Archive for Growth Hormone (HGH)

Why Do Players Take Human Growth Hormone If It Doesn’t Work?

I hear this question quite a bit when I point out that growth hormone does not improve athletic performance. One plausible explation is that players are not well informed on the subject, given that most of their information comes from drug pushers (see Andy Pettitte’s and Chuck Knoblauch’s depositions) and the ill-informed media. But, Justin Wolfers at Freakonomics points to a new study that offers another possible explanation: the placebo effect.

A placebo is a benign substance used in medical trials to control for psychological responses to drugs. For example, a drug given to arthritis patients may cause them to feel better just because they expect to feel better, not because the drug actually worked. Similarly, players who use human growth hormone may notice themselves feeling stronger and more productive after taking a substance that is supposed to have this effect. A colleague of mine who conducts clinical trials on athletes tells me it is common for his placebo subjects to insist they are getting the real stuff.

It turns out that the placebo effect of human growth hormone could be even stronger than previously expected. New research by economist Dan Ariely finds that the placebo effect is exacerbated by the price of the drug.

A higher price can create the impression of higher value, just as a placebo pill can reduce pain.

Now researchers have combined the two effects. A $2.50 placebo, they have found, works better one that costs 10 cents.

The finding may explain the popularity of some high-cost drugs over cheaper alternatives, the authors conclude. It may also help account for patients’ reports that generic drugs are less effective than brand-name ones, though their active ingredients are identical.

Why is this relevant? Human growth hormone is very expensive relative to other performance-enhancing drugs. According to the Mitchell Report, Kirk Radomski charged his clients $1,600 for a one-month supply of human growth hormone, while he only charged $400 for Winstrol.

Radomski typically paid at least $1,000 or more for one “kit” of human growth hormone, which included seven vials of distilled water and the same number of packages of lypholized human growth hormone powder, but the price depended on availability. He generally resold kits for $1,600 each, but in some instances charged less depending on his relationship with the player (pp. 144–145).

Radomski believed he made between three and five sales to [Chad] Allen involving Winstrol, testosterone, and Deca-Durabolin. According to Radomski, Allen could not afford human growth hormone…. Radomski mailed a one or two-month supply of Winstrol to Allen at his home in Texas. Allen paid Radomski approximately $400 by check (pp. 225–226).

Players who use performance-enhancing drugs have a strong reason to believe that a drug that is four-times as expensive as a common anabolic steroid is also going to improve performance. Thus, in light of Ariely’s study, it is not surprising that some players have convinced themselves that human growth hormone is responsible for improved performance.

How Players View Drug Testing

Yesterday, AJC Braves beat writer David O’Brien featured an interview with Chipper Jones and Tom Glavine about blood testing for human growth hormone in baseball. I don’t want to get sidetracked by the fact that it would be a total waste of resources to test for HGH, or that it would make more sense to allow it than to police it; instead, I want to focus on the player’s decision to submit to testing.

I believe that Chipper Jones echoes the sentiments of many major-league baseball players.

“I don’t care,” the third baseman said Tuesday. “I’m not on anything, so it doesn’t bother me. The only people I would say who would object would be people afraid of needles, or who are on something.”

A player who is clean has every reason to want testing, but users may favor testing as well. A substance that is performance-enhancing gives users an edge over non-users, which translates into higher salaries. Players face the choice of using to keep their edge or abstaining and settling for compensation less than equally-talented players who use. Thus, there is a strong incentive to use. In a world where all players use, the end result is that players are no better than one another, yet they incur the expense and health consequences of using. Therefore, it makes sense for players to want stringent testing to stamp out this behavior.

However, there is another side to this, and Chipper is well aware of it.

He added, “I’m sure the players association would have something to say about it.”

Jones was asked about the issue three days after Yankees star Derek Jeter said in a radio interview that he wouldn’t object to a blood test, since players already are required to have blood drawn for physicals during spring training.

“You’re talking about individual guys coming out and saying they wouldn’t mind,” Jones said. “I’m sure if [players union head] Don Fehr sat us down and listed the pros and cons, and what the majority of players thought, it might be different.”

Former union representative Tom Glavine elucidates the cons.

