KCSSA

Abhijit Banerjee asked:


Meat and dairy products form the basis of many Western diets. In fact, the popular perception is that a portion of meat and two glasses of milk every day will ensure good bones and muscle mass. However, many people are unaware of what actually goes into the cartons of milk they get from the local supermarket, or the cuts of beef they grill on the barbecue.

The ugly fact of dairy and meat (especially beef) production is that many large producers are extensively using growth hormones to boost production. This is not a new issue, bovine growth hormones, used in the US to boost beef and milk production, have been the focus of debate for some time now. But although growing numbers of consumers and scientists have expressed concerns about potential human health risks of this practice, the USDA and FDA have approved the use of six hormone growth promotants (HGPs) in the cultivation of beef cattle, and one more hormone used to increase milk productivity. Only a few other countries have approved the use of HGPs, while many others have banned their use.

Controversy also surrounds the fact that there are no labeling requirements in the U.S. for growth hormones in food. A recent study making a strong environmental case for the controversial cattle injections, has added a new twist to the debate. The growth hormone debate is centred around four main issues: who benefits from these growth hormones; animal health and welfare; food safety and environmental concerns.

The History of Artificial Growth Hormones

Growth hormones in milk

Bovine somatotropin or BST is a hormone naturally secreted by the pituitary glands of cows. Traces of BST are found in the milk secreted by the hormone injected animal. BST is also poularly known as BGH, or bovine growth hormone. It interacts with other hormones in cows’ bodies to control the amount of milk they produce.

Scientists working for Monsanto, the agricultural giant, developed a genetically-engineered synthetic version of the hormone called recombinant bovine growth hormone or rBGH, that increased milk production by 10% to 25%. Approved by the U.S. Food and Drug Administration (FDA) in 1993, it was offered to interested farmers the next year. By 2008, a third of American dairy cows were being injected with rBGH.

Growth hormones in beef

The US cattle industry started using hormones to enhance beef produciton in 1956. They used DES (diethylstilbestrol) – which had been approved for use in beef cattle in 1954. In the 1970s, US Food and Drug Administration (FDA) approved six hormone growth promotants (HGPs). These included three naturally occurring hormones – Oestradiol, Progesterone and Testosterone – and three synthetically prepared hormones – Zeranol, Trenbolone, and Melengestrol.

Growth hormones in veal

In 2004, the US veal industry was found guilty of injecting 90% of its calves with growth hormones. These hormones included all six HGPs approved for use in adult cattle only, bringing into focus the safety or side effects of injecting calves with hormones intended for heifers and steers over 700 lbs, a fact that has never been evaluated. It is suspected that these hormones may be metabolized differently in the young calf’s body which could lead to greater amounts of hormones consumed by people who eat veal.

Which Countries Allow Growth Hormones?

Milk — The use of growth hormones to increase milk production is approved for use in the US. However, it is not approved for sale in Canada or the European Union (EU).

Beef-- The use of hormonal growth promoters in beef cattle is an issue which has sparked much debate around the world. They are approved for use in Canada and the US. However, the use of hormonal growth promoters is banned in the EU.

How Are Growth Hormones Used?

Milk-- Lactating cows are injected with rBGH to increase their lactation period. This hormone interacts with other hormones in cows’ bodies to increase the amount of milk they produce.

Beef– The US FDA approved six hormone growth promotants (HGPs) including three naturally occurring hormones – Oestradiol, Progesterone and Testosterone – and three synthetically prepared hoemones – Zeranol, Trenbolone, and Melengestrol. These are implanted or injected into cattle in various stages of maturity. The FDA however, does not permit injecting calves with these hormones. The male hormone testosterone and its synthetic equivalent trenbolone acetate, and the female hormone progesterone including three synthetic derivatives zeranol , 17 beta-estradiol, and melengestrol acetate (MGA) are either implanted or injected into the cows. Melengestrol is a feed additive and is not injected, but added to the feedstock. Hormones are also said to help the animal improve its nutrient absorption. This translates into feedstock needed for the animal to reach its finish weight (market weight). Hormones help to improve meat quality by changing the deposition of fat, producing the lean meat that consumers desire.

