This is an article by vanity fair on HGh
t was the moment every movie star fears most. It happened about two years ago, the actor recalls, a tad defensively. There he stood, in all his A-list glory, in front of the full-length mirror in his bathroom. Nine times out of 10, the mirror was just that big shiny thing he brushed past en route from the shower to the bedroom. He wasn’t one of those actors. Despite his natural charisma, or perhaps because of it, he had always scored low on the Celebrity Vanity Index. “Admittedly, it’s a relative scale,” he says. “We do grade on a curve here.”
His first inclination, as he edged closer to his reflection, was to give himself the benefit of the doubt. He’d been around long enough to appreciate the degree to which harsh lighting and bad angles can make anyone look bad. But now, as the steam dissipated and the reflection took on crystal clarity, the time had come to confront a few essential truths. “You know how actors look in movies that ‘age’ their character over several years?” he asks. “I felt like I was glimpsing myself in the Act Three scene that begins with a tagline that reads, ‘Ten Years Later.’ It was kind of a De Niro in Raging Bull moment. Except not award-winning.”
The skin around his eyes bordered on slack, grayish. Although the rest of his body was in relatively solid shape—he still exercised regularly, albeit with varying degrees of gusto—the star detected telltale indicators of impending decline. There were “little blotchy patches” on his skin and “weird saggy stuff” on his upper torso. The latter was especially disheartening, considering his immediate goals. The actor was circling a film role that would require him to be, in addition to semi-athletic, half naked. Nobody, least of all him, wanted to see this body on a screen 70 feet wide.
Then there was his energy level, which had been heading south for months. Likewise his libido. If being a movie star was all about charisma, and charisma was a kind of energy, then he needed to start exploring alternative energy sources, and fast. To hell with all those damned protein bars and shakes and oxygen chambers. And, frankly, he’d tattoo PATHETIC on his forehead before he’d let some shiny plastics guy cut his face open, or shoot it full of goo, or do any sort of “work.” There’s no sadder specimen, in his view, than the actor who labors under the impression that no one can tell.
The first time he was offered H.G.H.—short for “human growth hormone”—it freaked him out. This was about three years ago, while he was vacationing with friends. During a late-night search for toothpaste, he found his friend injecting a needle into his belly. “Party, drugs, needles, bathroom,” the actor says. “Do the math.”
He was relieved to learn that the syringe contained H.G.H., which the friend was taking as part of doctor-prescribed treatment for a hormone deficiency. “Makes me feel 10 years younger,” the friend said.
The guy did have a certain zip. And he looked, if not younger, pretty good. But still. H.G.H.? The junk all those roided-out ballplayers were using? Why would any actor go there?
As it turned out, though, the actor knew plenty of people who used H.G.H. Most of them sang its praises, saying it made them look and feel stronger, sharper, younger; one of them, a studio executive, told him it had changed his life.
Two weeks later, the star again stood staring into his full-length mirror. He took a deep breath, pinched a layer of belly fat, and plunged the needle in.
A business in Hollywood is small potatoes until it’s known by three letters: CAA, MGM, PMK, SAG, UTA, WME. These days, though, nothing is hotter than Hollywood’s latest health-and-fitness craze: H.G.H. therapy. Just ask any major-league Hollywood player. Earlier this year, following a game of tennis at a swank Beverly Hills country club, a prominent movie producer sat nursing a sore knee. “Just take this,” one of the club members said, offering a vial of H.G.H. A former studio executive recalls a recent dinner out with one of his colleagues. “He’s a family man with a wife and kids,” the executive says. “And he just starts talking about using H.G.H. I was like, ‘Are you crazy?! You’re fucking shooting yourself up?!’ But he said, ‘No, it’s great. And I feel great in the morning. And it’s invigorating.’ ”
Both sources can rattle off a list of Hollywood H.G.H. users, starting with several top-shelf movie stars of both genders. H.G.H.—or “H,” as jocks call it—is an equal-opportunity employer, except as pertains to age. Although one particularly ripped twentysomething heartthrob is said to be on the needle, H.G.H. is largely the domain of stars who wish they were still under 35. The surest giveaway? “Any actor over 50 you’re still seeing with a ripped stomach and veins in his forearms is probably taking H.G.H.,” says a talent manager who represents one famously veiny TV star.
“I definitely saw a difference in my skin,” says Alana Stewart, an active member of the Hollywood social scene. “I know it gave me energy and made me feel kind of more balanced.” Before she began the treatment, she says, “I had started noticing a few gray hairs coming in. But I noticed that when I was taking it—no gray hairs.”