“I’m not going to say it’s never going to change, but I see it as a very thorny issue right now,” Glavine said. “There’s too many potential problems, too many question marks.

“It’s potentially opening up a big can of worms. There’s the potential for so many problems with the way that it’s handled, the way it’s stored.”

Glavine said he could envision a player’s career being ruined by blood sample being tampered with by someone with a vendetta.

“On a personal level, it scares me to think of somebody having my blood and the potential to tamper with it down the road,” Glavine said. “Your career could be ruined, and you wouldn’t be able to do anything about it.”

Urine is urine and blood is blood. These substances yield more information than just the use of performance-enhancing drugs. Players are right to be suspicious about the motives of owners, players, and other associates. This is why I suggest handing over all testing and enforcement to the players. Here is my Op-Ed in the NY Times, and here is post with further explanation. I also discuss this in Chapter 9 of my book.


It’s nice to see the scientific consensus on human growth hormone (HGH) finally reach the general public.

The House Committee that on Wednesday is expected to hear the differing viewpoints of Roger Clemens and Brian McNamee did its pharmacology homework Tuesday, holding a hearing on the “Myths and Facts about Human Growth Hormone, B-12, and Other Substances.”

The consensus from the four doctors who testified: Neither HGH nor vitamin B-12 appears to help athletic performance very much, although much more research is needed on HGH, which also has a litany of unappealing side effects.

“There is no credible scientific evidence that growth hormone substantively increases muscle strength or aerobic exercise capacity in normal individuals,” said Dr. Thomas Perls, director of the New England Centenarian Study at the Boston University of Medicine.

It’s only been ten months since I started my campaign.

How Informed Are Steroid Users?

A question that people often ask me is: if human growth hormone doesn’t enhance performance, then why do athletes use it? My response has been that athletes don’t have the proper information. My guess is that men like Kirk Radomski are spreading false information to push their product.

In the next issue of Time Magazine, Sylvester Stallone weighs in on his own use of testosterone and GH. It is a prime example of how informed users may be.

Playing a guy who acts with only his eyes and his biceps is harder than playing a fast-talking, earnest boxer, especially on a 61-year-old body. Which was one of the reasons Stallone wanted to do it. He pumped up to a freakish 209 lbs. (95 kg); in Rambo II he weighed only 168 (76 kg). And, he insists, he did it without steroids, though with the help of a prescription testosterone. “HGH [human growth hormone] is nothing. Anyone who calls it a steroid is grossly misinformed,” he says. “Testosterone to me is so important for a sense of well-being when you get older. Everyone over 40 years old would be wise to investigate it because it increases the quality of your life. Mark my words. In 10 years it will be over the counter.” He was in such great shape, it freaked out his co-star, Julie Benz. “I’m a runner. I sprint. And I’m extremely competitive. And he blew past me every time. And he doesn’t run at all. He’s that focused,” she says. [Emphasis added]

HGH isn’t nothing. It won’t help you play sports, but it has serious effects on the body. Has he looked in the mirror lately? I’ll give him the benefit of the doubt that he was referring to its strength benefits.

But, it is his comments about testosterone that blew me away. Testosterone isn’t a steroid?

From Wikipedia:

Testosterone is a steroid hormone from the androgen group. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands. It is the principal male sex hormone and an anabolic steroid.

Definition of testosterone from The American Heritage Medical Dictionary:

A steroid hormone and the most potent naturally occurring androgen that is formed by the interstitial cells of the testes, and possibly by the ovary and adrenal cortex, may be produced in nonglandular tissues from precursors such as androstenedione, and is used in the treatment of hypogonadism, cryptorchism, carcinomas, and menorrhagia.

It’s hard to be this badly informed, especially when you consider that the guy built a career off of using the stuff. Maybe the reporter misunderstood him. I wouldn’t be surprised, because it must have been difficult to decipher a collection of grunts and snarls.

Thanks to Craig Calcaterra for the pointer.