How Growth Hormones Boost Production

Milk – Experts opine that there are two obvious benefits of the widespread use of rBGH:



The manufacturer benefits from the use of the hormones manufactured by the company.

Results in an estimated 12 per cent increase in the US milk supply



However, it is argued that the US did not need higher milk supply. It is said that since the l950s, America’s dairies have consistently produced more milk than the nation could consume, the surplus being bought up every year by the Federal Government to prevent the price from plummeting.

Beef-- Beef producers inject their cattle with growth hormones because they:



Improve meat quality by increasing the development of lean meat and decreasing fat content;

Increase feed efficiency, thereby allowing more growth with less feed;

Reduce costs for producers thereby reducing the price of meat and meat products for consumers.



The Canadian Animal Health Institute observes that the use of growth hormones benefits both producers and consumers.



Producers — With the animal growing larger and quicker on less feed, producers have lower feed costs and therefore lower inventory costs.

Consumers — Without the use of growth hormones, producers would experience higher costs. This would translate into higher prices for the consumer. In 2000, 500 g of lean ground beef in Germany cost about $4.60 while it cost about $3.19 in Canada for the same amount. That is a difference of 44%.



Animal Health and Welfare

rBGH hormone for milk production

Animals treated with the hormone are subjected to tremendous stress. For about 12 weeks after calving, a cow produces milk. During this process, the cow loses weight, is infertile and is more susceptible to diseases. As the milk output diminishes, the cow’s body begins to recover. By injecting a cow with rBGH, a farmer extends this milching period by eight to 12 weeks. Even as these hormone injections substantially increase the cow’s milk output, they also make her more susceptible to disease.

The US Food and Drugs Administration (FDA) requires Monsanto to state on the labels of every shipment of Posilac (the name of the rBGH hormone), the 21 health problems associated with the use of the hormone. These include cystic ovaries, uterine disorders, decrease in gestation length and birth weight of calves, increased twinning rates and retained placenta.

Hormone injected cows are susceptible to mastitis — inflammation of the udder. Since a cow with mastitis produces milk with pus in it, something which is not acceptable to dairies (dairies check milk for high somatic cell count i.e. high proportion of pus), farmers give antibiotics to treat the ailing cows.

Growth hormone for beef production

There are serious concerns about health and welfare of animals in factory farms and those that are injected with growth hormones. Organisations such as the nonprofit Animal Welfare Institute, supports family farms and the humane treatment of animals and periodically check on them.

The place of injection and the gap between two points where the hormone injections have been given are very important. Places such as below the ear have significant muscle movement, causing the lesion to enlarge and the medication and irritation to spread beyond the site of original injection.

Growth Hormones and Health

rBGH hormone for milk production



Antibiotics given to cows to treat mastitis results in antibiotic residues in milk. Apart from causing health problems in those who drink this, it can lead to the development of antibiotic resistance amongst bacteria present in the person’s body.

Scientific studies link rBGH to cancer citing the fact that the presence of rBGH in the cow’s blood stimulates production of another hormone (Insulin-Like Growth Facto) in the cow and traces of it are found in its milk. Since this hormone is also active within humans, it can lead to uncontrolled cell division or cancer.



Growth hormone for beef production



Exposure to growth hormones in beef could be putting Americans at risk for infertility. A recent study found that women who routinely ate beef were far more likely to give birth to boys who grow up to have lower-than-normal ***** counts.

Hormone residues in beef have been implicated in the early onset of puberty in girls, which could put them at greater risk of developing ****** and other forms of cancer.



Growth Hormones and Health rBGH hormone for milk production



Antibiotics given to cows to treat mastitis results in antibiotic residues in milk. Apart from causing health problems in those who drink this, it can lead to the development of antibiotic resistance amongst bacteria present in the person’s body.

Scientific studies link rBGH to cancer citing the fact that the presence of rBGH in the cow’s blood stimulates production of another hormone (Insulin-Like Growth Facto) in the cow and traces of it are found in its milk. Since this hormone is also active within humans, it can lead to uncontrolled cell division or cancer.



