HGH: Are We Being Misled?

[Ksyrup]

Rob Neyer has a link on his blog today about how HGH isn't the performance-enhancer we had been lead to believe it is. Is there a counter-point to this argument, or have we just been going on a presumed impact of HGH (or trainers/chemists touting something that doesn't actually work and getting a bunch of athletes to buy into it) that no one has bothered to ask the medical community about? Or, is this no more reputable than anything else we've read on the subject?




April 5th, 2007
I Don’t Worry about HGH in Baseball, and Neither Should You (http://www.sabernomics.com/sabernomics/index.php/2007/04/i-dont-worry-about-hgh-in-baseball-and-neither-should-you/)



Last week, I happened across an article by Daniel Engber entitled “The Growth Hormone Myth (http://www.slate.com/id/2162473/nav/tap1/),” and I was a bit shocked by its contents. According to Engber, Human Growth Hormone (HGH or GH) has little to no performance enhancing-benefits.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….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.I was intrigued. Engber is a credible source, and his documentation solid; however, I remained skeptical. I closely follow media coverage of performance-enhancing drugs yet I was not aware of the dubious benefits. Did I miss something? Then I realized that I didn’t have to take Engber’s word for it or go do a lit review in research out of my field. I have the benefit of working down the hall from several exercise physiologists.

I forwarded the article to my colleague, John McLester, with whom I have had numerous steroid discussions. He showed up at my office door a few minutes later, and our conversation went something like this.

Me: What do you think of this argument?

John: Oh yeah, I agree with him. This isn’t even controversial in exercise physiology.

Me: Why haven’t I heard about this in the media?

John: I guess no one has asked anyone in the profession to comment. People think andro works, and that is laughable.

Me: How does HGH work?

John: Unlike anabolic steroids, growth hormone doesn’t target muscle, everything grows. You will get bigger muscles, but you’ll also do things like enlarge your organs. In an adult who has finished growing, it’s going to result in acromegaly (http://en.wikipedia.org/wiki/Acromegaly). Remember Andre the Giant’s gut? That wasn’t fat. That’s where his organs had to go because there wasn’t room in his chest cavity.

Me: But, doesn’t the subject benefit from bigger muscles.

John: There is no evidence of this. It seems that the muscle that is developed is abnormal and not mature. I’ll point you to some studies (see below).

Me: Wow. So you think there are no performance-enhancing benefits to using HGH?

John: Little to none, especially in baseball. An offensive lineman in football might benefit just from gaining mass, but there are probably easier and cheaper ways to gain mass—HGH is very expensive. If I were to use PEDs, I’d take steroids and there is no way I’d even touch HGH. If benefits to taking HGH exist they are tiny, and the health consequences are not pretty.

After several more conversations with John and following up on his leads I believe that there are no performance-enhancing benefits from using HGH in baseball. There is no documented evidence that HGH improves performance. While studies are sparse due to ethical limits, what studies have been done show that while growth hormone may promote muscle growth that it does not increase strength. This is quite different from anabolic steroids for which there exists evidence of improved strength. Of course, future research may change this, but right now I see little reason to contradict what is out there.

Here is some documentation.



Mary Lee Vance, New England Journal of Medicine, 2/27/2003. (http://content.nejm.org/cgi/content/full/348/9/779)A recent double-blind, placebo-controlled study involving 27 women and 34 men, 68 to 88 years of age, who were given growth hormone or placebo for 6.5 months confirmed the effects of growth hormone on body composition; there was no change in muscle strength or maximal oxygen uptake during exercise in either group. This study corroborated the findings of a study by Papadakis et al. involving 52 healthy men, 70 to 85 years of age, who were given placebo or growth hormone for six months. Not mentioned on the “antiaging” Web sites is a study of 18 healthy men, 65 to 82 years of age, who underwent progressive strength training for 14 weeks, followed by an additional 10 weeks of strength training plus either growth hormone or placebo. In that study, resistance exercise training increased muscle strength significantly; the addition of growth hormone did not result in any further improvement.