Selig and Fehr on Human Growth Hormone

I watched a good bit of yesterday’s Congressional hearing regarding the Mitchell Report. The star of the show was not a person, but human growth hormone (HGH). Bud Selig and Donald Fehr were honest and acknowledged mistakes about the past, but the league and the players union have come along way to develop a system for deterring the use of performance-enhancing drugs. Mandatory random drug testing with fines and suspensions are consistent with what other governing sports bodies employ to deter doping. But the fact that HGH remains undetectable is distracting everyone from the progress that has been made. It is just not that big of a deal. And it pains me that both Selig and Fehr are being blamed for not being able to eradicate a drug that people only think enhances performance.

Here is what Selig had to say.

Senator Mitchell’s report reveals that those who are intent on cheating will continue to search for ways to avoid detection, such as turning to the use of Human Growth Hormone (“HGH”) which is not detectable in a urine test. Perhaps my single biggest frustration in reading Senator Mitchell’s report was in learning that, just as Baseball was putting in place an effective testing program aimed at steroids, HGH use was growing. Just as we have seen our programs effectively reduce the use of steroids in Baseball, I am committed to stop the use of HGH in our sport, as well. Along with the National Football League, Baseball is funding an effort by Dr. Don Catlin, one of the leading drug testing experts in the world, to develop a urine test for HGH, and we will be convening a summit of the best minds in sports and science to develop a strategy to address the use of HGH by players. Just recently, we have joined with the United States Olympic Committee in a new, longterm program of research on performance enhancing drugs. Our initial commitment is for $3 million in funding. When a valid, commercially available and practical test for HGH becomes reality – regardless of whether the test is based on blood or urine – Baseball will support the utilization of that test.

A $3 million initial commitment to detect a drug that even the Mitchell Report declares to be ineffective (pp. 9-10)? [See I Don’t Worry about HGH in Baseball, and Neither Should You for further evidence.] Selig may be acting on many of Senator Mitchell’s recommendations, but he’s got no one to blame but himself on this one. I’d much prefer that MLB allow HGH use, spend some money educating players on how this stuff doesn’t work—and please no more scare-tactic commercials with deflating balls or crumbling statues; these do nothing—and then devote the bulk of those resources to the RBI program. Take HGH off the banned list and send a credible signal to players that this stuff doesn’t work (my plan).

Fehr seemed even more bothered than Selig by the fact that there are not reliable tests for HGH.

Senator Mitchell pointed out that our JDA is indeed working to detect the use of detectable performance enhancing substances. With respect to steroids, the numbers are clear: We have conducted more than 3,000 tests in each of the last two years, and the number of steroid positives we have had during that time is five. More precisely, during 2006 and 2007 we conducted 6,252 tests, and there were five steroid positives (two in 2006 and three in 2007).

But what about undetectable PEDs, most notably Human Growth Hormone (HGH)? We share Senator Mitchell’s concern, and we have acted. Starting in January 2005, we banned HGH. We do not test for HGH, because there is no scientifically reliable urine test available. As soon as one is, our agreement states that HGH testing for players will begin automatically.

Even in the absence of a test, our commitment against HGH is no less strong than our commitment against steroids. We have developed and agreed to procedures which allow players to be suspended for HGH use based on evidence other than a positive test, a so called “non-analytical” finding. In both 2006 and 2007, players were suspended on that basis.

Of course, it is possible that a valid blood test for HGH will be developed before a valid urine test. However, as Senator Mitchell has indicated, if there is a blood test developed in the near future it may well be of very limited utility; i.e. a player will need to have used HGH a very short time before the test in order for it to show up. In addition there are very serious issues involved with blood tests for athletes, particularly on competition days, and in baseball we play nearly every day. As of now, no major professional sport has blood testing for PEDs. If and when a blood test becomes available, we will consider it based on the facts then available.

However, the biggest problem with HGH is very probably its availability to the American public. Anti-aging clinics and others openly advertise in magazines stressing the benefits of HGH. We will continue to take steps against HGH, but this is a societal, not just a baseball problem. If we did not know that before, the investigations into internet pharmacy sales of HGH made public over the last year have made this apparent.

All one need do in order to appreciate the magnitude of this problem is to go onto Google’s website and type in the words, “Where can I buy HGH?” A few days ago this search returned 349,000 options in a quarter of a second. Advertisements for HGH can be found in newspapers and magazines nationwide. For example, in the current Continental Airlines magazine, on page 99, there is an advertisement with the following headline: “Choose life. Grow young with HGH.” Abuse of HGH and other licit (and illicit) pharmaceuticals is not just baseball’s problem.

