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Category Archives: Human Growth Hormone

HGH: Side Effects in Men and Women – Healthline

Posted: October 28, 2022 at 1:58 am

Overview

Human growth hormone (hGH) is a naturally occurring hormone produced by the pituitary gland. Its important for growth, cell regeneration, and cell reproduction.

HGH helps to maintain, build, and repair healthy tissue in the brain and other organs. This hormone can help to speed up healing after an injury and repair muscle tissue after exercise. This helps to build muscle mass, boost metabolism, and burn fat.

HGH is also said to benefit the quality and appearance of the skin. Its said to slow down the aging process and treat age-related diseases. However, research supporting these claims is limited.

HGH works by stimulating metabolic processes in cells to activate metabolism. It stimulates the liver to make an insulin-like protein that produces cartilage cells. This plays a part in bone and organ growth, as well as muscle protein synthesis.

Although hGH is a naturally occurring substance, its also available in synthetic forms as a treatment or supplement. But what are the risks of taking it?

Synthetic hGH is used to treat poor growth in children and adults. It can also be used to treat adults with short bowel syndrome or muscle loss due to HIV or AIDS.

Lack of growth may be the result of medical causes such as:

Injections of hGH can help people with a growth hormone deficiency to:

Because of these benefits, many people use hGH to enhance their athletic ability. Its sometimes used in combination with anabolic steroids to increase muscle mass and to enhance athletic performance.

Some people believe hGH has anti-aging effects since natural levels of hGH decrease with age. Its also said to naturally increase testosterone. However, it should be noted that not all of these benefits have been scientifically proven. The use of hGH for athletic and anti-aging purposes is controversial due to this lack of scientific evidence and its potential side effects.

HGH is injected intramuscularly (IM) and subcutaneously (under the skin) if its been prescribed. Sometimes, illicit manufacturers offer hGH in an injectable form as well.

HGH and substances that promote hGH production are sold online by some companies as dietary supplements, which claim to have the same benefits as the injections. These supplements are sometimes known as human growth hormone releasers. Some of them are said to increase hGH levels in your body because of ingredients such as amino acids.

However, theres no evidence that these supplements have the same results as prescribed hGH. Homeopathic remedies containing human growth hormone also exist. Evidence supporting their benefits is lacking.

SeroVital is a popular brand of dietary supplement. Its said to be able to naturally raise hGH levels because of the amino acids it contains. This is said to have an anti-aging effect. SeroVital also claims to build stronger bones, increase lean muscle mass, and reduce body fat. These claims need more study. SeroVital contains no hGH.

There are several side effects that may go along with hGH use. These side effects are possible with the prescribed version, as well as an illicit form of hGH since the content isnt completely known and regulated. Side effects may affect older adults more than younger people. The long-term effects of hGH arent known.

Possible side effects of excess hGH injections include:

Possible side effects of SeroVital differ from those of hGH since SeroVital is an amino acid blend that doesnt contain hGH. Side effects of the amino acids in SeroVital may include:

HGH should be used with care and consideration. Only use hGH that you get via a doctors prescription. Check in regularly with your doctor while youre taking it.

Take special care to note how your body reacts and if you experience any adverse reactions. If you wish to strengthen your body or improve your health but dont have a condition known to cause growth hormone deficiency, you may consider finding other ways to do this. Eat a healthy diet, exercise regularly, and engage in healthy habits to improve your overall health and well-being.

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HGH: Side Effects in Men and Women - Healthline

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Easy HGH Cycle for Beginners – Length, Dosages & Results – GoodHGH

Posted: September 26, 2022 at 2:07 am

Are you new to human growth hormones? So, in hgh cycle, it means the use of growth hormones, over a specific period, in given prescribed dosages.

There are many queries about hgh, on how to use, correct dosages, how long to take, reasons on cycles, and well look into these on this discussion.

Ive been using HGH dosages and cycles for some time now. I discovered that if you do it the right way, you can get the best results. But there can still be reaction as well and you should not dismissed that. The fact that its use is regulated says something about the risks involved.

In the event, you want the advantages given by hgh, but dont want to deal with the unwanted problems, the best way to use it is by the cycles and dosages Ill point out here.

This guide will show you hgh cycles, lengths and doses. Ill show you how to make it work, safely, and how to lessen the chance of probable body reactions.

An HGH cycle is actually your duration of use, with periods sustained between several weeks, generally according to your goals.

Take note that this cycle also depends on your experience and anabolic compounds used. My normal cycling pattern usually lasts for 4 to 8 months for human growth hormone. At times, I usually stacked with another supplement, but nonetheless you can just take hgh with the appropriate cycle, as given by your doctor.

Before you start to cycle Human growth hormone, it s crucial that you consider your ultimate target and when you would like to do it. Ive done this myself and observed that HGH can be a slow-acting hormonal agent. It does take some time to have any Human growth hormone cycle effects. If you want to build mass rapidly, or if you have to burn unwanted fat while maintaining your overall mass prior to a competition, then HGH might not be right for you.

Your HGH cycle dose can vary based on your objectives. The reason I said this is that you need to use human growth hormone along with the quantities based on your desired goals like anti-aging, body training, fat loss, general health, or medication. So, if youre about to start on a cycle, answer first whats your objective for using it.

Take for instance on cycling hgh for medication, the doses used as medical treatment would be substantial. You need to be tested by a medical professional, since doctors will prescribe the amount of HGH for specific cycles. If you still dont know hgh is used as a fast therapeutic treatment in people who have critical traumatic personal injuries like burns, wounds, or big cuts.

The dosage is an essential factor of human growth hormone use. It is essential to consult your doctor before you start Human growth hormone usage so that you can determine the ideal dose for yourself. Generally, the dosage is dependent upon your purpose of HGH use.

Though HGH provides the same outcomes in any medication dosage, their strength is highly dependent upon the amount of Human growth hormone you take.

2-3 IU every day is used for anti-aging reasons and enhancement of skin, hair, bones, and joints. You can inject it any moment of the day or possibly take orally on a full or empty tummy it does not matter. It will be the most beneficial to consider taking it each morning, or at least several hours before bedtime (before 6pm) for the reason that body actually lets out its own endogenous growth hormone if you go to sleep. Taking it minutes before bedtime may possibly reduce the bodys own hgh production robbing you of the beneficial dose.

4-8 IU each day is usually utilized by athletes for sports, fat loss, build lean muscle mass, and standard fitness. A lot of people take 6IU per day, nevertheless, the higher the amount though, the more the reaction can be. Carpal tunnel issue being the common effect which normally forces the athlete to reduce the dosage or pause the period for 2 3 days until the carpal disappears. It can be preferred to spread the daily amount into several shots during the day. For example 2 IU each day and 2 IU in late mid-day.

8 to 16 IU per day is commonly used to increase recovery right after severe burns up, injury, or accidents. This is a quite high amount and it ought not to be continued for over a few weeks. The carpal tunnel syndrome will most likely bother the person, but in the name of faster healing, some pain may be bearable. This high dosage is only prescribed by doctors, so take note of that.

First, you have to know that Human growth hormone is normally taken in milligrams or IUs. So, whats this ratio? 1 mg is about 3 IUs. Dont confuse the amount of milligram is the same asiu, and vice versa.

If youve just started, there wont be any unwanted reaction if you take about less than 3 IUs every day as it enhances the body functioning. Yes, you ll really feel energetic as well as other advantages like having lean muscles, good sleeping, fat loss but those results will gradually come, several weeks of regular use.

Try taking 4-6 IUs in a day, if you will be focusing on a muscle building dose, and this means that you will have to take more time in the gym to get the pounds or reduce it.

With a medication amount of 8-16 IUs, you might see some adverse reactions and medication quantity is much better for a small amount. The male growth hormone needs to be taken 750 mg (3 mL) per week.

A good check cycle should last 12 weeks. The recommendation is that you take a dose of three IUs in case you are a beginner, and you can go for 6 IUs only when you begin hitting the fitness center frequently. It can be best not to take the higher dose of HGH and Testosterone. When you start, use the smallest quantity as possible to obtain better results.

I take my doses any time of the day, either on a full or empty belly. Its your option, depending on how convenient would it be for you. You can have it yourself at any time but many users want to do it throughout the morning or some time before heading to bed during the night as these are the times when the body releases human hormones.

For those into fitness, workouts, sports, fat loss, you can start at 4 IU every day. Hardcore and advanced users can take higher dose up to 6 IU. If youre on your very first hgh cycle, the dose amounts I mentioned will work. If your in general good health, you can increase the amount depending on the condition.

If your objective is to faster healing after an accident, increase it around 8 to 16 IU every day. This really is a high dose and it is not suitable for anyone. When getting anything more than 4 IU, divide the dose each day rather than having it at a single take.

Given that you know the many positive aspects of HGH, it is time to think about an actual cycle. The following routine uses natural Human Growth Hormone.

Those getting it the very first time are advised to use 500 mg (mg) weekly, split into two weekly shots. If you do not, it can react to testosterone s reaction, so lower your medication quantity to 400mgs or much less.

You can use Human growth hormone every day with a moderate medication amount. But many endorse that you should have a couple times off each week. The reason becoming is that regular growth hormone will come in spikes, consequently, you should try to tightly mimic this with 4-5 weekly shots.

Here s a sample regular HGH dosage schedule:

Monday = Use HghTuesday = Use HghWednesday = Use HghThursday = OffFri = Use HghSaturday = OffSunday = Use Hgh

Also, keep in mind that the everyday HGH dose depends upon the standard of the product you are using. For 100 % pure HGH, it only requires 3 IUs each day for good results. However, the generic Human growth hormone requires 5-6 IUs for more comparable outcomes.

One more thing you will see together in the following period is that Human growth hormone works longer than testosterone. This is a milder compound that can take longer to provide results. Human growth hormone also has a less heavy reaction, which is the reason it can be used for so long.

The Human growth hormone cycleusually need to lasts for 50 days at first. This can be followed by a 20-40 day time gap, then, the 2nd period begins. A standard HGH pattern length could vary from 5-8 months, in line with the reason for its administration.

Experts say that the length of the HGH pattern is more crucial(yes, more important) than its dose. For that reason, a strategy of 5 IU/day for 6 months could be more effective than 10 IU/ day for 90 days.

Its recommended that hormone treatment should always begin with a very low dose pattern, gradually improving the amount right after your body undergoes adjustment. Thatsn how I used it

In line with adjustment, your human growth hormones objective often change as the time goes by. For example, you may intend to use hgh initially to slow aging by having optimum health, then start at two to three IU of Human growth hormone. Eventually, you look at the mirror and wanted to lessen superfluous fat, improve your body shape, augment lean body mass, then you increase dose around four to eight IU/day.

When I started, I observed that about 7 weeks of HGH treatment is adequate for that favorable outcome of treatment to become obvious. Heres how I did it.