But don’t expect many on-the-record testimonials. So far, the only major players to step forward have been Sylvester Stallone, Nick Nolte, and Oliver Stone. To acknowledge H.G.H. use is to acknowledge weakness. “People talk about H.G.H.—which can cost upwards of $10,000 per year—the way they talk about people who get Botox or Viagra,” says a movie producer. “What you don’t ever hear is people talking about it as if they do it. It’s always those other dudes who look ridiculous.”
In a sense, H.G.H. is the love child of Viagra and Botox; when administered appropriately, it is said to smooth wrinkles, reduce body fat, and increase lean-muscle mass and bone density, while also improving one’s libido, mood, and overall sense of vitality—to the point that the recipient both looks and feels years younger. “It is a rejuvenating force,” says Dr. Uzzi Reiss, a Beverly Hills physician on the forefront of the H.G.H. trend.
In the late 1950s, doctors began injecting severely undersize children with growth hormone extracted from human cadavers. A protein produced by the pituitary gland, it stimulates the growth of pretty much everything, including cells, bones, and muscles. Major H.G.H. deficiency in children leads to stunted growth, even dwarfism. Supplies were limited and therefore restricted to the highest-need patients. Sometimes the treatment sparked modest growth spurts; sometimes the child experienced nothing except aching joints and crushing disappointment. The great leap forward occurred in 1985, when the Food and Drug Administration approved a biosynthetic form of H.G.H. developed by Genentech, the South San Francisco—based biotechnology company.
The modern iteration of H.G.H. went boom because the therapy showed promising results. The average pre-teen patient grew two inches, maybe a bit more; the gain, although modest by the standards of most people, was gold to the tiny nine-year-old everyone taunted in gym class. Side effects—the main ones were joint pain and swelling—tended to be mild and treatable.
Long-term risks were somewhat more troubling. Endocrinologists have been monitoring H.G.H. recipients ever since those first treatments. Now, armed with 30 years’ worth of data—a bounty, by new-to-market standards—the researchers found a few concerning trends, among them an increased risk of cancer, heart failure, and diabetes. The diabetes is thought to be caused by H.G.H.’s tendency to increase glucose intolerance (because the hormone impacts the metabolization of carbohydrates). But all pharmaceuticals pose some degree of hazard. The medical establishment, having done the risk-reward analysis, came down in favor of H.G.H. for appropriate patients.
The F.D.A. subsequently approved the therapy as a treatment for a handful of disorders that impair physical growth and development, among them Turner’s syndrome (a genetic condition in which a female does not have two complete X chromosomes), Prader-Willi syndrome (another congenital genetic disease, which causes obesity and reduced muscle tone and mental ability), chronic renal deficiency, and H.I.V.-associated wasting disease. The treatment’s efficacy in these areas was clear. You didn’t need to be a clinician to see that H.G.H. could keep an H.I.V.-positive patient’s muscles from atrophying, if only temporarily. By now pretty much everyone agreed the therapy was the gift that kept on giving; H.G.H.-deficient patients taking it experienced more attractive physiques—lean muscles, shrinking waistlines—and improved strength, speed, and endurance. They evinced a glow of skin and spirit, and presented as better versions of themselves; they were happier.
Skeptics were politely handed copies of The New England Journal of Medicine, circa 1990. There, in the Talmud of medical scholarship, doubters read the results of a study in which a dozen men between the ages of 61 and 81 received large doses of H.G.H. for six straight months. The men ended up losing 14 percent of their body fat while gaining 8.8 percent in lean muscle and 1.6 percent in bone density. The treatment, in the authors’ view, essentially reversed “10 to 20 years of aging.”
This was exciting news to Big Pharma, whose favorite sons (Pfizer, Eli Lilly, Novo Nordisk) horned in on the action, sparking a marketing orgy that turned H.G.H. into a multi-billion-dollar industry.
Naturally, that’s when the shouting began.
One minute, H.G.H. was a godsend; the next, it was the scourge of the sports world. World-class athletes, in their never-ending quest to out-engineer one another, were “enhancing” themselves with whopping doses of H.G.H., often using it in tandem with anabolic steroids, testosterone, or other banned substances of the sort that turned East Germany’s women’s swim team into the Pittsburgh Steelers.
