Human-Growth Hormone

Human-growth hormone - The 'secret boost?'

LACK OF A TEST MAY MAKE HGH THE DRUG OF CHOICE

This summer, the Nebraska State Patrol arrested several men and charged them with operating a “steroid ring” in Lincoln. In the media reports describing the arrests in June, police noted that they suspected the men of receiving shipments of steroids and human-growth hormone from New York City and distributing the substances to athletes and weight lifters.

The most intriguing part of that story might not be the steroids at all. If the distribution ring really was selling human-growth hormone to athletes, that’s news.

What’s the difference? It’s as simple as a test. A drug test, like the ones used by the NCAA, professional sports and institutions all over the country, can detect most steroid use.

If you use anabolic steroids and compete in sports at a high level, whether it’s the Olympics or the Division II football championship, you stand a good chance of getting caught. Use human-growth hormone, and well, you probably won’t get caught, at least not by a drug test. It’s a troublesome reality that sport may be dealing with for some time.

WHAT IS HUMAN-GROWTH HORMONE?

“Human-growth hormone is perhaps one of the most important of hundreds of hormones that circulate through the human body,” said Dr. Don Catlin, director and founder of the UCLA Olympic Analytical Laboratory.

Human-growth hormone is made in the pituitary gland—a pea-size gland that sits in a protected pocket in the center of the brain. Once it’s released into the blood stream, it is carried by the blood throughout the body to different organs.

“Human-growth hormone affects many different organs too numerous to mention,” Catlin said.

Generally though, human-growth hormone is involved with a variety of body processes pertaining to strength and growth, bone strength, tissue repair, and protein formation — all obviously areas of interest to athletes.

“It acts on the muscles and the heart. Everything begins to grow. The theory is that using it (for athletics performance) could make you stronger and give you a competitive edge,” Catlin said.

Human-growth hormone also is of interest to people with medical disorders, including parents of children with short stature and those with the rare Prader-Willi Syndrome, who fail to grow normally. In fact, that’s why it was developed.

“Pediatricians are trained to spot children with growth problems, and they treat them with human-growth hormone,” Catlin said, noting that doctors used to harvest it from the pituitary gland of cadavers. That hasn’t been necessary since a U.S. drug company developed a synthetic version of human-growth hormone about 20 years ago.

Though it probably has some of the same kind of performance-enhancing properties as steroids, human-growth hormone is not actually a steroid. It is, however, banned by most sporting organizations. The NCAA bans it in the “peptide hormone and analogues” category.

NO 'DEFINITIVE TEST'

It might be banned, but human-growth hormone is difficult to detect, leaving the bans without much teeth.

“There is no definitive test for it,” Catlin said. “There are people working on a test, but so far there’s been nothing definitive. There are partial tests for it, but not a definitive test.”

Catlin points out that athletes at the Athens Olympics were subjected to a test that may (or may not) have worked to detect human-growth hormone.

“There was an antibody test tried at the Athens Olympics, but it hasn’t been released as a standard test,” he added.

Catlin’s laboratory at UCLA has a small grant to work on developing a test for human-growth hormone, but it’s a difficult task. To develop the test, scientists must be able to distinguish recombinant growth hormone from natural growth hormone in the body.

“We must be able to tell if a molecule was made by a pharmaceutical company or by the pituitary gland. We’re going to work on it, but it will be a long project. It could be years,” he said. “Obviously, if we get more funding it will be a shorter process.”

Catlin acknowledges that it will be difficult to develop a test, but he thinks it will be done eventually.

“I am hopeful. I think there is interest today by the professional organizations to pursue it, and some of the sports agencies do fund it. WADA (the World Anti-Doping Agency) also is working on it.”

Catlin also believes a urine test may be possible, rather than the more invasive blood test.

“I’m not convinced you can’t test for it through urine,” he said. “Yes, human-growth hormone is in urine, but there are a lot of other things in urine as well, and we’ve been able to develop tests for them.”

Andrea Wickerham, Drug Free Sport’s legal relations and policy director, agrees, noting that funding research is critical for drug testing to continue to advance.

“There was no good urine test for EPO (Erythropoietin) not that long ago. Now there is one,” she said. Wickerham also noted that the invention of carbon-isotope ratio (CIR) testing to distinguish pharmaceutical testosterone from testosterone made in the body is another fairly recent development in drug testing.