2 iu first 4 weeks2.5 iu 5th week3 iu divided into two injections, 1.5 IU each inside the 6th full week3.5 iu divided into two injections, 1.75 IU each inside in the 7th week.

You can follow this, at least in first seven weeks.

On my human growth hormone studies and research, it says that the perfect hgh cycle span is three months.

I would say that 90 days is the minimum length. The 2-3.5 ius for 3 months is optimal for workout reasons in the beginning, though I adjust the doses 4-6 ius in the fourth to sixth months. Then I took a month off to give a rest to my pancreas. After a month break, Ill start another cycle at 4ius for 3 months, then 6ius for 3 months. Keep going until you reach 1-year cycle but no more. Heres your reference.

2iu to 3.5 iu first 3 months4iu to 6 iu 4th to 6 monthsTake a break one month4iu next 3 months6iu final 3 months

I feel the long-term benefits eventually took place, the doses was safer and I got better results. Thats just my experience though.

Youll realize that many men that use genuine GH will agree with this. Of course, not all are the same, but most manage to get this dosage cycle close in the numbers.

If its something new, I look at it or check with other users for a starting point. Eventually, Ill establish my own dosage cycle in the course of use. Ive been consuming GH for quite a while. I get checked out more than anybody mostly cuz Im evaluating products, so I try this myself to know if the dosage cycle work.

Thats just me, but your personal health is within your hands. So always consult a doctor before you use growth hormones.

Clinical studies reveal that remedy taken only for 4 weeks or short periods would not give apparent results. A minimum of 90 days and up to 9 months of treatment would show good effects. Obvious results were noticed in a few instances, when the Human growth hormone procedure was given for five months and results appear by 6-7 months, usually according to the objective.

The good thing about using HGH is basically that you dont need to bother about ancillaries and PCT just for this drug by yourself. Instead, you just need to take splits from using it after many months. Otherwise, you will become desensitized to the medication and get significantly less advantage from it.

The goal of ancillaries like testosterone is to minimize negative effects while you are on an anabolic steroid routine. Post-cycle treatments are used to retrieve your all-natural hormone levels, provided that both estrogen and androgenic hormone or testosterone are affected in a cycle. In spite of this, let s include what you need to do both whiles in and right after using Human growth hormone and male growth hormone

The one thing that you need to do, however, consume more water and reduce your sodium absorption. This helps you minimize water retention by using an HGH cycle.

Based on my experience, you can get quick results by stacking stack Human Human Growth Hormone (HGH) and Testosterone.

Studies state that testosterone help HGH release by stacking it together as an enhancement. It has raises its effectiveness after I stack, which allowed me to workout better. The Testosterone and HGH cycle lasts for a while depending on the amount that you take it. For me, the HGH and testosterone period lasts for about 3 months.

What happens to your body when you stack these two supplements. Heres a background on how body process the interactions. You have different hormones and they are naturally sourced from your body, and they are very important to your body. As you age, the interaction HGH and Testosterone with each other, decreases. That is why most athletes and bodybuilders begin to stack HGH and Testosterone in a cycle.

Ive tried this myself, since I wanted to boost my muscle mass, but it is extremely challenging, since it requires regularly adjusting the doses. I experienced a lot of pain and struggle for the first several weeks, since side effects happen at the onset, before positive results happen. Take note, Ive worked my butts off and lifted weights till my wrists and arms sore. In addition, I incorporated a protein-rich diet to get the results that I wanted to enhance lean muscles mass.

Yes, you must do it for the following some factors. Splitting the shots give you an easy level of GH and IGF-1, so fat reducing and muscles growth are more powerful.

Sometimes liver organ cant take the big volume of HGH to stimulate IGF-1 quickly. Our system is tweaked to 5-7 HGH peaks of release during the daytime, not to 1 big maximum release. Liver might not convert all growth hormone to somatomedins as well as the rest will likely be destroyed, thus your just wasting away as its flushed out of the body.

Also, if you split doses, unwanted effects, in this case, are milder.

It all depends. How much you take is really an individual issue. Also, there is absolutely no real formulation for you to decide if xxx amount is useful for you.

I experience great results on 3ius every day. For general health, like anti-aging, I started in a low dose like 2ius. After some time of use, I wanted to improve my workout stamina and energy, I used 3ius. When I switched to intense muscle building so I can change my body significantly, where Ill lose fat and gain a lot lean muscle, I increase it to 5ius dose. Take note, that I always started in a low dose, then I adjust in small increments.

The right Human growth hormone dosage vary and depends upon why you would like to use it. These variables can vary from user experience, current physique, state of health, other drugs you might take, body shape, percent of fat, duration, protocol of using, budget, other health purposes like recovery and faster healing.

Years ago, the most frequent belief was that one was supposed to take HGH before going to bed. As time went by people have found that was not always the case.

The body releases GH at night if you sleep. Consuming synthetic GH prior to bedtime will only restrain your all-natural output.

The perfect time to take it is actually upon waking up in the morning. That way you take advantage of your natural GH output after which have one more surge, first thing you wake up in the morning.

As you can see the duration of HGH dosage cycles and the approach is tremendously dependent on goals involved, as well as on how many other compounds, if any, are stacked and used with Human Growth Hormone.

In summary, as I previously stated and reiterated, even what doctors told me, start with the lowest doses and then make adjustments as period goes by. Never ever go over the given doses just because you feel impatient of the results and wanted to see quick benefits.

Do you have questions or comments, just let me know below.

Sourceshttps://goodhgh.com/therapy/https://goodhgh.com/best-supplements/https://goodhgh.com/how-to-increase-hgh-naturally/https://goodhgh.com/buy-online/https://goodhgh.com/legal-status/www.steroid.com/Human-Growth-Hormone-Doses.phpwww.somatropin.cn/dosage.htmlhttps://goodhgh.com/serovital/www.hgh.com/health/dosage-hgh-needed-speed-healing-injuries/www.linkedin.com/pulse/hgh-dosage-how-choose-proper-dosagelandmarkchem-nancy-nancy-niewww.hgh.biz/how-to-use-hgh/www.hghfaq.com/493/how-much-hgh-should-you-take-per-day/www.steroidal.com/hgh-peptides/human-growth-hormone/human-growth-hormone-cycle/www.elitefitness.com/articles/hgh-ultimate-guide/mybodylife.com/hgh-cycle/www.hgh.org/HGH-Cycle-Length.htmlwww.superiormuscle.com/forums/jintropin-us/67190-hgh-cycle-lengthwww.evolutionary.org/testosterone-hgh-fat-loss-cycle/steroidly.com/how-to-take-hgh/anabolicminds.com/forum/igf-1-gh/188210-first-hgh-cycle.html

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Easy HGH Cycle for Beginners - Length, Dosages & Results - GoodHGH

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Promoting adherence to r-hGH therapy | PPA – Dove Medical Press

Posted: July 16, 2022 at 2:00 am

Martin O Savage,1 Luis Fernandez-Luque,2 Selina Graham,3 Paula van Dommelen,4 Matheus Araujo,5 Antonio de Arriba,6 Ekaterina Koledova7

1Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, London, UK; 2Adhera Health Inc., Palo Alto, CA, USA; 3Kings College London, London, UK; 4The Netherlands Organization for Applied Scientific Research TNO, Leiden, the Netherlands; 5Neurological Institute; Cleveland Clinic, Cleveland, OH, USA; 6Paediatric Endocrinology, Hospital Universitario Miguel Servet, Zaragoza, Spain; 7Global Medical Affairs Cardiometabolic & Endocrinology, Merck Healthcare KGaA, Darmstadt, Germany

Correspondence: Martin O Savage, Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Charterhouse Square, London, EC1M 6BQ, UK, Tel +44 7803084491, Email [emailprotected]

Abstract: Pediatric growth hormone (GH) deficiency is a licensed indication for replacement therapy with recombinant human growth hormone (r-hGH). Treatment, consisting of daily subcutaneous injections, extends from the time of diagnosis until cessation of linear growth at completion of puberty. Suboptimal adherence to r-hGH therapy is common and has been well documented to substantially impair the growth response and achievement of the optimal goal which is attainment of adult height within the genetic target range. The causes of poor adherence are complex and include disease-, patient-, doctor-, and treatment-related factors. Interventions for suboptimal adherence are important for a long-term successful outcome and can include both face-to-face and digital strategies. Face-to-face interventions include behavioral change approaches such as motivational interviewing and non-judgmental assessment. Medical and nursing staff require training in these techniques. Digital solutions are rapidly advancing as evidenced by the electronic digital auto-injector device, easypod (Merck Healthcare KGaA, Darmstadt, Germany), which uses the web-based easypod connect platform allowing adherence data to be transmitted electronically to healthcare professionals (HCPs), who can then access GH treatment history, enhancing clinical decisions. Over the past 10 years, the multi-national Easypod Connect Observational Study has reported high levels of adherence (> 85%) from up to 40 countries. The easypod connect system can be supported by a smartphone app, growlink, which facilitates the interactions between the patients, their care team, and patient support services. HCPs are empowered by new digital techniques, however, the humandigital partnership remains essential for optimal growth management. The pediatric patient on r-hGH therapy will benefit from these innovations to enhance adherence and optimize long-term response.

Adherence to a therapeutic regimen is an essential component of the success of any prescribed therapy. In the case of treatment of pediatric growth disorders, prescribed therapy in the form of recombinant human growth hormone (r-hGH) will generally be started in early childhood when the child presents with short stature and continued for many years. The aim is to normalize height during childhood and adolescence and achieve an adult height consistent with the genetic target of the family.1 Such a therapeutic regimen, consisting of daily subcutaneous injections lasting for many years, places a considerable psychological and physical burden on the patient to adhere. There is also a pressure on healthcare professionals (HCPs) responsible for this care to induce a beneficial long-term result.2

Two important considerations linked to good adherence to r-hGH are necessary for optimal outcomes. These are, first, the extent to which the patients behavior matches agreed recommendations from their HCP and, second, persistence with the therapy, ie lack of discontinuation.3 Adherence can be defined as the extent to which the patient follows a prescribed therapeutic regimen and, in the case of r-hGH, the extent to which daily r-hGH injections are taken. The success of r-hGH therapy, as in other chronic conditions, is thought to be dependent on the patients ability to maximally adhere to their treatment regimen.2,3

In this review, we will discuss the challenges, both to the patient and HCP, of maintaining a high level of adherence to r-hGH, and the factors which have been shown to influence adherence both negatively and positively. We will summarize feedback data from both HCPs and patients, and discuss knowledge from other more advanced therapeutic areas regarding the importance of data generation and analysis to understand how to positively support adherence. Our aim is to look forward to future developments in digital health which will positively impact on adherence. We will discuss the contribution of behavioral support and its digitalization as a means of supporting the family and patient, and conclude by debating the importance of design of adherence support, with continuous evaluation cycles of new digital tools, in order to achieve maximal personalized impact on the adherence paradigm and the patients journey.

