Many of the supplements to encourage chondrogenic differentiation also encourage osteogenic differentiation. Since growth plates are made of chondrocytes, it is much more advantageous to encourage chondrogenic over osteogenic differentiation. Some of these factors include BMP2, TGFBeta1, etc.
This study suggests that Sox9 levels may be one factor affecting whether BMP2 encourages osteogenic or chondrogenic differentiation of mesenchymal stem cells:
“Bone morphogenetic protein 2 (BMP2) is one of the key chondrogenic growth factors involved in the cartilage regeneration. However, it also exhibits osteogenic abilities and triggers endochondral ossification{but enchondral ossification is good for height growth, however without the growth base chondrocytes for the growth plate the stimuli for endochondral ossification is pointless}. Effective chondrogenesis and inhibition of BMP2-induced osteogenesis and endochondral ossification can be achieved by directing the mesenchymal stem cells (MSCs) towards chondrocyte lineage with chodrogenic factors, such as Sox9. Here we investigated the effects of Sox9 on BMP2-induced chondrogenic and osteogenic differentiation of MSCs. Exogenous overexpression of Sox9 enhanced the BMP2-induced chondrogenic differentiation of MSCs in vitro. Also, it inhibited early and late osteogenic differentiation of MSCs in vitro. Subcutaneous stem cell implantation demonstrated Sox9 potentiated BMP2-induced cartilage formation and inhibited endochondral ossification. Mouse limb cultures indicated that BMP2 and Sox9 acted synergistically to stimulate chondrocytes proliferation, and Sox9 inhibited BMP2-induced chondrocytes hypertrophy and ossification. This study strongly suggests that Sox9 potentiates BMP2-induced MSCs chondrogenic differentiation and cartilage formation, and inhibits BMP2-induced MSCs osteogenic differentiation and endochondral ossification.”
Quercetin had the most prominent effect on increasing Sox9 in normal stem cells.
“BMP2 induced Sox9 expression was transient and relatively at a lower level during the early stages of MSCs differentiation.”
“Sox9 and BMP2 synergistically promoted chondrocytes condensation and proliferation. However, Sox9 inhibited BMP2 induced chondrocytes hypertrophy, and ossification.”<-So we want optimal levels of Sox9 to form neo growth plates as chondrocyte hypertrophy and ossification are vital stages in the growth plates mechanisms of increasing height.
“Sox9 inhibits BMP2-induced early osteogenic differentiation.”<-So stem cells need to have high Sox9 expression to become chondrocytes but then levels of Sox9 need to increase to undergo endochondral ossification.
“we also explored the effect of Sox9 on skeletal development using the fetal limb culture assay. The skinned fetal limbs were isolated from mouse E18.5 perinatal embryos and cultured in the organ culture medium in presence of AdGFP, AdBMP2, and/or AdSox9 for 14 days. The limbs were infected with indicated recombinant adenoviruses effectively at day 5. On histological examination, both BMP2 and Sox9 induced chondrocytes proliferation and condensation. However, only BMP2 induced chondrocyte hypertrophy and ossification. When the limbs were co-infected with AdBMP2 and AdSox9, the proliferating chondrocyte zone was expanded with no obvious expansion of hypertrophic chondrocyte zone”
“combined treatment of BMP2 and Sox9 had the largest length of proliferating chondrocyte zone, while BMP2 alone exhibited the largest length of hypertrophic chondrocyte zone”<-So you’d be taller if you just had BMP2 and not Sox9. This link is supported by genes such as Twist1 which supress Sox9 but which overexpression increases height.
” Sox9 alone was insufficient to induce MSCs chondrogenic differentiation, but required other growth factors, such as Sox5, Sox6, IGF1, FGF or TGF-β”
“transient overexpression of Sox9 using adenovirus vector was insufficient to induce chondrogenic differentiation of MSCs.”<-So you need sustained expression of Sox9 to induce the initial chondrogenesis.
“exogenous overexpression of Sox9 in BMP2-induced osteogenic differentiation of MSCs showed a significant decrease in the levels of Runx2 expression, sequentially with delayed osteogenic differentiation, and endochondral ossification. Apart from overexpression of Sox9, silencing or removing Runx2 might achieve a similar outcome in BMP2-induced MSCs differentiation.”<-Alternatively inducing Runx2 after chondrogenesis has been inducted by Sox9 might be the right way to get the chondrocytes back on track to endochondral ossification.
Given that you start with an initial pool of progenitor cells to form a growth plate(although the idea with LSJL is to create new progenitors), to maximize height growth you want to maximize the growth per progenitor cell via increasing expression of genes like CNP and Twist1. After this pool is exhausted how much growth you get per cell is less important as any growth is better than zero so it’s more important to induce this initial expression of Sox9 to get the right kind of cells in the first place.
