Juicy Story, But No Dope

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By Daniel Engber
Sunday, March 25, 2007

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."

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 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.

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, drawing a straight line from the BALCO investigation to the busts in Florida. But Jerry Hairston isn't Barry Bonds. Sure, both guys probably took banned substances in an effort to boost their stats, and both were involved in 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 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 six months, the men had denser bones, thicker skin, less fat and leaner 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 during adolescence. But HGH levels fall off as we get older; 60-year-olds might make half as much 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 PhD 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, HGH treatment seems to reduce body fat and increase muscle mass. It may not lengthen your lifespan, but it can certainly improve your looks.

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 enhanced athletic performance. Unlike steroids, growth hormone doesn't increase weightlifting ability; in the lab, it has more 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 the effect is too subtle to measure. 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 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 claims that 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 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 that 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.

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 contrary 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.

Daniel Engber writes on science and culture for the online magazine Slate.

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