And I feel for Fehr, because he can’t come out and say that HGH doesn’t work, even if he is aware that of this—I believe that both Selig and Fehr know this. The committee would have laughed him out of the room because he is the enemy. This runs counter to every thing we “know”. He might as well have said that Neil Armstrong never walked on the moon. Instead, he provided a comical advertisement that puts the drug on the same footing as ionic bracelets. Nice tactic, by the way.

And what about the children for whom the representatives showed so much concern? What about them?! Do children buy growth hormone to improve performance? According to Kirk Radomski, the going rate for the drug is $1,600 for a one-month supply. That’s more than most parents’ house payments. Teenagers are not buying HGH to pump up anymore than they are buying $200 bottles of mail order wine to get drunk. There is the role model issue, but this just doesn’t concern me. The world is full of immoral people. Teach your kids right and wrong and get over it. I’m more worried that my children will be influenced by friends and family than baseball players. Anyway, I find Tony La Rusa to be more offensive than any of the players he has ever managed, but I think it would be a bad idea to hold congressional hearing on rampant arrogant jackassery in sports. This is a bigger problem in the role model department for professional sports.

The fact that HGH is undetectable is a problem only if it enhances performance. The evidence is that it doesn’t, so let’s move on. The war on HGH serves as the drug’s best advertisement, and Congress just bought anti-aging clinics a 30-second spot during the Super Bowl. At the next hearing, I hope that Congress invites some clinical researchers who have studied the substance to weigh in.

Missing the Boat on HGH, Again

It’s hard to take MLB serious when it forms a task force to support anti-doping research that includes the following priorities.

• New methods to more cost-effectively detect and deter the use of banned and illegal substances at every level of sport
• Identification and detection of designer substances the consequences of doping, from both a medical and ethical perspective
The further development of a widely-available, cost-effective test to detect Human Growth Hormone (HGH) [Emphasis added]

I have no problem with the first two goals, but why—WHY!—must they insist on continuing the needless war on growth hormone. There is no point in devoting resources to an HGH test, when there is no evidence that the drug improves performance. Why not go after B-12 while they are at it? Even the Mitchell Report acknowledges this.

A number of studies have shown that use of human growth hormone does not increase muscle strength in healthy subjects or well-trained athletes. Athletes who have tried human growth hormone as a training aid have reached the same conclusion. The author of one book targeted at steroid abusers observed that “[t]he most curious aspect of the whole situation is that I’ve never encountered any athlete using HGH to benefit from it, and all the athletes who admit to having used it will usually agree: it didn’t/doesn’t work for them.” (pp. 9-10)

My plan is cheaper and money would be better spent by educating players on the lack of performance-enhancing effects of growth hormone. Instead, we are stuck with this.

Flushing $ down the toilet

My Solution to Rid MLB of HGH: Legalize It

Over the past year, I have written several blog posts about the lack of performance-enhancing properties of human growth hormone. I have not participated in any research on the subject, nor am I even remotely qualified to conduct such studies. Instead, I have relied upon experts in the field, who are in near-unanimous agreement that human growth hormone has little to no impact on athletic performance. Despite the academic consensus, the media has reported on the use of growth hormone by athletes in many sports without investigating the science. I have scolded the media enough—this is not the main point of this post—now, I wish to suggest a policy change to help rid baseball of this product.

The Mitchell Report identifies several players who allegedly purchased and used growth hormone, and it notes that players are moving to the drug from steroids because of the difficulty in detecting its use. Currently, there exists no urine test capable of detecting growth hormone. The popularity of the drug despite its benign performance effects is a paradox. Why do players spend large sums of money, while risking their health and player eligibility, to use a substance that does nothing? This is like sneaking near-beer into a high school prom, without the comedy.