Since the development and widespread clinical use of r-hGH in 1985, a range of growth disorders have been approved for this treatment by regulatory organizations such as the US Food and Drug Administration and European Medicines Agency.4 Initially, GH deficiency (GHD) was approved, followed by non-GH-deficient disorders such as Turner syndrome, short stature related to birth size small for gestational age (SGA), and idiopathic short stature.5 Treatment of these disorders until adult height is reached is, by definition, demanding and the issue of good adherence to the prescribed therapy is highly relevant to the final outcome.6

Thus, begins a multi-year journey involving daily injections and regular consultation visits (typically every 6 months) to assess growth and metabolic parameters. Along this journey and depending on the healthcare setting, the child and his/her parents receive various levels of information, support, and encouragement to comply with the therapy regimen. HCPs may also be involved in dealing with clinical, emotional, and behavioral issues that may arise during teenage years. Adolescents with GHD may require transitional care and continued r-hGH therapy through into adulthood to optimize body composition maturation and metabolic factors that could adversely affect their cardiovascular health.7,8

Factors adversely affecting adherence which are encountered by HCPs include managing clinical, emotional, and behavioral issues arising during teenage years.9 Other factors shown to be strongly associated with non-adherence and lack of persistence include poor understanding of both the condition and consequences of missed r-hGH doses, injection discomfort, dissatisfaction with growth outcomes compared with pediatric endocrinologist predictions, and inadequate or problematic contact with HCPs.10

Digital health technologies have become an essential part of daily life and, consequently, they have high potential to support patients and caregivers in their health management. As early as 1996, research showed the positive impact of digital tools in diabetes patient education for children.11 However, the wider adoption and implementation of such technologies is still a major challenge.12 The scientific community has been looking into many factors that address adoption and acceptance of technologies and these often highlight human factors such as usability, perceived usefulness, and literacy levels.13,14 These factors related to the adoption of technology have some similarities to drivers for medication adherence,1517 including education or how the medication is being introduced.

Addressing the patients and caregivers perspectives is crucial, especially in areas where digital health interventions are supporting medication adherence or other long-term self-management behaviors. In the case of digital interventions in pediatrics, a key aspect to consider is the interplay between caregivers and patients especially during the transition to adult care18 or patient-initiated medication. For example, a key moment to intervene is when injections are transitioning from being delivered by the caregivers to the children themselves.

In recent years, a lot of effort has been put into the use of new methodologies to capture end-users feedback when using digital interventions, including participatory research and design research.19 Such methodologies facilitate the capture of feedback and the perspective of patients and caregivers for adjusting behavioral interventions.20 This feedback can then be used to adjust digital interventions to minimize adoption challenges. For example, the project Sisom (from the Norwegian phrase Si det Som det er, meaning Tell it how it is) focused on capturing the feedback of children with chronic conditions using a child-friendly patient-reported outcome mobile solution designed to enhance nursepatient relationships.21 Another example is the mobile solution Pain Squad for children with oncologic pain, for example, where patients were heavily involved in the design to maximize adherence to the use of the mobile-based pain diary.22 A more recent example, explained below, is the CARING study which focuses on the feasibility of supporting the emotional wellbeing of caregivers in a mobile-based digital intervention.23

Several factors are important when capturing feedback from patients and caregivers for the development of digital health interventions. Studies have shown that socio-cultural factors such as gender, ethnicity, and education level are relevant in the adoption of such digital health technologies.2426 Also, caregivers and patients perspectives concerning digital health interventions should be included in the analysis of healthcare delivery since, in most cases, the roll-out and implementation of such solutions will impact the provision of healthcare. To address this service delivery angle, methods aligned with service design are often applied.14 Finally, emerging research highlights the relevance of addressing digital health literacy as an enabler for adoption. Consequently, it represents a major aspect to consider when studying the patients and caregivers perspectives. For example, high levels of digital health literacy reduce risks regarding the adoption and safe usage of digital health tools by both caregivers and patients.27

There are several ways of administering r-hGH to pediatric patients, including syringes, pens, and auto-injector devices. One such device, the easypod autoinjector, transmits data to a web-based platform that allows HCPs to monitor adherence and access longitudinal patient data. To test the impact of this digital ecosystem on adherence, the Easypod Connect Observational Study (ECOS) was performed across multiple countries.28 The ECOS demonstrated how a digital health ecosystem, that records dose, date, and time of r-hGH administration, can help to maintain high adherence (85%; mg injected/mg prescribed) over the course of several years in different countries.28 Real-world data extracted from the easypod connect ecosystem support these findings. In an analysis performed from 2007 to the end of 2020, adherence data were available for 20,264 patients from 38 countries.29,30 Levels of high adherence increased over time in European (76% in 2010; 8284% in 20152019; 86% in 2020), North American (Canadian) (65% in 2010; 68% in 2015; 88% in 20192020), and Asian (5862% in 20142015; 6873% in 20162020) patients.29,30 No consistent change in adherence was found among Latin-American and Caribbean patients.29,30 Importantly, the observed adherence levels also had a statistically significant effect on change in Height Standard Deviation Scores (HSDS) from treatment start. Mean HSDS were 0.4, 0.7, 1.0, and 1.1 after 12, 24, 36, and 48 months treatment, respectively, in patients with high (85%) monthly adherence, 0.3, 0.6, 0.8, and 0.9 in patients with intermediate (>5684%) monthly adherence and 0.2, 0.5, 0.6, and 0.7 in patients with low (56%) monthly adherence.29,30

Expansion of digital health ecosystems, like easypod connect, through addition of new digital tools that have been co-created with HCPs and patients, offers an exciting opportunity to further improve both adherence and clinical outcomes for patients with growth disorders. When developing such digital tools, we propose following an iterative cycle that leverages the use of patient-generated data (Figure 1). The approach implies that defined hypotheses are validated based on patient-generated data prior to the design of prototypes, which are then tested in a clinical setting as the basis for future hypotheses. This continuous feedback loop can help pinpoint areas for improvement based on pre-defined patient populations. First, a team of interdisciplinary HCPs defines a hypothesis to improve management towards an optimal outcome based on their clinical experience. For example, they propose a mathematical model that predicts future therapy response based on experience and demographic information. Once the hypothesis has been thoroughly defined, data scientists use information from connected devices and other data sources, such as electronic health records, to develop, analyze, and validate data-driven models in an experimental setting. If successful, an experimental model (prototype) is designed and tested in collaboration with the HCP team, taking end-user feedback into consideration. An enhanced digital ecosystem is then established as the basis for real-world evaluation of (determinants) of use and outcome, for example, in prospective clinical trials. This enhanced ecosystem not only has the potential to improve disease management, but also serves as the basis for hypothesis generation within the next iterative loop. Over time, with increased patient-generated datasets, improved synergy between experienced teams, and new assumptions and hypotheses, this agile and incremental approach to the development of digital ecosystems will reflect the evolution of healthcare provision.

Figure 1 Continuous feedback loop based on patient-generated data. The data provided by patients, the HCP team and data scientists contribute to the development of an enhanced ecosystem.

To complement digital solutions, the use of psychology-based approaches within the healthcare environment can be beneficial to support HCPs in learning how to help patients to make healthy choices and decisions in their lives. HCPs are uniquely positioned within clinical settings to monitor, support, and promote adherence behaviors due to their existing supporting relationships with patients and their families.31 Importantly, HCPs are trusted by their patients and are often the people patients will turn to when they are thinking about making a health-related change. Addressing adherence-related issues within routine clinical practice can be a struggle, as patients and/or their families generally find it difficult to talk openly about adherence and are often reluctant or apprehensive to disclose treatment non-adherence.32 Thus, it is important for medical and nursing HCPs to be supported in core training to develop and reinforce key consultation behaviors and skills, ie motivational interviewing (MI).33

MI is a skill which can benefit both medical and nursing HCPs. Examples of the benefits of MI can be taken from experience in making healthy life choices. When considering these choices, reaction to the individual can be unhelpful, such as not listening or negatively encouraging regressive behavior. By contrast, a helpful response to the same life choices would consist of positive reactions such as genuine empathetic listening and exploration of the individuals feelings without judgement. This behavior typifies the spirit of MI, the key principles of which are partnership, acceptance, compassion, and evocation (PACE). Collaboration is important because partnership on an equal level with the patient is a key aim. Acceptance leads to better understanding of the decisions and choices that patients and families are making without judgement. These choices are accepted and the HCP responds with guidance. Compassion is a further component that is combined with Evocation, which means drawing out a patients inner motivation and commitment, and building on this to effect change.2,33

Core skills in MI can be discussed under the acronym OARS, which stands for Open questions, Affirmations, Reflective listening, and Summarising.2,33 The conversation can be structured by following these headings. Open questions such as what, how, and why will open conversations and evoke dialogue. Other examples would be what are your hopes for your consultation today? and I am curious to learn how you have been getting on with your injections? These questions can be prefaced by saying help me understand and the conversation can develop by inviting the patient or family to talk about what is on their mind and what their needs and their priorities are. Affirmations are about helping patients to recognize their own strengths and positive beliefs that are going to help them to adhere to r-hGH therapy. Examples could be to say to a patient, I can see it took courage for you to try this out today or to a parent, your creative ideas around this are very helpful. Reflective listening consists of not only listening and reflecting back what is said, it also helps in verbalizing the thinking and feelings that lie underneath, showing a depth of empathy that leads to further conversations. The last skill here is summarizing, which serves the useful purpose of wrapping up conversations and can be started by saying let me see if I have got this right, you are feeling this on one hand and perhaps feeling this on the other?.

Pediatric endocrinology nurse specialists can play a key role in addressing and managing the needs of patients prescribed r-hGH treatment and their families within their medical consultations. In view of this, psychologically-based patient support programs (PSPs) have been designed to help support patients and families to better manage their condition and treatment, with the purpose to optimize treatment adherence and improve clinical outcomes. These programs have demonstrated improved outcomes in a wide variety of diseases, through multidisciplinary HCP training and coaching; therefore, it is crucial for HCPs to begin to implement these new approaches within clinical practice in order to make a positive impact.34,35

One such PSP is TuiTek, a digital, multicomponent, personalized program designed to support the needs of patients, caregivers, and HCPs throughout the treatment care pathway. The intervention comprises two key service components: 1) a PSP training session, which aims to provide the HCP with the tools and strategies to deliver the TuiTek PSP and 2) a PSP Manual, consisting of A) a personalization screener, for HCPs to identify the key issues and challenges faced by patients and caregivers, and tailor the patient support; and B) a set of personalized one-to-one telephone call guides and resource packs which utilize a range of behavior change techniques (BCTs) and principles of MI, to support the HCP to engage in high-quality adherence-focused conversations with the patient during scheduled outbound calls with caregivers.

