By Ann Oldenburg, USA TODAY

By Bob Riha Jr., USA TODAY
The prince of time: Actor Nick Nolte, 59, takes HGH.
Growing old gracefully used to be OK, a natural part of life. Not any more. The quest for the fountain of youth has spawned a new, growing, and very lucrative sub-specialty in medicine: Anti-aging. At the heart of the process for many patients is injections of human growth hormone, or HGH, first used by athletes as a muscle-building agent. Patients say it restores youth to the body in an almost miraculous way. Practices are cropping up across the country, appealing to an endless supply of eager, affluent baby boomer patients, particularly those in the entertainment field, including Oliver Stone, Nick Nolte and others. But anti-aging medicine is generally not covered by insurance, so you�ve got to have money to be a player. And not only is the cost high, the risk is high. Some doctors are calling the off-label use of HGH irresponsible and dangerous.

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NEW YORK � Twice a day, fashion designer Diane Gilman fills a small syringe with an expensive clear liquid and injects the needle into her hip. She also takes 10 pills: six supplements and four prescription drugs.

At 55, an age when many people are feeling the inevitable aches and pains of getting older, Gilman insists she has never felt better. She's muscular, has tons of energy and doesn't have a wrinkle on her face.

"It's a miracle. People will say, 'So, you're 32?'" she boasts. "People that have known me and haven't seen me in five years, honestly, they'll stop in their tracks. They'll say, 'What's happening to you? We're aging, and you're going in the other direction.'"

Actually, what she's doing is injecting bioengineered human growth hormone (HGH).

It's a practice more closely associated in the public mind with Olympic athletes trying to enhance their performances than with baby boomers trying to keep Father Time at bay. It's also a practice that many doctors consider highly risky.

That doesn't seem to matter. Gilman, who appears regularly on the Home Shopping Network, is at the forefront of a national anti-aging revolution that has HGH as its elixir and Hollywood as its epicenter.

Oliver Stone, Nick Nolte and Dixie Carter are a few of the show-biz celebrities who acknowledge using HGH.

"I think I look younger," says Stone, who has been attempting an anti-aging program, on and off, since the early '90s. "But feeling better is the issue."

"It's 21st century medicine," says Alan Mintz, an HGH user and founder of Cenegenics, a Las Vegas-based anti-aging clinic with 1,200 patients, the largest such clinic in the nation.

Paul Jellinger of Hollywood, Fla., president of the American Association of Clinical Endocrinologists, calls it something else. "Personally, I think it's misuse," he says of the HGH injections. "Or let's say inappropriate use, off-label use � with exaggerated expectations. It is an interesting hormone, and we're learning about it, but the full effects of it as we age are far from known."

How it works

What is known is that the body's natural HGH levels begin to drop at age 25 or 30. With the injections, advocates claim, growth of muscles and bone density begins anew, energy is restored, memory is enhanced, a sense of well-being is instilled, and, in general, you feel like you're 25 or 30 again.

Although the Food and Drug Administration approved HGH for "deficient" adults in 1996, many conventional doctors say that using HGH simply to return to age 25 doesn't properly constitute the correction of a deficiency.

Anti-aging began to develop as its own area of research about 15 years ago, and Harvard University proctored the first medical board examination for anti-aging practitioners in 1997.

It's the edge of a futuristic field of medicine that promises biomedical breakthroughs as efforts to prolong life make progress in a variety of ways: cryogenics, regeneration, gene mapping, cloning and more.

The anti-aging phenomenon holds a special fascination for Ken Dychtwald of AgeWave, a think tank in Emeryville, Calif. He estimates that 250,000 Americans are injecting HGH regularly. "I'll be at a conference, and people come up to me � usually the rich ones � and say, 'Are you on the program? Doing anything to keep yourself young?' It's become an in-thing among the rich and powerful."

Generally, the program begins with a comprehensive evaluation of nutritional, metabolic, immune, hormonal and mind-body-spirit connections, followed by hearing and vision screenings, bone-density scans, treadmill stress tests and mind/brain assessments. The cost for the complete work-up at Cenegenics is $1,750. At Lifespan, a clinic with offices in Beverly Hills and Dallas, the price is closer to $5,000.

