Raised Cancer Risk From hGH Treatment. Deaths from Adrenal Crisis. Despite the limitations in their study the high incidence of cancer, and in particular of colon cancer, is worrying

Many people treated with hGH also have problems with other pituitary hormones. A pituitary hormone tells the adrenal gland to make cortisol, a hormone needed for life. People lacking this hormone are at risk of death from adrenal crisis, but this can be prevented. More hGH recipients have died from adrenal crisis than from CJD. Please read the enclosed yellow sheet and discuss the information with your doctor.

Adrenal crisis is a preventable cause of death in people who have been treated with hGH. Many of these people do not know about their risk of adrenal crisis, though it has caused more deaths than CJD. Most people who received hGH lack growth hormone. They may also lack other key hormones made by the pituitary gland. Having too little of these hormones can be fatal if not properly treated. Earlier updates have talked about how adrenal crisis can be prevented, but deaths have still occurred.

The authors conclude that the increased rate of growth of melanocytic nevi and the presence of HMB-45 staining within dermal nevus cells suggest that HGH may have a stimulatory effect on melanocytes

If there is a severe shortage of cortisol then an individual’s life can be in danger with an adrenal crisis. This event is very rare is will never happen to most people with CAH who take treatment regularly, make appropriate increases in dose when ill and seek help early if unexpectedly unwell or vomiting. The symptoms are faintness, nausea, vomiting and abdominal pain. An adrenal crisis can be triggered by a stressful illness such as severe flu or gastro-enteritis. An injection of hydrocortisone should be given immediately. Admission to hospital may be needed so that fluids can be given into a vein – a ‘saline drip’. If in doubt – always give an injection of hydrocortisone and go to the nearest accident and emergency department. Background: Do not confuse acute adrenal crisis with Addison disease. In 1855, Thomas Addison described a syndrome of long-term adrenal insufficiency, which develops over months to years, with weakness, fatigue, anorexia, weight loss, and hyperpigmentation as the primary symptoms. In contrast, an acute adrenal crisis can present with vomiting, abdominal pain, and hypovolemic shock

The symptoms are faintness, nausea, vomiting, abdominal pain and dehydration. Make sure you always wear your Medical Alert bracelet which is available through the link at Chemists for around $45

Issues for Men with CAH -------------------------------------------------------------------------------- The problems of weight gain and the side effects of treatment can affect men as much as women. Short stature, which can result for difficulties in treatment of CAH in childhood, can be a particular psychological burden for men. High levels of testosterone in CAH can cause problems with aggression and excessive sex drive in men. There are two important long-term consequences of CAH which only affect men, both of which are the result of too little treatment with cortisol. These are infertility and testicular enlargement. If adrenal suppression is inadequate then the adrenal gland makes too much testosterone. High testosterone production from the adrenal gland can occur because the dose of cortisol is too low or because tablets have been missed. The testicles, which also make testosterone, then shutdown as the testosterone levels are high. Unfortunately, 'shutting down' the testicles also means that sperm are not produced in normal quantities and this can cause infertility. Sperm production usually picks up if the adrenal cortisol treatment is increased allowing the testosterone production from the adrenal glands to fall, so the testicles can begin to work again. It can take several months the sperm count to rise after an increase in steroid treatment. Testicular enlargement is a rare effect of under dosage of cortisol treatment and it takes many years of inadequate treatment for this to occur. Normal testicles contain a few adrenal cells that enlarge if the levels of cortisol in the body are low. This enlargement usually goes away if the dose of cortisol treatment is increased. Occasionally doctors advise a biopsy of the enlarged testicle to make sure that there is no hidden cancer. CAH does not cause cancer but it is reassuring to make this check.

In Australia, more stringent entry and exit criteria for use of GH were introduced in 1993-1994. According to Dr. Werther's article in the May issue of the Journal of Pediatric Endocrinology and Metabolism, patient numbers and drug costs were halved after the guidelines were implemented. Of 1,250 Australian children currently being treated with GH, 26% have idiopathic short stature, with final adult height -1.8 standard deviation score (SDS), or improvement of 1.1 SDS.

How steroids work Steroids work by imitating the properties of naturally occurring hormones. Muscle tissue is peppered with receptor sites specific to growth. These sites or 'locks' can only be accessed by the correct hormonal 'key'. Steroids can activate these receptor sites because their chemical composition is so similar to the hormone testosterone. Once the receptor sites have been stimulated, a domino effect of metabolic reactions takes place as the body is instructed by the drug to increase muscle tissue production.

Males are more likely to present with conduct disorders, attention-deficit/hyperactivity disorder (ADHD), substance abuse, learning disorders, and chronic motor tics. Furthermore, the onset of male-typed disorders and other psychiatric disorders, such as schizophrenia and OCD

Adrenal crisis is a preventable cause of death in people who have been treated with hGH. Many of these people do not know about their risk of adrenal crisis, though it has caused more deaths than CJD.