HCP-led calls which use BCTs and implement MI principles have been shown to affect meaningful behavior change across different health conditions such as increasing physical activity and improving diet,36,37 as well as demonstrating a positive impact on treatment adherence.38 This aligns with the findings of the TuiTek PSP which has been shown to positively address disease- and treatment-related barriers amongst caregivers regarding optimal adherence of their children to GH treatment; this, in turn, has the potential to improve adherence levels and patient clinical health outcomes.

Caregiver emotional distress has been found to be a driver of poor adherence and self-management skills in pediatrics and growth disorders.3941 This includes aspects related to anxiety and fear of the medication itself, but also aspects such as poor communication between parents and children. Overall, poor emotional wellbeing has a direct impact on the self-efficacy of both caregivers and patients themselves which ultimately will drive poor self-management behaviors.

There is a body of literature in pediatrics showing the efficacy of interventions to address the emotional wellbeing of caregivers of children living with chronic conditions. These include the use of techniques such as cognitive behavioral therapy and mindfulness.42,43 As a result, caregivers are better equipped to handle emotional stressors. Also, there is evidence of the positive impact of enhancing parenting skills such as communication to help cope with stressful situations related to the self-management of a chronic condition.44

In the CARING study, a digitally enabled intervention was designed and implemented to complement the work of the pediatric endocrinology unit in the University Hospital of Miguel Servet in Zaragoza, Spain.23 The clinicians identified children with suboptimal adherence using the easypod connect platform, their caregivers were then invited to participate in a study that includes the use of a digital program to deliver an intervention designed to improve the mental wellbeing of caregivers.

The digital intervention was powered by the ADHERA CARING platform that incorporates educational content to improve self-management skills, including gamification elements (eg quizzes), and is designed to ensure understandability and usability. This is complemented by content addressing mental-wellbeing based on cognitive behavioral therapy, including content such as videos of relaxation techniques aimed at helping families to reduce anxiety before injections. Furthermore, tailored motivational messages were sent to caregivers to reinforce engagement and therapeutic effectiveness. The behavioral design of the intervention was based on the Integrated Model for Behavioral Change (I-CHANGE).20

The first phase of the study included the recruitment of 10 caregivers who tested the program for a month and provided feedback in a semi-structured interview. The qualitative feedback data was used to identify areas for improvement and adjustment of the intervention prior to starting the second phase of the study which is aimed at quantifying the clinical impact of such an intervention. The preliminary results achieved in the first phase of the study showed high engagement and positive feedback; in addition, participants highlighted the importance of such interventions not only when adherence is suboptimal but also at the initiation of the treatment.23

There are several unmet clinical needs related to the management of a child with GHD. The first is the late age of diagnosis. In a recent study of 39 children with GHD, the mean age of diagnosis was 4.6 years in Germany, 7.0 years in the UK, and 9.4 years in the USA.45 The late age of diagnosis has a negative impact on the adult height achieved after r-hGH therapy.1 The subjects with abnormal variables are sent for investigation and diagnosis.46 Such a technique of height screening has not yet been demonstrated to work in a real-world busy inner-city environment.

A second unmet need relates to the poor quality of growth response to r-hGH therapy, for which there are a wide range of causes. Therapy needs to be individualized, in terms of starting dose, for every child starting therapy. The one-dose-fits-all philosophy which was widely practiced in the 1980s and 1990s can no longer be defended and is inconsistent with the current standards of precision medicine.47 Many children are receiving inadequate doses of r-hGH with a lack of sophisticated dose individualization taking into consideration the known predictive factors.48 In addition, GH responsiveness may be affected by influences outside the GH-IGF-1 axis such as genetic variants which can induce a degree of GH resistance.49 In these subjects, r-hGH therapy should logically be discontinued. The range of responses to r-hGH also extends to children with more severe GH deficiency, who respond well to r-hGH doses below the recommended dose. A third unmet need relates to patients displaying poor adherence to r-hGH therapy, as discussed in this article.

Finally, the standard of transitional care of the adolescent with GHD after completion of linear growth from pediatric to adult care is highly variable between centers and countries.50 Several digital tools are available to assess a young patients readiness for transition, including the Transition Readiness Assessment Questionnaire. This has been used in endocrinology to compare young people with Turner syndrome to those with type 1 diabetes, and revealed that those with Turner syndrome are less mature in the management of their healthcare and may find the process of transfer to adult services difficult.51 This aspect is, however, also connected with national healthcare policies. Mobile devices, such as smartphone apps (e.g. Tiny Medical Apps Digital Health Passport app), have been developed that can assist young people in self-managing their condition.

We believe that supporting patients across their disease journey means more than just providing them and their physicians with an effective therapy. Beyond the prescription of r-hGH, it means providing all stakeholders involved with the tools, information, services, and support needed to achieve the goal of effective treatment and clinical benefit. Methods for assessment of adherence need to be standardized, both from the point of view of definition of adherence and its measurement.52 For GH-deficient patients, caregivers, and HCPs, this has meant a change in the attitude towards r-hGH adherence and embracing the concept of a successful humandigital partnership which is essential to achieve these goals.2 The relationship between poor adherence and poor response to r-hGH therapy is well established.53 While enthusiasm and support for digital health technologies was slow at first, these efforts have accelerated with broader awareness and acceptance amongst both patients and HCPs. New digital technologies will evolve and the introduction of innovations and new technologies, while providing challenges for patients and HCPs, have the potential to further improve the personalized management of the GH-deficient patient receiving r-hGH therapy. The development of digital ecosystems reflecting the evolution of healthcare provision and an agile incremental approach of their enhancements by Iterative loops has the potential to improve disease management.

Editorial assistance was provided by Amy Evans of inScience Communications, Springer Healthcare Ltd, UK, and was funded by Merck Healthcare KGaA, Darmstadt, Germany.

This study was sponsored by Merck (CrossRef Funder ID: 10.13039/100009945).

MOS has consultancy agreements with Merck Healthcare KGaA Darmstadt and Pfizer as well as honoraria for lectures from Ipsen, GeneSciences, and Sandoz. LF-L is Chief Scientific Officer at Adhera Health Inc., Palo Alto, CA, USA. SG and PvD have consultancy agreements with Merck. MA has previously had a consultancy agreement with Merck. AdA does not have any conflicts of interest to declare. EK is an employee of Merck Healthcare KGaA, Darmstadt, Germany and holds shares in the company. The authors report no other conflicts of interest in this work.

1. Wit JM, Deeb A, Bin-Abbas B, Al Mutair A, Koledova E, Savage MO. Achieving optimal short- and long-term responses to paediatric growth hormone therapy. J Clin Res Pediatr Endocrinol. 2019;11(4):329340. doi:10.4274/jcrpe.galenos.2019.2019.0088

2. Child J, Davies C, Frost K, et al. Managing paediatric growth disorders: integrating technology into a personalised approach. J Clin Res Pediatr Endocrinol. 2020;12(3):225232.

3. Fisher BG, Acerini CL. Understanding the growth hormone therapy adherence paradigm: a systematic review. Horm Res Paediatr. 2013;79(4):189196. doi:10.1159/000350251

4. Dattani M, Malhotra N. A review of growth hormone deficiency. Paediatr Child Health. 2019;29:285292. doi:10.1016/j.paed.2019.04.001

5. Ranke MB, Wit JM. Growth hormone - past, present and future. Nat Rev Endocrinol. 2018;14(5):285300. doi:10.1038/nrendo.2018.22

6. Dimitri P, Fernandez-Luque L, Banerjee I, et al. An eHealth framework for managing pediatric growth disorders and growth hormone therapy. J Med Internet Res. 2021;23(5):e27446. doi:10.2196/27446

7. Kuromaru R, Kohno H, Ueyama N, Hassan HM, Honda S, Hara T. Long-term prospective study of body composition and lipid profiles during and after growth hormone (GH) treatment in children with GH deficiency: gender-specific metabolic effects. J Clin Endocrinol Metab. 1998;83(11):38903896. doi:10.1210/jcem.83.11.5261

8. Johannsson G, Albertsson-Wikland K, Bengtsson BA. Discontinuation of growth hormone (GH) treatment: metabolic effects in GH-deficient and GH-sufficient adolescent patients compared with control subjects. Swedish study group for growth hormone treatment in children. J Clin Endocrinol Metab. 1999;84(12):45164524. doi:10.1210/jcem.84.12.6176

9. Taddeo D, Egedy M, Frappier JY. Adherence to treatment in adolescents. Paediatr Child Health. 2008;13(1):1924. doi:10.1093/pch/13.1.19

10. Graham S, Weinman J, Auyeung V. Identifying potentially modifiable factors associated with treatment non-adherence in paediatric growth hormone deficiency: a systematic review. Horm Res Paediatr. 2018;90(4):221227. doi:10.1159/000493211

11. Brown SJ, Lieberman DA, Germeny BA, Fan YC, Wilson DM, Pasta DJ. Educational video game for juvenile diabetes: results of a controlled trial. Med Inform. 1997;22(1):7789. doi:10.3109/14639239709089835

12. Stome LN, Wilhelmsen CR, Kvaerner KJ. Enabling guidelines for the adoption of eHealth solutions: scoping review. JMIR Form Res. 2021;5(4):e21357. doi:10.2196/21357

13. El Benny M, Kabakian-Khasholian T, El-Jardali F, Bardus M. Application of the eHealth literacy model in digital health interventions: scoping review. J Med Internet Res. 2021;23(6):e23473. doi:10.2196/23473

14. Shaw J, Agarwal P, Desveaux L, et al. Beyond implementation: digital health innovation and service design. NPJ Digit Med. 2018;1:48. doi:10.1038/s41746-018-0059-8

15. Acerini CL, Segal D, Criseno S, et al. Shared decision-making in growth hormone therapy-implications for patient care. Front Endocrinol. 2018;9:688. doi:10.3389/fendo.2018.00688

16. Assefi AR, Roca F, Rubstein A, Chareca C. Positive impact of targeted educational intervention in children with low adherence to growth hormone treatment identified by use of the easypod electronic auto-injector device. Front Med Technol. 2021;3:609878. doi:10.3389/fmedt.2021.609878

17. World Health Organization. Adherence to long-term therapies: evidence for action; 2003. Available from: https://www.who.int/chp/knowledge/publications/adherence_report/en/. Accessed July 08, 2022.

18. Tornivuori A, Tuominen O, Salantera S, Kosola S. A systematic review on randomized controlled trials: coaching elements of digital services to support chronically ill adolescents during transition of care. J Adv Nurs. 2020;76(6):12931306. doi:10.1111/jan.14323

19. Syed-Abdul S, Zhu X, Fernandez-Luque L. Digital Health. Mobile and Wearable Devices for Participatory Health Applications. 1st ed. Elsevier; 2020.

