A MELBOURNE doctor who prescribes human growth hormone to more than 100 patients is being investigated by the state's medical board amid concerns he is flouting the law to help ageing Victorians turn back the clock.
The Medical Practitioners Board has notified 77-year-old John Levin that his professional conduct is under investigation, prompted by a Sunday Age article in which he admitted dispensing the drug for anti-ageing purposes.
Government guidelines state that human growth hormone should only be prescribed to children with growth disorders and adults with severe hormone deficiencies.
Specialists warn it has serious side effects if misused, but a Sunday Age investigation last month found many anti-ageing clinics in Melbourne's wealthier suburbs prescribe to people as young as 35 who want to look good, stay fit and boost their sex lives.
Dr Levin — who has been injecting the drug for 15 years and says he feels 30 years younger than his biological age — says it has medical benefits and that hundreds of doctors across Australia are prescribing HGH to help slow the ageing process.
He says he expected the board to launch action against him because he went public about his practices. Use of the drug was not well understood in Australia, he added.
"Of course you're worried if somebody's investigating you, but I've done nothing wrong. I've stuck to all the medical principles and the main one is to do no harm," said Dr Levin, speaking from Belgium where he is attending an anti-ageing conference.
A spokeswoman for the board would not confirm if other doctors named in the article would be investigated for prescribing the drug.
The AustralAsian Academy of Anti-Ageing Medicine and the Cosmetic Physicians Society estimate up to 15 per cent of their members dispense human growth hormone.
If investigators believe Dr Levin has behaved improperly, they can take the case to a formal board hearing where he could face deregistration or suspension.
The decision to examine Dr Levin's conduct is unusual as board investigations are typically launched following complaints from patients or other doctors.
It is believed the board was prompted to act when he appeared on two current affairs programs spruiking the benefits of growth hormone, following The Sunday Age report.
Since the publicity, Dr Levin says his practice has been inundated with patients.
With a private prescription, synthetic human growth hormone is injected daily at home. Photo: Craig Sillitoe
Cameron Houston and Jill Stark
May 10, 2009
The illicit trade in human growth hormone has moved to expensive anti-ageing clinics. Cameron Houston and Jill Stark investigate the boom.
MIDDLE-AGED men are increasingly injecting human growth hormone in a bid to fight old age, spending up to $15,000 a year on a drug they believe is the fountain of youth.
Government guidelines state it should only be prescribed to children with growth disorders and adults with severe hormone deficiencies.
But a Sunday Age investigation has found many anti-ageing clinics in Melbourne's wealthier suburbs are flouting regulations by prescribing to people as young as 35 who want to look good, stay fit and boost their sex lives.
Most are men who use human growth hormone (HGH) to improve fitness and energy levels, but leading specialists claim it can have serious side-effects.
Black-market sales are also booming, with a former dealer claiming $5000 worth of the drug can fetch up to $50,000 on the street. Possession is illegal without a prescription and importation is prohibited.
The dealer said some people were getting the hormone for personal use from anti-ageing clinics then selling it for profit.
Australian Customs has reported a four-fold increase in HGH seizures in the last year. Imports from China have risen steeply but the United States remains the main source of supply.
While six pharmaceutical companies contacted by The Sunday Age refused to confirm figures, a senior industry source said HGH sales had soared during the past two years.
"There is no logical explanation for the significant rise — other than most of it is being taken by middle-aged men trying to look younger," the source said.
John Levin, a 77-year-old Prahran doctor, has been injecting the drug for 15 years and prescribes it to 100 patients who want to delay old age.
He says 70 per cent are men and insists there are no health risks at low doses, typically less than 0.33 milligrams a day.
"I feel great, I feel like I'm 50 — and I'm going to be 80 in two years," Dr Levin said. "I don't give it to my patients for aesthetic reasons. I give it purely to get a better quality of life."
Human growth hormone is secreted naturally by the brain's pituitary gland and promotes growth during childhood and adolescence by stimulating production of an insulin-like growth factor in the liver.
Levels of HGH deplete as the body ages. The synthetic form of the hormone — which is not on the pharmaceutical benefits scheme — is injected daily and costs $125 to $200 a week with a private prescription.
Doctors can prescribe the drug "off-label" — outside the purpose approved by the Therapeutic Goods Administration — if they deem it "medically appropriate".
Human growth hormone builds muscle mass and helps to reduce fat. Some anti-ageing doctors claim the drug also reduces wrinkles, improves skin appearance and lowers cholesterol.