In the meantime, the Internet was flooded with a billion opportunists peddling half-baked H.G.H. creams, powders, and pills. Overnight, it seemed, the country was filled with “longevity clinics” that prescribed H.G.H. to anyone with sniffles and a checkbook.
And then came Suzanne Somers. In 2006, the onetime sitcom star published the magnum opus of her H.G.H. trilogy. That would be Ageless: The Naked Truth About Bioidentical Hormones. The book, which celebrated H.G.H.’s impact on the Seven Dwarfs of Menopause—Itchy, Bitchy, Sweaty, Sleepy, Bloated, Forgetful, and All-Dried-Up—was criticized by some doctors, including three who were quoted in the book. And it debuted at No. 1 on the New York Times best-seller list.
“A change is a-comin’,” Somers says today. “As the boomers age and lose their edge, they are looking around at the ones who are looking like they have a secret More and more, my phone rings with Hollywood folks who want to know who to go to. That’s progress and I get great satisfaction from it. And I know my stuff. I live it, walk it, talk it.”
The trend arrived in Hollywood by way of the city’s flourishing community of bodybuilders, who passed it on to their confederate in show business. Hollywood’s early adopters were action stars. The genre’s crown prince, Arnold Schwarzenegger, has denied ever using H.G.H. But Sylvester Stallone and several other action stars are known to have taken it.
Actors who use H.G.H. have one major advantage over athletes who do. “There’s no real stigma about performance enhancing,” says one filmmaker. “Acting is a business that operates on the any-means-necessary thing. It’s not like sports. There’s less prejudice about altering your body.”
Producers and studios routinely urge actors to “enhance” their appearance by way of, say, boob jobs, rhinoplasty, capped teeth, or buttocks implants. And acting is, after all, the art of transformation. The producer explains: “An actor’s view would be ‘Well, it wasn’t really me who did H.G.H. It was just the character.’ ”
H.G.H. finally started entering the mainstream in the late 2000s. We know this because that’s when the MTV alerts started flying. In 2008 the Albany Times Union reported that Mary J. Blige, Timbaland, 50 Cent, Tyler Perry, and Wyclef Jean were among tens of thousands of people found to have received shipments of H.G.H. and steroids. (Blige later denied using H.G.H., and none of the stars was accused of wrongdoing; the probe focused on doctors and pharmacies that illegally prescribed steroids.)
But the biggest headline appeared around the same time: At Sydney Airport, in Australia—a country that tightly restricts H.G.H.—a search of Stallone’s luggage revealed 48 vials of liquid youth. “H.G.H. is nothing,” the star later told People magazine. “Anyone who calls it a steroid is grossly misinformed Mark my words. In 10 years, it will be over-the-counter.”
Macho, Macho Men
‘I’ll tell you why I took H.G.H. in the first place,” says a longtime Hollywood filmmaker. “I love fucking.”
He continues: “I like that sense of self that comes from confidence in that area. And when I hit my 50s, although I was still very sexually active, I was less so than I was in my 20s. And like other pathetically insecure Hollywoodites, I had an internal panic that led me to curiously explore what options were available in the world.” He adds, “I am one of the pathetically insecure Hollywood people who, like everyone else who lives here, is overly concerned with looks.”
Previously, he had tried testosterone therapy, which is also popular these days, and which is often administered in tandem with H.G.H. therapy. But “T,” as it’s often called, made him a bit too alpha. He began berating one of the most powerful producers in Hollywood, who happened to be his boss, and who swiftly became his ex-boss. Testosterone, being testosterone, has the potential to produce roid-rage-type aggression in users who push the margins. One Hollywood executive known for his serial tantrums and abuses has since blamed the ugliness, in part, on his T therapy.
But H.G.H., unlike testosterone or steroids, is said to be a harbinger of peace. A few weeks into an H.G.H. regimen, the filmmaker says, “my internal organs got healthier quickly. And I could feel it—the main impact of H.G.H., to me, was in mood. I was just generally healthy. I would wake up feeling great. H.G.H. is really useful, I found. It very much imbues you with a sense of clarity and confidence.”
The filmmaker, like so many of his peers, received his H.G.H. straight from one of the top H-men in town. That would be Dr. Uzzi Reiss, an Israeli-born practitioner of gynecology and anti-aging medicine. Reiss, although affiliated with Cedars-Sinai Medical Center, spends most of his time running his private practice: the Beverly Hills Anti-aging Center for Men and Women & Advanced Nutrition and Hormone-Based Gynecology.
