Too many patients, as documented in an on-line study of 12,000 individuals conducted by the American Thyroid Association published in June 2018, (https://doi.org/10.1089/thy.2017.0681) , complain of persistent symptoms of hypothyroidism despite what their doctors believe is successful treatment with levothyroxine (brands include Synthroid, Unithroid, Tirosent, Levoxl). We believe something needs to be done to resolve this conflict between patients and their doctors.
Finally, Growth Hormone Treatment in a Pill?
 For years, false promises have been made about pills that produce therapeutic increases in growth hormone levels in adults. I countered those claims in a number of articles on this site https://www.metabolism.com/2008/08/23/adults-receive-growth-hormone-treatment/. Recent scientific advances may have finally made this myth into reality. A recent study from the University of Virginia of healthy elderly individuals whose growth hormone levels were low has shown that a synthetic drug mimicking a naturally occurring brain hormone, when taken orally, can restore growth hormone levels to young healthy levels.
Growth hormone levels normally decline as we get older. It is my opinion that age related declines in hormones like growth hormone may be a form of natural programmed death of the aging body. Along with decline in growth hormone comes a decline in muscle mass and an increase in body fat. This combination makes older people weaker more likely to suffer injury and develop diseases such as diabetes, high blood pressure and coronary artery disease. Ghrelin is a hormone normally made in the intestine and brain.  It has the ability to stimulate the release of growth hormone from the pituitary gland. The new drug MK-677, a synthetic molecule which mimics ghrelin action, is absorbed into the blood after oral administration and creates a long acting natural stimulus to the pituitary to release growth hormone. Making this drug even more appealing is that it causes growth hormone release in a natural up and down rhythm (pulsatile) rather than a single big daily elevation as occurs with standard injections of growth hormone.
Does MK-677 help?  According to the researchers, muscle mass increased, and body fat remained the same but overall weight increased a small amount. The bad cholesterol (LDL) level declined when taking the drug. The study was conducted in healthy elderly people so any benefit to quality of life was hard to measure. Additional problems may arise because ghrelin also stimulates appetite and may cause weight gain as shown in the present study.
MK-677 is an investigational medicine and is not available to the public. Only your personal health care professional can recommend whether any medical therapy is appropriate for you.
Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com