1.35 Mg of GH per day & Igf-1 levels still sub optimal

  1. Kid
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    1.35 Mg of GH per day & Igf-1 levels still sub optimal


    For the past few months I've been on Norditropin (HGH) Pen, which I take 1.35 mg (a little over 3 IU per day) I take it at night 1 hour before bed (doctors orders) SQ injected into my thigh. My doc is a little concerned because my IGF-1 leves are still not where they should be, around 300. His goal for me was to get IGF-1 into 500 range. I never miss a shot. Also on TRT protocol (100 mg test cyp. per week & 250 IU of HCG days 5, 6 & Arimidex .25 mg every third day). Currently on thyroid as well, compounded all natural (2 grains) per day. Not sure what I'm doing wrong. Is it possible if, due to previous hypothyroidism, the skin on my thigh has become somewhat thick, that the SQ injection is not getting in there enough? Maybe my stomach would be a better place to inject as the skin there seems to be more appropriate for SQ in my case?

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    Quote Originally Posted by Kid
    For the past few months I've been on Norditropin (HGH) Pen, which I take 1.35 mg (a little over 3 IU per day) I take it at night 1 hour before bed (doctors orders) SQ injected into my thigh. My doc is a little concerned because my IGF-1 leves are still not where they should be, around 300. His goal for me was to get IGF-1 into 500 range. I never miss a shot. Also on TRT protocol (100 mg test cyp. per week & 250 IU of HCG days 5, 6 & Arimidex .25 mg every third day). Currently on thyroid as well, compounded all natural (2 grains) per day. Not sure what I'm doing wrong. Is it possible if, due to previous hypothyroidism, the skin on my thigh has become somewhat thick, that the SQ injection is not getting in there enough? Maybe my stomach would be a better place to inject as the skin there seems to be more appropriate for SQ in my case?
    What are your dhea-s levels and also magnesium, zinc, copper deficeincy can reduce IGF-1. Try some ZMA before bed it might do the trick. Also you may have elevated insulin levels AKA reactive hypoglycemia. Check hga1c for a better indication of blood sugar then serum glucose. high inuslin equals low glucagon = low gh. Examine your diet and if you want to increase gh low glycmeic carbs with moderate protein, and fat should help do the trick.
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    I have my guys inject their GH first thing in the morning. But there are good arguements--and by respected professionals--on both sides of that fence. At his time, immediately upon arising (well, s/p answering Nature's Call, and taking one's Armour, that is) for my guys.

    The best place to inject SC is within six inches (not in) of the navel.

    When is the timing of your labs? Late the next day? Let's consider the PK's of GH.

    Otherwise, you are not inducing IGF-1 production from the GH supplementation. At night, your insulin levels may be low. This can prevent same.

    Yes, I believe the current thinking of keeping insulin very low s/p GH injection to be incorrect.

    Supplementation with glycine and arginine stimulates GH-induced IGF-1 production.[/QUOTE]



    How long after taking Armour Thyroid do you recommend your patients to wait to take their GH?

    Is it better to take it on an empty stomach or with food?

    What about just dividing the dose and taking 1/2 in morning and then 1/2 nighttime?

    would having a small meal with my night time GH dose give me a modest enough insulin spike to enable more effective GH induced IGF-1 stimulation to occurr?

    Also my Doc instructed me to take Pregnenolone with the HGH at night as he said this will help for it to be utilized more effectively.

    Apologies for the abundance of questions, no hurry as I know you're extremely busy Dr. John, any and all advice is greatly appreciated. Thanks.
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    oops, sorry bout the error with the quotes Dr. John. Still getting the hang of this.
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    My question was about the GH-is it better to take it with food or on an empty stomach? Although I tend to get low blood sugar so pherhaps I will try it after breakfast.


    Right now I wake up- take my thyroid, wait one hour, take my multi-vitamin/CLA/GLA/omega fish oil/DHEA-25mg/Pregnenolone 25-mg I will talk to my doc and ask him to allow me to try morning dosing to see what happens. At night I've been taking the GH=1.35 mg with some melatonin=.5 mg/GABA/Glycine/Inositol/Passion Flower(recently added) Pregnenolone 10mg.

    My blood tests have almost always been taken in the early evening. Around 6:00 pm. As for the (pregnenolone-10 mg) I will ask how that helps the IGF-1 but I believe his assistant said that it had to do with my cortisol levels being a bit low. I'm not certain so I will ask again at my next appointment.

    Doc, I'm learning a lot and I appreciate the help. I can't imagine trying to maintain a successful practice and still having the time, much less the energy helping out to this extent. My hat's off to you. Don't mean to sound like I'm kissing your ass but seriously, it's some great stuff you're doing, thanks.