Growth hormone for beef production



Exposure to growth hormones in beef could be putting Americans at risk for infertility. A recent study found that women who routinely ate beef were far more likely to give birth to boys who grow up to have lower-than-normal ***** counts.

Hormone residues in beef have been implicated in the early onset of puberty in girls, which could put them at greater risk of developing ****** and other forms of cancer.



Environmental Concerns

Hormone residues in cow manure enters the ecosystem. Manure from factory farms enters the soil in the area and the surface and groundwater in that area. Apart from impacting the gender and reproductive capacity of fish and the aquatic ecosystems, there are concerns about traces of growth hormones finding way into the food we wat, though there are no conclusive studies to support that.

There is another school of thought which advocates that using growth hormones is environmentally friendly and reduces greenhouse gases. They argue that by using growth hormones we can produce more milk using less land, feedstock, nutrients, greenhouse gases, excretion — translating into all round postive impact on the environment.” The same holds true for beef also, growth hormone supporters add.

Understanding Beef and Milk Labels

Conventional — These come without specialty designations. The cattle might have been fed corn and other grains on an industrial feedlot, even if it started out on grass. Grain is used in the place of grass as it is quicker and cheaper, and transates into a faster turnaround and higher profits. However, grains are tough on the digestive system of cows, and makes them vulnerable to sickness. The cows then require antibiotics. They are also routinely given growth hormones .

USDA Certified Organic – The cattle is raised on grass or grain-based feed that does not contain animal by-products. These animals are not given antibiotics (unless required by a veterinarian, and then the animal loses organic status) or growth hormones. To address animal welfare concerns, cattle are raised in conditions “which allow for exercise, freedom of movement, and reduction of stress appropriate to the species” and “access to pasture”.

Grass Fed or Pasture Finished – These cattle are raised only on grass or hay, no grain. Studies indicate that grass-fed beef contains higher levels of Omega-3 essential fatty acids than conventional beef.

No Hormones/No Antibiotics — The USDA allows this label for growers who provide documentation, but they do not check up on the claims. “Hormone free” and “antibiotic free” are not USDA approved designations and so are meaningless.

Animal Welfare Approved – A new seal instituted by the nonprofit Animal Welfare Institute ensures that the animals were raised on independent farms and were given seasonal access to the outdoors. It also assures the humane treatment of animals at all stages.

Natural. This does not really mean anything in regard to how the cattle was raised. The USDA’s policy is that all fresh meat is natural, and it can’t contain any artificial flavors, colorings, or preservatives.

Source: Growth Hormones in Food

Juliet Cohen asked:


Growth hormone (GH) deficiency is a disorder that absorbs the pituitary gland (a small gland sited at the base of the brain), which produces increase hormone and other hormones. When the pituitary gland does not produce adequate growth hormone, growth will be slower than normal. GH deficiency can arise at any age, and the most common mark in kids and teens is a slowing of growth to less than 2 inches (5 centimeters) a year. Kids with this disorder generally have normal body proportions - in other words, their bodies look normal, just smaller. Growth hormone deficiency does not involve intelligence or brain function.

Growth hormone is generally secreted in response to sleep, exercise, and hypoglycemia and encourages growth and metabolic function. It is likely that GHD affects 1 in every 4,000 school-age children. GHD occurs three or four times more frequently among boys than girls. Causes of GHD embrace hypothalamic disorders that impair secretion of growth hormone, and lesions of the pituitary gland or pituitary stalk that cause deficiencies. In addition, 65% of children who have received radiation therapy for such diseases as leukemia or middle-ear or nasopharyngeal tumors have deficiencies in growth hormone.

GHD can also arise among children with emotional disturbances caused by living in hostile and not enough living environments. In normal aging, there is a reduce in the amount of growth hormone secreted each day and in the pattern of secretion. It is not clear if this is clinically important or requires any additional administration. Acquired causes of growth hormone deficiency comprise infections; brain tumors; and injury, surgery, or radiation to the head. GHD is characterized by a decrease in growth, wait in skeletal maturation and lack of other explanations for poor growth.