Here’s a study about Notch inhibiting Twist1 which inhibits Sox9:
Notch inhibits chondrogenic differentiation of mesenchymal progenitor cells by targeting Twist1.
“Notch inhibition of chondrogenesis acts via up-regulation of the transcription factor Twist1. Upon Notch activation, murine limb bud mesenchymal progenitor cells in micromass culture displayed an inhibition of chondrogenesis. Twist1 was found to be exclusively expressed in mesenchymal progenitor cells at the onset stage of chondrogenesis during Notch activation. Inhibition of Notch signaling in these cells significantly reduced protein expression of Twist1. Furthermore, the inhibition effect of NICD1 on MPC chondrogenesis was markedly reduced by knocking down of Twist1. Constitutively active Notch signaling significantly enhanced Twist1 promoter activity; whereas mutation studies indicated that a putative NICD/RBPjK binding element in the promoter region is required for the Notch-responsiveness of the Twist1 promoter. Finally, chromatin immunoprecipitation assays further confirmed that the Notch intracellular domain influences Twist1 by directly binding to the Twist1 promoter.”
“Twist1 is developmentally expressed in mesoderm-derived embryonic tissues and postnatally in adult mesoderm-derived mesenchymal stem cells, where it functions as a major regulator of mesenchymal cell differentiation”
“mRNA expression of both Col2a1 and Agc1 in NICD1-expressing cells was down-regulated at time points 3–7 days, in which NICD1 protein expression was highly expressed, suggest an inhibition of cartilage matrix synthesis at that stage.”
This Non-Prescription Supplement Has Been Scientifically Proven To Make You Grow Taller Even With Closed Growth Plates
The other day I read an article in a business related website from a well known financial writer that it is next to impossible to change people’s behavior. The internal inertia within people (described as entropic entities) suggest that on average, humans will always choose the path with the least resistance, that require the least bit of energy or effort. It turns out that the way to change a person to adjust their lifestyle and their behavior is either through giving pain which is a form of operant conditioning after they correct behavior, or you give the person who might only make the smallest of effort a series of easy wins in the beginning. Apparently the early wins create a type of reward or positive feedback loop pathway. It causes the release of dopamine which makes people want to continue to do the new behavior, as opposed to falling back onto their old behavior and habits. So, I’m going to take that advice and help you guys get a small win. This will be one of the first posts you will see when you arrive to our website Natural Height Growth.
So I guess it is time to just tell the people who visit this website the first, and probably the only, real supplement or pill that has been scientifically proven to increase height in people, even if they have no hyaline cartilage left between their secondary and primary ossification centers (aka growth plates). I once wrote in a very early post about the people’s desire to find some type of magic pill that will make them taller without pain, effort, and maybe just a little bit of money spent (Read the post “There Is No Magic Bullet“). Well, today I’ll tell the people that there is just one type of pill. I am not joking or lying to you guys. This pill will make you grow taller even with closed growth plates. We would never make false claims about just things, since that is not the culture and style of this website.
Caveat: Of course, there is just a slight “catch” about this pill, which I will state at the very end. (If you have been trying to get taller before, you already know the “but” part however the ending is reserved for beginners, people who are just starting out and looking for something that can give them some hope and encouragement in the beginning.)
So what is this pill?
– Glucosamine Sulphate –
At what dosage? 1500 mg
Yes, that’s right. This is one of the most common non-prescription supplement pill which you probably have seen at your local Costco which lets you buy it in bulk. It has been proven to be not just good for your joints in removing the pain from such cartilage degenerative diseases as osteoarthritis, but also has been shown with almost conclusive evidence to help people increase their height, even after all of their epiphyseal growth plate cartilage has disappeared from endochondral ossificationcompletion. However, it does not increase height in the way that most people are led to believe.
(Note: Yes, the link above is an Amazon Affiliate Link. If you are kind enough to buy the pills, or anything from Amazon through that link, the website will get about 6-7% commission from your purchases.)
What are some possible side effects?
First we note that all supplements are drugs. Let’s remember how our old D.A.R.E course back in middle school defined the term “Drug“. A “drug” is any type of substance , besides food and water, you put in your body that will alter the state of your body or mind. All drugs, taken at high enough dosages can become toxic and start to hurt your body. Even food and water can do that. Remember the story of that woman who died from Dihydrogen Monoxide Poisoning a few years ago trying to win a car? So, our recommendation is this. DO NOT Overdo the dosage. It is asinine to believe that swallowing 5 of these pills in one day is somehow better than just 1. The side effects that are most common has been upset stomach and indigestion. Those are however benign adverse reactions. Also, refer to the WebMD article on Glucosamine Sulfate.
