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Growth Hormone Dosing and Frequency

  [ 29 votes ]   [ Discuss This Article ]
By Carol Sieverling • www.ProHealth.com • December 27, 2000



Six months of treatment

"Now I want to tell you a little bit about our six months of experience with GH. It is a very powerful treatment. It's one of the most powerful treatments you'll ever give a CFIDS patient."

"There's one publication out there by Robert (Roberta?) Bennett using GH in FM." (I think Cheney believes most, if not all, of the participants in that study also had CFIDS.) "She saw GH deficiency and said let's treat them. And she treated them and it didn't really show a lot of benefit. So we decided to treat, and we found out why they didn't get a lot of benefit. Because it matters how you treat them."

"Here's a syringe." (He draws a 1cc insulin syringe, taking up a whole sheet, drawing the markings: 10, 20, 30 etc. up to 100.) "The normal dose recommended by the PDR (Physician's Desk Reference) for GH is 0.1 to 0.2 cc. At 5 mg/cc concentration." (He lightly shades in the syringe past the 10 mark down to the 20. On the syringe 0.1 cc = 10, and 0.2 = 20.) "If you give this much to a CFIDS patient they crash and burn. Right into bed. They can't move they're so fatigued. What's happened is, well, they don't have GH and you just gave them a big shot of GH. That's a command directive to increase protein synthesis, including, though not limited to, RNase L. That is very energetically expensive. It'll push you right into bed because with no extra energy available, you're redirecting all your energy toward protein synthesis. You don't have energy for anything else. Plus the possibility you're making RNase L, which could be good and bad, most good probably. But you're in bed. That's why she didn't see any benefit in her study. She was giving ordinary doses."

More than Normal Dose Required

"We hypothesized that well, you just could not give regular doses. We rationed it down to 0.02 cc. And it worked. What it does, it produces an energy boost within a few hours after injection, plus an even bigger energy boost the next day, and every day thereafter. As you keep climbing back to baseline you give another shot. That determines your dose. We found the dose range to be 0.01 cc to 0.07 cc. No CFIDS patient of mine has ever tolerated above 0.07 cc. You have to give very tiny doses. How do you tell what your dose should be? If it gives you an energy boost, you're there. Nothing - you're too low. Creamed - you're too high. With the possible exception of, if it activates your RNase L, it might make you a little bit under the weather, but not too bad at these tiny doses. I don't see that as a real problem."

Frequency of dose

"Next thing is frequency. The recommended dose frequency is three times a week. The frequency for CFIDS patients is once or twice a week. This is what happens if you give it three times a week, even if you have the dose right. You get an energy boost, but over time you have a downward trajectory. Say a six percent downgrade with each injection. So each week you get just a little worse. Cumulatively it's too much. But if you lessen the frequency, it's the opposite. It's a six percent upgrade. Every week and month that goes by you get a little better and a little better and a little better. Our best responder's been on it 6 months. He worked himself up to 0.07 once a week. He won't take it more than once a week. So it's a very powerful treatment, but you can't use regular doses at regular frequencies."

More Notes on Dosing

(I know from previous posts that some who are taking GH found the previous comments on the dose to be confusing, if not out-and-out incorrect. The following two paragraphs are taken directly from the study protocol. The first, by referring to doses in mg/kg, seems to imply that the doses are titrated according to body weight. The second paragraph seems to imply that body weight is not a factor. I talked to a nurse at the clinic, and she said that calculating GH dose according to weight is not something she's ever heard Dr. Cheney mention in his explanations to patients, or to her. She said everyone starts out at 0.005 cc and advances from there.)

From the study protocol:

"Previous clinical observations in CFS patients have suggested that optimal doses will range between 0.005 and 0.02 mg/kg administered every five days, up to three times a week. Begin subcutaneous injections of rhGH in the thigh with 0.005 mg/kg every five days when you receive the rhGH cartridge and sterile water dilutant. During the first several injections, you may note fatigue and lethargy. With time you should resolve these symptoms and can advance to between 0.01 mg/kg and 0.02 mg/kg given twice a week.”

β€œThe correct dose is achieved when you experience a slight boost in energy hours after the injection and even more energy the next day. The energy boost should then decline with every day thereafter until the next rhGH injection. We recommend the shots be given when you arise or during the daytime just before heightened activity begins. Some patients will prefer to give the injections just before bedtime as it may substantially improve sleep quality. Some patients may wish to advance the injection frequency to three times a week if there is no adverse response to this. We recommend you experiment, within the boundaries we set, with dose (0.005 - 0.02 mg/kg), frequency (every fifth day to three times per week) and time of day (AM to PM)."

"One common manufacturer of rhGH uses a dual cartridge with 5.8 mg of rhGH powder on one side and 1.17 cc of sterile water on the other side. The cartridge is shipped overnight and must be refrigerated immediately upon receipt. Following a puncture and mixing procedure within the cartridge itself, the final solution contains 5.0 mg per cc in 1.17 cc. It is important to note that after mixing, the rhGH is only good for three weeks. At a 0.01 mg/cc dose given twice a week, about 40% of the cartridge would be discarded. Another manufacturer requires that the patient mix the 5.8 mg (15 units) of rhGH powder himself with 1-3 cc's of sterile water from a separate vial of sterile water supplied through a kit. It also will last three weeks and is 30% cheaper. RhGH is also supplied in a 1.5 mg cartridge but it only lasts 24 hrs after mixing. However, a special dilution procedure done by the patient will extend the product life for three weeks. Choosing which product to use can be a complicated choice between ease of use and expense, and hinges on dose or frequency, which will be changing and cannot be predicted."


CLARIFICATION ON CHENEY'S WORK WITH GROWTH HORMONE AND GROWTH FACTORS:

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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