Child with intrauterine GHD at birth can have hypoglycemic seizures and prolonged jaundice; boys have micropenis and undescended testes. Growth failure is frequently is apparent by the end of the first year, and increase rates continue to sluggish during childhood. Children and some adults with growth hormone deficiency will advantage from growth hormone therapy. The aims of treatment are to enlarge growth in children and restore energy, metabolism, and body composition. Growth hormone therapy is given by injection, either every day or several times per week, by parents who are trained to give these injections.

Raj Kumar asked:


Growth hormone is not just beneficial but essential component of human body because it promotes cell regeneration, tissue repair and supports the immune system as well in combating infection and diseases. Growth hormone is a large protein molecule that should be injected into the human subcutaneous tissue or muscle to go into the blood. Human growth hormone ingredient refers to some or one of the ingredients that must be supplied as hormones for proper functioning of the human body.

It maybe possible that you are deficient of growth hormone and treatment is required then at that time you may show signs of beginning to grow faster within months of staring the treatment. Other benefits also include increased strength, increase in motor development and a reduction of body fat and issue.

There are several types of human growth hormone ingredients available in the market today and Sytropin is one. It is artificially synthesized and is usually a differentiated conflate of homeopathic human growth hormone made to induce larger production of human growth hormone by the anterior pituitary gland in the brain.

Having said that this is synthesized the ingredients of this supplement comply to all of FDA’s GRAS listing regulations for human growth hormone products and have visualized no side effects.

When the cells of your body die then this human growth hormone acts as a Trigger to ensure that replacement cells are healthy and readily available. It has found that when you grow older your human growth hormone tends to decline thus resulting in causing the cell replacement levels to a fraction of the levels to your youth. However the reason behind this event has not been found out yet by anyone. Thus, a deficiency of the human growth hormone might result in several ailments.

One fact is that your natural human growth hormone usually is a complicated hormone containing 191 amino acids. But what to do when this natural human growth hormone diminished? Well with the advancement in the field of science and medicine, many types of artificial human growth hormones are available in the market. Sytropin that we talked above is also one of them.

However the human growth hormones available without a prescription can be classified into two categories. These are releasers and secretagogues. Releasers are very inexpensive and provide the building blocks of the 191 amino acids human growth hormone, mostly L-group amino acids like L-valine and L- arginine. But the releasers are not same as true human growth hormones.

The other category is the secretagogues. These contain minute amounts of human growth hormone substance. These are basically a form of homeopathic medicine that promotes little amounts of a natural body chemical taken to simulate he body to produce more.

After knowing releasers and secretagogues, the best human growth hormone available today in the market is Sytropin. It contains both releaser amino acids and true secretagogues human growth hormone into one supplement and also easily available in the online market as well.

Related Articles:

Top HGH Releasers

HGH supplements

Amy Fakterowitz asked:


Human growth hormone prescriptions are human growth hormone recommendations by physicians. They are used as remedies or as a cure for ill-effects caused by decreased level or absence of natural human growth hormone produced in our body.

There are also other human growth hormone products (http://www.buyhumangrowthhormonepill.com/ )that are sold and marketed by many companies in different kinds of forms such as in syringes, liquids, sprays, and capsules but the Federal Trade Commission has enforced a rule which states that the human growth hormone can only be sold with human growth hormone prescriptions and these prescriptions will only recommend the human growth hormone in syringe or injection form. This is because the human growth hormone molecules are too big to be taken or administered sublingually and if taken orally, the acid in our stomach will break it down to an ineffective level. Since it is FAD approved, this human growth hormone prescription is also safe to be used on patients suffering from human growth hormone deficiency.

There are two types of injection or syringe form of human growth hormone that are recommended by the doctors. The first and more popular one includes high dose of synthetic human growth hormone. And the second option is to inject a secretagogue to stimulate the production of the human growth hormone. These injections can be administered under the skin or into the muscles.

