Off-Label Use and Misuse of Testosterone, Growth Hormone, Thyroid Hormone, and Adrenal Supplements: Risks and Costs of a Growing Problem

Irwig, Michael S.; Fleseriu, Maria; Jonklaas, Jacqueline; Tritos, Nicholas A.; Yuen, Kevin C.J.; Correa, Ricardo; Elhomsy, Georges; Garla, Vishnu; Jasim, Sina; Soe, Kyaw; Baldeweg, Stephanie E; Boguszewski, César Luiz; Bancos, Irina

doi:10.4158/ps-2019-0540

Cited by 23 publications

(12 citation statements)

References 110 publications

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“…This potential underscore the need for clinicians to have an open and nonjudgmental discussion with patients before prescribing testosterone therapy, especially if recent or concurrent AAS use is suspected. “Physician source” may also include prescriptions from “men’s health centers” and “integrative” or “anti-aging” centers, which commonly prescribe compounds such as anabolic steroids, growth hormone, and porcine thyroid hormone in an inappropriate manner ( Irwig et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

2020

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Additional characterization of patients using anabolic androgenic steroids (AAS) is needed to improve harm reduction and cessation resources for patients. Our group sought to expand upon the currently limited data regarding AAS use by performing a web-based survey assessing experiences of males using AAS. Participants included men over the age of 18 with history of AAS use within the past 5 years. Data were collected between August 2019 and April 2020. Primary outcome measures included age when starting AAS, dose of AAS, motivations for use, experiences with health-care professionals, and rate of successful cessation. The survey was accessed 3640 times, resulting in 2385 completed surveys meeting the inclusion criteria (68.93% participation rate). Average participant age was 31.69 ± 10.09 years. Over half of respondents were from the United States ( n = 1271, 53.3%). Motives to use AAS included improving appearance ( n = 1959, 82.2%), strength gain ( n = 1192, 50%), and self-esteem/body image issues ( n = 712, 29.87%). Participants rated physicians poorly, regarding knowledge of AAS (4.08 ± 2.23). Most participants did not reveal AAS use to their health-care providers ( n = 1338, 56.1%); of those that did, 55.30% ( n = 579) reported feeling discriminated against for their use. Of 46.16% ( n = 1101) attempting AAS cessation, 60.22% ( n = 663) were unsuccessful. Challenges in the management of AAS use include early onset of use, supraphysiologic doses used, and frequently present body image disorders stress. Distrust of health-care providers, poor cessation rates, and lack of physician training further exacerbate this. These findings should serve to reinforce previous calls to action for further research on the treatment of AAS use disorder.

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Section: Discussionmentioning

confidence: 99%

Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

2020

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“…Despite the benefits of GH replacement therapy for patients with AGHD, rhGH has also gained popularity for its presumed anti-aging, weight loss, and cognitive-enhancing effects in patients without AGHD, creating the potential for misuse despite a lack of scientific evidence of these effects [ 42 , 43 ]. Additionally, potential anabolic effects of GH have led to illicit use by athletes, even though there is also a paucity of data demonstrating efficacy in this area [ 44 ]. Use of GH without a prescription or for indications not recognized by the FDA is illegal in the United States, and GH is on the World Anti-Doping Agency’s list of banned substances [ 44 ].…”

Section: Risk Of Illicit Usementioning

confidence: 99%

Adult Growth Hormone Deficiency: Diagnostic and Treatment Journeys From the Patients’ Perspective

Hoffman

Mathison²,

Andrews³

et al. 2022

Journal of the Endocrine Society

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Adult growth hormone deficiency (AGHD) is a rare and serious condition associated with significant morbidity, including reduced quality of life and is underdiagnosed and often missed in patients. Although the onset of AGHD can occur in either childhood or adulthood, adult-onset AGHD is more difficult to identify as it lacks the auxologic signs caused by GHD during childhood, includes symptoms that tend to be nonspecific, and lacks reliable, simple biomarker testing options. A panel of 9 patients with AGHD (3 with childhood onset; 6 with adult onset) was assembled to share their firsthand experiences, to help reveal important areas of need, increase health literacy, and to raise awareness about GHD among patients, caregivers, and health care practitioners. Interviews with patients yielded valuable insights from the patient perspective to supplement prior knowledge about AGHD symptomatology, biomarker testing, and treatment outcomes. Some patients described a burdensome and ineffective screening process that sometimes included many visits to different specialists, repeated rounds of biomarker testing, and in some cases, excessive delays in AGHD diagnosis. All patients expressed frustration with insurance companies that often resist and/or delay treatment authorization and reimbursement and frequently require additional testing to verify the diagnosis, often leading to treatment gaps. These findings emphasize the necessity of more efficient identification and screening of patients with possible AGHD, better recognition by clinicians and insurance providers of the importance of sustained GH replacement therapy during adulthood, and better patient support for accessing and maintaining uninterrupted GH replacement therapy for patients with documented AGHD.

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“…Although administration of supra-physiological doses of GH to athletes exerts potentially beneficial effects on body composition, it remains unclear whether these effects translate to improved performance (247). Nevertheless, GH abuse has been widespread among the athletes for more than 20 years, with consequences such as edema, carpal tunnel syndrome, arthralgias, myalgias, glucose intolerance and diabetes mellitus (248,249).…”

Section: Metabolic Regulationmentioning

confidence: 99%

Growth Hormone Receptor Regulation in Cancer and Chronic Diseases

et al. 2020

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Off-Label Use and Misuse of Testosterone, Growth Hormone, Thyroid Hormone, and Adrenal Supplements: Risks and Costs of a Growing Problem

Cited by 23 publications

References 110 publications

Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

Characteristics and Attitudes of Men Using Anabolic Androgenic Steroids (AAS): A Survey of 2385 Men

Adult Growth Hormone Deficiency: Diagnostic and Treatment Journeys From the Patients’ Perspective

Growth Hormone Receptor Regulation in Cancer and Chronic Diseases

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