Karl E. Friedl, “Performance-Enhancing Substances,” in Baechle and Earle (eds.) Essentials of Strength Training and Conditioning, 2e, p. 219, . (Textbook)There is no evidence that supplemental growth hormone produces effects of the same magnitude [as growth hormone deficiency] (it may not even produce normal muscle) or enhance athletic performance in a normal man or woman….Apparently, few athletes are actually using this hormone, which suggests that they may well be aware that the substance probably does little to enhance performance, carries risks, and is very expensive. 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.

Posted by JC in General (http://www.sabernomics.com/sabernomics/index.php/category/general/), Steroids (http://www.sabernomics.com/sabernomics/index.php/category/steroids/)

[ISiddiqui]

Wow... very interesting stuff. Though I always did wonder at the name - Human Growth Hormone almost feels like it should work the way the professionals say it does (growing everything, not just muscles).

[14ers]

Mary Lee Vance, New England Journal of Medicine, 2/27/2003. (http://content.nejm.org/cgi/content/full/348/9/779)A recent double-blind, placebo-controlled study involving 27 women and 34 men, 68 to 88 years of age, who were given growth hormone or placebo for 6.5 months confirmed the effects of growth hormone on body composition;
(http://www.sabernomics.com/sabernomics/index.php/category/steroids/)
There is not enough info here to actualy prove anything.

1) 68-88 years old?
2) Natural or synthetic hgh?
3) Method of delivery?
4) Quantity taken?


I am not yet ready to proclaim HGH safe, or a non-performancing enhancing drug.

[Tigercat]

Certainly it sounds premature to give concrete answers.

But with bigger experts than us saying HGH isn't performance enhancing? And when their logic to why it isn't can make perfect sense to us laymen? Hmmmm

[Crapshoot]

In other words, people are overreacting based on a hyperbolic media and fans who apply one standard to baseball, and another one to the NFL? Shocking.

[Ksyrup]

I don't think this is a baseball vs. football thing. My reaction to all of this is that the discussion on HGH began as a presumption that not only was it as bad as steroids, but it was undetectable. It was like steroids, except they couldn't even test for it. And people are calling for keeping blood samples for years so that when HGH tests are able to be performed, we'll have something to test. This information, even if not concrete, suggests that we need to go back to the basic question of whether this stuff is really the performance enhancer everything thinks it is. And I, for one, haven't seen that question asked.

[dawgfan]

I am not yet ready to proclaim HGH safe, or a non-performancing enhancing drug.
I don't think anyone is saying that taking HGH is 'safe' (outside of prescribed use), but it is interesting that this article claims the field of exercise physiology has dismissed the idea of HGH as a performance-enhancer.

This is definitely something that needs more attention from the media - if there's going to be such wealth of attention paid to the issue of performance-enhancers, it should also be their responsibility to determine whether HGH is something that belongs in the discussion of performance-enhancement.

[cougarfreak]

And Cigarettes don't cause cancer.


Sincerely,

US Tobacco Companies before 1990

[Ksyrup]

And Cigarettes don't cause cancer.


Sincerely,

US Tobacco Companies before 1990

And explain how that is an appropriate analogy here? What benefit do various members of the medical community derive from falsely claiming that this stuff doesn't enhance athletic performance? These aren't people sitting in some lab creating this stuff and doing anything illegal - they're publishing results of studies in respected medical journals.

I don't get your point, or you're so off the mark that it doesn't make any sense.

[Leonidas]

I wonder if Rob may be asking the wrong questions. As I understand it, track and field athletes and cyclists don't take HGH to get bigger and stronger, they take them to enhance recovery and to improve stamina. Anecdotal evidence among cyclists is pretty consistent that it gives them a boost in their training ability. They feel less fatigued. Could be a placebo affect, but if nobody has done any real research on it then who knows?

[CU Tiger]

My opinion is that all the reasrch does is usueless for the way these athletes are usin it.

For performance enhancemnet they are routinely using 8-10x the recommended hormone theerapy replacement levels.