The advisable dose of shot is 3 I.U./week per each pound of body weight. The popular daily dosage of an average man is between 4-10 I.U. per day. The formal dose must give the user 2,750,000 nanograms of HGH. Doctors and patients must take extra care not to inject human growth hormone at the same area of the body again.

The reason the Federal Trade Commission prescribe only the syringe / injection form of human growth hormone to the users is the structural specialty of the hormone. This complex protein molecule has 191 amino acids and a molecule weight of 20,000 daltons. This molecule is also considered complex because it will simply refuse to work or be ineffective if the delicate interconnections of its 3D arrangement are messed up. This is also why only injections and usage of syringe can deliver the molecules into the blood stream without any deformation. Physicians who prescribe human growth hormone will only recommend FDA approved synthetic human growth hormone, synthesized using recombinant technology.

Prescribed human growth hormone injections are very expensive, with prices ranging from $850 to $2000, with some places offering injections / syringes that cost even more expensive than that, depending on which institution and which doctor that you see. There are also some institutions and organizations that offer cheaper alternatives but it is a bit risky not to mention dangerous to take your prescriptions from these so called cheaper places.

Any improper administration of the human growth hormone can cause some serious side effects to the user and that is why the risk factors associated with the human growth hormone should not be taken lightly. These side effects include the risk of cancer and kidney failure. We should always see a physician first if we think we are suffering from human growth hormone deficiencies because only certified physicians can legally dispense human growth hormone prescriptions and this rule will make no exceptions whether you are a child or an adult.

Tim Faber asked:


Chemotherapy - Chemo - targets fast growing cancer cells in the body. Unfortunately, treatments generally do not discriminate among cancer and other fast(er) growing cells in our body such as hair and nails. As a result, patients often experience severe hair loss during treatment. Hair growth after Chemo requires proper hair care to help accelerate healthy hair growth.

Common cancer treatments include Chemotherapy, which there are several primary treatments, Radiation Therapy and Hormonal Therapy. All typically affect hair growth, the hair follicle growth cycle or destroy the follicles and their ability to reproduce.

Fortunately hair loss symptoms disappear after treatment and hair growth returns - though not always as expected. My mother for instance, experienced soft, curly hair growth following several chemo treatments for ****** cancer - which she won, by the way! Previously her hair was wavy and somewhat coarse.

Generally, the timing and dosage of chemo will have a direct impact on hair loss. The larger the dosage or the more rapidly the treatments, the more severe the loss.

It is common for hair growth to return two to three weeks after treatments end and normal hair growth can be expected to return within a month. Normal hair growth is 4-6 inches per year, so it may take 3-6 months before manageable stylable hair is grown.

For hair growth after chemo, stimulation of the hair follicles, accelerating blood flow and nutrients, and providing proper (and lost nutrition) is essential to restoring healthy hair and hair growth.

We recommend several types of products for hair growth after chemo to promote faster growing hair and to re-grow new hair:

Follicle Stimulators - Follicle Stimulators are topical applications used to promote faster hair growth. Rich in Trichogen and scalp nutrients, follicle stimulators use clinically proven ingredients to promote faster hair growth and invigorate new hair re-growth.

Trichogen, developed and tested in France, is a unique trichogenic complex which make-up the hair growth complex. It consists of a selection of synergistic components of botanical, biotechnological and synthetic origin. This ingredient is composed of many components that when combined together they become Trichogen. It stimulates blood flow, aids in blocking DHT, and has been shown to work in over 88% of tested subjects.

DHT Blockers - Though not a direct hair stimulant, DHT blockers are formulated to block DHT (Dihydrotestosterone) which often is a function of hormonal changes - common in chemotherapy or hormonal therapy. DHT blockers use natural ingredients that help to block the 5 alpha reductase enzyme that must be present for DHT to form.

It is important to note that blocking the enzyme is important, but equally important is adding extreme amounts of vitamins and aminos to your diet. This is because the hair has been mal-nourished and must be jump started. This is why scalp stimulation is also important to re-establish blood supply.