Endocrinologists, who are specialists in hormones and glands, say the claims are not backed by scientific evidence, and have hit out at "unscrupulous" doctors prescribing the drug for non-medical reasons.
They say that for people with a normally functioning pituitary gland, growth hormone treatment is potentially dangerous even in small doses. Ken Ho, chair of endocrinology at St Vincent's Hospital in Sydney, said misuse could increase the risk of cancer and elongate the jaw.
Professor Ho said the medical properties of HGH were being exploited by anti-ageing clinics.
"They are trying to sell an expectation that if you're 55 and you no longer have the body of a 21-year-old, then you can reclaim former glories by taking these drugs. There are claims about improved sex life, which are completely unfounded … They are trying to tell you that ageing is an insidious disease, but there is no hormone that can stop ageing."
Dr Martin Hill, of Life Sense clinic in Windsor, is known to prescribe and supply HGH to men as young as 35, after conducting blood tests and a prostate examination. He is believed to have told patients in consultations that he personally used it and the only side-effect was the cost.
A prominent endocrinologist said he had seen a number of Dr Hill's patients, who had been given an "incredible mixture of medications". One woman was allegedly given five different hormone treatments by Dr Hill and was being sued by an insurance company over a $100,000 debt.
In a letter in response to questions from The Sunday Age, Dr Hill's lawyer wrote: "Dr Hill's management of his patients is supported by substantial scientific and medical research and literature."
Doctors from anti-ageing clinics in Prahran and South Yarra are also prescribing the hormone.
David (not his real name), a health practitioner, was prescribed it a year ago after a serious back injury. He pays $125 a week for the drug, which he injects daily into his stomach. "If I was rich I'd probably use it forever. It's all about a lifestyle, where you want to stay young and fit and healthy and hopefully live to 100," he said.
David was initially rejected by several Melbourne doctors because of his age. "The first guy panicked when he found out I was only 39. Doctors need to move with the times and embrace new ideas," he said.
A Melbourne body builder, who asked not to be named, started taking equine and pig growth hormones about a decade ago and was a dealer in HGH for five years, his supply sourced mainly from South Australia.
He said demand had shifted from body builders to affluent white-collar workers, nightclubs and gays. He also claimed to have supplied an AFL footballer and three professional rugby players, who used it to improve performance.
"When you're training at the gym, you feel like you're bouncing of the walls from one machine to another; it's almost like an amphetamine. It also makes your sex drive go through the roof — you'll be having sex twice, three times a day," he said.
Delaying the march of time is big business — in the US the anti-ageing sector is expected to rake in $US106 billion ($A139 billion) this year, rising to more than $US115 billion by 2010. The AustralAsian Academy of Anti-Ageing Medicine describes it as the "fastest-growing medical speciality in the world".
Chairman Bill Anton insists the use of growth hormone is a very small part of what they practise and is prescribed to fewer than 10 per cent of patients treated by the academy's 200 members.
He says those who are given the drug are expected to follow a nutrition and exercise regime, and are closely monitored with regular blood tests. But he concedes tighter regulation is needed, as some doctors are not prescribing responsibly.
"There's a whole lot of cowboys who have gone off to do a one-hour seminar somewhere and found out it's the fountain of youth — that is not the case. Growth hormone deserves the same level of respect as we give any other hormone," he said.
Dr Anton, a biochemist, said endocrinologists were critical because they feared anti-ageing doctors were encroaching on their patch. He said there was no evidence that growth hormone caused cancer, citing an array of peer-reviewed journal articles that proved it had many benefits.
"With innovation, first everybody calls you a charlatan, a crook, an idiot, and as the momentum builds up they steal the ideas and call it their own. All I'm saying is there is a place and a use for growth hormone."
But while Dr Anton claims it is not used for aesthetic purposes, some in the sector freely admit to prescribing HGH to those who want to lose weight and boost sexual prowess.
Gabrielle Caswell from the Cosmetic Physicians Society of Australia said about 15 per cent of its 450 members prescribed growth hormone.
She said demand soared in 2007 when Hollywood star Sylvester Stallone was caught by customs officials at Sydney Airport trying to bring 48 vials of the drug into Australia. When asked by customs officials why he used it, the actor, then 60, said it gave his body a boost and made him look and feel good, adding: "Doing Rambo is hard work."
Dr Caswell said HGH was popular with men over 45 who often found it dramatically improved their skin. "Inwards, they will tell you that they have a lot more energy and they're obviously very happy with the results if they do actually lose weight and feel more physically attractive," she said.