Our Thoughts and Explanations
More than a year ago, we had already questioned the efficacy of this one supplement, and the results and feedback we got about the effectiveness of this supplement in the post “Increase Height And Grow Taller Using Chondroitin And Glucosamine (Breakthrough?)” showed that there was already a lot of interest and belief that this supplement does seem to work. The video we had uploaded was a guy who explained that he managed to increase his height by upwards of even 1.25 Inches (3 cm) from the supplement. (Note: We originally had made a conversion mistake and said that 1.25 inches was 4 cms, but recently corrected it. It is closer to 3 cms)
We reposted that video below so you guys won’t have to scramble around trying to figure out where we have been getting our information from.
Even I started to take the Glucosamine Sulphate in the middle of last year. I wrote about it back in the monthly update post “May of 2013 – What I’ve Been Doing“. I had measured myself and I also noticed around 2-3 millimeters of height increase after 2 months of oral supplementation. I would say that the increase was probably not because of measurement error. I made sure to get about a dozen measurements using mirrors and rulers. That was when I shaved my head and was swimming on a regular basis because I was living back in the US, after traveling around Asia the last year and a half.
The Scientific Proof and Studies
If you guys have any doubts about the scientific proof of this claim, Click Here and you’ll get a copy of the PDF of the randomized, double-blinded, placebo controlled study. The title of the paper is “Effects of Glucosamine Sulphate on Spinal Height: A Randomized, Double-Blinded, Placebo Controlled Pilot Study”
One of the authors of this exact study is Dr Peter McCarthy, from the Welsh Institute of Chiropractic at Glamorgan University, who carried out the study. It is the exact study that was referenced by our older post about the effect of using Glucosamine with Chondroitin. The reference we are talking about was written on the Daily UK Website entitled “Can a pill make you taller in four weeks?” maybe 3 years ago.
The results showed that on average, a person would gain around 2-4 mm of extra height from taking the pill on a regular basis for upwards of 4 weeks. This is assuming that they don’t do anything else to help with the height gain.
The Catch: The pill probably won’t give most people the type of extra height that they would hope for. When we get messages from people asking for help, they ask for usually 4-5 inches. If people are hoping to turn from a Messi into a Peter Crouch, they are going to be severely disappointed. The maximum one would ever expect from this type of pill form of grow taller technique is probably 2-3 cms, but I know quite a few people who have paid almost $100,000 to get just 5 cm of extra height from going through with limb lengthening surgery. (Click here to listen to our interview with Andrew, who did 9 cms of extra height in his femurs through surgery)
So if you are interested in possibly getting upwards of even 3 cms of extra height which might be more permanent that most people would believe, then this pill is the best, cheapest, most convenient option at the current time. This is as close to a cheap form of magic pill as we are probably going to ever get, at least for the next few decades.
Remember that for most people, getting 3 cm is probably very abnormal without other factors included. The extra rewards will require more than just popping a pill into one’s mouth every night before sleep. It won’t be that easy. You will be required to do some types of stretching/decompressing of the vertebrate discs exercises to get more height. Refer to our other post “Restore Spinal Disk Height And Increase Height Temporarily Through Land Based Supine Flexion“. This will get one’s lower back/lumbar intervertebral discs to become fully straightened out/decompressed.
Future Research: There have been claims that Chondroitin, Hyaluronic Acid, and Heparan Sulfate would also work, but let’s just start off by taking this supplement for now, and worry about other supplements for a later time.
The study says that with age there is a decrease in glycosaminoglycan in the iVD.
The authors state that glucosamine can affect the height of normal spinal height of non arthritic population. The authors speculate that this may be a result of reduction in dirunal shrinkage.
“Both the glucosamine sulphate and the placebo were supplied by Health Perception (UK) Ltd and were identical in appearance and packaging. The active tablets contained 500 mg of glucosamine sulphate with potassium chloride. In addition, both the active tablets and the placebo contained microcrystalline cellulose, di-calcium phosphate and magnesium stearate. It was necessary for all participants to take three tablets per day of their respective treatments so that those in the glucosamine group would be taking 1500 mg day of the active substance.”