AFAIK there is simply no research done at those levels

[BishopMVP]

I wonder if Rob may be asking the wrong questions. As I understand it, track and field athletes and cyclists don't take HGH to get bigger and stronger, they take them to enhance recovery and to improve stamina.That's what I thought. Steroids help build muscle and recovery time, HGH doesn't build muscle but rather helps in recovery, specifically from injuries. I'm pretty sure I remember seeing this as one of those unspoken secrets in how athletes are coming back from torn ACL's and broken legs in a few months vs. the old year-long recovery?

Regardless, I've always referred to "HGH" or "Steroids" in a much broader sense of different substances than how the media reports it. Plus there is still plenty of stuff available at GNC over the counter that will build mass and help you lift more/increase stamina that it's not even necessary to be on "Steroids/HGH" to be seeing large increases in strength.

[Ksyrup]

I wonder if Rob may be asking the wrong questions. As I understand it, track and field athletes and cyclists don't take HGH to get bigger and stronger, they take them to enhance recovery and to improve stamina. Anecdotal evidence among cyclists is pretty consistent that it gives them a boost in their training ability. They feel less fatigued. Could be a placebo affect, but if nobody has done any real research on it then who knows?

Just to be clear, none of what I posted is from Rob Neyer himself. It's just a blog he linked to. He was pretty non-committal about what it meant in his blog, too, just something to the effect that anyone who takes to the airwaves to discuss HGH ought to read this blog first.

[st.cronin]

I seem to remember Rob Neyer making a lot of strange claims about steroids, back when I used to read him. It almost seemed like he had something personal invested in the debate.

I could be thinking of somebody else, though.

[Leonidas]

I seem to remember Rob Neyer making a lot of strange claims about steroids, back when I used to read him. It almost seemed like he had something personal invested in the debate.

I could be thinking of somebody else, though.
Neyer has a history of trying to take unconventional positions. It's one of the things I really like about him. I just wonder if maybe he's a bit out of his depth on this one.

[Leonidas]

From the geniuses of wikipedia

http://en.wikipedia.org/wiki/Growth_hormone

Although height growth is the best known effect of GH, it serves many other metabolic functions as well.

* It increases calcium retention, and strengthens and increases the mineralization of bone.
* It increases muscle mass through the creation of new muscle cells (which differs from hypertrophy)
* It promotes lipolysis, which results in the reduction of adipose tissue (body fat).
* It increases protein synthesis and stimulates the growth of all internal organs excluding the brain.
* It plays a role in fuel homeostasis.
* It reduces liver uptake of glucose, an effect that opposes that of insulin.
* It promotes liver gluconeogenesis.[6]
* It contributes to the maintenance and function of pancreatic islets.
* It stimulates the immune system.


and

GH treatment improves muscle strength and slightly reduces body fat in Prader-Willi syndrome, benefits more important to these children than increased height. It has also been shown to help maintain muscle mass in AIDS wasting.

and

Uses that are controversial include

* GH treatment to reverse effects of aging in older adults (see below)
* GH treatment to enhance weight loss in obesity
* GH treatment for fibromyalgia
* GH treatment for Crohn's disease and ulcerative colitis
* GH treatment for idiopathic short stature
* GH treatment for bodybuilding or athletic enhancement


and

Claims for GH as an anti-aging treatment date back to 1990 when the New England Journal of Medicine published a study where GH was used to treat 12 men over 60. At the conclusion of the study all the men showed statistically significant increases in lean body mass and bone mineral, while the control group did not. The authors of the study noted that these were the kind of changes that would occur naturally over a 10 to 20 year aging period. Despite the fact the authors at no time claimed that GH had reversed the aging process itself, their results were mis-interpreted as indicating GH was an effective anti-aging agent. [7]

A Stanford University School of Medicine survey of clinical studies on the subject published in early 2007 showed that the application of GH on healthy elderly patients increased muscle by 2 kgs and decreased body fat by the same amount. However, these were the only positive effects from taking GH. No other critical factors were affected, such as bone density, cholesterol levels, lipid measurements, maximal oxygen consumption, or any other factor that would indicate increased fitness. Researchers also didn't discover any gain in muscle strength, which led them to believe that GH merely let the body store more water in the muscles rather than increase muscle growth. This would explain the increase in lean body mass.