That Reiss is not an endocrinologist is sort of the point. Too many of those guys, Reiss thinks, are behind the curve on the benefits of H.G.H.—a subject he has written about extensively, most recently in his book The Natural Superwoman. The man has been on Oprah. “The same doctors who criticize the uses of H.G.H. for anti-aging reasons take young, short children—the most vulnerable population—and give them much larger doses and claim it is safe,” Reiss says. “It doesn’t make any sense.”
The other top H.G.H. guy in town is Dr. Andre Berger, a Canadian-born physician expert in the field of non-surgical cosmetic medicine. He, like Reiss, has authored an H.G.H.-centric book (The Beverly Hills Anti-aging Prescription), works the TV circuit, markets his own line of health-care products, and runs a practice whose name (Rejuvalife Vitality Institute) sounds like something out of a Philip K. Dick story. Berger is a practitioner of “anti-aging medicine,” rather than “longevity medicine”—the designation preferred by certain other H.G.H.-friendly doctors. “If you’re thinking about this as extending life, we can’t do that,” Berger says. “Anti-aging medicine is about making people as vital, functional, happy, and active as they can be. It’s about maximizing their potential.
“It’s quite clear what the indications are for treatment,” he adds. “We treat a deficiency disease.” Then comes the million-dollar question: “So what is the definition of a deficiency?”
The answer depends on whom you ask.
For starters, at least, everyone agrees on one thing: a person’s natural supply of H.G.H. declines with age. A 20-year-old produces more than twice as much H.G.H. as he will when he’s 40; the losses continue from there, at the rate of about 15 percent per decade. Anti-aging doctors look at those numbers and say, in essence, “Not so fast!” They want the world to stop seeing the human life span as a triangle: full at the bottom, then steadily narrowing toward nothing. Life, they say, should be a rectangle: consistently broad until the end. “People are going to be living longer,” Berger says. “This is about preventing the chronic diseases and all the ravages that affect your quality of life.”
H.G.H., by turning back the body clock, turns back the aging process. That’s the basic premise. “I see it every day in my practice,” Reiss says. “I see it in myself. I’ve been taking H.G.H. for many years. I have the energy and vibrancy of a man half my age. Ask anyone. I don’t get sick, don’t get jet-lagged. I can’t see why anybody would inject H.G.H. if it doesn’t have benefits.”
The typical endocrinologist determines whether a patient is H.G.H.-deficient by way of, in addition to blood tests, something called a “growth-hormone stimulation test.” The pituitary gland secretes the most H.G.H. at night, during sleep. The stimulation tests essentially force the situation, at which point the patient’s H.G.H. level is revealed to the endocrinologist, who then determines whether the number falls into the deficiency range. For example, a normal adult’s H.G.H. level should fall somewhere around 250 micrograms a day. If it turns out to be very low, and if the subject is also showing symptoms of H.G.H. deficiency, he’s deficient. That’s how the Establishment—doctors, the F.D.A., insurance companies—determines whether H.G.H. therapy ought to be administered and covered.
But anti-aging specialists take a broader—and, in their opinion, more progressive—view of what constitutes a deficiency. And they do so legally, since F.D.A. guidelines allow for degrees of latitude and interpretation. Anti-aging doctors read tests a certain way, especially when a patient is clearly displaying symptoms of H.G.H. deficiency: fatigue, weakness, etc. In short, goes the theory, listen to H.G.H. “The testing to diagnose deficiency is controversial,” Reiss says. “It’s too restrictive. Endocrinologists ignore a significant segment of the population that needs H.G.H.”
He has been giving himself H.G.H. injections for more than 20 years. And he does look terrific, with smooth skin and a lean body. And, by the way, H.G.H. needles are extremely thin, like those used by diabetics or acupuncturists. H.G.H. therapy, doctors say, is virtually painless.
There’s just one catch. The vast majority of endocrinologists, when asked about the widespread treatment for H.G.H. deficiency, agree.
House of Mirrors
Everyone agrees the therapy is effective for legitimately H.G.H.-deficient patients—a population of fewer than 5 out of 10,000. One of the F.D.A.’s lead endocrinologists, Dr. Dragos Roman, can’t fully explain why the number of new H.G.H. patients per year exceeds 6,000, except to say this: “The F.D.A. doesn’t regulate off-label uses of H.G.H. Sometimes it’s used appropriately. Sometimes it’s not.”
