But isn’t this an acute symptom of hgh use where acromelagy is more of a long term use side effect? Meaning that if one were suffering from these symptoms as a result of acromelagy, merely stopping hgh administration would not necessarily reduce the symptoms, right?
Noted here that the study found that the symptom was related to swelling of the nerve and not enlarged soft tissues.
Sent from my iPhone using Tapatalk
Acromegaly is defined by supra-physiological levels of GH and IGF-1 in adults due to mainly pituitary tumors. Your GH levels can be elevated for only a couple of months and you'd still be diagnosed with acromegaly. Some symptoms such as soft-tissue swelling occur almost immediately, whereas others, like facial changes, occur over years of increased GH levels.
But you are right that the severity of symptoms may differ with the duration of elevated GH levels. For example, the median nerve swelling may be more severe when people start GH administration, and may subsequently decrease a bit.
But the main findings of the paper are not changed by this. They are as follows:
1) In the study, lowering of GH levels (due to tumor removal or treatment with somatostatin) was associated with decreased swelling of the median nerve as well as improvement of the symptoms. This indicates that GH is the causal factor for the nerve swelling and subsequent CTS.
2) The pathophysiology of GH-induced CTS is different from the 'normal' case. In the latter case, the volume of the carpal tunnel contents increases, leading to symptoms. But in the former case, no volume increases are observed in radiographic imaging.
3) The study compared 2 groups of people with similar GH and IGF-1 levels. Despite the similar GH levels, only some people develop CTS. So there's an individual factor, meaning that it is not proper to evaluate the quality of generic GH based on whether CTS occurs. With that being said, if previous use has lead to CTS, we can assume that the person is predisposed. If that same person then switches GH brands and no longer observed CTS symptoms, there is a high likelihood that the GH is underdosed.
4) It remains unclear how exactly the GH leads to nerve swelling. Analogous to the case of papilledema (swelling of the optic nerve due to increased intracranial pressure), we can speculate that an increase in extracellular fluid within the carpal tunnel applies pressure to the median nerve, leading to edema of the perineural sheathes. This extracellular fluid may not be picked up with the MRI.
.gif "IP Gear")
