Author: Vernon Gambetta

"The Outlaws will always be ahead of the law" Frank Dick, Chief Coach of Great Britain at the time, said that to Gary Winckler and myself in the cafeteria in Helsinki at the first World Track & Field Championships in 1983. In my opinion one of the reasons that this is so is reflected in the article below from the New York Times. The naive viewpoint in this article is the same stance that the medical and scientific community has taken sine the 1960's. If reserach says is does not work then obviously it does not work, this is a classsic example of the tyranny of dead ideas . Everybody who has been around elite sport knows that HGH works! These guys can keep denying it but the Victor Conte's of the world prey on and make a killing on this mentallity. I think it was Einstein who said and I am paraphrasing here – that you cannot go to those who have created the problem for the solution. If the medical and scientific community would have admited that anabolic steriods worked and were being used extensively by athletes in the late sixties and early seventies maybe we would not be where we are now. New York Times – December 20, 2009 H.G.H.’s Conundrum: Does Costly Treatment Enhance Performance? By IAN AUSTEN OTTAWA — While human growth hormone has a remarkable ability to generate controversy, exactly what it does for athletes, both good and bad, is as much of a mystery today as when it first found favor as a performance booster during the 1990s. “That’s uncharted territory,” said Richard J. Auchus, a professor of endocrinology at the University of Texas Southwestern Medical School in Dallas. “We just don’t know what happens when people use high doses for long periods of time.” H.G.H. is among the drugs prescribed by Anthony Galea, a Toronto-based sports medicine physician who was charged by the Royal Canadian Mounted Police last week with, among other things, conspiring to smuggle it into the United States. H.G.H. is legal in Canada but approved in the United States for only a few specific uses that do not include hastening recovery from injuries. Galea has treated a number of elite athletes, including Tiger Woods, the sprinter Donovan Bailey and the swimmer Dara Torres, and is being investigated by American authorities for supplying performance-enhancing drugs to athletes in the United States. Both Galea and his lawyer have strongly rejected that allegation and dispute the Canadian charges. Galea told The New York Times before being charged that he had never given an athlete growth hormone. But he acknowledged that he prescribed the drug to some patients at his Toronto clinic who were at least 40 and fatigued. Galea, 50, is such a believer in its restorative powers that he said he had injected the hormone into his body five days a week for the last decade. But physicians and medical researchers who have studied people with medical conditions that lead to growth hormone overproduction said that available evidence suggested that athletes who cheat by using costly H.G.H. may simply wind up being cheated themselves. “Ultimately I’d have to say that its main effect is that it makes your wallet a little less heavy,” said Dr. Alan D. Rogol, a professor emeritus of endocrinology at the University of Virginia. Rogol also reviews requests to the United States Anti-Doping Agency from athletes seeking permission to use banned hormones for therapeutic treatments. Suspicions that athletes may be using growth hormone first surfaced in the 1980s. But at the time, the only source of the hormone was cadavers. Advances in genetics, however, allowed biotechnology companies to clone and market several hormones, including H.G.H., beginning in the 1990s. Those products swiftly found an illicit following among athletes. H.G.H. is considered a performance-enhancer in sports, and the World Anti-Doping Agency subsequently banned it. The hormones came with a long list of side effects. For H.G.H., they include cardiovascular problems, an increased risk of diabetes, arthritis, carpal tunnel syndrome, glucose intolerance, colon polyps, skin growths, excessive sweating and serious headaches. Heavy and prolonged growth hormone use can lead to abnormal bone growth in the face, head, hands and feet. It is widely suspected, but not proved, that excessive H.G.H. may promote cancers. Despite Galea’s practice for older patients, growth hormone injections ultimately leave users fatigued, said Auchus, who acts as the Endocrine Society’s spokesman on hormone abuse. “Rather than being some fountain of youth, the older you are the less you tend to benefit,” Auchus said. The United States determined that potential harm from H.G.H. is so great that federal law puts it in an unusual category of drugs that doctors cannot prescribe for unapproved, or off-label, uses. (No such ban exists in Canada.) Its approved uses are not conditions common among professional athletes: it can be used in children with severe growth problems, H.I.V. patients may receive it if they have muscle wasting, and it can be prescribed to offset exceptional weight loss in people who have had much of their small intestine surgically removed. When it came to doping, the new hormones had an attractive feature. Because they are clones of natural hormones, they were invisible to antidoping tests that relied on looking for chemical abnormalities in urine samples. Although a blood test for H.G.H. was subsequently developed, it has not been highly effective. Rogol said that it only worked if the test subject had injected H.G.H. shortly before being asked for a sample. Some of the cloned hormones unquestionably enhance performance. Erythropoietin, or EPO, boosts red blood cells, offering athletes in endurance sports significant gains in speed and endurance. The possible gains from H.G.H. use are more varied and far less proven. Auchus said that it reduces body fat and increases lean muscle mass, which are desirable not just for body building, where growth hormone abuse is believed to be widespread, but in a variety of other sports, including cycling, where leanness boosts results. But, like everything, there is debate about the full extent of that effect. Anecdotal evidence suggests that some athletes use H.G.H. to increase muscle mass. But Auchus and Rogol said that there was considerable research showing that such gains were modest. One key difficulty in determining what an individual performance-enhancing drug brings to an athlete, Rogol said, is that few people involved in doping use just a single treatment. That opens up the potential for complex interactions, both beneficial and harmful, between various drugs and treatment methods. There is speculation that growth hormone may be used in conjunction with platelet-rich plasma injections to swiftly heal injured muscles and tendons. While Galea is a leading proponent of platelet therapy, he said during an interview that he never combined the technique with growth hormone. But there is considerable doubt about whether injecting H.G.H. directly into injured tissue — with or without platelet therapy — actually achieves anything. Growth hormone does not act directly. Instead it prompts the body to produce insulin-like growth factor 1, or I.G.F.-1, which then triggers growth. The overwhelming majority of I.G.F.-1 is produced by the liver and delivered through the blood stream. Evidence shows, however, that growth hormone can prompt local I.G.F.-1 production in other cells of the body. Auchus said that it was not clear if such local production was significant enough to accelerate healing. Even platelet therapy, widely practiced on injured tissue, is an unproven treatment marked by uncertainties; it is however legal and not banned by the World Anti-Doping Agency. To create platelet-rich plasma, a small amount of the patient’s blood is put in a centrifuge to separate its red blood cells from the platelets that release proteins and other particles involved in healing. A small amount of the substance is then injected into the damaged area. The belief is that the high concentration of platelets — 3 to 10 times that of normal blood — prompts the growth of new soft-tissue or bone cells. Scott A. Rodeo, an orthopedic surgeon at the Hospital for Special Surgery in New York and a former United States Olympic team physician, said that when it comes to platelet therapy, “the underlying rationale makes sense but there’s very little underlying research.” Rodeo, who is also a physician for the New York Giants, said that Galea was far from unique in providing the treatment in North America. “If you want to do P.R.P. today, there are many places to do it, although it may have been different two years ago,” he said. “But sometimes in sports, a name gets out and gets recycled among athletes.”