Hair Vitamins - Your body needs nutrition and it is necessary for your hair to grow properly, and hair vitamins help. Amino acids build protein chains in the hair shaft. As your hair grows up and out of the scalp it is reproducing rapidly and making these protein chains. By giving your body more of the amino acids, hair grows faster and healthier.

B Group vitamins get your hair growing faster and minerals form the bonds in the hair. Chemo generally strips vital nutrients, so vitamins, nutrients, minerals, and amino acid compounds help promote healthy hair growth.

Facing chemo hair loss can be difficult and embarrassing - adding to a very difficult life challenge. Proper diet and utilizing hair care products formulated to restore natural hair re-growth can help combat the effects of chemo and restore natural, healthy hair.

Gary Toh asked:


Everybody knows that you cannot stop the aging process. Even so, you don’t need to feel older just because of the fact that you are advancing in years. Why? Because aging can be slowed down or delayed by taking human growth hormone (HGH) boosters. Yes, it is now possible for you to look and feel younger and healthier than what your age may suggest.

According to a clinical study conducted by the New England Journal of Medicine in 1999, it was found that there were increases in muscle mass and bone density in men aged 60 to 80 years of age. This increase was up to 20%. In effect, they seem to have delayed their aging process by ten to twenty years.

This study has shown how useful human growth hormone supplements are in slowing the aging process. The subjects under trial were all given human growth hormone boosters or supplements. None of them changed their diets or lifestyles during the period of the study. The findings of the study have really shaken up the field of longevity research.

The common symptoms associated with aging, such as hearing loss, vision loss, memory loss and reduction in sexual functions can be delayed, thanks to human growth hormone boosters. These anti aging boosters increase the levels of growth hormone secretion in your body, thus slowing down the aging process and making you look and feel younger. HGH boosters are available as tablets as well as sprays but the tablets or supplements are the more popular choice.

Human growth hormone boosters can also be used to treat diseases due to growth hormone deficiencies. Growth hormone deficiency in children results in them being short in stature. By giving these children HGH boosters, their height can be increased. HGH supplements can also be used to treat other diseases which have no connection to growth hormone deficiency. Turner’s syndrome, a genetic defect which affects only girls, can be treated with the help of these boosters or supplements.

Another benefit of human growth hormone boosters is in helping people suffering from AIDS. Wasting of muscle mass is a common phenomenon for people with AIDS. Because of this, AIDs sufferes grow very thin. HGH supplements can help them maintain their muscle mass in addition to boosting their immune system.

Note that human growth hormone boosters do not contain growth hormones. Instead they help the body to increase the secretion levels of growth hormones. One main reason why human growth hormone boosters do not contain growth hormones is that it is against the law to do so. Certain levels of HGH are allowed to be used therapeutically.

If a manufacturer of human growth hormone boosters claims to have abnormal levels of Human Growth Hormone in his/her products, it is either information designed to mislead the consumers or the manufacturer is breaking the law. So, beware of such products.

Before you start taking Human Growth Hormone boosters, you should consult an endocrinologist. In order to reap the maximum benefits out of Human Growth Hormone boosters, you must take them on an empty stomach. The results are better if the Human Growth Hormone boosters are consumed dry or with three or four ounces of water.

The best times for taking Human Growth Hormone boosters are just before going to bed, just after waking up, before starting a work out session and when you are feeling famished. Believe or not, this will ensure maximum anti aging benefits.

Robert M. Bernstein, MD, F.A.A.D. asked:


The asynchronous cyclical nature of human follicular activity contrasts sharply with the synchronized “molting” pattern seen in other mammalian species. In the process of molting, animals shed their hair in a synchronized, seasonal pattern to adapt to the changing climate. This shedding of hair is controlled by mediators released by the hypothalamus, pineal, and anterior pituitary.

Humans differ from other mammals in that their growth cycle is almost totally asynchronous, and this pattern is established shortly after birth. Human hair has a growth cycle of approximately three years. Since human hair grows approximately 1/2 inch per month, it would reach a length of about 18 inches before it is shed. Therefore, in the average person, hair length is limited to approximately 1 1/2 feet. There is, of course, significant normal variation with hair cycles varying in each individual and from person to person. At the extreme end of the bell curve, continuous patterns of growth may be seen (Angora). In a given period of time about 13% of hair is in the resting (telogen) stage, which lasts about three to four months. For example, if the average person had 100,000 hairs on his head, approximately 90 should be shed each day, and 90 would begin to re-grow.