This study found that glucosamine had no effect on cartilage parameters:
Assessment of the effect of glucosamine sulfate and exercise on knee cartilage using magnetic resonance imaging in patients with knee osteoarthritis: A randomized controlled clinical trial
“Osteoarthritis (OA) is a chronic disease characterized by the focal deterioration and abrasion of articular cartilage. The goals of therapy are preserving normal joint function, relieving pain and improving quality of life (QOL). This study is performed to investigate whether glocosamine sulfate and exercise could both delay joint structure degradation evaluated with magnetic resonance imaging (MRI) and improve symptoms in a short time period. Materials and methods: Thirty-nine women with the diagnosis of knee OA were enrolled in the study. Patients were randomized into two groups. Group I (n=20) received an exercise program, while group II (n=19) received glucosamin sulphate (1500 mg/day) in addition to the exercise therapy. Both groups were treated for 12 weeks. The patients were evaluated before and after the treatment regarding pain, disability, functional performance, muscle strength, QOL, depression and MRI findings (cartilage volume, medial and lateral cartilage thickness{If these increase it could be an indication that height could increase}). Results: Both groups showed significant improvements in pain, disability, functional performance, QOL and depression with no statistically significant difference between the groups after the therapy. While there were significant improvements for all MRI parameters expect right knee cartilage volume and lateral cartilage thickness in two groups, statistically significant differences could not be demonstrated between the groups after the therapy. Conclusion:We found no additional effect of glucosamine in delaying the radiological progression and relieving the symptoms of OA. We also demonstrated that exercise alone was adequate to prevent structural changes and cartilage loss of the knee joint as assessed by MRI. Level of evidence: Diagnostic study (prospective study).”
This study did find a difference:
Effects of Chondroitin and Glucosamine Sulfate in a Dietary Bar Formulation on Inflammation, Interleukin-1β, Matrix Metalloprotease-9, and Cartilage Damage in Arthritis
“This study examined the effects of chondroitin sulfate (CS) alone and CS plus glucosamine sulfate (GS) in a dietary bar formulation on inflammatory parameters of adjuvant-induced arthritis and on the synthesis of interleukin-1β (IL-1β) and matrix metalloprotease-9 (MMP-9). Following 25 days pretreatment with dietary bars containing either CS alone, CS plus GS, or neither CS nor GS, rats were either sham injected or injected with Freund’s complete adjuvant into the tail vein. Rats were fed their respective bars for another 17 days after inoculation. Parameters of disease examined included clinical score (combination of joint temperature, edema, hyperalgesia, and standing and walking limb function), incidence of disease, levels of IL-1β in the serum and paw joints, levels of MMP-9 in the paw joints, paw joint histology, and joint cartilage thickness. Treatment with CS plus GS, but not CS alone, significantly reduced clinical scores, incidences of disease, joint temperatures, and joint and serum IL-1β levels. Treatment with CS alone and CS plus GS inhibited the production of edema and prevented raised levels of joint MMP-9 associated with arthritis. Similarly, CS alone and CS plus GS treatment also prevented the development of cartilage damage associated with arthritis. Combination CS plus GS treatment in a dietary bar formulation ameliorates clinical, inflammatory, and histologic parameters of adjuvant-induced arthritis. The benefits of CS and GS in combination are more pronounced than those of CS alone. The reduction of arthritic disease by CS plus GS is associated with a reduction of IL-1 β and MMP-9 synthesis.”
“Glycosamine is an amino-monosaccharide present in connective and cartilage tissues that contribute to the maintenance, resistance, flexibility, and elasticity of these tissues. This study aimed to determine the in vivo effects of glucosamine sulphate (GS) on the temporomandibular joint (TMJ) of ovariectomised rats (OVX).Thirty-two rats were distributed into four groups as follows: G1, sham-OVX + saline solution; G2, sham-OVX + glucosamine sulphate (80 mg/kg) – oral administration; G3, OVX + saline solution; G4, OVX + glucosamine sulphate (80 mg/kg) – oral administration. Animals were treated for seven days. The TMJ was removed and stained with toluidine blue. The thickness of the cartilage layers and cytokines IL-1β, IL-6, and TNF-α levels were determined by histomorphometry and immunoassay, respectively. The administration of GS to OVX females did not change the thickness of condylar cartilage when compared with the other groups (p > 0.05). There was an increase in the total cartilage thickness in sham-OVX females. IL-1β and TNF-α levels were significantly lower in sham-OVX females than in OVX females, indicating that ovariectomy acts as potent cytokine inducer. IL-6 levels were significantly higher in sham-OVX females. GS did not affect cytokine production in OVX females (p > 0.05). In conclusion, the administration of GS did not affect cytokine levels, but did induce an increase in the total thickness of the TMJ condylar cartilage in sham-OVX rats.”
It may the type of glucosamine that affects whether it works or not
“Osteoarthritis (OA) of the knee is one of the main causes of mobility decline in the elderly. Non-surgical treatments such as administration of supplements to strengthen the joint cartilage matrix have become popular not only for pain relief but also for joint preservation. Glucosamine has been used in many countries based on the increasing evidence of its effectiveness for OA. Although there are many previous studies and systematic reviews, the findings vary and different conclusions have been drawn. We aimed to review recent randomized controlled trials on glucosamine for knee OA to reveal up-to-date findings about this supplement. We also performed a meta-analysis of some of the outcomes to overcome the unsolved bias in each study. Eighteen articles written between 2003 and 2016 were analyzed. Many used visual analogue scale (VAS) pain scores and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which were assessed in our meta-analysis. We found a marginally favorable effect of glucosamine on VAS pain scores. The effect on knee function, as measured by the WOMAC, was small and not significant. A newly established knee OA scale, the Japanese Knee Osteoarthritis Measure (JKOM), is commonly used in Japan. Although the number of subjects was small, the JKOM meta-analysis indicated that glucosamine is superior to a placebo in alleviating knee OA symptoms. Given this, we concluded that glucosamine has the potential to alleviate knee OA pain. Further studies are needed to evaluate the effect of glucosamine on knee function and joint preservation, as well as to evaluate the combined effect with other components, such as chondroitin.”