Consider the story of Larry Bigbie, a marginal major league player who reports that he began using steroids during his 2001 rookie season. To Bigbie, it was easy to find a justification to use: it was a “make or break” year, he needed recover from injury to “finish the season strong,” he wanted to “jump-start” his off-season training. I’m sure he has no problem identifying with Michael Corleone—“Just when I thought that I was out they pull me back in.” When random drug testing began in 2004, Bigbie was worried. He was on the hard stuff, and there was a good chance he would fail a test if he kept up his current regimen. Though he originally rejected using growth hormone out of the fear of potential side effects, his desire to remain in the big leagues forced him to switch over to the undetectable substance.

According to the Mitchell Report, “Bigbie did not believe that he was seeing a benefit from using human growth hormone that was comparable to the effects he had seen with steroids” (p. 157). Yet, Bigbie reports buying “five or six kits” from Kirk Rodamski in 2004 and 2005. After being traded to the Cardinals prior to the 2006 season, he contacted Radomski to order more growth hormone “to prepare for spring training.” At this point, the Rodomski was already working with the feds, so Bigbie never got his drugs and also ended up cooperating with the government. This tale is so sad, because we have a player who is using a substance that he thinks is dangerous, and he doesn’t even think it works! We only know about Bigbie because he got caught, but I’m sure that his story is similar to many other players’ experiences.

The point is that players have a strong incentive to gain an edge on each other. This road will inevitably lead many of them to seek out illicit solutions in an area where the experts are the guys who sell the stuff. And when they investigate further, they find prominent sports reporters declaring that HGH is just as effective as steroids. Do you think players are going to search through the scientific literature on PubMed? Heck, if I didn’t share an office suite with exercise physiologists, I probably wouldn’t know any better.

At the end of the day, players are going to take a long hard look at the list of prohibited substances. The fact that these drugs are banned will be sufficient to convince most players that the performance-enhancing benefits are real. The desperation felt by players may cause them to behave like the citizens of Springfield when they were beseiged by the Osaka flu.

Crowd: We need a cure! We need a cure!
Hibbert: Ho ho ho. Why, the only cure is bedrest. Anything I give you would be a placebo.
Woman: [frantic] Where can we get these placebos?

The crowd overturn a truck in search of placebos, but alas the only thing inside is a crate of killer bees.

But human growth hormone isn’t benign. It’s side effects are real and dangerous. The problem is that now that everyone thinks it works, players are driven to take it only to experience the harmful effects. Baseball has a responsibility to get the drug out of the game for the sake of the players.

In order to reduce the use of human growth hormone in baseball, I suggest a two-part plan.

First, the league must educate players about the scientific evidence regarding human growth hormone. Bring in doctors and medical researchers—not league or team officials—to talk to trainers and players. Make up simple pamphlets that show a scorecard of the number of studies showing the performance benefits versus the ones that don’t—it will be an obvious blowout. Explain to these guys that they have been duped. Give players a chance to discuss this with the doctors in confidence, as well as holding public sessions to which the media are invited. Union officials need to be involved, too.

The second and most important step is to pull human growth hormone off its list of banned substances. This sends a credible signal about the efficacy of growth hormone in improving athletic performance. Education alone won’t do it. As a public school student during the “Just Say No!” era, I am well aware that propaganda serves only as comedy to the target audience. As long as human growth hormone remains on the banned list, players are going to assume there is a reason. It is a waste of resources to search for a urine test to remove it from the game. Instead, tell players, “This stuff doesn’t work. If you want to use it, go right ahead and be an idiot. But, don’t complain when you experience pain and swelling and that you have to buy new hats, shoes, and gloves.”

While my libertarian sympathies make it easy for me to suggest legalizing many things, I believe athletic leagues have a strong interest in prohibiting certain performance-enhancing drugs. My desire to legalize human growth hormone has nothing to do with concerns for individual liberty. This is a league safety concern. I feel that legalizing human growth hormone, while publicly explaining the reason for doing so, is simplest and most effective way to discourage players from taking it.

More Reasons Not to Worry about HGH in Baseball

With the Mitchell Report supposedly being released this Thursday, I wanted to post some links to more studies of the performance-enhancing effects human growth hormone (HGH). You can read more here and here.