    Just a thought but when they measured my cortisol levels last time it was at (3) that was in the evening though. Still very low they said. I wonder if maybe the reason that I have been getting low blood sugar and why maybe the GH might not be inducing an effective enough level of IGF-1 stimulation in my liver is because my insulin levels are low from the low cortisol, which if I'm not mistaken can cause hypoglycemia. I read on pub med that adequate cortisol levels were necessary for augmenting adequate Growth Hormone Treatment responsiveness as measured by the results of an IGF-1 assay. My cortisol is always low, sometimes below normal and the rest of the time at the very bottom of the range..never done a 24 hour cort. assay but it looks like that's the next step. I've mentioned the cortisol and how it seems like it would be important. I feel I have a good doc who genuinely wants to see me feel good. I would like to have some things explained to me in regards to what the reasoning is behind certain choices but it's hard to get the scoop at times. When I've asked to see my bloodwork I'm told "no". My Progesterone is above normal and my DHT is above normal too, meaning bo, I know that cause I snuck a peak at the papers in the office the other day. My SHBG is "normal" my estrogen is around 30 (and I'm on Arimidex .25 mg every three days plus test cyp. 100 mg/week plusHCG 250 IU x 2 days (5 and 6). but I know that to explain everything and the reasoning behind it comes across as an insult to many professionals. I'm starting to realize that when it comes to dealing and properly fine tuning hormones, the words "quickly" and "sooner" and "now" aren't usually the way to go. The less variables the better. I see these things take time and patience. I feel better this month than last month so I'm thankful for that. Ok, wow no more ramblings-lol, thanks again.


    Hardasnails-I'm taking a Zinc/copper (30mg/3mg) supplement but no Magnesium. I take my multi-vitamin religiously so I figured I would get enough that way. Pherhaps I figured wrong. Does ZMA have any copper in it, or would it be wise to supplement with copper when taking a supplement like that? Thanks man.
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    Quote Originally Posted by Kid
    My question was about the GH-is it better to take it with food or on an empty stomach? Although I tend to get low blood sugar so pherhaps I will try it after breakfast.


    Right now I wake up- take my thyroid, wait one hour, take my multi-vitamin/CLA/GLA/omega fish oil/DHEA-25mg/Pregnenolone 25-mg I will talk to my doc and ask him to allow me to try morning dosing to see what happens. At night I've been taking the GH=1.35 mg with some melatonin=.5 mg/GABA/Glycine/Inositol/Passion Flower(recently added) Pregnenolone 10mg.

    My blood tests have almost always been taken in the early evening. Around 6:00 pm. As for the (pregnenolone-10 mg) I will ask how that helps the IGF-1 but I believe his assistant said that it had to do with my cortisol levels being a bit low. I'm not certain so I will ask again at my next appointment.

    Doc, I'm learning a lot and I appreciate the help. I can't imagine trying to maintain a successful practice and still having the time, much less the energy helping out to this extent. My hat's off to you. Don't mean to sound like I'm kissing your ass but seriously, it's some great stuff you're doing, thanks.

    Just a thought but when they measured my cortisol levels last time it was at (3) that was in the evening though. Still very low they said. I wonder if maybe the reason that I have been getting low blood sugar and why maybe the GH might not be inducing an effective enough level of IGF-1 stimulation in my liver is because my insulin levels are low from the low cortisol, which if I'm not mistaken can cause hypoglycemia. I read on pub med that adequate cortisol levels were necessary for augmenting adequate Growth Hormone Treatment responsiveness as measured by the results of an IGF-1 assay. My cortisol is always low, sometimes below normal and the rest of the time at the very bottom of the range..never done a 24 hour cort. assay but it looks like that's the next step. I've mentioned the cortisol and how it seems like it would be important. I feel I have a good doc who genuinely wants to see me feel good. I would like to have some things explained to me in regards to what the reasoning is behind certain choices but it's hard to get the scoop at times. When I've asked to see my bloodwork I'm told "no". My Progesterone is above normal and my DHT is above normal too, meaning bo, I know that cause I snuck a peak at the papers in the office the other day. My SHBG is "normal" my estrogen is around 30 (and I'm on Arimidex .25 mg every three days plus test cyp. 100 mg/week plusHCG 250 IU x 2 days (5 and 6). but I know that to explain everything and the reasoning behind it comes across as an insult to many professionals. I'm starting to realize that when it comes to dealing and properly fine tuning hormones, the words "quickly" and "sooner" and "now" aren't usually the way to go. The less variables the better. I see these things take time and patience. I feel better this month than last month so I'm thankful for that. Ok, wow no more ramblings-lol, thanks again.


    Hardasnails-I'm taking a Zinc/copper (30mg/3mg) supplement but no Magnesium. I take my multi-vitamin religiously so I figured I would get enough that way. Pherhaps I figured wrong. Does ZMA have any copper in it, or would it be wise to supplement with copper when taking a supplement like that? Thanks man.
    1. Before doctors visit, get written list of questions

    2. work on your attitude, do not even think that you are insulting doctor by questioning him

    3. For blood work, on your paper with questions, have him put a note or initial to a nurse asking for a copy. Often nurses are less cooperative, not a doctor, specially when they are really busy

    4. next blood test, try to get done in outside laboratory, (as Quest Diagnostic), ask for patient copy of your blood test

    5. if you really see that doctor is acting as insulted, or otherwise makes you feel bad, life is too short, change doctor

    6. Glad to hear that you are feeling beter
  7. Kid
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    Ok, sounds good. I'll eat twenty minutes after thyroid/talk to the doc about dosage induced glycemia (hgh)/change to morning shot rather than pre bed(hgh)/get a fasting insulin test/do a 24 hr. urinary cortisol/just to rule out any adrenal issues/ and get a copy of each and every medical records.......thanks guys/dr.john
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