20. Cheung KL, Hors-Fraile S, de Vries H. How to use the integrated-change model to design digital health programs. In: Syed-Abdul S, Zhu X, Fernandez-Luque L, editors. Digital Health. Mobile and Wearable Devices for Participatory Health Applications. 1st ed. Elsevier; 2021:143157.

21. Arvidsson S, Gilljam BM, Nygren J, Ruland CM, Nordby-Boe T, Svedberg P. Redesign and validation of sisom, an interactive assessment and communication tool for children with cancer. JMIR Mhealth Uhealth. 2016;4(2):e76. doi:10.2196/mhealth.5715

22. Stinson JN, Jibb LA, Nguyen C, et al. Development and testing of a multidimensional iPhone pain assessment application for adolescents with cancer. J Med Internet Res. 2013;15(3):e51. doi:10.2196/jmir.2350

23. Signorelli G, Nunez-Benjumea FJ, Munoz AA, et al. Digital health platform for emotional and self-management support of caregivers of children receiving growth hormone treatment. Stud Health Technol Inform. 2022;289:371375. doi:10.3233/SHTI210936

24. Mitchell UA, Chebli PG, Ruggiero L, Muramatsu N. The digital divide in health-related technology use: the significance of race/ethnicity. Gerontologist. 2019;59(1):614. doi:10.1093/geront/gny138

25. OConnor S, Hanlon P, ODonnell CA, Garcia S, Glanville J, Mair FS. Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies. BMC Med Inform Decis Mak. 2016;16(1):120. doi:10.1186/s12911-016-0359-3

26. Rahimi B, Nadri H, Lotfnezhad Afshar H, Timpka T, Systematic A. Review of the technology acceptance model in health informatics. Appl Clin Inform. 2018;9(3):604634. doi:10.1055/s-0038-1668091

27. Magsamen-Conrad K, Wang F, Tetteh D, Lee YI. Using technology adoption theory and a lifespan approach to develop a theoretical framework for eHealth literacy: extending UTAUT. Health Commun. 2020;35(12):14351446. doi:10.1080/10410236.2019.1641395

28. Koledova E, Stoyanov G, Ovbude L, Davies PSW. Adherence and long-term growth outcomes: results from the easypod connect observational study (ECOS) in paediatric patients with growth disorders. Endocr Connect. 2018;7(8):914923. doi:10.1530/EC-18-0172

29. Koledova E, Bagha M, Arnaud L, Piras F, van Dommelen P. Optimising adherence using a connected injection device can improve growth outcomes: evidence from real-world data on 11 million injections in 20,000 patients with growth disorders. Horm Res Paediatr. 2021;94:1445.

30. Tornincasa V, Dixon D, Le Masne Q, et al. Integrated digital health solutions in the management of growth disorders in pediatric patients receiving growth hormone therapy: a retrospective analysis. Front Endocrinol. 2022. doi:10.3389/fendo.2022.882192

31. Abdel-Tawab R, James DH, Fichtinger A, Clatworthy J, Horne R, Davies G. Development and validation of the Medication-Related Consultation Framework (MRCF). Patient Educ Couns. 2011;83(3):451457. doi:10.1016/j.pec.2011.05.005

32. Engel T, Ungar B, Ben-Haim G, Levhar N, Eliakim R, Ben-Horin S. Re-phrasing the question: a simple tool for evaluation of adherence to therapy in patients with inflammatory bowel disease. United European Gastroenterol J. 2017;5(6):880886. doi:10.1177/2050640616687838

33. Miller W, Rollnick S. Applications of Motivational Interviewing. 3rd ed. Guilford Press; 2012.

34. Weingarten SR, Henning JM, Badamgarav E, et al. Interventions used in disease management programmes for patients with chronic illness-which ones work? Meta-analysis of published reports. BMJ. 2002;325(7370):925. doi:10.1136/bmj.325.7370.925

35. Bennett HD, Coleman EA, Parry C, Bodenheimer T, Chen EH. Health coaching for patients with chronic illness. Fam Pract Manag. 2010;17(5):2429.

36. Cook PF, Emiliozzi S, El-Hajj D, McCabe MM. Telephone nurse counseling for medication adherence in ulcerative colitis: a preliminary study. Patient Educ Couns. 2010;81(2):182186. doi:10.1016/j.pec.2009.12.010

37. McBride CM, Rimer BK. Using the telephone to improve health behavior and health service delivery. Patient Educ Couns. 1999;37(1):318. doi:10.1016/S0738-3991(98)00098-6

38. Turner AP, Sloan AP, Kivlahan DR, Haselkorn JK. Telephone counseling and home telehealth monitoring to improve medication adherence: results of a pilot trial among individuals with multiple sclerosis. Rehabil Psychol. 2014;59(2):136146. doi:10.1037/a0036322

39. Silva N, Bullinger M, Sommer R, Rohenkohl A, Witt S, Quitmann J. Childrens psychosocial functioning and parents quality of life in paediatric short stature: the mediating role of caregiving stress. Clin Psychol Psychother. 2018;25(1):e107e118. doi:10.1002/cpp.2146

40. Gerain P, Zech E. Does informal caregiving lead to parental burnout? Comparing parents having (or not) children with mental and physical issues. Front Psychol. 2018;9:884. doi:10.3389/fpsyg.2018.00884

41. Alsaigh R, Coyne I. Mothers experiences of caring for children receiving growth hormone treatment. J Pediatr Nurs. 2019;49:e63e73. doi:10.1016/j.pedn.2019.09.005

42. Segal Z, Teasdale J, Williams J. Mindfulness-based cognitive therapy: theoretical rationale and empirical status. In: Hayes SC, Follette VM, Linehan MM, editors. Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition. Guilford Press; 2004:4565.

43. Townshend K, Jordan Z, Stephenson M, Tsey K. The effectiveness of mindful parenting programs in promoting parents and childrens wellbeing: a systematic review. JBI Database System Rev Implement Rep. 2016;14(3):139180. doi:10.11124/JBISRIR-2016-2314

44. Okafor M, Sarpong D, Ferguson A, Satcher D. Improving health outcomes of children through 10 effective parenting: model and methods. Int J Environ Res Public Health. 2014;11:296311. doi:10.3390/ijerph110100296

45. Brod M, Alolga SL, Beck JF, Wilkinson L, Hojbjerre L, Rasmussen MH. Understanding burden of illness for child growth hormone deficiency. Qual Life Res. 2017;26(7):16731686. doi:10.1007/s11136-017-1529-1

46. Savage MO, Backeljauw PF, Calzada R, et al. Early detection, referral, investigation, and diagnosis of children with growth disorders. Horm Res Paediatr. 2016;85(5):325332. doi:10.1159/000444525

47. Fernandez-Luque L, Al Herbish A, Al Shammari R, et al. digital health for supporting precision medicine in pediatric endocrine disorders: opportunities for improved patient care. Front Pediatr. 2021;9:715705. doi:10.3389/fped.2021.715705

48. Polak M, Konrad D, Tonnes Pedersen B, Puras G, Snajderova M. Still too little, too late? Ten years of growth hormone therapy baseline data from the NordiNet(R) international outcome study. J Pediatr Endocrinol Metab. 2018;31(5):521532. doi:10.1515/jpem-2017-0489

49. Argente J, Tatton-Brown K, Lehwalder D, Pfaffle R. Genetics of growth disorders-which patients require genetic testing? Front Endocrinol. 2019;10:602. doi:10.3389/fendo.2019.00602

50. Colver A, Rapley T, Parr JR, et al. Facilitating transition of young people with long-term health conditions from childrens to adults healthcare services - implications of a 5-year research programme. Clin Med. 2020;20(1):7480. doi:10.7861/clinmed.2019-0077

51. Culen C, Herle M, Ertl DA, et al. Less ready for adulthood?-Turner syndrome has an impact on transition readiness. Clin Endocrinol (Oxf). 2020;93(4):449455. doi:10.1111/cen.14293

52. Gomez R, Ahmed SF, Maghnie M, Li D, Tanaka T, Miller BS. Treatment adherence to injectable treatments in pediatric growth hormone deficiency compared with injectable treatments in other chronic pediatric conditions: a systematic literature review. Front Endocrinol. 2022;13:795224. doi:10.3389/fendo.2022.795224

53. Loftus J, Miller BS, Parzynski CS, et al. Association of daily growth hormone injection adherence and height among children with growth hormone deficiency. Endocr Pract. 2022;28:565571. doi:10.1016/j.eprac.2022.02.013

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Human growth hormone (hGH): How to boost it and illegal use – INSIDER

Posted: November 19, 2021 at 2:02 am

Human growth hormone (hGH) is a key hormone that helps maintain muscle tissue and is often associated with enhanced athletic performance, increased bone density, and reduced body fat.

This has led some athletic communities to attempt doping with hGH to improve strength and performance. That's why you may sometimes hear about illegal hGH use.

Note: HGH is prohibited by the World Anti-Doping Agency. And even though growth hormone is abused in competitive athletics, its benefits in a healthy, adult population are uncertain, according to a 2018 study.

However, if your doctor prescribes you hGH for hGH deficiency, then it's perfectly legal to use. There are also ways to increase hGH levels without medical aid, though they are not very effective long-term.

Here we discuss why some people have low hGH, how to boost hGH levels, and common side effects.

Human growth hormone (hGH) is a hormone you produce naturally. In childhood, it plays a key role in your physical growth and development.

However, hGH is also important in adulthood, helping maintain tissue and organ function. You can't get hGH from food, so if you're hGH deficient, it's important to see a doctor.

A doctor will typically prescribe injections of a synthetic version of the hormone called recombinant growth hormone (rhGH) to combat symptoms of low hGH.

HGH is produced by the pituitary gland, a small pea-sized organ located at the base of your brain. When that gland doesn't produce enough hGH, you're at risk of low hGH levels.

Children who are deficient in hGH may have short stature or stunted growth. Treatment requires daily injections of rhGH and typically continues until the child has stopped growing, around age 16 to 18, says Alan Rogol, MD, PhD, a pediatric endocrinologist and professor emeritus at the University of Virginia.

In adults, low hGH is often due to damage to the pituitary gland or the hypothalamus, a part of the brain that controls the pituitary gland. Damage is often from tumors in the area of the pituitary gland and hypothalamus, Rogol says.

Symptoms of adult growth hormone deficiency include:

To test for growth hormone deficiency, the first step is a blood test called IGF-1 to screen for a deficiency, and then a test called a growth hormone stimulation test, Rogol says.

Because you can't take growth hormone legally unless you're being treated for a deficiency, people may want to try to boost hGH levels naturally for its purported benefits.

Certain activities, such as exercise, do boost hGH levels, but the effects may not be significant enough to see the desired effects, Rogol says. "It's a controversial issue," he says.

Moreover, it's unclear from present research whether these changes are long-lasting or only temporary. So, whether these results are clinically relevant is unclear and more long-term research is needed.