Wickerham also pointed out that Catlin developed the test to detect THG (Tetrahydrogestrinone), the designer steroid at the center of the BALCO scandal.

'WHERE THERE'S SMOKE, THERE'S FIRE'

How difficult is it to purchase real human-growth hormone? No one knows. “Human-growth hormone” is all over the Internet, but Catlin points out that most of that is probably not the real thing. And even real human-growth hormone is ineffective in tablet form, which accounts for most of the human-growth hormone that is available over the Internet.

“If you take a tablet that is supposed to be human-growth hormone, you are wasting your time and money,” he said. “Even if it is real human-growth hormone, it is ground up by stomach acid and won’t help you.”

“Real human-growth hormone is administered by injection, though there are some forms coming that are nasal insufflation, essentially nose sprays,” Catlin said.

Human-growth hormone is produced by legitimate pharmaceutical companies for medical disorders and available by prescription in the United States from medical doctors, particularly those specializing in disorders of growth. Other doctors are said to be prescribing it as “anti-aging medicine,” a more controversial use that’s not approved by the Food and Drug Administration.

“One reason we’ve believed athletes, particularly collegiate athletes, have not been using much human-growth hormone is that it’s tremendously expensive,” points out Drug Free Sport’s Frank Uryasz.

Indeed, one journalist for Outside Magazine, who detailed his experiences experimenting with performance-enhancing substances in 2003, said his monthly dose of prescription human-growth hormone was $750 a month.

“Most collegiate athletes can’t afford the expense that would be required to get any real benefit from actual human-growth hormone,” Uryasz said. “But having said that, we also know that those desperate to cheat will always find ways to do that.”

Are elite athletes using human-growth hormone to boost their athletics performance?

“I believe it is being used,” Catlin said. “Where there’s smoke, there’s fire. Law enforcement agents are finding it. Customs agents are finding it. And it is being stolen from big pharmaceutical companies by the truckload.”

Catlin points to one pharmaceutical company that discovered that employees were putting human-growth hormone under their clothes and smuggling it out of the facility.

“There clearly is a market for it. How much is it really influencing sport? I don’t know. I don’t think anyone does,” Catlin said.

“Many experts are of the opinion that it enhances human performance, but some experts disagree,” Catlin said. “It’s probably available in every country in the world. The technique (for creating it) is known, so clandestine chemists could make it. It might not be the best stuff, but it might be enough to enhance performance. Clandestine chemists synthesize drugs but generally do not take the time to purify them.”

Do NCAA student-athletes use human-growth hormone? In compiling the 2005 NCAA Study of Substance Use Habits of College Student-Athletes, released on a limited basis this fall, the NCAA surveyed 20,000 student-athletes on their drug use. In that study, 1.2 percent reported that they had taken human-growth hormone.

“It’s difficult to translate that statistic to actual use though,” points out Drug Free Sport’s Wickerham. “The student-athletes who responded to that survey might have taken a supplement they thought contained human-growth hormone that actually didn’t. It’s difficult to know.”

THE DOWN SIDE TO GROWTH HORMONE

“It’s clear that human-growth hormone, in addition to being a way to cheat, also is a huge student-athlete health and safety issue,” Wickerham said. “Some people wonder why we should talk about it if there isn’t a test for it. I think we should be educating people about it so administrators and student-athletes understand the risks of using it.”

Many athletes who spend their money on human-growth hormone are likely to find the product they’ve bought is something else entirely. That concerns Wickerham.

“It’s like most black-market purchases. When you buy from an unknown source, who also bought from an unknown source, you risk that what you get is not what you’re paying for,” Wickerham said. “Who knows what’s really in that bottle? And why would you want to put something in your body that you can’t be sure is safe?”

Those who acquire the real human-growth hormone might be dismayed by its side effects as well.

“The most disastrous side effect of using human-growth hormone is the disease acromegaly, which is a disease of excessive growth and, in a sense, disfigurement. It causes the hands and feet to enlarge, and it causes the jaw to protrude. It is not a very handsome disease,” Catlin said.

Catlin notes that though it takes years to develop acromegaly, in the meantime, taking human-growth hormone could push an athlete toward diabetes and poor blood-sugar control, among other problems.

“Is it worth it?” Wickerham asked. “We know athletes are willing to roll the dice on other substances.”

Perhaps human-growth hormone is the new game.