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Grow Young with HGH by Ronald Klatz and Carol Kahn

Most readers will get 90% of the value of this book just from reading chapters 16-19, which deal with things you can do you increase/enhance your own GH levels naturally via diet, exercise, (non-pharmacological) supplements and other practices. 

The bulk of the rest of the book covers "studies show" theories, explanations and speculations of how and by what mechanism GH works in the body, and since the book was published in 1997, I'm certain most of these studies have been either debunked or better explained by more recent research.

Notes: 
1) Key supplements to keep in mind: 
Melatonin: for sleep/recovery from training
Glutamine: up to 2,000 mg/day plus weight training
L-Carnitine: one to two grams a day
Ubiquinone (Co-enzyme Q10): 60 mg up to 100 mg.
Chromium (binds to insulin) 200 micrograms per day
Creatine: 45 g per day after heavy exercise
Ginseng: for cognition and recovery from stress, 200 to 400 mg a day
Dibencozide (coenzyme B12): 1000 micrograms a day
Gamma Oryzinal (esterified ferulic acid): enhances blood circulation, decreases workout fatigue, helps muscle build up, 200 to 500 mg a day
Branched chain amino acids: leucine isoleucine and valine, found an egg whites or whey protein, 2 grams a day, serious bodybuilders may take up to 30 g a day.

2) Key practices: 
Fasting/calorie restriction
Weight training
HITT exercise with appropriate recovery
Good sleep hygiene
[This book was ahead of its time discussing fasting and weight training as early as the 1990s.]

3) Rx's to consider: 
DHEA
IGF-1
Testosterone

4) On "cycling": 
Keep in mind the idea of "cycling": going on supplements (or Rxs) for a period of time, then going off them, say three weeks on, one week off, or 6 days on, 1 day off. This is to make sure the body doesn't homeostatically stop making the chemical/nutrient you are adding, or adapt to it by increasing tolerance. This is the same reason bodybuilders will cycle testosterone. It's interesting to consider cycling in the context of any med we take: the body can adapt homeostatically to nearly anything you do to it. 

5) I also couldn't help thinking as I read this book whether I should work on acceptance of my aging or whether I should fight against it; perhaps the entire process of fighting against aging is unhealthy in its first place, kind of a form of Boomer behavior, a resistance to what "is." Can't help but think what much of the reading I've done on Buddhism and Taoism would say about seeking youth via HGH. 

6)  GH normally taken by injection but supposedly there was to be an inhaled form released in the late 1990s. Acromegaly due to massive HGH intake, lower doses tend to have no side effects. Low dose, high frequency vs higher side effects from high dose/low freq. Lower extremity edema, joint pain. Self administered subcutaneous, before sleep and on arising 6 days out of seven. More like human body patterns. .3-.7 IU twice daily. 1mg = 3 IU

7) First GH sources were human brains of cadavers The source produced Creutzfeldt-Jakob disease in 7 out of 5,000 hormone recipients. Later recombinant GH, via Genentech, then 100% identical GH from Eli Lilly called humatrope.

8) Trophic factors: proteins that promote cell growth and liability.

9) Dr. Marc Blackman/John's Hopkins: growth hormone with or without testosterone in men; important early study. Also: GH studies with mice significantly extending life expectancy, Also calorie restriction raises GH for older rats, not younger ones.

10) Drs. to look up: See Dr Edmund Chein, first doctor in the US to openly offer GH replacement, currently runs Palm Springs Life Extension Institute, in Palm Springs CA; also the El Dorado clinic in Cancun Mexico (to avoid the FDA ban on the use of GH). See also: Dr. Vincent Giampapa MD, Longevity Institute International, Montclair NJ.

11) The Hayflick Limit: the number of times the cell will divide before it stops, then ages and dies; see also telomeres, telomerase.

12) There's a U-shaped relationship between growth hormone levels and cardiovascular disease: too much and too little are both dangerous, just as there is a higher cardiopulmonary risk for those who are GH deficient and those who have acromegaly. 

13) Excellent cardiac effects from low-dose GH: thickening heart walls (particularly the left ventricle), raising cardiac output, strengthening stroke/pump volume, etc.

14) Salutary benefits for bone density: osteoblasts which produce new bone tissue, osteoclasts which destroy/remove bone tissue. HGH drives increased bone density by increasing osteoblast activity. 

15) GH also drives body fat/body composition, increases muscle mass, decreases central and visceral fat.

16) This book is repetitive, you see many of the same studies or quotes/comments from many of the same clinicians repeatedly arriving at similar conclusions in multiple chapters. Nobody really understands the mechanism(s) by which HGH does what it does, there's much speculation about it throughout the book. Also many of the studies were done on growth hormone-deficient adults, not so many on normal adults, this may indicate a lack of robustness in results on "normal" adults. Further, when used with regular people the results seem to be much more anecdotal, self-reported, etc., again, not as robust.

17) Another negative to think about re GH therapy: The benefits of growth hormone stop and completely go away once the therapy ends--thus it's really just another type of dependence, a type of fragility even. Later on the book discusses natural ways to improve and increase your growth hormone levels, this would be a more robust approach. I also suspect that it would be very difficult to persuade your doctor to give you growth hormone!

18) GH and sex; male andropause, gradually declining T and GH levels across lifespan. 

19) [Interesting theme here] The notion of "identifying with a model of degenerative disease and death": your knee hurts, so instead of working around it the way you did when you were younger, you worry about arthritis, you exercise less, you decrease your activity. All of this is agency based by the way: you can choose your way of looking at training at whatever age, and identify with a way of looking at it that is more empowering rather than less. 