[dawgfan]

Plus there is still plenty of stuff available at GNC over the counter that will build mass and help you lift more/increase stamina that it's not even necessary to be on "Steroids/HGH" to be seeing large increases in strength.
Yep - this is one of the reasons I think it's too simplistic to just assume steroids or HGH when players get bigger and stronger and hit for more power.

[Leonidas]

And from here, most interesting

http://www.humangh.com/Growth-Hormone-Releaser.htm

L Glycine: A nonessential amino acid.

Effects on HGH: Two studies found that this amino acid increased HGH in the serum. In one, 6.75 grams at bedtime caused an three-fold increase, while a Japanese research team showed that 30 grams raised HGH levels ten times over baseline in patients who had gastric surgery. An oral dose of 250 milligrams in normal volunteers also showed a significant, but less pronounced, rise in HGH. They conclude that "the facts demonstrated that glycine is one of the stimulatory agents inducing the pituitary gland to secrete HGH." Glycine has also been found useful in increasing output in exercise workouts.

[Leonidas]

And from here

http://www.hormoneandlongevitycenter.com/growthhormone/

Growth Hormone diminishes rapidly after the age of 30 and it is this rapid decline that results in many negative aspects of aging, including increased body fat, decreased muscle mass, increased wrinkles, cancer, and heart disease. It is found that GH deficient patients have almost 50% higher rate of death from heart disease than those with more optimal levels. In a 1990 New England Journal of Medicine article, Dr. Rudman reported on his study with the use of human Growth Hormone (hGH) in elderly veterans. He discovered that their body fat and wrinkles decreased and lean muscle mass, strength, and bone density increased. The usual progression of aging was halted and reversed by bringing an individual’s growth hormone to a more optimal (youthful) level.

Other noted benefits include:

* Increase in libido
* Reversal of balding with regrowth of hair
* Improved cholesterol profile
* Faster wound healing with lower infection rate
* Decrease in hospitalization and sick days from work Increase in exercise capacity and energy level
* Decreased blood pressure Improved memory
* Decreased heart disease and athrosclerosis Improved sleep
* Decreased disease and cancer Increased life expectancy

[cougarfreak]

And explain how that is an appropriate analogy here? What benefit do various members of the medical community derive from falsely claiming that this stuff doesn't enhance athletic performance? These aren't people sitting in some lab creating this stuff and doing anything illegal - they're publishing results of studies in respected medical journals.

I don't get your point, or you're so off the mark that it doesn't make any sense.

There are plenty of Drs. and scientists who "supported" the tobacco companies. It would benefit the companies who sell the stuff, they stand to make a shitload of money, just like the tobacco companies did. Hell, look at all of the scientists and drs. who routinely say the latest wonderdrug created to cure heart disease, or lower cholesterol, etc. is safe after "testing", only to find out a few years later it fries your liver or something. It's common practice in the drug business IMO.

[dawgfan]

There are plenty of Drs. and scientists who "supported" the tobacco companies. It would benefit the companies who sell the stuff, they stand to make a shitload of money, just like the tobacco companies did. Hell, look at all of the scientists and drs. who routinely say the latest wonderdrug created to cure heart disease, or lower cholesterol, etc. is safe after "testing", only to find out a few years later it fries your liver or something. It's common practice in the drug business IMO.
Huh. So these exercise physiologists who are claiming that HGH has no performance-enhancement benefit are working for the drug companies that make HGH, is that your argument? Can you explain to me how this makes any sense whatsoever?

[EagleFan]

There is not enough info here to actualy prove anything.

1) 68-88 years old?
2) Natural or synthetic hgh?
3) Method of delivery?
4) Quantity taken?


I am not yet ready to proclaim HGH safe, or a non-performancing enhancing drug.

but it was on a blog.... A BLOG!!!!!! It has to be true.... ;)

[primelord]

FWIW most of the stuff I had always read on HGH in the past suggested that alone it was not particularly useful. The real benefits came when it was part of a steroid regimine.

