Are anti-aging hormones safe??? Want to trade in your body for a younger model? Hormone supplements hold promise, but carry risks. Top experts debate what you should do - Expert Roundtable

Natural Health, May-June, 2003 by Erin O'Donnell

IF YOU WANT TO STAY YOUNG, anti-aging hormone supplements sound great: They're touted to firm up flabby muscles, reduce your wrinkles, and ignite your sex drive. As you enter middle age, your own supply of hormones dwindles. So, anti-aging doctors reason, taking doses of hormones could turn back the clock. If you visit an anti-aging doctor, your treatment may include a cocktail of prescription-only hormones including human growth hormone (HGH), a substance you inject daily, and estrogen and testosterone, often prescribed as gels. You can also treat yourself with over-the-counter hormones like DHEA and pregnenolone, Physicians who prescribe these hormones say their patients love the results and look and feel years younger than they really are.

But some experts say these hormones pose serious risks. Because of a lack of long-term studies, no one knows what happens when you use them for years. One study suggests that HGH could increase your risk of cancer, and another shows that HGH triggers diabetes and joint pain (although hormone proponents dispute these findings). DHEA and pregnenolone may cause heart rhythm irregularities and irreversible hair loss. On top of that, these treatments can cost up to $1,000 a month.

Still, some say the benefits are worth the costs. Should you try these hormones? We asked five experts--representing a range of opinions--to debate the issues. Here's what they said.

IS THIS THE SECRET OF ETERNAL YOUTH?

Natural Health: Are anti-aging hormones a fountain of youth, a health risk, or something in between?

Ron Rothenberg: Fountain of youth sounds too glib. But these hormones can' help people improve their quality of life. Although there's not the perfect amount of data on these hormones, there's enough data to show that low levels [in people] are associated with health problems, and that more youthful levels are associated with better health.

Ray Sahelian: I believe these hormones have a good potential of risk. Over the last four decades doctors have been prescribing estrogen and progesterone. Data had come out for years that these hormones improved heart health and osteoporosis. And then we recently found out after four decades or so of using these hormones that they increase the risk of heart disease and cancers.

DHEA and pregnenolone ... can cause side effects that I have noticed in my practice. People have gone to the emergency room with [irregular heart rhythms]. They can also cause acne, irritability, anxiousness, and hair loss in both men and women that's sometimes irreversible.... It boils down to this: They may be perfect for the short-term, but we know nothing of the long-term side effects.

Thomas Perls: They're a health risk. Or another answer would be, we just didn't know. It would be very helpful to have large, randomized, placebo-controlled trials for these medications, but such trials are incredibly expensive and the research community may want to put its money into more disease-specific therapies.... treatments for heart disease, stroke, and cancer.

There's significant evidence that human growth hormone could actually shorten a life span, as well as increase the risk of cancer. So I would never go for prescribing human growth hormone in the long run. With regard to the over-the-counter therapies, DHEA and pregnenolone, that industry is so poorly regulated, and there is no way for people to report side effects. I think it is tremendously prone to abuse and hucksterism.

ARE HORMONES RIGHT FOR YOU?

Describe the person who you believe benefits most from anti-aging hormones.

Perls: There are some potential benefits in using human growth hormone in very frail individuals for a short period of time, but beyond that, I see no use for it, except in kids who are growth-hormone deficient.

Ronald Klatz: The person who benefits most is deficient in these various hormones. No one in the American Academy of Anti-Aging Medicine is recommending that these things should be taken blindly or willy-nilly without physician supervision and laboratory monitoring. When these hormones are taken under a physician's guidance and at pharmacologic replacement dosages Ia dose that is naturally present in a healthy person], not super-physiologic doses [a dose that far exceeds the amount in a healthy person] ... they are incredibly safe.

Sahelian: As far as DHEA is concerned, those who are middle-aged and older and who have very low DHEA levels could benefit, and they could well get an enhanced sense of well-being, feel more alert, and have increased stamina and libido. This is for both men and women. But we don't know the long-term dosage requirements or what the ideal form is.

Who should definitely not take anti-aging hormones?

Sahelian: That's hard to say, but certainly people who have cancer or severe heart disease.

Rothenberg: The cancer situation is very controversial.... The package insert on human growth hormone says "should not be used in active malignancy." But there's really no data to support that statement, so [some growth hormone experts] think it should be removed.... Every hormone is different; we can't talk about them all in one sentence. In general, I'd be very cautious. I'd educate the patient about the benefits and risks and have the patient make an informed decision.