As discussions around performance enhancing drug scandals, doping and potential multi-game suspensions continue to plague Major League Baseball and some of its top talent; Health Talk recently talked with U of M experts about how human growth hormone (HGH) and testosterone actually affect performance.
We sought out University of Minnesota College of Pharmacy pharmacology and drugs of abuse expert David Ferguson, Ph.D., and Bradley S. Miller, M.D., Ph.D., a pediatric endocrinologist with the University of Minnesota Medical School who has studied growth and development associated with HGH.
Here’s what we learned:
Health Talk: Can HGH and testosterone be considered performance-enhancing drugs?
Ferguson: Definitely. Testosterone is listed in the textbooks for performance enhancement and HGH, while newer to the game, is also listed. Football, baseball, the Olympics and many other sports list both as performance enhancers, although football still isn’t testing for HGH.
Health Talk: So both HGH and testosterone can enhance performance. Do they work in similar ways?
Ferguson: The two function differently. Testosterone is a steroidal hormone that causes fairly rapid increases in lean muscle mass and strength. It’s a small molecule that’s primarily responsible for growth, and it influences and enhances male characteristics such as muscle and bone mass, aggression, and facial hair among other things. Testosterone is very potent when taken orally as a pill, applied topically as a gel, or injected with a syringe. The consequences of abuse are well documented to produce long-term effects in users. HGH, on the other hand, is a protein. HGH activates a receptor that tells cells that cause growth to turn on. It’s a large protein, as opposed to a small molecule. Additional HGH is introduced to the body via an injection… not pills or gels.
Miller: HGH introduces a slower onset of strength than testosterone might. HGH tells body to use calories to build muscle and bone. If you were deficient, you would store them as fat. Studies have shown you recover from injury associated with athletics more quickly.
Health Talk: How do we detect use?
Ferguson: Testosterone use is very well documented. There are really good tests out there to detect it’s abuse.
Miller: You can measure levels and ratios of growth hormones in the body to detect HGH. But you’d have to catch somebody the day they take HGH, because it has a pretty quick half-life. Levels come down pretty quickly once you stop taking it. Mayo Clinic researchers are currently looking into better ways to detect it.
Health Talk: Both HGH and testosterone are available with a prescription. What are their appropriate uses?
Ferguson: Testosterone can help restore libido in older men, which can help with erectile dysfunction. It is commonly used in replacement therapy to alleviate metabolic disorders or deficiencies in people young or old.
Miller: HGH, on the other hand, is responsible for growth. It has a lot of uses in pediatrics and in people with growth-related disorders. For example, it can help cancer patients—especially children—regain growth after chemotherapy.
Health Talk: What about long-term affects of unnecessary use or abuse?
Ferguson: We don’t have data on what’s going to happen to someone that uses HGH who shouldn’t be using it in five years. With patients who take HGH for legitimate reasons, when they stop taking it they tend to see a little bit of a relapse, because their body doesn’t produce it, but HGH production does recover and normal function comes back.
Miller: Andre the Giant and Jaws from the 007 movies are good examples of the physical changes that can occur from too much growth hormone. Both had a tumor producing growth hormone that made them unusually tall, resulting in an enlarged jaw and dental problems. Too much HGH can lead to pre-diabetes symptoms, but we don’t know if that stops after HGH use ends. One question out there is, as you get older and take HGH unnecessarily, can it increase your cancer risk? HGH doesn’t make cancer happen, but it might make someone predisposed to cancer experience an accelerated rate of development.
Ferguson: With testosterone abuse, the body stops producing the levels of testosterone it needs naturally. Shrunken testicles are the classic long-term effect of abuse, but there’s a whole list of negative effects: shrunken muscle mass leading to hanging flesh on the body, an inability to produce enough testosterone later on, enlarged heart, kidney and liver problems, increased male characteristics in females and increased female characteristics for men, et cetera. If you use something like testosterone off-and-on, it can put you at a greater risk for injury during the low point of that cycle.
Health Talk: What’s the bottom line?
Ferguson: HGH and testosterone use encourages artificial enhancement of the body’s natural capabilities. Artificial enhancement is cheating, and sooner or later, the abuse of these drugs will catch up to them in one way or another.