“Two important reviews, Cochrane review in 2005 and the review by Eriksen et al. in 2014, reported the importance of the brand of glucosamine to explain the variance and that the studies using the Rottapharm/Madaus product showed statistically significant effects on knee OA symptoms, while other glucosamine products failed to prove their effects“
” the use of the prescription formulation of patented crystalline glucosamine sulfate (Rottapharm/Madaus product) and chondroitin sulfate”
In the spinal height study the subjects did perhaps a crystalline form.
“Insulin-likeGrowthFactor2 (IGF2) belongs to the IGF/Insulin pathway, a highly conserved evolutionarily network that regulatesgrowth, aging and lifespan. Igf2 is highly expressed in the embryo and in cancer cells. During mouse development, Igf2 is expressed in all sites where hematopoietic stem cells (HSC) successively expand, then its expression drops at weaning and becomes undetectable when adult HSC have reached their niches in bones and start to self-renew. In the present study, we aim to discover the role of IGF2 during adulthood. We show that Igf2 is specifically expressed in adult HSC and we analyze HSC from adult mice deficient in Igf2 transcripts. We demonstrate that Igf2 deficiency avoids the age-related attrition of the HSC pool and that Igf2 is necessary for tissue homeostasis and regeneration. Our study reveals that the expression level of Igf2 is critical to maintain the balance between stemcell self-renewal and differentiation, presumably by regulating the interaction between HSC and their niche. Our data have major clinical interest for transplantation: understanding the changes in adult stem cells and their environments will improve the efficacy of regenerative medicine and impact health- and life-span.”<-This is interesting as we would except increasing IGF2 levels to be anti-aging but stimulating existing stem cells with IGF2 could potentially help stimulate new growth plate formation. Stem cells are supposed to be used so decrementing that pool to use them for functions is not necessarily a bad thing.
“[IGF2] is highly expressed in all sites where hematopoietic stem cells (HSC) successively migrate and expand during development ”
“In adult mice, Igf2 appears to be re-expressed in specific cell types during regeneration ”
“As a potent mitogen, IGF2 has been shown in vivo to promote regeneration of tissue mass by increasing cells numbers, and in vitro to expand fetal and adult stem cell populations.Insulin-like growth factor 2 expressed in a novel foetal liver cell population is a growth factor for hematopoietic stem cells. An increase in IGF2 can lead to organ overgrowth ”
“deleting the main paternal Igf2 transcription unit in mice, results in Igf2 deficiency and growth retardation ”
IGF2-deficient HSC may have deregulated interaction with their bone marrow stem cell niche.
IGF2P2 is an IGF promoter.
IGF2P2 deficiency decreased the mobilization of stem cells and progenitors which resulted in higher anchoring of IGF2B2 cells to the BM stroma so again less stem cells being used.
The scientists found that lower IGF2 levels resulted in lower differentiation. So maybe you only want high IGF2 levels during short bursts of time to allow HSCs to recover.
In this recent post, Michael indicated that he thought that LIPUS would not help the longitudinal growth of bone. However, only certain MSCs expressing CMF608 may be able to form new growth plates. Since LIPUS is a form of mechanical stimulus and CMF608 is sensitive to induced expression by mechanical stimuli, LIPUS may still be able to form new growth plates.
“Among MSCs, adipose stem cells (ASCs) are attractive because of accessibility, their large number, and rapid growth. Common in vitro protocols successfully induce chondrogenic differentiation by expression of multiple cartilage-specific molecules. However, transforming growth factor β (TGFβ) promotes chondrogenesis to terminal stages{which is good for us because that’s what happens in the growth plate to cause longitudinal bone growth}.
In this study, we focused on inducing chondrogenesis in the early stages of differentiation by using low-intensity ultrasound (LIUS). Four groups of ASC pellets (control, ultrasound, TGFβ, and ultrasound/TGF) were cultured under chondrogenic (10 ng/ml of TGFβ3) and ultrasound conditions (200 mW/cm2, 10 min/day){much stronger stimuli than the study that did not find the length difference 30mW vs 200mW}. After 2 weeks, differentiation was evaluated.
