What athletes, fans, and the sports media don't understand about human growth hormone.

The state of the universe.
March 24 2007 7:50 AM

The Growth Hormone Myth

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

Illustration by Rob Donnelly. Click image to expand.

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."

Daniel Engber Daniel Engber

Daniel Engber is a columnist for Slate

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.

Advertisement

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.

TODAY IN SLATE

Sports Nut

Grandmaster Clash

One of the most amazing feats in chess history just happened, and no one noticed.

The Extraordinary Amicus Brief That Attempts to Explain the Wu-Tang Clan to the Supreme Court Justices

Amazon Is Officially a Gadget Company. Here Are Its Six New Devices.

Uh-Oh. The World’s Oceans Have Broken Their All-Time Heat Record.

The NFL Explains How It Sees “the Role of the Female”

Future Tense

Amazon Is Now a Gadget Company

Food

How to Order Chinese Food

First, stop thinking of it as “Chinese food.”

The NFL Should Lose Its Tax-Exempt Status, Which It Never Should Have Had Anyway

The Country Where Women Aren’t Allowed to Work Once They’re 36 Weeks’ Pregnant

The XX Factor
Sept. 18 2014 11:40 AM The Country Where Women Aren’t Allowed to Work Once They’re 36 Weeks’ Pregnant
Moneybox
Sept. 17 2014 5:10 PM The Most Awkward Scenario in Which a Man Can Hold a Door for a Woman
  News & Politics
Politics
Sept. 18 2014 6:52 PM Ground Zero for the Fight Over Female Voters  Colorado Democrats and Republicans are testing theories for reaching women that will resonate far beyond the Rocky Mountains.  
  Business
Moneybox
Sept. 18 2014 6:02 PM A Chinese Company Just Announced the Biggest IPO in U.S. History
  Life
Outward
Sept. 18 2014 4:15 PM Reactions to a Sketch of Chelsea Manning Reveal Transmisogyny
  Double X
The XX Factor
Sept. 18 2014 3:30 PM How Crisis Pregnancy Centers Trick Women
  Slate Plus
Behind the Scenes
Sept. 18 2014 1:23 PM “It’s Not Every Day That You Can Beat the World Champion” An exclusive interview with chess grandmaster Fabiano Caruana.
  Arts
Brow Beat
Sept. 18 2014 4:33 PM The Top 5 Dadsplaining Moments From The Cosby Show
  Technology
Future Tense
Sept. 18 2014 6:48 PM By 2100 the World's Population Could Be 11 Billion
  Health & Science
Science
Sept. 18 2014 3:35 PM Do People Still Die of Rabies? And how do you know if an animal is rabid?
  Sports
Sports Nut
Sept. 18 2014 11:42 AM Grandmaster Clash One of the most amazing feats in chess history just happened, and no one noticed.