Generally, following a transplant, all of the transplanted hair is shed in an effluvium and enters a resting phase. If all the hair was to simultaneously begin a new anagen cycle, the asynchronous normal growth pattern in man would be effectively converted to the synchronous growing/molting pattern of animals, and much of the new hair would fall out during the next normal telogen three years later. This obviously doesn’?t happen to any significant degree.

To prevent this from happening and to keep our hair cycle “human,” there are at least two possible mechanisms at work. In the first, each hair might resume its growth cycle at the point where it was interrupted, thus continuing the previous totally asynchronous pattern of growth. In the second possibility, each hair would begin a totally new 3 year cycle. In this case, if all the hair was to begin growing simultaneously, this new hair would fall out at approximately the same time three years later. In the second scenario, in order for nature to restore its normal asynchronous pattern, it would have to delay the onset of growth in a portion of the follicles. In theory, to be totally asynchronous, new crops of transplanted hair would continue to appear over an extended period of time, possibly up to three years.

It is unclear which of these two physiologic mechanisms best explains the natural course of events, but it is likely that both are at work. In the first, abundant new hair growth would be seen at 3 to 4 months with each follicle resuming its original cycle. In the second scenario, hair would gradually reappear over an extended period of time with each follicle at the beginning of a full new cycle. It is noted that in some patients substantial hair growth is delayed significantly past the usual “three to four months,” with some new growth occurring as late as a year or more after surgery. It is possible that in this subset of patients, the second natural mechanism is at work.

We wonder if this phenomenon of delayed growth is unique to the newer techniques or has always been present and is only now being recognized. With 4mm grafts, containing an average of 20 hairs, a delay in the growth of some of the hair would largely go unnoticed. With the use of smaller grafts, such as mini-grafts, but especially with micro-grafts and follicular implants, any delay would be immediately apparent. In fact, it has been the experience of these authors that the appearance of the large grafts often worsen with time as the full complement of hairs in each graft become visible.

If delayed growth is indeed a new phenomenon unique to the implantation of very small grafts, it is possible that the growth cycle of the hair in these grafts may react differently to the trauma of transplantation than those in the larger grafts. In other words, the desiccation, temperature change, and mechanical trauma to which small grafts might be more subject actually cause a delay in growth in situations where there was not quite enough injury to completely destroy the follicle. Thus, small degrees of trauma may either induce the second physiologic mechanism to occur, or may cause a more pathologic delay in growth. Of course, with increasing trauma, poor growth or no growth would be the result and this “point of no return” must be elucidated in carefully controlled studies. An additional type of trauma that may contribute to delayed growth has been recently reported by doctors Cooley and Vogel. They suggest that when the dermal papillae is lost during graft preparation and handling, it must regenerate from the fibrous root sheath before the hair will re-grow, and this regeneration can often take several months. The role that this important mechanism plays in the delay that we see clinically must also be determined.

Our guess is that “delayed” growth has always been part of the transplant process, representing a normal physiologic shift in the growth cycle on one hand and a reaction to sub-lethal injury on the other; with the very small grafts making both of these changes more obvious. What percentage each represents and how much of “delayed growth” will turn out to be no growth at all still needs to be determined. But before we panic about “perceived no growth” and before we set our patients up for unrealistic expectations about how soon their growth may occur, we should work to have a better understanding of all the biologic factors that impact our surgery.

REFERENCES

1. Ebling FJ, Hale PA: The control of the mammalian molt. Mem Soc Endocrinol 18:215, 1970

2. Pecoraro V et al: Cycle of the scalp hair of the new born child. J Invest Dermatol 43:145, 1964

3. Cooley J, Vogel J. Loss of the dermal papilla during graft dissection and placement: Another cause of x-factor? Hair Transplant Forum Int 1997; 7:20-21.