Our data demonstrated that ultrasound differentiated pellets showed increased expression of early chondrogenesis marker, Col2A, than those in TGFβ groups, and Col2B and Col10 expression were more prominent in TGFβ groups. Immunostaining of sections showed Col2 fibrils around lacuna in LIUS and TGFβ treated groups.”
“ultrasound transducer directly on cells like chondrocytes or MSCs [induces] chondrogenesis differentiation.”
“continuous wave at 1 MHz [for ultrasound]”<-the other study was pulsed wave. Which is surprising as usually pulsed wave results in more beneficial effects on chondrogenesis and/or longitudinal bone growth.
“ASCs were isolated from subcutaneous adipose tissue taken from the knee”<-ASCs have slightly different properties than MSCs. Also, the ASCs were taken from the knee which would have different properties than stem cells in the epiphyseal bone marrow.
“LIUS produces Col2A more than Col2B. Type IIA collagen is the splice variant of type II collagen that has been found in prechondrocytes and immature chondrocytes.”
“There are major differences between studies of this kind, therefore discrepancy of results could be caused by differences in the cell source, with or without scaffold, and LIUS stimulation mode, particularly transducer–cell distance.”<-explanation as to why the study mentioned by Michael does not indicate that LIPUS cannot aid with longitudinal bone growth. We wouldn’t be able to affect with or without scaffold(but we could affect the properties of bone via supplements & exercise). We wouldn’t be able to alter cell source. We could alter LIPUS stimulation mode and potentially transducer-cell distance.
How Orthopedic Surgeons Performing Limb Lengthening Surgery Are Making Over 8 Figures A Year In Salary
After this recent podcast posting I did with Andrew on his experience with going through with cosmetic surgery to gain almost 4 inches in extra height, I started to become interested in wondering “just how much money do this doctors make on average, annually?”
I decided to do some “back of the envelope” calculations and if my values are accurate, then orthopedic surgeons who perform the limb lengthening surgery may be the highest paid medical specialty in the world.
About a month ago, I was trying to find information on which medical specialties make the most out of all the medical professions. It turns out that from all the sources I’ve found online, orthopedic surgery is consistently ranked the highest paid specialty. The average values that are usually raised are about $430,000-$450,000/ year in earning for guys who work with the spine specifically. (source 1, source 2, source 3)
There was one resource (here) , which a different value, putting the average earnings much higher, at $710,000/ year.
We find that orthopedic surgeons who perform specifically on the spine makes even more than neurological surgeons and cardiovascular surgeons. I guess the old image of brain surgeons and heart surgeons was not as financially beneficial as we are made to believe. They may be within the top 3, but are not at the top. That goes to spine surgeons.
If we are to assume that the average non-spinal orthopedic surgeon (hip & joint) was making about $600,000, then having a ranking of being an excellent surgeons would increase that salary upwards by 30%, making their earnings to be around $1,000,000/year.
Now these guys are reaching the level of earnings only seen in Investment Banking ($1-$3 Mil/year), Senior Partners at Mckinsey ($2-$4 Mil/year), and Senior Partners at Wachtell, Lipton, Rosen & Katz($4-$8/year). Only Hedge Fund Managers and Major Movie Stars (and directors) have a higher earning potential per year, and those entertainment guys don’t have the same level of stability has guys in consulting & finance. However, there is a few unique breeds of physicians whose earnings rival even the guys in finance, consulting, and law practice. That is what we are talking about here.
I was recently watching the TV Show House MD, in the 2nd season in the episode “The Mistake“, A surgeon that house tries to bribe (and then blackmail) mentions his salary at the hospital. It turns out that even one of the worst surgeons in the hospital who performs liver transplants makes around $600,000 on average. Obviously the show is not based on reality, but the producers and writers of the show try to be accurate on those types of figures when they do their research, especially for a medicine based tv show. So let’s assume that the value the actor playing the doctor speaks of is reasonable, at $600,000. Of course this was back in 2005, so we would have to take into account the 3-5% increase annually of physician salary to keep up with inflation over the years, even accounting for the factor of the major economic depression of 2008-2009. This is the first indicator that the salaries of surgeons in general are very high. So we can already assume that really good physicians at major hospitals are bringing in already almost 7 figures a year. I remember an anecdote about the highest paid physician in Canada, and his/her earnings per year was around $4-5 Mil/Year.
Something that doctors don’t tell their patients is their salaries, but one well known fact is that doctors who do their own private practices, instead of working in hospitals, clinics, and teach make the most money, but only if their private practice is doing very well with a good marketing department. So let’s increase that factor by another 30% for surgeons.
My own dentist back in Bellevue, WA (one of the richest regions of the USA because of Microsoft, Bill Gates and Jeff Bezos who both live in Medina) was making half a million a year herself from good marketing which she paid for years ago after finding a firm to advertise her services. She was the only dentist with a medical staff of half a dozen dental hygienists, which doesn’t include the front desk people who do all the accounts and billing.