Short-Term Administration of Supraphysiological Recombinant Human Growth Hormone (GH) Does Not Increase Maximum Endurance Exercise Capacity in Healthy, Active Young Men and Women with Normal GH-Insulin-Like Growth Factor I Axes

Annika Berggren, Christer Ehrnborg, Thord Rosén, Lars Ellegård, Bengt-Åke Bengtsson and Kenneth Caidahl

The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 6 3268-3273

CONTEXT: Despite the fact that the use of GH as a doping agent in sports is widespread, little is known about its short-term effects. OBJECTIVE: The objective was to study the effects of GH on exercise capacity. DESIGN: A double-blind, placebo-controlled study was used, with a treatment period of 28 d. SETTING: Subjects from general community studied ambulatory at a university hospital. PARTICIPANTS: Thirty healthy active young normal volunteers (15 women and 15 men) were recruited by local announcement, and all completed the study. INTERVENTION: All subjects were randomized to receive a low GH dose (0.033 mg/kg.d or 0.1 IU/kg.d), a high GH dose (0.067 mg/kg.d or 0.2 IU/kg.d), or placebo. MAIN OUTCOME MEASURES: Power output and oxygen uptake on bicycle exercise were the main outcome measures. Results: We found no effect of the low or high dosages of GH on maximum oxygen uptake during exercise (mean +/- se for placebo, 45.2 +/- 1.6 to 45.2 +/- 2.1 ml/kg.min; GH low dose, 42.8 +/- 1.6 to 42.8 +/- 1.6 ml/kg.min; GH high dose, 44.8 +/- 3.4 to 44.8 +/- 2.2 ml/kg.min; not significant by two-way ANOVA). Neither was there any effect on maximum achieved power output during exercise or on blood pressure, heart rate, or the electrocardiographic ST level at rest or during exercise. GH significantly increased total body weight (P = 0.028), an effect predominantly ascribed to fluid retention (increased extracellular water volume), whereas muscle mass (as indicated by intracellular water volume) did not change. However, changes in the latter correlated to changes in physical performance, possibly due to different training efforts. CONCLUSION: Administration of supraphysiological recombinant human GH during a period of 4 wk does not improve power output or oxygen uptake.

Supraphysiological growth hormone: less fat, more extracellular fluid but uncertain effects on muscles in healthy, active young adults

Ehrnborg C, Ellegård L, Bosaeus I, Bengtsson BA, and Rosén T.

Clinical Endocrinology, Volume 62 Issue 4 Page 449-457, April 2005

OBJECTIVES: To study the effects on body composition after 1 month’s administration of supraphysiological doses of growth hormone (GH) in healthy, active young adults with normal GH-IGF-I axis. SUBJECTS AND METHODS: Thirty healthy, physically active volunteers (15 men and 15 women), mean age 25.9 years (range 18-35), participated in this study, designed as a randomized, double-blind, placebo-controlled, parallel study with three groups (n = 10: five men and five women in each group). The groups comprised the following: placebo (P), GH 0.1 IU/kg/day [0.033 mg/kg/day] (GH 0.1) and GH 0.2 IU/kg/day [0.067 mg/kg/day] (GH 0.2). RESULTS: In the pooled group with active GH treatment (n = 20) the results showed significant increases: IGF-I increased by 134% (baseline vs. after 1 month), body weight by 2.7%, fat free mass by 5.3%, total body water by 6.5% and extracellular water (ECW) by 9.6%. Body fat decreased significantly by 6.6%. No significant change in intracellular water was detected. The observed increase in fat free mass by 5.3% was explained by the ECW increase, indicating limited anabolic effects of the supraphysiological GH doses. Changes were noticeable in both genders, although more prominent in the male subjects. Fluid retention symptoms occurred in the majority of individuals. CONCLUSIONS: This is, to our knowledge, the first placebo-controlled trial to show the effects of supraphysiological GH doses on body composition and IGF-I levels in physically active and healthy individuals of both genders; the results indicate limited anabolic effects of GH with these supraphysiological doses. The role of GH as an effective anabolic doping agent is questioned.

This paper summarizes the findings of several studies.
Ergogenic aids: human growth hormone.

Stacy JJ, Terrell TR, and Armsey TD.

Current Sports Medicine Reports 2004 Aug;3(4):229-33.

