Hormones and Other Changes

The exact cause of HIV-associated wasting is not clearly understood. But research suggests that hormones and other changes may play a role. Here’s how.

Low Testosterone

Hormones regulate bodily functions like growth and development, metabolism, and reproduction. Testosterone is a type of hormone that helps produce bone and muscle growth. When testosterone levels become too low, significant loss of lean body mass may occur.1

Changes in Metabolism

When you are eating right and exercising regularly, your body converts the food you eat into energy. The conversion is called metabolism. With regular metabolism, the body also draws energy from stored fat in addition to carbohydrates.

In many people diagnosed with HIV-associated wasting, their bodies may draw energy from lean body mass which may cause a reduction in physical endurance. When you lose lean body mass, you lose muscle, organs, blood cells and water, which are all essential to energy production and physical endurance.2-6

Inflammation

Inflammation is a natural body response to things like infection or cell injury that helps control tissue damage. If the body produces too much inflammation, it can change metabolism, break down muscle, and can suppress appetite.7,8

Growth Hormone Resistance

Growth hormone inside your body helps promote tissue growth, including lean body mass. Growth hormone can also help the body properly regulate the use of body fat as a source of energy. The loss of lean body mass, including muscle, can occur when the body has problems utilizing the growth hormone that it naturally produces.1

Learn about dietary changes

References:

  1. Dudgeon WD, Phillips KD, Carson JA, et al. Counteracting muscle wasting in HIV-infected individuals. HIV Med. 2006;7:299-310.
  2. Serostim® [somatropin (rDNA origin) for injection] Prescribing Information. Rockland, MA: EMD Serono, Inc. 2007.
  3. Castaneda C. Muscle wasting and protein metabolism. J Anim Sci. 2002;80(suppl):E98-E105.
  4. Roubenoff R, Grinspoon S, Skolnik PR, et al. Role of cytokines and testosterone in regulating lean body mass and resting energy expenditure in HIV-infected men. Am J Physiol Endocrinol Metab. 2002;283:E138-E145.
  5. Lutz NW, Yahi N, Fantini J, et al. Perturbations of glucose metabolism associated with HIV infection in human intestinal epithelial cells: a multinuclear magnetic resonance spectroscopy study. AIDS. 1997;11:147-155.
  6. Frost RA, Lang CH, Gelato MC. Transient exposure of human myoblasts to tumor necrosis factor-α inhibits serum and insulin-like growth factor-I stimulated protein synthesis. Endocrinology. 1997;138:4153-4159.
  7. Kotler DP. Cachexia. Ann Intern Med. 2000;133:622-634.
  8. Gelato M, McNurlan M, Freeland E. Role of recombinant human growth hormone in HIV-associated wasting and cachexia: pathophysiology and rationale for treatment. Clin Ther. 2007;29:2269-2288.
Important Risk Information and IndicationToggle Button

Important Risk Information and Indication

Before beginning treatment, patients should discuss with their clinician potential benefits and risks associated with Serostim® [somatropin (rDNA origin) for injection].

You should NOT take Serostim® if:

  • You are hospitalized with complications due to heart or abdominal surgery
  • You are hospitalized for serious injuries
  • You are hospitalized for respiratory failure
  • You currently have cancer. Any cancer treatment should be completed before starting Serostim®
  • You are allergic to growth hormone products or any materials associated with the product

You should tell your clinician if:

  • You are pregnant or breastfeeding
  • You are currently taking any medications for HIV
  • You have a history of diabetes

The most common adverse reactions associated with Serostim® are:

  • Muscle aches
  • Joint pain
  • Swelling (particularly of the hands or feet)

These side effects were generally mild-to-moderate in severity, and were often managed by lowering the dose.1

High blood glucose (sugar levels) may occur in HIV-infected individuals for many reasons and has also been reported in Serostim® clinical studies. If you have a history of high blood glucose or have other risk factors for glucose intolerance, you should be monitored closely while on Serostim®. New onset type 2 diabetes or worsening of current diabetes has been reported with Serostim®. Patients have experienced complications of diabetes, some of which were serious and continued after stopping treatment with Serostim®.

What is Serostim®?

Serostim® is human growth hormone and is the only FDA-approved medicine clinically proven to significantly increase lean body mass and body weight, and improve physical endurance. You must be on anti-retroviral therapy to be prescribed Serostim®.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

This information is not intended to replace discussions with your doctor. For additional information about Serositm® please consult the Prescribing Information and ask your doctor if Serostim® is right for you. You can also call the AXIS Center toll-free at 1-877-714-AXIS (2947). Serostim® is available by prescription only.

Please see Serostim® Prescribing Information available in English and Spanish

Reference:

  1. Moyle GJ, Daar ES, Gertner JM, et al. Growth hormone improves lean body mass, physical performance, and quality of life in subjects with HIV-associated weight loss or wasting on highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2004;35:367-375.

Indication

Serostim® is indicated for the treatment of HIV patients with wasting or cachexia to increase lean body mass and body weight, and improve physical endurance. Concomitant antiretroviral therapy is necessary.