20) One of the doctors cited in this book, Dr Chaovanee Aroonsakul, later had his medical license revoked... (!) 

21) Part 2 of the book covers how to maximize your body's own growth hormone production/release:

22) Testing is for GH breakdown products (IGF-1 or somatomedin C), less typical and much more involved to test GH levels directly.

23) [Another good insight here on matching your healthcare philosophy with your doctor's] Does your doctor have an anti-aging philosophy, or a "well, you're just getting old" mindset? What does the doctor do for his/her own health/aging (lift, supplementation, intermittent fasting, etc.)? Also ask: how many patients are you actively treating in anti-aging regimens?

24) Orgs/publications to follow: 
Journal of Longevity Research
Life Extension by The Life Extension Foundation
American Academy of Anti-Aging Medicine (A4M)

25) On combining multi-hormone replacement: it allows you to use a lot less growth hormone, also lowers the overall cost of treatment (HGH is very expensive), also "there is greater anti-aging efficiency and greater safety." Looking at six hormones: estrogen, progesterone, testosterone, DHEA, melatonin and thyroid. One hypothesis is that these hormones stimulate growth hormone production in the body and therefore indirectly act as a type of growth hormone proxy.

26) DHEA for example is an inexpensive growth hormone alternative for only $30 for a one month supply of 100 mg capsules (now available OTC, when this book came out it required a script). Recommended dosage 25 to 50 mg per day.

27) GH agonists (releasers):
Amino acid supplementation: 
* 10 g of arginine per day on an empty stomach, then lift 45 minutes to 1 hour after taking it.
* Arginine-lysine combination
* Arginine and glycine as ingredients that the liver uses to make creatine.
* Stacking lysine with arginine ornithine and glutamine.
* OKG: L-ornithine Alpha-Ketoglutarate "French tickler"

28) Giampapa's "beginner stack":
* 2g arginine, 2g ornithine, 1g glycine. 1g glutamine: work up to 2 g each of all. 

29) Di Pasquale's stack: 
3g each: glutamine, arginine, lysine at bedtime, add 1 gram a week until you reach 5g/week each

30) Niacin is another GH releaser, more potent form called xanthanol nicotinate

31) GHB: gamma hydroxybutyrate
Giampapa protocol: 500-750mg added to amino acid stack, along with 1-3mg melatonin at bedtime

32) Rx meds that release GH and have a role in anti-aging:
L-dopa, low dosages, 125 to 500 mg
Hydergine: Pearson and Shaw touted it in their book as a "smart" drug
Clonidine: antihypertensive drug, releases GH
Dilantin/Phenytoin: anti-convulsant but also multifunction drug, see Jack Dreyfus's books below

33) The importance of cycling GH releases, use them for a period of time and then go off them for a period of time. This goes for HGH injections as well as supplements/releasers. You don't want to mess with the feedback mechanisms of your body. A standard cycle would be 3 weeks on, then stop for one week. Or 4 to 6 weeks on 2 weeks off. Know also the value of cycling any nutrients you take, because your body's response is always to adapt to any input.

34) Diet/nutrition:
* Don't run at a high body fat content! GH falls 6% for each unit increase in BMI.
* Fasting, Periodic 24-hour fasts
* High protein: 1g protein eaten per day per pound of body weight plus significant physical activity, plus extra water every day
* Exercise for GH release: weight training with standard compound lifts: deadlifts, bench press, shoulder press, etc. Workouts 5 days a week, 3 days on, then rest one day, then two days on, rest one day. Alternate your exercises so you don't work the same body parts in a row (e.g. shoulders/arms one day, chest/back the next day, legs the day after, etc.).... all standard advice here. 

35) Metabolic enhancers / nutritional supplements:
L-Carnitine: 1-2 grams a day
Ubiquinone (Co-enzyme Q10): 60 mg up to 100 mg/day
Chromium (binds to insulin) 200 micrograms per day
Creatine: 45g/day after heavy exercise
Ginseng: for cognition and recovery from stress, 200 to 400 mg a day
Dibencozide (coenzyme B12): 1000 micrograms a day
Gamma Oryzinal (esterified ferulic acid): enhances blood circulation, decreases workout fatigue, helps muscle buildup, 200 to 500 mg a day
Branched chain amino acids: leucine, isoleucine and valine, found in egg whites and whey protein: 2 grams/day, serious bodybuilders may take up to 30g/day.

36) See also: 
* GHRH, growth hormone releasing hormone, a growth hormone precursor
* IGF-1, insulin like growth factor, a GH "post-cursor" considered highly effective for bodybuilding
* Secretagogues: prescription GH releasers
* Other growth factors: EPO, EGF, FGF, and neurotrophic factors or nerve growth factors (NGF) which helps regenerate peripheral nerve and brain cells
* Growth hormone pills and patches (vs injectable GH) 

37) Some of the optimism in this book, for the potential for GH, for the potential for human lifespans, etc., borders on delusional: one example is the prediction (in 1997) that by 2027 potential lifespans will be 150-200 years or more. (!)


To Read: 
Vladimir Dilman: The Grand Biological Clock
Roy Walford: The 120 Year Diet: How to Double Your Vital Years
Dick Pearson and Sandy Shaw: Life Extension: A Practical Scientific Approach
Judy Shabert: The Ultimate Nutrient Glutamine
Jack Dreyfus: The Lion of Wall Street
Jack Dreyfus: A Remarkable Medicine Has Been Overlooked
Robert Goldman: Death In the Locker Room

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