Human growth hormone (GH) has a number of accepted medical uses, but has quickly become a popular ergogenic aid among athletes. The issue of performance-enhancing substances such as anabolic steroids and GH has drawn the attention of athletes, their parents, and politicians. On almost a daily basis, headlines about the status of doping in professional, international, and amateur sports seem to be more pervasive. The supraphysiologic effects of GH lead to lipolysis, with increased muscle volume. Due to the ethical limitations of studying the use of high doses of GH in isolation or combined with anabolic steroids, the scientific literature has not produced compelling results on its efficacy. GH has potential as an anti-aging drug and does lead to some improved athletic performance in isolated studies. Despite the lack of compelling data, GH seems to have developed a reputation among athletes for enhancing performance. The detection of illegal doping with GH has been the focus of a concerted international effort by the International Olympic Committee. A number of promising detection techniques may allow the detection of illicit GH use. This review on GH as an ergogenic aid includes a discussion of the basic physiology of GH and its actions, the accepted medical indications for its use, the results of scientific studies that assess whether it improves exercise performance or work capacity, and the scientific techniques under development to detect ergogenics with strong abuse potential.

From this same study, here is what the authors conclude regarding the ergogenic properties of growth hormone.

There is no current study that has demonstrated a significant increase in workload capacity in response to human GH administration in healthy adults. The studies that have addressed the impact of GH on muscle mass and athletic performance do not show consistently favorable results. For instance, patients with acromegaly do have greater muscle volume than normal individuals, but they do not show an increase in strength or performance. No controlled study to our knowledge has shown a beneficial effect of supraphysiological doses of human GH on muscle strength in trained athletes.

Also, I would like to clarify my motivation for highlighting the evidence regarding the ergogenic impacts of growth hormone. The main reason is that I want to point out where the media has dropped the ball. And, I’m not one of those “it’s the media’s fault” conspiracy nuts. I love the media. Both my parents are former journalists, and my dad was a newspaper editor for over 30 years. I spent a lot of time in The Charlotte News and The Charlotte Observer newsroom(s) as a kid, and I have a lot of respect for what journalists do. Journalism has its share of jerks and hacks, but I suspect it’s no different than in any other profession. This isn’t meant to be a personal indictment of these people.

The reporting on performance-enhancing drugs in baseball has been as much of a black mark on journalism as the actual substances have been for the game, and not because reporters may have given players a pass many years ago. Guys like Brady Anderson and Luis Gonzalez have been accused of using performance-enhancing drugs based solely on a bump in performance, which is outrageous. This is the type of claim that columnists shouldn’t have written and editors shouldn’t have allowed, as there are many alternative explanations for sudden changes in performance.

The reporting on growth hormone has been beyond bad. There has been a grand total of two articles on the scientific evidence regarding the performance-enhancing effects of the drug in the the midst of this latest drug scandal. When home runs didn’t fall after testing started, it was too convenient to say, “well, there is still HGH, and there is no test for that yet.” Yet, few stopped to check to see if the drug had any more effect than eating chicken, pre-game dance routines, or jumping foul lines when running to and from the dugout. Steroids do improve athletic performance, HGH does not.

This isn’t a harmless mistake either. The first question I get asked when I point out the non-effect of HGH is, “why do players take it, then?” These guys read the papers, too. Members of the media who have reported on HGH being a performance enhancer are as much to blame for the use of HGH as the trainers and athletes themselves. When the first whispers of HGH in the clubhouse were heard, reporters should have been calling exercise physiologists and searching PubMed. Instead, some struggling fourth outfielder gets tired of being a spare part, goes to an online pharmacy, and before he knows it his wrists hurt and he isn’t playing any better.

Right now, MLB is paying researchers to develop a urine test for HGH. This is a colossal waste of resources. Instead, MLB should institute a campaign summarize the scientific findings and present them to the players. I would also remove the ban on HGH to take away some of the “forbidden fruit” magnetism. If it remains illegal, then some players may think that it must work. If you want carpal tunnel syndrome, a swollen head, smooshed internal organs, a dangerous blood profile, etc., then that is your business.

Finally! A Good Article on HGH

Childs Walker writes an excellent piece in The Baltimore Sun on the scientific community’s opinion of HGH as a performance-enhancing drug. There is some disagreement among the researchers he contacted, but it is clear that the media’s perception of HGH as an equivalent to steroids is wrong.