The testing reveals weak spots or deficiencies in any number of areas � maybe early signs of osteoporosis, maybe a thyroid condition, maybe a blood-sugar imbalance. Prescribed regimens range from taking supplements, which a patient can buy or get packaged through a doctor, to injecting HGH, which can cost more than $1,000 a month.

Gilman's anti-aging supplements and injections cost $1,500 a month and, like most such regimens, are not covered by health insurance.

What exactly is HGH?

Produced in the body by the pituitary gland, it's what the name says: the hormone that makes us grow. Doctors began prescribing it about 35 years ago for children who were in need of a growth boost.

It first was extracted from cow carcasses, but several incidents of children contracting mad-cow disease prompted synthetic production. In 1985, San Francisco-based Genentech introduced one of the first bioengineered human growth hormones, Protopin.

Now five drug companies sell HGH in the USA; top seller Genotropin, from Pharmacia & Upjohn, had sales totaling $461 million last year.

Thicker hair, sore joints

Considered potent only when prescribed by a doctor and injected, as opposed to pills or sprays offered over the Internet or through other advertising , HGH promises to lower blood pressure, build muscles without extra exercise, increase the skin's elasticity, thicken hair, sharpen vision, help ensure restful sleep and heighten sexual potency � among other things.

Skeptics point out, however, that potential side effects include joint pain, carpal tunnel syndrome, fluid retention and insulin resistance. Such problems, however, are generally corrected by adjusting the dosage.

HGH skeptics also fret that there's something inherently scary about putting things into our bodies that aren't naturally there. Think fen-phen, breast implants, thalidomide.

"This is exciting as a research area, but there continues to be no proven clinical utility as an anti-aging compound," says Stanley Slater, deputy director of geriatrics at the National Institute on Aging .

Ronald Klatz, head of the American Academy of Anti-Aging Medicine (A4M, for short), gets exasperated with such talk. "This is something that we have studied and studied and studied," he says. "It has been in clinical use for the last 50 years, common use for the last 35 years. There are tens of thousands, if not hundreds of thousands, of people who have received growth hormone � whether they be children or adults. This is not secret information.

"You hear these boogeymen out there, and these naysayers saying it can cause this and that and cancer � it scares the heck of out people."

Murray Susser, a Los Angeles-based physician who counts Dixie Carter among his patients, says: "It's off-label use, it's legal, and people have the choice. It's only misuse if I lie to them. I say to people who are taking it, 'It's experimental, it may help, but I don't know for sure.'"

HGH's poster girl

Diane Gilman. (USATODAY)
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Gilman began shopping for an aging remedy when, at 50, she was approached to sell clothes on TV.

"I thought, 'This is a little late to start a television career,'" she says. "When I looked at myself in the mirror, I was not thrilled with what I saw. So I went ahead and got some plastic surgery, like every other good person in America. But then I found my energy was really flagging. I thought, 'How could I possibly do this?'"

She heard about HGH, called a doctor and has injected the drug daily for 2 1/2 years.

Holding the syringe for a photo, she jokes, "I feel like I'm going to appear in Junkie Monthly."

But the designer says she is happy to be the HGH poster girl. "My energy level is superb. My skin looks like a 20-year-old's. I dropped 25 pounds. I used to have aches in my back and my knees, and they are completely gone because I have more muscle and my bones are building back up. Every single thing it promised, it has delivered."

Any side effects?

"Absolutely zero."

She remembers the first day she injected it. "My body felt just like a clock. I felt like all the gears were grinding to a halt. Then on the second day, it felt like they started up again, going in another direction."

Klatz, the A4M president and author of Grow Young With HGH and other books on anti-aging, also has used HGH. He says his pants size dropped two notches, and his chest size increased 2 inches. "That was without changing my diet at all." He says he's 44, but "biologically" he's 34. He adds: "I expect to see 150. I'll be disappointed if I don't."

Dan Yaffe, 52, a mortgage banker in Las Vegas, is another believer, even with the high cost. "There are some years that I've paid almost $800,000 in federal taxes. So $24,000 a year for this isn't that much."