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Growth Hormone Deficiency in Chronic Fatigue Syndrome (CFS)

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By Carol Sieverling • • December 27, 2000

Continued from previous article "Dr. Cheney on Growth Hormone: What it is, How it Works, and What CFS Patients Can Expect"

"What Moorkens found when she measured GH - using the Insulin Tolerance Test (ITT) - was that on average, CFIDS patients were 50% reduced. What we found significant was that, on average, her patients were only 18 months out." (Meaning they had only been ill for 18 months. Cheney suspected that GH deficiency might be more profound in those who had been ill for a longer period.)


"We decided to do both the ITT and a physical stress test on some of our patients to compare the two tests, and of course to measure GH. We only did both tests on a few patients - the ITT is a really hard test." (From other comments, I gathered that he meant it was very hard on CFIDS patients, not that it was a difficult test to run.) "Our patients were zero on the ITT test. Zero. (Said with intensity and emphasis.) So I think CFIDS patients range from about 50% impaired to completely impaired."
"Now the ITT test induces the same GH response as a maximum exercise test. It doesn't matter which of these you do - you get the same results. Most insurance companies and endocrinologists prefer the ITT. The problem with the exercise test is that if I don't push you quite so hard, I can reduce the response." (Make that spike lower than it should be - make us look more deficient that we are.) "So how do you know you've challenged the body enough? Pushed it hard enough? With ITT you can always show you got a blood sugar level of four. So you always know where you are. The exercise test, though valid, is subject to some variance of the effort.”


“My response to an insurance carrier, when asked did I prove you were GH deficient - because when you have a documented GH deficiency many, if not most, insurance companies have to pay for treatment, and it's expensive. But they can be forced to pay if you're deficient. You just have to prove it."

"If we use the ITT, they will definitely pay. If we use the exercise test, at least so far they've all paid. But I fully expect at some point for one to say 'Well, we want the ITT because we don't fully trust the exercise.' And then I'll say 'Here's the computer data that shows I pushed her to three out of three endpoint criteria for maximum effort. You can't say I didn't push her hard enough. Here's the data.' Then they may say 'Our peer review committee believes the only valid test is the ITT.' But we always try the bicycle stress test first because it's a lot safer."

Dr. Cheney draws blood to measure GH before the bike test, ten minutes after, and twenty minutes after. The GH is measured in ng/mL, and anything less than 10 ng/mL twenty minutes after max exercise is considered a deficiency. The "mid-normal" amount is 24 mg/mL, so 10 ng/mL is the lower end of the normal range. Three members of our support group have recently had GH measured by Cheney using the bike test. Two had no change at all - no GH response what so ever to maximum exercise! Mine did rise - from 0.14 before the test to 6.5, then dropped to 5.6 ng/mL at twenty minutes out. So at least I have some GH, but that 5.6 is a far cry from the typical 24, and well below the 10 that determines deficiency. And Dr. Cheney said insurance should pay for my GH injections.”

Cheney said one study was done in which two men both took the same bicycle stress test - a maximum stress test. One was paralyzed from the waist down and the other was a healthy control. The paralyzed man had his feet strapped to the pedals and the bicycle moved his legs. Both men met the criteria for a max exercise test. Two of the three endpoint criteria are heart rate and respiratory exchange rate. (I don't know the third.) The only significant difference between the two men in this test was that the brain of the paralyzed man did not know the leg muscles were receiving a maximum work-out, or moving at all for that matter. The control had a typical burst of GH, the paralyzed man had no change at all. Conclusion: "the brain controls GH, not the actual action of the muscles. It's hypothalamic - and the hypothalamus doesn't know you're working if the nerves are severed."

Test Results

"If you're zero - major trouble. You lack sufficient control of protein synthesis to respond to exercise, to respond to the needs of stage four sleep, to respond to the needs of detox, and all kinds of other problems. And as I illustrated in this diagram" (much earlier in our conversation), "this illness starts with protein synthesis disruption via RNase L. And it ends with protein synthesis disruption via GH. You end up with the same problem, but through a different mechanism."

"To make matters worse, if you're TH2 dominant and TH1 suppressed, the only thing standing between you and cancer and viral infections and intracellular bacteria is RNase L, which you can't make without GH! So it's a big problem. A very big problem."

"I think what happens is our sickest patients who don't respond to treatment are GH deficient."

The GH deficiency explains why it's hard for so many patients to make progress even though they're doing all the right things: vitamins, supplements, whey, MSM, gut manipulation, etc. "And they tell me it's just not working. Why isn't it working? No GH. And I didn't know that until I read Greta's paper."


Dr. Cheney is refining the use of growth hormone and growth factors for use in CFIDS. Others have been researching this area for years. In particular, Dr. Sam Baxas pioneered the use of human growth hormone and growth factors more than twenty years ago. A discussion of his work can be found in the book "Grow Young with hGH" by Ronald Klatz.

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