Two of the country’s most noted academic clinicians in the field of endocrinology—Dr. Stanley Korenman (U.C.L.A.) and Dr. Mark Molitch (Northwestern)—agree that only a tiny fraction of the population is actually H.G.H.-deficient. “But now,” Korenman says, with a hint of irritation, “we have clinics all over Beverly Hills where they do their own testing and everyone is growth-hormone-deficient.”
“I’m not thrilled with those people,” Molitch says. “You can prescribe anything if the patient is going to pay for it.”
Hollywood is fertile ground for people seeking a fountain of youth at any price. (See sidebar.) “There are all sorts of characters who went into medicine to make a lot of money,” Korenman says. “They’ll be ‘obesity doctors.’ They’ll be ‘longevity doctors.’ They’ll be one goddamned thing or another in order to get rich.” Too often, Korenman says, anti-aging specialists are fast-buck artists who push H.G.H. because they get a piece of the action. Since insurance companies rarely cover H.G.H. therapy, patients buy the hormones from their prescribing physicians. The physicians, often having bought the hormones directly from the manufacturers, sell the vials at marked-up prices. The average H.G.H. recipient will fork over roughly $8,000 to $10,000 a year, not including office visits and lab tests.
More often than not, the doctors say, H.G.H. recipients are a self-selecting lot: the sort of people willing to pay big dollars in order to enhance their bodies. “I’ve got a bunch of patients who’ve been through the longevity thing,” Korenman says. “And they realize they’ve spent fortunes, because not only do they buy growth hormones and testosterone, but these doctors sell them all these herbs and spices, as I call them. All the ‘supplements.’ The patients always come with a bag full of them.” He adds, “People with money get the worst medical care, by the way. They have an idée fixe. And they’re going to look for the doctor who agrees with it.”
And with self-selection comes a placebo effect. Korenman says, “Doing these rituals, making these sacrifices, spending the money—it’s all very powerful. It makes them feel that they’re doing the right thing. And then they feel better.”
For every H.G.H. user who sings the praises of H.G.H. comes a patient who sees no improvement. That studio executive whose dinner companion took it? “It was funny because he’s not in good shape,” the executive says. “He wasn’t transformed. I think it was psychological.”
Gunnar Peterson, a personal trainer whose client list includes Jennifer Lopez, Penélope Cruz, and Madonna, sees plenty of H.G.H. users. He says, “If you think you’re just going to inject yourself in the belly with a little prick and not train and eat whatever you want and you’re going to be ripped, you’re joking. People like that are going to try whatever the next flash in the pan is.”
The medical experts acknowledge that most users will see some small benefits. Recent data indicate that they will lose a few pounds of fat and gain a few pounds of lean muscle. But they won’t gain any muscle strength. (A recent study of H.G.H.’s effects on a competitive sprinter, however, suggested that the therapy improved his time by almost 4 percent.)
Molitch cites several studies that explored whether H.G.H. therapy could in some way slow the aging process of adults with normal hormone levels. “All of those studies have uniformly shown no benefit,” he says. “It was a legitimate question to ask. It’s been asked and answered.”
Worse, the doctors say, are the potential hazards of long-term H.G.H. use. It’s thought that people whose bodies produce too much H.G.H. face increased rates of cancer, heart disease, and early mortality. But the medical community also suspects that H.G.H. increases the risks of edema, high blood pressure, prostate cancer, and breast cancer. Because it stimulates cell growth, H.G.H. basically fertilizes any sort of malignancy. That’s among the reasons why many endocrinologists don’t encourage adults 50 or over (who are more prone to malignancies) to take H.G.H.
In the end, though, the doctors understand why actors and athletes go for it anyway. “Their lives and income depend on being the best,” Korenman says. “They think, everyone is doing it, and the difference between being No. 1 and No. 2 is less than 1 percent.”
Or as one of the movie producers puts it, “If you had chosen to be an actor, I almost guarantee that if somebody you trusted said, ‘Dude, this could really help you,’ you’d do it. You’ve already sort of accepted that there’s probably a shelf life on your career, right? And so immediate changes become wildly attractive.”
That’s how a certain movie star thought. The actor—the one featured at the top of this article—remained on H.G.H. for about two years, during which his body definitely seemed to … something. His skin seemed to smooth out a bit. His abs made an appearance. And those dumbbells sure seemed lighter.
“Do I know for sure that H.G.H. helped me?” he wonders. “No, not really.” He pauses. “I guess the only thing I know for sure is that starring in movies is great until you get man tits.”