The Growth Hormone Myth

Animator

Interesting article. I'd like to hear some counter-arguments (but not more lunatical rantings from Dick Pound).

http://www.slate.com/id/2162473/nav/tap1/

The Growth Hormone Myth

What athletes, fans, and the sports media don't understand about HGH.

By Daniel Engber
Posted Saturday, March 24, 2007, at 7:50 AM ET The sports world's latest doping scandal began last month, when federal and state agents raided a seedy office building in Jupiter, Fla., and a pharmacy in Orlando. According to a pair of embedded reporters from Sports Illustrated, the investigators busted up a "massive illegal distribution network" for performance-enhancing drugs; the fallout, they say, "promises to rock sports."

It's worth noting that what SI touted as a "Steroid Sting" has produced very little evidence of, well, steroids. Instead, the disclosures and public shamings have focused on human growth hormone, an almost-undetectable substance that has recently replaced anabolic steroids as the trendy, performance-enhancing boogeyman. SI's ongoing series of reports has fingered baseball players Jerry Hairston Jr. and Gary Matthews Jr., pro wrestlers Edge and the Hurricane, and boxing champion Evander Holyfield for ordering HGH. Even fictional athletes have had their reputations tainted by the stuff. A few weeks ago, Sylvester Stallone, portrayer of Rocky Balboa, was charged with importing 48 vials of synthetic growth hormone into Australia.

The media haven't spent much time making a distinction between HGH and steroids. An AP story, titled "After BALCO, Another Steroid Scandal," glosses over any differences between the two, drawing a straight line from the BALCO investigation to the busts in Florida. But Jerry Hairston isn't Barry Bonds. Sure, both of these guys probably took banned substances in an effort to boost their stats, and both were involved in major drug busts involving large numbers of Major League players. But it's just plain wrong to put growth hormone in the same category as anabolic steroids. In the sports version of the war on drugs, Bonds was shooting heroin while Hairston was smoking marijuana.

What's the difference between steroids and HGH? For starters, we know that a baseball player can beef up on steroids and improve his athletic performance. But most clinical studies suggest that HGH won't help an athlete at all. The other key difference is that while steroids cause a bevy of nasty side effects—testicular shrinkage, an increased risk of stroke—taking HGH doesn't seem to be that bad for you.

If growth hormone doesn't help, why are athletes breaking league rules to get it? And if it doesn't hurt, why are there league rules against it in the first place? Widespread belief in the efficacy of HGH dates back to a 1990 article in the New England Journal of Medicine. A research team led by Daniel Rudman of the Medical College of Wisconsin gave regular growth hormone injections to a dozen men over the age of 60. At the end of the six-month treatment period, the test subjects had denser bones, thicker skin, less fat, and more lean body tissue. The paper likened these effects to a reversal of "10 to 20 years of aging."

The Rudman study soon spawned a mega-industry of rejuvenation clinics and anti-aging drug regimens. Healthy people secrete growth hormone naturally throughout their lifespan, with the highest concentration coming during adolescence. But HGH levels fall off as we get older; 60-year-olds might make half as much growth hormone as they did in their 20s. In 1996, the FDA approved growth hormone as a replacement therapy for adults whose HGH secretions had fallen below normal levels. Since then, immersion journalists have written paeans to the drug that jibe with Rudman's findings. In 2003, a writer for Outside claimed it improved his eyesight and made a scar on his forehead disappear. Last January, a GQ guinea pig said it filled him with "youthful radiance," deepening his voice and renewing his interest in Internet pornography.

Clinical researchers have been a bit less sanguine. You don't need a Ph.D. to find serious flaws in the Rudman study—no one in the control group received a placebo, for example. Still, a recent review in the Annals of Internal Medicine found that better studies have produced similar results: At the very least, treatment with HGH does seem to reduce body fat and increase muscle mass. Growth hormone may not lengthen your lifespan, but it can certainly improve your looks. (While HGH isn't as bad for you as anabolic steroids, it does have some minor side effects. Click here for more information.)

That doesn't mean very much for athletes: A chiseled physique won't help you hit a baseball or throw a punch. So far, no one has been able to connect the increase in lean body tissue caused by HGH with enhancement of athletic performance. Unlike steroids, growth hormone hasn't been shown to increase weight-lifting ability; in the lab, it has a greater effect on muscle definition than muscle strength. And it doesn't seem to help much with cardiovascular fitness, either.

So, why do so many athletes take HGH? One possibility is that the drug really does enhance performance but that the effect is too subtle to measure in a controlled setting. An elite athlete might be able to detect very slight improvements in strength and agility that would be invisible to lab scientists or statistical tests. At the highest levels of sport, a tiny edge can make a big difference. Athletes might also derive some added benefit by mixing HGH with other drugs—anti-aging doctors often prescribe growth hormone in combination with testosterone.

It's also possible that baseball players aren't using HGH to beef up at all. Almost everyone who gets caught red-handed claims they were using the drug to recover from an injury. This might be more than a ploy to win sympathy: Some doctors believe that growth hormone can speed up tissue repair. There isn't much clinical work to support this idea, however. One study even found that HGH actually shortened the lifespan of patients in an intensive-care unit.