With that in mind, here are some ways you may be able to boost hGH naturally, according to Shawn Arent, PhD, professor and the chair of the Department of Exercise Science at the University of South Carolina and an ACSM fellow:

Fasting and avoiding sugars can also affect hGH levels, but the effects are complicated because of how growth hormone interplays with other hormones and activities, and exercise will have a much greater effect, Arent says.

Last, there are supplements you can buy that claim to stimulate the natural release of hGH. For example, some supplements contain the amino acid L-arginine, which "some studies ... show that L-arginine can increase growth hormone. Whether it's meaningful or not, though, is pretty debatable," says Arent.

Moreover, a 2008 review looked at how exercise and L-arginine supplementation affected growth hormone responses and found that L-arginine increases growth hormone levels, but that exercise increases them more dramatically.

Although hGH has important benefits for people who take it to treat a deficiency, hGH also has some potential long-term side effects, according to the FDA, including:

Other side effects can include:

Growth hormone injections are effective in treating people with hGh deficiency, but other ways of taking the hormone are illegal.

By exercising and getting a good night's sleep, you may help boost your hGH levels, but this effect may only be temporary and not lead to any significant long-term changes.

If you're looking to boost hGH to build muscle or lose fat, eating a well-balanced diet and incorporating high-intensity exercise and weight training may be a better approach.

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Elite HRT Releases Guidance on Lipotropic Injections – StreetInsider.com

Posted: November 6, 2021 at 1:57 am

News and research before you hear about it on CNBC and others. Claim your 1-week free trial to StreetInsider Premium here.

Detailed guide will help you understand if these injections are right for you

LOS ANGELES--(BUSINESS WIRE)--The experts at Elite HRT have published a new guidance on the ingredients and effectiveness of lipotropic injections, which work to break down fat in the body. This free online resource provides information about the various benefits seen from these injections as well as who they may be right for, and who would be unfit to receive them.

The article, reviewed by regulatory affairs specialist Camille Freking, explains that lipotropic injections help to not only induce weight loss, but also improve the health of the integumentary system that supports the skin, hair, and nails. The most commonly known type of these injections is the MIC injection, which stands for methionine, inositol, and choline; these are the primary substances that help to break down the fat. Methionine is an amino acid that acts as an antioxidant to remove free radicals from the body and help the liver to metabolize fat. Inositol is a substance akin to a vitamin that helps break down both cholesterol and fat itself, while Choline is an essential nutrient that helps to produce a hormone that also breaks down fats. Also seen in lipotropic injections are B-12, a vitamin that boosts both energy and metabolism to help both with exercise and healthy eating. There are other essential B vitamins included in these injections as well, including thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, and folic acid, which all help support weight loss.

Elite HRT notes that lipotropic injections do not cause weight loss, but help facilitate it, meaning that it is still advised to both exercise and diet when working to burn fat from the body. In addition, these procedures can bring side effects such as pain or swelling at the injection site, dry mouth, anxiety, fatigue, allergic reactions, or disruptions to bowel movements. These injections should not be used as a get thin quick method, but instead should be used only with the supervision of a trained medical professional.

About Elite HRT: Elite HRT is a telemedicine firm led by a network of physicians specializing in hormone replacement therapies. With unique approaches to HRT, TRT, HGH, and more, Elite HRT works to tailor solutions uniquely created for specific patients, all at affordable rates. Those wanting to learn more and contact Elite HRT can visit https://www.elitehrt.com/ and submit a contact request form with background information today.

View source version on businesswire.com: https://www.businesswire.com/news/home/20211103005007/en/

Media Contact:Emma LombardiGR0press@gr0.com

Source: Elite HRT

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HGH Common Side Effects: Is Growth Hormone Worth the Risks and Are There Safe Alternatives? – Gilmore Health News

Posted: July 16, 2021 at 1:50 am

In the last few years, human growth hormone, which is simply referred to as HGH, has become increasingly popular. More and more people are talking about powerful HGH injections and their wonders. Perhaps, you are contemplating trying the injections to enjoy the benefits you have been hearing others talk about. But before you do that, you should first go through the information provided in this piece to determine if you should take such a decision or just forget about it. Most importantly find out what kinds of HGH side effects do you expose yourself to when you use HGH incorrectly.

HGH Side Effects

HGH or GH is a hormone that helps to stimulate cell reproduction, regeneration, and growth in animals, including humans. The hormone helps to control how the human body grows. Described as a type of mitogen, HGH is a single-chain polypeptide that comprises 191 amino acids. It is typically produced by the pituitary gland which can be found at the base of the brain. Growth hormone produced naturally within the human body is sometimes referred to as somatotropin, while that which is generated through the use of recombinant DNA technology goes under the generic name of somatropin and is what we mostly refer to as HGH. The natural secretion of GH in the body is determined by several factors, including sex, age, diet, and exercise.

HGH has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of a number of conditions. In children, HGH injections are recommended for the treatment of growth-related issues. It is used to tackle growth hormone deficiency and short stature which may be the result of certain medical conditions like Turners syndrome, a genetic disorder that affects a female childs development, and Prader-Willi syndrome, a rare genetic disorder that is associated with constant hunger, poor muscle tone, and low sex hormone levels. HGH is also believed to be helpful in dealing with growth issues resulting from chronic kidney disease and being born small for gestational age.

HGH injections, such as Norditropin, are also recommended for dealing with HGH deficiency in adults, although that is not a common occurrence. HGH deficiency in adults mostly occurs as a result of rare pituitary tumors or because of their treatment. The FDA has also approved the use of this hormone for treating short bowel syndrome, a disorder characterized by the inability of the body to properly absorb nutrients as a result of severe intestinal disease or removal of a sizeable portion of the small intestine. Furthermore, HGH is administered to adults for combating a muscle-wasting disease that may result from HIV/AIDS.

However, HGH is probably more popular for off-label uses because of its anti-aging benefits. It is often used by many for dealing with signs of aging in fact, it has been used for this purpose as far back as 1990 when the results of a study confirmed its usefulness for this purpose. Some athletes also use HGH to build their muscles and boost their level of performance, which was why it has been banned by some sports bodies. Some even take things a bit further by using insulin to enhance the muscular effects of HGH, but this is quite risky as it is capable of lowering blood sugar. The hormone has also been used to treat signs of multiple sclerosis, muscle mass building, and for weight loss purposes. The use of HGH for other purposes than those for which the FDA approved it is considered illegal in the U.S.

HGH, also known as somatropin, does come with some potentially life-threatening side effects, especially when used for off-label purposes. Let us consider some of these possible side effects both the severe and less severe or temporary ones. The following are some of the more serious or severe side effects of HGH that will require you to check with your doctor immediately if you still can:

The use of somatropin-based injections can cause water to be retained in the tissues of the body, giving rise to a swollen look.

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HGH for Bodybuilding: How Effective Is It?

Posted: January 23, 2021 at 10:48 pm

An Ultimate Guide on Use of Growth Hormone for Bodybuilding

When it comes to the use of human growth hormone for off-label purposes, bodybuilders are among those that easily come to mind. This group of users was quick to grasp that the anabolic properties of this substance could be beneficial in achieving their goal of an attractive, ripped body. But there exists some amount of controversy on whether HGH does help much, if at all, in this regard. We discuss here practically all you need to know about growth hormone for bodybuilding.

For many decades, bodybuilders have been trying out one substance or another to get ahead of the pack. The popular belief is that this has been the trend as far back as the 1950s, maybe earlier. Some of these were natural and others synthetic. Anabolic steroids readily come to mind here. The use of these substances led to extraordinary bulk, highly chiseled look among competitors, or so they say. But the experimentation continued to find something that gives greater advantage even to this day. It was this that led many bodybuilders to human growth hormone.

HGH is a naturally occurring substance that is secreted by the pituitary gland in the head. It is a single-chain peptide comprising 191 amino acids having a molecular weight of around 22 kilo Daltons (kDa). Humans mostly need it to promote growth and development in the young. But the usefulness doesnt stop there. The peptide is crucial to your overall health and well being. This is why scientists went ahead to produce a synthetic version to help people who have very low levels.

It is thought in some circles that bodybuilders started using growth hormone to achieve more impressive results as early as the 1970s. This is because it was around this period that competitors started showing greater bulk and better sculpted bodies. Some say all bodybuilders, more precisely the professionals, now have the substance in their regimen. However, the use for this purpose has been the subject of significant debate over the years.

Human growth hormone once it is secreted or introduced into the body enters your bloodstream and travels to your liver. There it stimulates production of growth factors, most notably insulin-like growth factor-1 (IGF-1). It is through IGF-1 that HGH delivers its muscle mass building benefit that bodybuilders are interested in.

IGF-1, a single-chain hormone made up of 70 amino acids, helps to speed up protein synthesis. It does this by binding to specific receptors in musculoskeletal tissue. Calories from what you eat are diverted to protein synthesis. Proteins are commonly referred to as the building blocks of the body or life. They are essential for building bigger, stronger muscles and for existence. So growth hormone does help bodybuilders by assisting with the absorption of more proteins from the foods you consume.

The role of HGH in muscle hyperplasia makes it quite enticing to bodybuilders. It just doesnt cause cell or tissue to become bigger; it also promotes creation of new cells. The substance causes cells to multiply very fast leading to greater increase in lean muscle mass. But this proliferative effect may predispose you to some scary medical conditions as well.

HGH has also been shown to discourage fat synthesis. Weight gain or lopsided body fat has been observed in people who have low levels, including elderly individuals. The substance is said to help use up body fat for energy, rather than storing it up. This makes you lose excess fat faster. To the bodybuilder, this helps to achieve better chiseled appearance.

Among the other benefits of growth hormone for bodybuilding is enhancement of cartilage strength. It promotes strong bones and joints. Another benefit that also makes it more attractive for some competitors is that it promotes faster recovery. It helps injuries and wounds to heal faster.

The extent of boost you get from the use of human growth hormone for bodybuilding depends on knowing the right dosage to use, among other important considerations. The optimal amount of the peptide to use is put within the range of 6 to 8 International Units (IU) per day. This should ideally be divided into two equal doses taken about 5-7 hours apart.

Some people may take higher amount than this suggested dosage in their desperation to achieve faster, more jaw-dropping results. This is not a great idea because doing this exposes you to very great health risks. Consistency is more important than the amount you take. It is better to take the recommended dosage for longer period than to use double the amount in a shorter period of time.

However, some people say dosages in the range 4 to 8 IU suggested previously is best for people who are taking growth hormone for the first time. You may use up to 15 IU a day as time goes on, according to them. We advice professional guidance before you consider such higher dosages.

Growth hormone is usually given via injections. This could be through subcutaneous or intramuscular means. Subcutaneous injections have, for many years, been the most popular. This is probably because injections for medical conditions are given this way. But this doesnt deliver the best results when taken for athletic purposes.

