Friday, March 30, 2007

Did Anna Nicole Smith’s HGH Anti-Aging Regimen Contribute to Her Death?

Earlier this week, the medical examiner here in Broward County released the autopsy report of Anna Nicole Smith. The coroner found evidence of repeated needle injections to her left buttock. These injections produced a deep-seated abscess filled with yellow-green pus. The medical examiner noted that it was possible that bacteria from this abscess entered her bloodstream, producing a fever of 105 F, and prompting her to respond with an overdose of medications, ultimately leading to her death.

What were these injections for? The coroner noted that Anna Nicole was receiving a cocktail of anti-aging drugs including human growth hormone (HGH) for “self-treatment for longevity and weight control."

This finding has placed the spotlight directly on HGH. This hormone is produced in the pituitary gland at the base of the brain. It has been used for decades in children whose growth was stunted because they were deficient in this hormone, but over the last 17 years, it has been touted as the pharmaceutical fountain of youth that builds muscle, sheds fat, and restores youth.

The only problem is that these “off-label” uses of HGH have not been systematically and are not approved by the FDA. However, this has not stopped the popularity of this latest wonder drug- just last month, Sylvester Stallone was charged by Australian authorities for illegally importing 48 vials of HGH.

How did HGH get so popular? The current boom in use can be attributed to findings in an article in the New England Journal of Medicine in 1990 which showed that 12 men over the age of 60 who received HGH injections showed increases in lean body mass and bone density. Although the authors and an accompanying editorial did not tout HGH as an age reversal drug, this study became the inspiration for a slew of anti-aging clinics. JAMA noted in 2005 that 20,000 and 30,000 adults used growth hormone as an anti-aging therapy. This therapy can get real expensive, real fast… often more than $1,000 per month. The irony to all this is that the side effects of HGH may actually make your body age faster… researchers have noted that people injecting HGH can develop diabetes, arthritis and hypertension. These are serious diseases which can affect a patient’s quality of life.

Authorities are beginning to crack down on this black market, as well. New York investigators have arrested doctors, pharmacists, and clinic operators involved in HGH clinics. The US Senate is also considering listing HGH as a controlled substance to help prosecute the illegal use and sale of this drug.

As a plastic surgeon, patients continually ask me about the latest anti-aging cocktail regimen. I remind all of my patients that this is not the approved use of drugs like HGH and we simply don’t have the benefit of long term studies that help us understand how these drugs can help, or even hurt, a patient. Would you let someone inject a drug into you when they aren’t sure what effect it will have? It’s really unfortunate someone didn’t explain this to Anna Nicole…

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