Use of the drug has divided the sector. Joe Kosterich, head of the Australasian Institute of Antiageing Medicine, said the definition of growth hormone deficiency was a "grey area".
"Generally speaking, most adults are not going to be deficient in human growth hormone, so there is going to be some usage that does skirt close to the legal boundary," he said.
Michael Rich, who runs a cosmetic surgery clinic in Armadale, said patients often asked for growth hormone but he refuses, as prescribing without adequate training would be negligent.
"I had a patient recently who had liposuction and he was a member of one of those gangs. He was a big fella, and he was … (using) a lot of growth hormone every day … I don't know where he was getting it from; he certainly wasn't getting it through medical means," Dr Rich said.
Sports medicine experts believe the use of HGH in elite sports has largely been eradicated since a blood test to detect the substance was introduced before the 2004 Athens Olympics.
Last year, the Australian Sports Anti-Doping Authority banned cyclist Andrew Wyper after customs seized a shipment of HGH the 20-year-old had been trying to import. Another cyclist, Mark Roland, was also banned last year for using the drug.
The Australian Medical Association is concerned that vulnerable people who will pay anything to stay young are being exploited. But investigations into the prescribing habits of individual doctors are often only launched after a patient makes a complaint. With the long-term effects of HGH still unknown, it is difficult for regulatory bodies to intervene.
Victorian Health Services Commissioner Beth Wilson, who fields consumers' medical complaints, said the anti-ageing industry often exaggerated benefits and played down risks: "It's really scary how people's fear of their own body image and ageing has been manipulated by the industry.
"But the claims of the anti-ageing industry are doomed to failure because the last time anyone looked at the statistics for human mortality, it was 100 per cent."
What is HGH
-HGH — also known as Somatropin — is registered by the Therapeutic Goods Administration for use in children with growth disorders and adults with severe growth hormone deficiency.
-It is not registered for use in anti-ageing but can be prescribed outside its TGA-approved indication (off-label use) for genuine medical reasons.
-Possession is illegal without a valid prescription.
-Importing HGH into Australia is prohibited.
-Customs seizures: 39 in 2007, 161 in 2008
British Dragon Anabolic Steroid Manufacturing and Distribution Organization Tuesday, May 20th, 2008 Bodybuilding brothers Justin and Jonathan DeProspo are being sentenced this month for their role in distributing anabolic steroids and human growth hormone manufactured by British Dragon and IP aka International Pharmaceuticals (”Brothers receiving prison sentences for steroid distribution,” May 20). According to court documents, their case was apparently part of a larger ongoing investigation of the “British Dragon Anabolic Steroid Manufacturing and Distribution Organization” by federal investigators. Clearly, the recently arrested founder of British Dragon has been on the steroid most wanted list for some time. The New England Field Division, Financial Investigation Team (NEFD FIT) is currently conducting an investigation into an international steroid manufacturing, importing and money laundering organization operating from Thailand, Austria, Moldova, The Peoples Republic of China (PRC), the United Kingdom, the United Arab Emirates (UAE), Greece, Canada and other countries. This organization is referred to as the BRITISH DRAGON ANABOLIC STEROID MANUFACTURING AND DISTRIBUTION ORGANIZATION. The DEA-Boston investigation centers on the importation of BRITISH DRAGON brand steroids into the United States by a series of manufacturers, wholesalers and repackagers/shippers based in the above-mentioned foreign countries. All of the following information is a matter of public record and entered into evidence by federal authorities. Court documents reveal that the DeProspo brothers claimed to have purchased over $100,000 in anabolic steroids primarily British Dragon from Alin at firstname.lastname@example.org in Moldova and IP at email@example.com in China. (Federal investigators have documented over $40,000 in transfers.) They transferred funds via Western Union to various recipients including “Matt Vanalst,” “Stela Batin,” “Stubei Ala,” and “Stubei Galina” in Moldova and “Xioming Yang Yang” and “Goucheng Jiang” in China. DeProspo admitted to successfully having about 150 steroid shipments sent to his parents home and subsequently had them delivered to his college post office box and various UPS Store private mail boxes. The case against the DeProspo brothers was made using video surveillance, public records, telephone records, pen register and trap and trace information, and search warrants on various email addresses used by defendants including firstname.lastname@example.org, email@example.com, and KAS1N0l3I30Y@aol.com. The federal government has devoted significant resources in their investigation of illegal steroid possession and distribution domestically and abroad even if major cases are only sentenced to probation or a year/day or less jail time as is the case with the DeProspos.
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