Something that most people who never went to Med School know about is this test called Step 1, which is the first version of the USMLE. It is based on the score you get in this one grade which determines which specialties you can apply and/or get into. The cut off point for passing is around 190 currently but to be considered for the best, highest paid specialities you need to have a score of around 240 usually, with the highest almost always being Plastic Surgery in recent years. What happens is that this three digit number is the best indicator of which residency programs that you would be even matched with. Matching is one of the most interesting processes medical school grads will ever half to go through. You fly around the country, or even other countries to interview with perspective residency programs so that you get to interview the programs/clinics/other physicians and they get to interview you. It really is very much like dating, but only there is no chance that you will end up naked in a hotel room at the end of the interview with the other people (unless it went really, REALLY well).
It might be interesting to ask oneself why is it that plastic surgery matching requires such a high step 1 score. (Read Successfully Matching Into Surgical Specialties: An Analysis of National Resident Matching Program Data). At this point, I guess cosmetic surgery is one of the most lucrative specialties with extremely high payoffs. We know that almost all types of cosmetic surgeries requires that the patient completely pay out of their own pocket. I don’t know any medical insurance plans which cover it. The only medical situation where I would guess is if one decides to use the medical excuse of a deviated septum causing sleep apnea to get a rhinoplasty but even that requires that a person use a medical reason first to justify their desire to get it just for cosmetic reasons.
I’ve been living in the Gangnam area of Seoul for almost a year and a half and I know personally very well just how lucrative plastic surgery can be. A 2 Hour surgery can be a total of $50,000 (and upwards) out of pocket. The BK Hospital based in Nonhyeon-Dong in Gangnam-Gu of Seoul is probably is the most famous and has surgical clients fly in from every corner of the world to go there for their excellent service and high quality of surgeons. There is no insurance, no discounts, just you and your bank account.
If we then combine the specialty of orthopedic surgeons and plastic surgery surgeons together, we create the most lucrative medical specialty there probably has ever existed, cosmetic orthopedic surgeons. Cosmetic Orthopedic Surgeons focus mainly on limb lengthening surgery and helping their clients to become taller. That fact is that even in Seoul, Gangnam there is still only maybe a dozen surgeons who are focusing on this micro-niche of surgical speciality.
Andrew has said that the combined total of his surgery with rehabilitation, room and board, etc. was about 70,000-80,000 Euros. That amounts to around $100,000-$110,000 USD. If Andrew wasn’t from Singapore, which is probably the richest country in the world (maybe Monaco is slightly more), then there is probably no way he would have been able to afford this type of surgery.
That was where I started to do actually do my back of the envelope calculations. The average american worker has an hourly rate, and we take that hourly rate and multiply it by a factor of 2000 to figure out how much their yearly income is. If we just took the $50,000 someone like Dr. Betz makes per surgery, and multiple that by 2000, that comes out to $10,000,000 income per year.
If instead we assumed that Dr. Betz himself did all of the real surgery, then he probably can only perform 1-2 surgeries every working day. If we then multiple the cost of each surgery, at $50,000 with the number of surgeries performed each day, at about 1.5, and then multiple that value by the number of days a person in either the USA or Germany works, around 200 days per year, that comes out to be $50,000*1.5*200 = $15 mil / year.
If we consider the fact that the most well known limb lengthening doctors like Paley, Betz, and Ilizarov have their own clinics and medical centers named after them, then it is not that unreasonable to assume that the best cosmetic orthopedic surgeons are bringing in 8 figures a year consistently. Of course that type of income would only come if one chose the right specialty in the beginning and they went into private practice for themselves, and they would need to chose cosmetic surgery since that would mean that there would be less hassle with the medical insurance people. Forget Insurance, Forget HMOs, Forget PPOs. The people who go to these medical also have to sign NDAs and medical legal forms which completely take away the possibility that the patient can fill lawsuits against the doctor if something goes wrong.
Cosmetic Surgery is notorious for the fact that unlike most other medical practices, there is very little blame on the surgeon, so any problems and complications would not affect them. The medical staff require that the patient understands all of the types of complications that they are likely to experience and makes the patient sign off the chance that the limb lengthening clinics would be legally responsible for surgeon/human error in the operating room.
For course I would guess that the medical doctors don’t pocket the full 8 figures. Half of that probably goes to paying their medical staff, the rent on the land for the clinic, the medical equipment, the annual licensing. At the end, His 8 Figure Salary gets reduced to about $3-5 Mil/year. Nice enough to get two summer homes. Dr. Betz may not be a Michael Bloomberg or Rupert Murdoch who can own their own private jets but he would be earning as much as most CEOs of major Fortune 500 Companies, minus the ridiculous stock options and yearly end bonuses. For limb lengthening surgery, the niche is still sort of like the Old Wild West.