Edit: Which I think would make some sense. If the HGH simply adds more mass, but the steroids allow you to develop that additional mass into more lean muscle you would get even stronger than without the addition of the HGH.

[Danny]

Steroid make your ball tiny, HGH make your ball huge!

[cougarfreak]

Huh. So these exercise physiologists who are claiming that HGH has no performance-enhancement benefit are working for the drug companies that make HGH, is that your argument? Can you explain to me how this makes any sense whatsoever?

I'm saying they certainly could be. Or maybe it's Neyer ;) , he seems to be taking a large leap to me. I don't know if they are or not. Their studies seem pretty ludicrous to me. Testing it on 68-88 year olds? And doesn't it make sense that people who are larger, would have the ability to hit a ball farther? Their tests have nothing to do with baseball, so to connect the two doesnt make a whole lot of sense to me.

[dawgfan]

I'm saying they certainly could be. I don't know if they are or not. Their studies seem pretty ludicrous to me. Testing it on 68-88 year olds? And doesn't it make sense that people who are larger, would have the ability to hit a ball farther? Their tests have nothing to do with baseball.
Explain to me why drug companies that make HGH would employ exercise physiologists who claim that HGH doesn't enhance athletic performance?

[cougarfreak]

Explain to me why drug companies that make HGH would employ exercise physiologists who claim that HGH doesn't enhance athletic performance?

Oh, don't worry, there will be plenty of people who say they do as well. I really jumped too soon, what I really should have said was Neyer made quite a leap.

[dawgfan]

Oh, don't worry, there will be plenty of people who say they do as well. I really jumped too soon, what I really should have said was Neyer made quite a leap.
OK. All I'm saying is that your comparison of tobacco companies and the scientists on their payrolls claiming tobacco wasn't harmful or addictive with HGH makers and these exercise physiologists who say it has no performance enhancing effects doesn't make any sense.

In the case of tobacco companies and the scientists on their payrolls, there's a clear motivation for the scientists to claim that tobacco wasn't harmful or addictive - this had an obvious benefit to the tobacco companies.

In the case of HGH manufacturers and the exercise physiologists saying it's not a performance enhancer, I don't see the benefit to the HGH manufacturers of such a claim.

And all Neyer did was say that media types yammering about HGH and baseball should really read that article he linked - he didn't make any statements of his own position regarding that article. Which is reasonable really - those who are trying to argue about this issue really ought seek a reasonable amount of information about the subject before offering up opinions and commentary about it. My take on him writing up that link was simply to offer a cautionary counterpoint to the conventional wisdom that HGH is basically the same as steroids in terms of performance enhancement impact. Maybe it does have performance enhancement impacts, but in different ways (such as quicker recovery times), but it does seem rather clear that the positive effects of HGH (if any) differ quite a bit from those of steroids. And even then, I suspect that if you dig deeper you'd find that not all steroids have the same level and type of enhancement impact.

[CU Tiger]

I think everal people are making an incoret jump in logic.

Steroids CAN make people bigger, but they (certain compounds) can also make peoplee leaner. And a STRINGER muscle is a FASTER muscle.

They idea of the muscle bound steroid head is castly mislead. Remeeber ben johnson was taking steroids (winstrol-V 1960s technology) to become the worlds fastes man.

I think to many people hear steroids,hgh etc. and have the wrong image. Its not just the power hitters, its also the pitchers and base stealers that could beneift.

There has been a few studies that have shown HGH to increase muscle mass and decrease BF% WITH NO ACTIVITY..

But again everyones body is different.

[Leonidas]

But again everyones body is different.
I think this is the key thing that gets overlooked. Some guys can take steroids and have very little effect. Some guys balloon up. Some people get bigger but not stronger. That's what gets me when people point to the career minor leaguer who got caught as certifiable proof that steroids don't really help baseball players. Who knows, maybe that career minor leaguer never would have gotten even that far if it weren't for the drugs. Then again maybe they made him worse. Canseco talks about this and about when he got other guys on the stuff to be forewarned that it works differently on everybody.