndrome, plaque instability, and ischemic myocardial damage. Low levels may represent an additional independent risk factor for cardiovascular disease.

Low levels of circulating growth hormone may be a predictor of stroke.

The health risks associated with obesity are closely correlated with abdominal, or visceral fat. Visceral fat causes Metabolic Syndrome, which is associated with serious metabolic disorders, including silent inflammation, heart disease, cancer, stroke, insulin resistance, diabetes, and Alzheimer’s disease. Visceral fat is associated with a decrease in normal growth hormone levels. Numerous studies of growth hormone replacement therapy have found that treatment decreases fat mass and increases lean body mass.

Doctors like me who administer growth hormone must adhere to federal guidelines. First, every doctor must conduct the appropriate testing required before administering this treatment to make sure that there is a clinical deficiency. The gold standard for diagnosing a growth hormone deficiency has been the insulin tolerance test (ITT): It has been the stimulation test used the most by endocrinologists. Another stimulation test is the glucagon stimulation test, which is considered much safer than the ITT. Many investigators and clinicians reject the ITT and other stimulation tests for diagnosing adult growth hormone deficiency and rely on a blood test called IGF-1 as a more reliable diagnostic and therapeutic marker of growth hormone deficiency.

In spite of all this controversy over the best method of diagnosing adult growth hormone deficiency, the FDA and hGH manufacturers have maintained their positions that stimulation testing is necessary and required for an accurate diagnosis. In my practice, I use glucagon pituitary stimulation testing as a prerequisite for diagnosing growth hormone deficiency.

I believe that before any man starts growth hormone therapy, he should be given an opportunity to improve his own production of growth hormone through correction of other hormone deficiencies and following a comprehensive program, such as the Life Plan, that maximizes diet and requires significant exercise. This strategy should be followed for at least six to eight weeks. After that, if growth hormone levels remain low and the signs and symptoms have not improved, I will consider performing a stimulation test to confirm my suspicions of growth hormone deficiency. Once therapy begins, all of my patients receiving hGH must be followed closely with repeat blood draws every three to four months to ensure that their levels are in the correct range and markers of disease are improving.

Pituitary stimulation testing not performed, or if performed, you passed the test and are not hGH deficient

A cancerous malignancy

Past history of malignancy (with the exception of basal cell carcinoma)

Diabetic proliferative retinopathy

Sclerosing diseases of the liver or lungs

Benign intracranial hypertension

Uncontrolled diabetes

If you are clinically growth hormone deficient—and even if you aren’t—you can retrain your brain to create more of this important hormone by taking better care of your health. Proper exercise and better nutrition can increase your production of growth hormone. I’m pleased when my patients follow my Life Plan protocol, because typically these men are able to come back to my office after just eight weeks with significant increases in their growth hormone levels. Once the body learns to do this, it will continue increased production as you continue the program.

Exercise can play a significant role in growth hormone secretion. About 10 to 20 minutes of aerobic exercise causes a rise in serum level that peaks at the end of that period and is sustained for up to two hours. If you train at 85 percent or more of your target HR
_max
for 20 to 25 minutes, you will stimulate your pituitary gland to produce more growth hormone. The same applies to exercises in which you lift heavy weights, such as squats, dead lifts, and bench presses, that involve large muscle groups.

If you were looking for the proverbial “last straw” in order to stop bad eating habits, it’s well documented that a high-saturated-fat, low-carbohydrate diet reduces growth hormone secretion by 30 percent. On the other hand, following a diet high in protein and healthy fat increases your levels. Amino acids such as arginine, found in all protein sources, stimulate growth hormone secretion. Positive correlations have also been shown between growth hormone production and the intake of micronutrients such as calcium, iron, potassium, magnesium, niacin, phosphorus, riboflavin, thiamine, and zinc found in vegetables, fruits, and nutraceuticals. While the Life Healthy Eating Plan was initially developed for heart health, the growth hormone benefits are equally important.

We produce growth hormone all day long, but mostly during deep sleep. Men who don’t sleep well or don’t sleep enough will invariably have low levels of growth hormone, and many will be growth hormone deficient. This is one more reason that getting proper sleep is absolutely a must while you are following the Life Plan.

Mike was a 60-year-old accountant with a long history of weight problems when he first came to see me. Stuck in front of a computer most of the day, Mike was fairly inactive, and he had the gut to show for it: a 41-inch waist and 31.8 percent body fat. But that was just the beginning of Mike’s problems: A bone density test in my office revealed he had osteoporosis.

I had Mike follow the Life Plan, beginning with the Basic Health Diet. I also started him on a weight-bearing workout at his gym, as well as vitamin D3 and calcium. I also restored his testosterone to healthy levels. After just one year, Mike no longer had osteoporosis. Instead, his bone density actually increased one standard deviation. He also was winning the battle of the bulge: His body fat dropped to 26.7 percent, and he lost 20 pounds. And he increased his IGF-1 into the low 200s from 88 without taking growth hormone.

T
he regular use of multivitamins and a few select nutritional supplements can measurably improve your nutritional status and lifelong health. Regardless of how healthy we eat, supplementing with quality nutraceuticals is critical, especially for men. Soils have long been depleted of vitamins and minerals from years of overfarming, chemical toxins, and acid rain. Supplementing your diet with key nutrients gives you the right vitamins, minerals, essential fatty acids, and antioxidants to optimize health, fight disease, improve libido, sharpen the mind, stabilize blood sugar/insulin, and maintain energy levels so that you can work out effectively and still have plenty of power for the rest of the day.

The truth is that most men do not consume sufficient amounts of the many nutrients we need from the foods we eat, even if we follow a careful diet, such as the Life Plan. Several years ago scientists thought that supplementing with vitamins and minerals was necessary only to prevent such diseases as scurvy, pellagra, and rickets—diseases we rarely hear about today. Now nutritional experts are beginning to understand that these types of micronutrients play key roles in the prevention of heart disease, cancer, arthritis, and cataracts, along with the signs and symptoms of aging, including loss of muscle mass, strength, and bone mass.

Men who push their bodies hard with aerobic and resistance training exercises, like those I have described in my Life Plan Workouts, definitely need additional nutritional support. During exercise, your sweat is detoxing your system, and as you lose water, you are also losing essential nutrients. We also require increased amounts of both macronutrients (carbohydrates, fats, and proteins) and micronutrients (vitamins and minerals) to make sure our metabolic machinery runs at peak performance to support our workouts.