Sports fans and commentators speak of human growth hormone as a magical substance that offers the same benefits as anabolic steroids but cannot be detected in urine tests.

So when a player is linked to hGH, as Orioles outfielder Jay Gibbons was by an report, many presume the player was desperate to bulk up and power baseballs into the stands.

The scientific community doesn’t uniformly agree, however, that hGH would help an athlete do so. Several studies of senior patients have found that hGH helps build lean muscle mass but does not increase muscle strength. This conclusion might not transfer perfectly to high-level athletes in their physical primes. But there is no laboratory-based evidence that hGH would help strengthen these elite performers, several researchers said.

Childs Walker is my hero!

Ankiel and HGH

Late yesterday, The New York Daily News broke the story that Rick Ankiel received several shipments of human growth hormone (HGH) in 2004.

According to records obtained by The News and sources close to the controversy surrounding anti-aging clinics that dispense illegal prescription drugs, Ankiel received eight shipments of HGH from Signature Pharmacy in Orlando from January to December 2004, including the brand-name injectable drugs Saizen and Genotropin. Signature is the pharmacy at the forefront of Albany District Attorney David Soares’ two-year investigation into illegal Internet prescription drug sales, which has brought 22 indictments and nine convictions.

Ankiel’s prescriptions were signed by Florida physician William Gogan, who provided them through a Palm Beach Gardens clinic called “The Health and Rejuvenation Center,” or “THARC.” The drugs were shipped to Ankiel at the clinic’s address.

THARC also provided a shipment of steroids and growth hormone to former major league pitcher Steve Woodard, who pitched for Milwaukee, Cleveland, Texas and Boston during a seven-year career that ended in 2003, according to records. Woodard and Ankiel were teammates with the Triple-A Memphis Redbirds in 2004.

First, let me repeat what I have said a number of times. There is no evidence that HGH improves athletic performance—none, zero, zilch. This is the consensus of the exercise physiology profession. The people who study this stuff as their profession say that HGH is useless for building strength. Why isn’t this being reported in the media? In the first post I wrote on the topic I reported the following.

With MLB’s adoption of mandatory testing for steroids, many thought that home run rates would drop dramatically. They didn’t, and many felt that the lack of a test for HGH could be part of the explanation. Well, it’s time for the scientists working on such a test to start something else more important. Even if players are taking HGH, the drug no more effective than ionized bracelets, magnets in your shoes, or jumping over the foul lines. The impact of HGH on home runs in today’s game is zero. If a player is dumb enough to take this stuff, let him go right ahead.

In a follow-up at Wages of Wins, I addressed some of the concerns about the first post.

Where we have evidence, the evidence is overwhelming that there HGH is not an ergogenic aid. If you are waiting on the perfect study, it’s never going to come. Ethical concerns will prevent scientists from running these tests. We start with the null hypothesis HGH has no effect on athletic performance, and no one has been able to reject this with the studies that exist. All we have to support HGH’s performance-enhancing claims are rumors that an extravagantly expensive drug does something very different from what we observe in carefully controlled scientific experiments. Unsubstantiated rumor or controlled scientific experiments?…I think I’ll go with the latter.

So, what was Rick Ankiel doing with HGH? Well, I’m not sure; but, if he took it to get stronger, he’s an idiot. It’s like corking a bat—which any physicist will tell you does not increase hitting distance—except corking bats is against baseball rules. At the time Ankiel is accused of receiving HGH, it was not a banned substance. More interesting is the allegation that former teammate Steve Woodward received steroids, which were against the rules and have been shown to improve athletic performance.

What is the likelihood that performance-enhancing drugs are responsible for Ankiel’s recent performance? Looking at his major and minor league numbers, I’d say that his performance is nothing out of the ordinary. Ankiel’s .338/.386/.675/1.061 line is pathetic compared to Jeff “The Natural” Francoeur’s first 22 games in the big leagues (.403/.410 /.818/1.228). They are both free swingers who can hit the ball a long way if they can get a hold of a pitch. Rick Ankiel has always been a good hitter. It’s hard to know if he got any help along the way to the majors, but one thing I know is that HGH didn’t help him one bit.