Serostim, HIV drugs, anabolism and lipodystrophy
Lipodystrophy may be caused by HIV itself but is also known to be caused by the drugs that treat HIV. These drugs include several of the protease inhibitors with Crixivan (Indinavir Sulfate) being the most widely known ("Crix Belly") and also drugs in the Nucleaside Reverse Transcriptase Inhibitor (NRTI) Class, most notably D4T (Zerit) but others in this class like 3TC (Epivir) among others can also contribute to the problem. In general, any of the HIV drugs that contribute to lipid problems (i.e. elevated total cholesterol, LDL, VLDL or depressed HDL or elevated triglycerides) as a side effect are suspect in causing or contributing to lipodystrophy. Serostim is primarily prescribed for the treatment of lipodystrophy. Since many HIV drugs cause lipid problems and the usual recourse to combat this is to prescribe Lipitor to control Cholesterol levels as the LDL, VLDL, and Total Cholesterol tend to increase and the HDL tends to decrease. This usually works very well for this purpose. However, Triglycerides also tend to climb, and in some cases, quite dramatically. There are no prescription drugs that I am aware of that will adequately treat this HIV drug induced elevation of Triglycerides. Interestingly, it has been demonstrated in several studies that Salmon or Cold Water Fish oil will actually lower Triglycerides rather significantly, returning them to normal levels if taken daily over time and some of the more informed HIV doctors will tell their patients this. I have seen enough lab results that I am very convinced that cold water fish oil absolutely works even in relatively low doses like two capsules per day, more if needed. What is also interesting is that in particular, D4T seems to cause a form of "programmed cell death" for fat cells. This is what tends to remove the fat from underneath the skin for people that use it. Unfortunately, it also seems to cause elevated lipids and facilitates in the redistribution of the lipids into "brown fat" deposits in the viscereal abdominal area and in some cases has been implicated in causing the notorious "buffalo hump" in the back of the neck. I have personally observed a patient with this manifestation respond quite well to Serostim treatment and it quite literally removed the entire buffalo hump within about three weeks of usage so it was kind of a wonder drug in that regard. The dosages prescribed for HIV patients seem to be outlandishly high, especially considering the enormous cost of the Serostim. I have it on good word, that it works just as well on a considerably reduced dose over that prescribed--probably less than one third of the amount will work fine and will usually eliminate the rather serious side effects like peripheral edema, numbness and in some cases, carpel tunnel syndrome among others as the side effects are also dose dependent. Outside of lipodystrophy issues, it seems to help burn fat particularly when combined with anabolic drugs. It has never been shown to cause hyperplasia (increasing the NUMBER of muscle cells by causing them to divide as is a theory surrounding human growth hormones in general and the idea behind IGF-1). To my knowledge, this was just a "rumour" that was circulated unofficially by Serono Labs along with no longer very credible claims that it increased lean body mass. Considering the cost, there certainly would be MANY other things that far surpass Serostim in this regard. It may have a very slight anabolic effect on lean mass when administered in very high doses but like the previous post points out, that effect is probably mostly water and "other" lean mass areas like organ tissue, etc. and largely exclusive of skeletal muscle tissue. I do know of one case where the patient took it for lipodystrophy and got another "benefit" from it that was not expected. He had a problem where his lower jaw was not long enough and this fact caused him to have a serious underbight. Also one side of the jaw was longer than the other. As a semi permanent fix, short of breaking both sides of the jaw and wiring his mouth shut and putting him on liquid diet, they had cemented in a brace to force the lower teeth forward to improve the bight. While on Serostim, his lower jaw started to grow and the one side caught up with the other and popped the cemented brace completely out. He had formally had problems with his lower jaw popping out of socket frequently. After the Serostim, this has never occurred since. Just an interesting thing that I had never seen before although I am aware that some growth hormones can cause the lower jaw to grow. It was interesting actually seeing it happen in someone where it actually fixed a medical problem that formerly caused him a great deal of discomfort and now no longer does.