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Hormone replacement - just testosterone or GH too?
Jul 8, 2012

Hi Mark,

Man, hard to pick a subject area to ask this!

I have been HIV+ and HBV+ (but always asymptomatic) for almost 10 years and on hormone replacement for about 7. Total test was ~ 100ng/dl and switched from gel to T-Cyp about a year ago now. My Doctor is a local HIV expert but is /not/ a HRT expert... I dose the 400mg/EOW prescription 100mg twice a week and run my own labs to stay on top of things.

I recently noticed that my IGF-1 is "low" - 142ng/dl on a scale of 115-307. Should I consider treating this as well? Is there a connection between IGF-1 and the HBV? I understand that IGF-1 is in large part produced in the liver. If this should be treated, is there a precedent for treating this? My Primary care is a real HIV treatment expert, but she is not a hormone expert! I don't think she will entertain anything too ambitious.

Thanks - J

Response from Dr. Holodniy

Great questions. I am not certain I can fully answer the questions, for as the movie title by that name implies, Its Complicated. You don't indicate whether you are on HIV treatment, but assuming you are, and you are on HIV meds that also have HBV activity, then it's likely that your HBV is either under control (suppressed) or eradicated. Given that, it is unlikely that HBV would be interacting with IGF-1. There is very little literature about this interaction, and most of that relates to patients with hepatocellular cancer associated with HBV infection. I also don't have an answer regarding treating low, but within range IGF-1 levels. There is a complex interplay between IGF-1, other hormones and cytokines that we understand some of, but not all the interactions. So manipulating the IGF-1 levels with exogenous IGF-1, nutritional supplements, or other hormonal therapy, may increase the levels, but create other down stream untoward consequences.



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