Intramuscular method provides the more effective means for people using HGH for bodybuilding. Injections that are given in this manner enter into your system quicker. This means they get down to work faster to promote the desired results.

The half-life of growth hormone is estimated at between 15 and 20 minutes from the time it enters the body. Its amount in the body reaches the highest level about one to three hours from when you take the injection. That period is the window it has to deliver its anabolic effect.

You need to understand the relationship between growth hormone and insulin in determining the best time to take the injections. When the level of one rises, that of the other falls. This means the ability of HGH to produce desired results reduces when insulin level is high. The implication of this is that you should aim to use the peptide when the amount of the other substance is low.

The suggestion is to take HGH after you might have finished your daily workouts. Insulin levels are typically low at such a time. Some suggests using on waking in the morning, but the idea of waiting until after finishing workouts looks more likely to deliver better results. If you also take insulin supplements, you can leave such until about 40 minutes afterwards.

You can wake and take the other half of the daily dosage in the middle of the night. But since that may not be convenient for you, the second dose can be taken before you go to bed.

There are particular protocols that are observed by people using growth hormone for bodybuilding. Some use it every day (ED) and others use every other day (EOD). Among the important considerations that will determine which is appropriate for you are costs and convenience. ED protocol obviously requires more money and may be considered more inconvenient.

As would be expected, the results to be delivered by the ED and EOD protocols differ. Everyday usage will lead to more pronounced results than when you use growth hormone every other day.

Still, some other people think using the hormone for five days in a week and then taking two days off is best. Certain users take it Mondays through Fridays and take the weekend off. But it is argued by others that using HGH for consecutive days and then taking a day off is a better approach to doing this.

Whichever of the protocols you decide on, it is important to note that growth hormone is taken in cycles. A cycle usually lasts from two to four months. It is typical for breaks to be advised between HGH injection cycles. This can help to reduce the risks associated with prolonged usage of the substance.

Bodybuilding is nothing like weight loss that requires you to moderate the quantity of food that you eat. You practically have the freedom to eat anything food you like. This is because calories are not stored up in the body. The regular workouts involved helps to do away with carbs and fat. Besides, growth hormone causes your body to use calories for energy. But this should not be taken as license to eat too much, especially when it comes to junks.

Your diet should feature high quality protein. This is a major reason you see professional bodybuilders eat lots of eggs. That is a great source of high quality protein. You need to consume lots of carbohydrates and as much as 3 grams per kilogram. Experts also advise eating every two or three hours.

With all the talks about the anabolic benefits of growth hormone, you should not make your expectations too high. The substance may not increase your muscle bulk to the level of those professional bodybuilders with eye-popping chiseled body. This is even unlikely if you have great genes that can make HGH work better. Steroids are said to offer more impressive results.

Competitors commonly stack growth hormone with anabolic androgenic steroids for this reason. This amplifies the muscle building benefits of both groups of substances. The synergistic effect causes you to achieve results faster. Other types of compounds that are commonly combined with HGH include:

And talking about insulin, you may wonder why someone would still need to consider that given the negative relationship to human growth hormone. It assists with protein synthesis and this can support HGH to produce greater muscle gains. Insulin is also very important if you take high amount of growth hormone higher than the dosage talked about previously. This keeps levels from getting too low, as that may impact your health adversely.

It follows then that when you use only HGH it takes longer time to achieve results. For example, you may be able to achieve results that will take growth hormone alone up to four months in just about two or three months when you stack with other compounds. Some experts advise introducing the other substances halfway into the HGH cycle say, from the third of a six-month cycle. The belief is that the amount of the hormone would have built up significantly by this time to amplify benefits when you introduce other types of compounds.

There is legal concern hanging over the use of HGH for muscle mass building. This is also the case with most other substances professional bodybuilders use for incredible bulk, especially steroids. See, growth hormone is a substance for just a few medical issues. Bodybuilding is definitely not a medical concern you can live a healthy life without it. So it is illegal to use growth hormone to achieve this goal.

The U.S. Food and Drug Administration is sternly against the use of HGH for off-label purposes such as this. And this is exactly the reason you need a doctors prescription to be able to get the synthetic hormone legally. This requires diagnosis. No reputable doctor will prescribe it to you just because you are interested in building greater muscle mass. In addition, these injections can set you back several thousands of dollars every year. This is considering the dosage required and how frequently you may need to take it.

Professional bodybuilders and others that use growth hormone for off-label purposes typically obtain it from the black market. But this is risky. You could be arrested if illegal HGH is found in your possession. This can land you a hefty fine and/or years in prison on drug charges. You also cannot be sure of the quality of the product you are getting from the black market.

If peace of mind is more preferable to efficacy for you, HGH releasers may be a good idea. A good example of products you can consider is Somatropinne. Just know that these may not really give the kind of results you expect, at least not fast enough.

People looking to build muscle mass and have a well sculpted body often make the mistake of taking excessively high doses. You expose yourself to side effects if you follow similar approach. These include:

It is also feared that growth hormone may contribute to enlargement of cancer cells. There appears no definitive conclusion on this in research for now.

You can receive a boost in your efforts at bodybuilding by using growth hormone. The efficacy is amplified when combined with other compounds such as steroids. But note that you cannot get it legally for this purpose. Professional bodybuilders typically get their supply from underground sources. This increases risk of side effects. You want to make sure you are in great health before going ahead to use HGH for bodybuilding.

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Prader-Willi Syndrome Facts: Causes, Diagnosis, Treatments and Prognosis – Gilmore Health News

Posted: December 6, 2020 at 12:56 pm

What is Prader-Willi Syndrome?

Prader-Willi syndrome is a rare genetic disorder caused by a defect of genes in the proximal arm of chromosome-15 which leads to life-threatening childhood obesity. It is associated with obesity, hypogonadism, intellectual deficits, small stature along with small hands, and feet.

A child with PraderWilli Syndrome

The first case of Prader-Willi syndrome was first described in a mentally impaired adolescent girl in 1887 by Langdon Down and was later described in medical literature in 1956 by Swiss doctors Andrea Prader, Alexis Labhart, and Heinrich Willi.

Presence of characteristic facial features like almond-shaped eyes, narrow bifrontal diameter, and the nasal bridge thin upper lip and downturned mouth. These features are noticed soon after birth.

Prader-Willi syndrome has been described worldwide and is a genetic disorder occurring in approximately 1 in every 15,000 live birth. It affects males and females equally, all races and ethnicities are equally susceptible.It is highly unlikely for parents to have more than one child with Prader-Willi syndrome.

PWS is caused due to abnormality in the expression of genes on Chromosome 15 specifically on the long arm of chromosome 15. This abnormality can be attributed to the following :

The defects seen in Prader-Willi syndrome is mostly attributed to hypothalamic disorder, which may explain some typical features of the syndrome like delayed growth and hyperphagia as the hypothalamus is the center for hormone production, growth, and hunger regulation.

Various studies have implied the role of Ghrelin in satiety defect and have found Ghrelin to be about 4-5 folds higher in people with PWS. (Ghrelin is a hormone produced by enteroendocrine cells and is also known as the Hunger Hormone)

Three sets of diagnostic criteria have been established for the diagnosis of Prader-Willi Syndrome. These are major, minor, and supportive.

These criteria though they dont have points, aid in the diagnosis of the disease.

Based on the guidelines established by Holmes et.al the diagnosis of Prader-Willi syndrome is highly likely in children younger than 3 years if they score 5 points with 3 of those coming from the major criteria.

In the case of children older than 3 years with Prader Willi syndrome is highly likely if they score 8 points with 4 from major criteria.

Magnetic Resource Imaging (MRI) of the head to assess hypopituitarism. The individuals with Prader-Willi syndrome are at risk of pathological fractures, however high degrees of pain tolerance in these patients make it necessary to diagnose fractures to prevent stiffness and malunion of fractures. DEXA Scan: To detect complications of osteoporosis. Scoliosis Film of the vertebra.

To reach the diagnosis of PWS we need to differentiate it from other diseases which may be causing similar features:

These conditions can be differentiated from PWS with the help of the DNA Methylation technique.

Apart from these, other genetic conditions are causing short stature and obesity which need to be ruled out:

There is no permanent cure for Prader-Willi syndrome currently, and the treatment of the syndrome requires a multidisciplinary approach from geneticists, endocrinologists, nutritionists, pulmonologists, neurologists to prevent complications from PWS.

The treatment is generally directed towards symptomatic relief and problem management.

The treatment plan needs to be continuously reassessed as the child grows older as it needs changes.

Early diagnosis and treatment of PWS can go a long way in improving their quality of life and help them reach their full potential.

Children with PWS require proper care apart from specific symptomatic treatments. Most children can benefit from the following:

Infants with PWS have low muscle tone consequentially they are unable to breastfeed properly. A pediatrician can help by recommending special feeding methods and prescribing high-calorie diets. Use of a Nasogastric tube may be required.

A proper diet low on calories but providing necessary nutrition is key in managing the weight of PWS in children. Supplemental vitamins and minerals are required for balanced growth. Proper diet complemented with increased physical activity help in weight management. The child should exercise for at least 60 minutes. The exercise routine should be broken down into multiple 5- 10 minute sessions in children having decreased energy levels.

As the desire for appetite in children with PWS is high, parents need to keep strict vigilance on their eating habits, there should be proper meal times, food should be kept out of their view and no extra feeding should be done.

Human growth hormone (HGH) treatment. An endocrinologist can help decide if the baby will benefit from HGH injections. In children with Prader-Willi syndrome, it helps in facilitating growth, decreasing body fat content, increasing muscle size, and muscle tone.

Sex hormone treatment. Children with PWS have a very low sex hormone level, requiring hormone replacement therapy (Testosterone for males; estrogen and progesterone for females). HRT begins as the child approaches puberty. Apart from raising hormonal levels, it helps also in preventing bone thinning. Orchidopexy may be required for Cryptorchidism (Undescended testis).

Treating sleep disturbances related to PWS can improve daytime sleepiness and behavioral issues in children.

Strict parenting is required to keep the behavior in check, especially concerning food, to prevent over-eating; a proper diet plan needs to be formulated. Calmness is required while dealing with children showing temper tantrums- the situation should be deflated as soon as possible by engaging the child in another topic. Medication may be required in some cases.

A psychologist or a psychiatric consultation may be required to address obsessive-compulsive disorders, skin picking, or mood disorders in children with PWS. The childs nails should be trimmed so that they do not develop cellulitis or other skin infections as a result of constant skin picking; any cases of skin infection should be treated immediately using antibiotics.

Most people with Prader-Willi syndrome will need specialized care and supervision throughout their lives for continuous consultation with the doctor is required to transition medical care to adulthood.

