a disgraceful lack of knowledge (and with no excuse)
Jan 2, 2004
how could you know so little about anabolics - clearly the only known medicine for wasting? you prescribe rhGH as if it builds skeletal muscle. BUT IT DOES NOT. the bodybuilding world knows a great deal about rhGH and knows that it is useless as a skeletal muscle builder unless used in combination with testosterone. see, the medical community knows little about these drugs because clinical trials are few and far in between do to legalities. but when people are using these drugs all the time illegally, they learn a great deal more through trial and error. there are presently hundreds, maybe thousands, of bodybuilders who know MUCH more about rhGH than you do because they have used the drug, and hundreds of thousands of people who learn from these bodybuilders who also put you to shame with their knowledge of the compounds. why don't you show true interest in improving the lives of persons wasting away, and reach out to the bodybuilding community in effort to actually learn something about these drugs you are prescribing. there is just a huge amount of information available to the medical community on these issues that doctors choose to ignore. and it is disgraceful, when this knowledge is in such high demand. smarten up, doc. do some real research, and learn about this stuff the real way. look at who is using these drugs, and study them.
Response from Dr. Wohl
I am not sure what statement of mine you are referring to regarding HIV-associated wasting.
For wasting syndrome associated with HIV itself, in which both fat and muscle are lost, a number of therapeutic approaches have been studied and applied. These include resistance training and the use of anabolic steroids but other agents including rhGH (growth hormone) have been found to be beneficial. Growth hormone does indeed increase lean body mass and physical function (it can decrease fat stores) and is actually US FDA approved for the treatment of HIV wasting syndrome. You do not have to take my word for it. Below are a couple of references that you should look read. The package insert of growth hormone (www.serostim.com) also provides data regarding this agent and lean body mass.
Schambelan M, Mulligan K, Grunfeld C et al. Recombinant human growth hormone in patients with HIV-associated wasting a randomized, placebo controlled trial. Ann Intern Med. 1996; 125:873-82. See http://www.annals.org/cgi/content/abstract/125/11/873
Waters D, Danska J, Hardy K et al. Recombinant human growth hormone, insulin-like growth factor 1, and combination therapy in AIDS-associated wasting. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1996. See http://www.annals.org/cgi/content/abstract/125/11/865
In the case of peripheral fat wasting associated with HIV therapy, not much has been found to help. Switching of antiretroviral therapy has been found in a number of large trials to produce some return of fat in the limbs.
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