Secretagogues have been used medically for many years for a variety of medical conditions where a specific substance is introduced for another substance to be secreted by the body. For example there are insulin secretagues (sulfonylureas) that stimulate the KATP channel within the pancreas, gastric secretagogues (gastrin, pentagastrin)for the increased production of gastric acid within the stomach, and adrenal secretagogues (angiotensin II) which allows for aldosterone. The point is that medically we have accepted secretagogues as a solution for medical problems and conditions where we want to stimulate the body’s own function rather than by artificially supplementing by other means.
Recently, the ongoing debate on Adult Growth Hormone Deficiency (AGHD) and the use of growth hormones to improve body composition, overall strength and increased metabolic function keeps resurfacing. New studies suggest that adult cognitive functions improve in correlation to levels of growth hormone and while the risks and benefits of such a replacement regimen have been documented in more than 1000 publications there are inherent risks associated with these forms of treatment (please refer to SmPCs for pre-requisites in administration of these substances). For many physicians they simply do not want to prescribe growth hormones for their patients. Growth hormone supplementation is also not guaranteed to work as it is dependent upon other stimuli such as sleep, stress, exercise, BMI or other conditions such as hypopituitarism and other hormone deficiencies.
While the data suggests that growth hormone increases your ability to increase muscle mass, endurance and cognitive function adult patients are more prone to the side effects associated with GH supplementation. Therefore, secretagogues could be the solution for many patients who cannot afford GH replacement or physicians who are hesitant to prescribe growth hormones. Secretagogues typically use ghrelin, somatostatin, and octanoyl as a way to stimulate growth hormone receptors as well as increased binding of the growth hormone molecule as well as stimulating the hypothalamus. Though it may not stimulate growth hormone synthesis in the manner that direct replacement does it makes the body more efficient. Secretagogues should offer a better physiologic approach than normal growth hormone replacement since it does not allow for negative feedback inhibition than prolonged elevation of growth hormones by replacement.
Remember, most of the growth hormone we create is produced at night when we sleep, exercise and eating habits influence our ability for deep sleep and increases GH secretion. By age 55 we will be producing only 16% of the growth hormone as compared to our teenage years. Though the data continues to expand as to the role of growth hormones and IGF -1 on the aging process, it is not the fountain of youth that we all wish.
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