The most likely reason that athletes use HGH, though, is superstition. A ballplayer might shoot up with HGH for the same reason we take vitamin C when we have a cold: There's no good reason to think it does anything, but we're willing to give it a try. The fact that the major sports leagues have banned growth hormone only encourages the idea that the drug has tangible benefits. Why would they ban something unless it worked?

This mentality has put doping officials and athletes into a feedback loop of addled hysteria. The World Anti-Doping Agency will ban any drug that athletes use, whether or not it has an effect. The WADA code points out that the use of substances "based on the mistaken belief they enhance performance is clearly contradictory to the spirit of sport." In other words, it doesn't matter if HGH gives athletes an unfair advantage. If Jerry Hairston believes he's cheating, then he really is cheating.

That twisted logic has turned the latest round of busts into a giant PR campaign for growth hormone. Every star athlete who gets caught with a vial of HGH turns into a de facto spokesperson for the drug. In a certain sense, that might be a good thing: The media hype may soon make HGH so popular that it squeezes the more dangerous anabolic steroids out of the market. That's one way to clean up the game.

A version of this article also appears in the Outlook section of the Sunday Washington Post.

Felt_Rider

That is an interesting article, but it seems flawed in some areas as if to "look the other way" when speaking about GH as a possibility for enhanced performance. Implying that GH will help in areas of vanity, but not performance perhaps is not an accurate statement since there are disagreements among researchers.

GH is one drug among PED's that I have not used, but I have been around enough competitors in bodybuilding to visually see a difference within a matter of months to the positive perfomance impact even if it only amount to decreased bodyfat even though the article disputes this claim. (Anna Nicole's autopsy discovered GH present and look how much leaner she looked this past year, where as, she could not get lean in previous years and had struggle with body composition.)

Improved body composition will improve athletitic performance even if there is not an increase in size for lean muscular tissue. Decreasing excess bodyfat in most sports will be beneficial.

Another danger of GH use is the possible introduction to using insulin as an aide to enhance the effects of GH. I do see some truth in the statement that GH works better for some than it does for others. I have heard from a few athletes that they did not feel or perceive enough improvement to justify the risks and the cost. I have one former associate that had always used the typical anabolic and androgenic selection of steroids and weighed a lean 240 lbs in competition, but the year he added GH his lean body mass increased to 275 lbs.. In his sport that was a posititive increase that would be considered performance enhancing.

The other facet that may impact cycling is the offset of GH to cortisol levels. In a heavy training state the body will respond by releasing hormones to react to the stress levels. My understanding of how this works is that GH, cortisol and testosterone try to bind to the same receptor. Cortisol is an antogonist to GH and testosterone and vice versa. Cortisol is considered a catabolic hormone, as far as, most athletes are concerned. For recovery it is more beneficial that the athlete tries to manipulate natural hormone levels to lean more to the side of T (testosterone) and GH than to lean toward an increase in cortisol levels. So if the athlete tries to manipulate these levels naturally through proper nutrition and rest why doesn't it make sense that an increase of synthetic GH will also net the same result. Maybe it will and maybe it won't, but none the less it is not a fair and balanced playing field if an athlete tries to overcome natural inadequacies by simply injecting a synthetic hormone. Even if it does not work for the athlete the intention still proves guilt of dishonesty because the athlete made the effort to bend or break the rules in a tested sport.

Going back to the article (I just finished a conversation on this subject with my personal doctor since we both take an interest on this subject) that it has an air of (HRT) hormone replacement therapy. In our conversation we talked about a senior competitor that is very outspoken against drug abuse calling others "cheaters" when he is on HRT. Doctors are finding a lucrative market for aging men just as plastic surgeons found a market for women desiring enhancement. These doctors are changing the terms each week to make it sound as if this therapy is needed to control aging and to feel better about self. I have talked to several athletes that are on HRT and they sound like a commercial trying to justify why they need HRT. Now where does that line stop in who gets HRT? Does it begin to trickle down from the 50 plus to the 30 year old now being justified by the doctor to receive HRT? Most of these doctors can find a way to twist the tests in order to justify administering a cocktail of designer drugs. The next thing you know everyone in the field of athletes have been approved to use PED's (HRT) not for sport of course, but just to have a healthy life (said with sarcasm).

My two cents for the discussion

mises

The hormone replacement therapy for men looks like a booming market for years to come. Since levels decline starting in late teens and early 20's there is no theoretical reason to draw a line on treatment before they are treating guys in their mid 20's. Nobody seems too concerned that all these hormones are implicated in the growth rates of cancers, or that men die younger than women for a reason which is quite likely related to the differences in male hormone levels.

As far as the benefits I think it's nearly impossible to construct an adequate study to test benefits on recovery from severe exercise. Finding an adequate pool of candidates able to exercise hard and long enough to cause a measurable decline in ability to recover is quite difficult. The typical use of untrained college students isn't going to be able to show anything (and is also the reason why some supposed experts question the need to do 8 hour training rides to be a pro cyclist).

For that matter just the changes in body comp would be a fantastic advantage in a stage race, especially for somebody nicknamed Fat Jan.