So is there any other type of medical speciality that would be comparable to what these guys do?
I thought about the possibilty of transplants, specifically liver, pancreas, heart, bone marrow transplants. On the website National Foundation for Transplants, we find out that the cost of getting these are in the millions.
I am reminded on what happened with Steve Jobs during the 2007-2009 time period after he found out that he had pancreatic cancer. He eventually got the Liver transplant. His name probably got bumped up the list because of his superstar status, his name, and his financial resources. For him, a $2 Million Liver Transplant doesn’t mean too much since Job’s Net Worth was around $5 Billion at the time, when the Iphone and Smart Phone market was still growing at a geometric rate.
So would a cardiac surgeon who regularly performs heart transplants make as much as a limb lengthening orthopedic surgeon? I would say no.
I remember volunteering for a professor who was doing research on plastic surgery after my Junior year in my undergraduate degree. I worked with three other research interns, who were both in the Pre-Med route. One of them had already gotten accepted to Duke Medical School and the UVA School of Medicine. The other was already in Medical School. The one already in medical school expressed to me about how he was one of 6 kids to a Gyno/Obstretrician who had his own private practice. His father who had been a OB/GYN for 30 years had over the last couple of decades been squeezed by the medical insurance companies making his practice and his life a living hell.
Now imagine that situation and multiple it by 3X to understand the malpractice insurance hazards of those physicians who perform heart transplants and liver transplants. With a limb lengthening surgery, it takes you about 4-5 hours to perform one. With a Heart transplant, because you are going to have to literally crack open the sternum, and rip open the chest, it would take usually 10-12 hours of surgical time. Add in the fact that you probably have 3 surgeons performing the surgery, 3 anesthesiologists, and a few nurses on call, and the idea of making slightly more than the low 7 figures goes out the door.
As a cardiac or neurological surgeon, you will make 7 figures, but you are restrained by the rules created by the medical insurance companies forcing you to pay for malpractice and liabilities. If you go with cosmetic orthopedic surgery, you can potentially reach in the 8 figures range.
Natural Height Growth Podcast, Episode 12 – Andrew Tells His Story On Getting Limb Lengthening Surgery
It has been so long since I’ve uploaded a podcast episode that I sort of actually forgot the process on how it was done. It took me about 2 days and 5 hours to remember all the steps and there might be a few things I left out so this post will probably be corrected and edited over time.
Episode #12: Andrew Comes On To Tell His Story of Getting Limb Lengthening Surgery and Answers Questions
Andrew is a currently a young man in his early 20s who went through with the Limb Lengthening Surgery to gain almost 4 inches in height. He went from 1.69 Meters tall (about 5′ 6″) to 1.78 meters tall (about 5′ 10″), gaining a full 9 cms in extra height. In the podcast, he explains how he was able to get up to 9 cm in extra height, the complications he went through, and the type of changes from other people he noticed after he got the surgery.
To can also get in contact with andrew through his website. His official website is at LegLengthening.Blogspot.Com. It is a free, image based blog similar to Tumblr. We clipped a few of the pictures he uploaded to the website and got the X-rays where the internal nails were still inside his inter-medullary cavity. The picture to the right is of him with the legs shown before the surgery. To see the after pictures, go to the website.
The X-Rays shows how much his femurs have been lengthened after 78 days after the surgery from clicking the internal nail.
After seeing how thin the rods are from the picture to the left, we sort of understand why the rods for him snapped in half cleanly. They do seem to be quite thin.
We note the diagram to the right where Andrew gives us a clue on how the surgical procedure is performed, based on his understanding. Something that I did not ask him in the 2nd version of the interview as whether the surgeons used a hammer and chisel to make the first incision or used a thin saw. It seems that for Betz, he used an electric saw to cut through the bones.
We see that the initial holes to insert the titanium rods are made to the back in the buttocks area.
Here is the video we found on him from his Youtube Channel TheAndrewshizzles showing how much his femur bones have healed and the types of movements that he can now perform.
Some major websites, people, and places mentioned include….
Make Me Taller (.org) Forum – You get multiple reviews of the dozens of doctors around the world who perform this specific type of cosmetic surgery.
You can find his limb lengthening diary on the MMT Forums from the thread “Andrewshizzles – Internal Femurs – Dr Betz – 2011 – Blitzkrieg For 9 CM“. This was one of the most extensive threads and well written dairies on the entire forum. There was a lot of great support from all the admins there.
Dr. Betz for this particular surgery used his own design, which is often called the Betz Bone Method, which is an extension or derivative on the Albizzia Nail. For the internal methods, there are three variations/versions…