In cases of severe skin and pinching and psychoses, Anti-depressant or anti-psychotics can be helpful. SSRIs are the antidepressants of choice. These drugs however come with associated risks, so they are generally avoided below the age of 18. Cognitive-behavioral therapy may be required in some cases. It is a talking therapy that helps to change the way the patient thinks and behaves to modify unhealthy behavioral patterns.

Patients with Prader-Willi syndrome are at risk of developing the following complications:

People with PWS, who receive early treatment usually have a normal lifespan and can function in a group home setting, perform vocational work.

People with PWS, having normal IQ can expect to accomplish many of the things their peers do. However, each person requires lifelong support from the people involved to lead an independent life.

Complications due to morbid obesity and psychological issues can affect the quality of life and sometimes shorten life expectancy in patients with PWS.

Scientists worldwide have been working on finding a permanent cure and improving the quality of life by reducing complications for PWS by carrying out various researches worldwide.

Livoletide is being monitored as a drug to reduce ghrelin and consequently hyperphagia and obesity.

A randomized, double-blind placebo-controlled study conducted in 2019 in 47 adults who took 3-4 mg of Livoletide once a day for two weeks, reported a significant decrease in food-related behaviors as compared to people who were given a placebo.

https://www.nhs.uk/conditions/prader-willi-syndrome/

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Growth hormone injections: Uses and side effects

Posted: November 5, 2020 at 1:57 am

Hormones play a part in nearly every major body function, including growth. If the body does not produce enough, a person may need to have growth hormone injections.

Several glands in the body produce hormones, but health experts consider the pituitary to be the master control gland. Not only does it control other glands, but it also makes the hormone that triggers growth.

The pituitary gland is in the brain below the hypothalamus. It secretes hormones in response to chemical messages from the hypothalamus.

The human growth hormone (HGH) helps to influence height, as well as build bones and muscles in the body. It is crucial for processes involved in normal human growth and development.

Genetic factors can lead to a lack of growth hormone in children. Damage to the pituitary gland is a common cause of a deficiency in adults.

In this article, we look at the reasons to use HGH, the function of growth hormones, and possible side effects.

HGH is essential to growth, especially in children, but it is also involved in many other processes in the body, including bone density, muscle mass, and mood.

Different hormones control various body functions and processes, including growth and development, metabolism, sexual function and reproduction, and mood.

It helps process protein and increases fat breakdown to help provide the energy needed for tissue growth.

Growth hormone levels can change through the day, and physical activity plays a part.

Exercise and similar activities can cause the levels to rise naturally. Sleep, stress, and low blood sugar levels also increase growth hormone levels.

Even small changes in HGH levels affect the body.

Too little or too much growth hormone can cause significant growth problems. Too little HGH is one of the main causes of short stature and conditions such as dwarfism.

Some people use HGH because they believe it will build muscle, improve performance, or slow aging. However, the existing evidence does not support the use of HGH for these purposes.

Children with low levels of lack of growth hormone may or may not be smaller at birth. Growth problems may appear in time, for example, if they are smaller than their classmates and growing less than 2 inches a year.

Some children are unable to produce growth hormone when they are born and continue to have low levels throughout their life.

Symptoms of growth hormone deficiency in children are:

In some children, a lack of growth hormone is part of a genetic condition, but sometimes the cause of the deficiency is unknown.

In adults, a lack of growth hormone is often due to damage to the pituitary gland, which may be permanent. The damage could have occurred in childhood or adulthood.

Other causes include:

Problems in the pituitary with producing growth hormone are commonly due to a pituitary tumor.

The pituitary can be damaged by the tumor itself or by treatment such as surgery and radiotherapy.

In adults, a lack of HGH can cause a number of different problems including:

Growth hormone deficiency can also be a combination of one or more hormone deficiencies.

Some medical conditions may also benefit HGH treatment.

These include:

The most common treatment in both adults and children is growth hormone therapy using lab-developed HGH injections.

Doses occur several times per week or on a daily basis depending on how severe the deficiency is.Manufacturers designed the growth hormone to mimic the behavior of natural growth hormone in the body. It will be prescribed by a doctor.

HGH treatments can be self-administered or given by a doctor. Treatments are often given for several years. Patients will see their doctor every month or so to check their condition.

Blood tests will be carried out to see if extra growth hormone is needed and if treatments should be increased, decreased, or stopped. Cholesterol levels, blood sugar levels, and bone density will also be checked to see if they are healthy.

Taking growth hormone can affect the bodys response to insulin, which controls blood sugar levels. Growth hormone deficiency can also lead to high cholesterol and brittle bones if it is not treated.

Specific treatment for growth hormone deficiency depends on the person.

Doctors base this treatment on certain factors, such as:

The earlier the lack of growth hormone is treated in children, the better chance they have to grow to a near normal adult height.

Children can gain as many as 4 inches or more over the first 3 years of treatment. Another 3 inches or more can grow during the next 2 years.

Many adults have to take HGH treatment for the remainder of their life.

Anyone taking HGH will undergo regular monitoring to assess the safety and effectiveness of the hormone.

The goal of growth hormone treatments in adults and children is to restore energy, metabolism, and enhance body development or shape. It can help to reduce total body fat, especially around the belly.

HGH injections can also help to improve strength and exercise tolerance and reduce the risk of heart disease in those who lack growth hormone.

Many people experience an increase in overall quality of life.

Most people tolerate HGH injection treatments well with few problems.

However, possible side effects include:

Those who experience these symptoms or other problems should talk to their doctor. They can change the dose if necessary to help remedy the symptoms.

HGH injections are not recommended for people who have:

HGH can affect insulin usage in the body, so people with diabetes should monitor their blood sugar levels carefully.

Other treatments may be required depending on the cause of the HGH deficiency.

Surgery or radiation may be necessary to treat a tumor in the pituitary. Pituitary hormones may also have to be taken to correct a gland that is not working properly.

If the levels of HGH are too high in adults, they may experience:

Long-term use of HGH injections can cause a condition called acromegaly.

Adults cannot grow taller by using the synthetic growth hormone. High doses will thicken the persons bones instead of lengthening them.

People with acromegaly will experience an overgrowth of bones, particularly in the hands, feet, and face.

The skin area can also be affected and may turn thick, coarse, and hairy. The excess HGH levels can also lead to high blood pressure and heart disease.

HGH injections have also become popular for nonmedical usage. Bodybuildersgro and athletes sometimes use them in an effort to get larger muscles, more energy, and increased stamina.

They are considered performance-enhancing drugs and are banned in professional sports.

HGH injections are also advertised as an anti-aging or weight loss treatment.

Many people aim to help increase their energy as well as fight the decrease in muscle and bone mass that happens with aging.

The Endocrine Society do not recommend HGH injections for adults or children unless they have a growth hormone deficiency.

Not enough evidence is available to prove that HGH injections can slow down the aging process, and studies show it does not improve athletic performance. Adverse effects often occur, especially fluid retention.

Using them for any nonmedical reason is illegal in the United States.

HGH injections are designed for adults or children who have a lack of growth hormone and should only be prescribed by a doctor.

Children and adults with low levels of growth hormone should ensure they have plenty of sleep, a balanced diet, regular exercise, and that they follow medical advice.

People seem interested in using HGH to have a more athletic body, to perform better in sports and to prevent aging. Is this a good idea?

HGH is a potent drug that can cause significant side effects. A person therefore needs to weigh up the benefits and risks. Do the potential benefits outweigh the risks?

For those without HGH deficiency, the answer is no. Very few data support the idea that HGH helps people with normal levels.

It may improve lean body mass in athletes and older adults but does not seem to improve strength or performance.

It also does not improve risk factors for chronic diseases, such as diabetes or heart disease. No reliable evidence confirms that it can prevent aging.

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Weight loss supplements: Are they effective? – Science World Report

Posted: October 28, 2020 at 3:53 am

First Posted: Oct 26, 2020 01:35 PM EDT

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If you find maintaining a healthy weight difficult, you can take comfort in knowing that you are not alone. According to a study published by The Institute for Health Metrics and Evaluation (IHME), an independent population health research institute in Seattle, WA, over 160 million people in America are either overweight or obese. And many of these same individuals are struggling with health problems related to their weight.

As a matter of reference, the National Institutes of Health noted that individuals who are overweight are obese are more likely to develop high blood pressure, high cholesterol, and cardiovascular disease. Excess weight can also lead to elevated blood glucose levels, which, in turn, can give way to diabetes, the study further noted. If there is a silver lining in all of this, it is that more people are taking steps to safeguard their health by losing weight.

Traditional Ways to Lose Weight

There are just as many ways to lose weight as there are people who are overweight or obese. And the argument could be made that some ways are better than others. Along with exercise, many individuals will choose one of many popular diets to shed unwanted pounds, some of which include the Mediterranean and Weight Watchers, both of which were named the best diets of 2020 by U.S. News and World Report.

While these diets are great, some people find that they don't lose much weight following them. And the weight that they did lose didn't stay off for very long. For these reasons, many people turn to dietary supplements to help them shed unwanted pounds, with some of the more notable ones being green tea extract, vitamin D, glutamine, caffeine, and raspberry ketone supplements.

How Effective are Mainstream Diets and Supplements?

If you're among the over 160 million people in America trying to lose weight, you might be curious about the success rate when it comes to mainstream diets and supplements. And if so, you might find this information interesting. A recent study found that individuals following a Mediterranean diet, a diet low in saturated fats and carbohydrates, lost as much as 22 pounds in one year.

A separate study related to the Weight Watchers diet noted found that most individuals were able to lose approximately 8 percent of their body weight in 6 months. However, it is worth mentioning that only 11 percent of those who followed this diet managed to keep the weight off long-term, according to Dennis Gage, a physician with Park Avenue Endocrinology and Nutrition in New York City. Rounding things out with dietary supplements, a study published by the Mayo Clinic found that individuals who took dietary supplements, namely raspberry ketones, lost about 4.2 pounds in 8 weeks.

Scientific Studies Reveal a Revolutionary Way to Lose Weight

For those who have tried to lose weight by exercising, dieting, and taking supplements but have been unsuccessful, you should know that all hope is not lost, especially for individuals age 40 and over. Current data shows that most middle-aged individuals have low human growth hormone (HGH) levels. Of course, this is not entirely surprising given that HGH levels gradually start declining from the age of 30.

For those who are perhaps not aware, one of the ill-effects of low growth hormone levels is an increase in visceral fat, especially around the abdomen. For many middle-aged individuals, visceral fat makes up the majority of their excess weight. What's more, it is a form of body fat that generally does not come off easily.

That said, science has identified a new supplement known as Resurge that could very well be the answer for older adults who are overweight or obese and want to slim down. There is also evidence that shows it could help younger individuals shed unwanted pounds as well.

But, it would be fair enough to say, that for people with tested and proven human growth hormone deficiency the most effective type of treatment is hgh injections with such brands as Genotropin, Norditropin, or Humatrope which is affordable enough in costs around US.

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