Doping with Growth Hormones—Is It Really Unbeatable?—Part 2

In Part 1, I provided what I believe to be a rather interesting insight into the discussion on the use of exogenous growth hormone, as published in the book *Anabolic Steroids—The Black Book*.

Aside from the fact that the authors stipulate the need to use four exogenous substances (growth hormone, thyroid hormone, insulin, and testosterone) for full effectiveness, the potential benefits one can apparently expect from this sound quite promising.

It seems that when it comes to using growth hormone, it’s “all or nothing,” unless one wants to use it “only” for slightly improved fat burning.

Long-term use is also recommended, as the actual effects don’t become apparent until after a few weeks. Today I’d like to present the results of a recent study by Hermansen et al., which incorporated data from a total of 11 scientific papers and 224 participants.

All of these studies examined the effects of growth hormone administration in young, healthy adults. Will we find today that all the effects mentioned in the “black book” are confirmed, or will a completely different picture emerge? Let’s find out…!

 

Introduction

The illegal use of growth hormone among elite and recreational athletes alike is by no means uncommon. Surveys indicate that between 3.5 and 5% of all college athletes regularly use several milligrams of growth hormone, either daily or divided into several weekly doses. Twenty-five percent of users report concurrent use of anabolic and androgenic steroids (18). While there were still challenges in 2006 regarding the unequivocal detection of GH doping offenders (1), more than 10 years later, this is no longer an issue and is now a standard part of the IOC’s testing repertoire (4).

Note: To date, doping in bodybuilding has been effectively monitored only in a few exceptional cases at the national level and, to some extent, at the international level!

Studies in humans with physiologically low levels of growth hormone clearly show positive effects of exogenous administration, including improved aerobic capacity and increased muscle volume (2), while—at least in the meta-analysis by Rubeck et al. (3)—no significant effects on muscle strength were observed.

The administration period in the studies involved ranged from 3 to 12 months. What occurred in some cases was a normalization of reduced IGF-1 levels, as observed in placebo groups.

Positive changes resulting from the use of growth hormone in cases of GH deficiency are certainly a great thing, but strictly speaking, they say nothing about what happens when growth hormone is administered at what is actually a normal physiological level.

 

The Study

The studies included in the aforementioned paper by Hermansen et al. were, of course, all human studies—randomized, double-blind, and placebo-controlled. All participants were found to have healthy growth hormone levels. They were between 18 and 45 years old.

All studies analyzed specific data on body composition, muscular characteristics, and exercise capacity, and also provided information on changes in metabolism.

It should certainly be noted here as a drawback that two of the studies involved examined only the effects of a single GH injection.

In the other studies, the duration of treatment—ranging from 2 to 12 weeks—unfortunately did not fall within the range commonly associated with doping in sports. An average of 36.5 mcg per kilogram of body weight was administered subcutaneously.

Based on an 80-kg athlete, this would equate to 2.9 mg and thus approximately 8.7 IU, which would be considered a moderate to even high dose in that context (5).

 

The Results

What is particularly interesting at this point is the analysis of changes in body composition and fluid balance.

Note: As we know, an increase in LBM does not necessarily equate to an increase in muscle mass. As discussed in Part 1, growth hormone is also known in practice to cause increased water retention.

As the attached graph shows, the administration of growth hormone increased body weight and, to an even greater extent, the proportion of lean body mass (LBM). After accounting for the increased levels of both extracellular and intracellular water, only a statistically insignificant increase in BCM (muscle mass) of 0.9 kg remains; in contrast, the fat mass percentage decreased significantly by an average of 1.22 kg.

With regard to fat metabolism, acutely higher levels of glycerol and free fatty acids were measured in the blood following growth hormone administration compared to placebo. However, in terms of metabolism, there was NO increase in lipid oxidation.

Based on all available data, it can be concluded that the administration of growth hormone had no significant effect on strength values, and oxygen uptake as well as aerobic performance remained unaffected by the administration in the majority of the studies involved.

Conclusion
: Disappointing results, at least for now. No significant muscle growth, no increase in strength, no improvement in performance, and increased lipolysis that does not, however, translate to increased fat burning—it doesn’t get any worse than this!

 

Discussion

Despite the sobering conclusion, the study initially suggests that growth hormone administration does produce effects even in healthy subjects. An increase in lean body mass that is noticeable at first glance turns out, upon closer inspection, to be less a genuine gain in muscle mass and much more fluid retention, accompanied by only a very small portion of actual muscle mass (5). One noticeable effect is an increase in lipolysis, measured by an elevated level of glycerol and free fatty acids in the blood (6).

Unfortunately, the increased release of triglyceride components was not accompanied by increased fat oxidation. Hansen et al. (9) rule out any significant effect even in conjunction with physical activity (aerobic training), which is why one does not seem to benefit from the lipolytic effect at all initially.

To make matters worse, two of the studies involved report an increase in plasma lactate levels (8, 9), which could ultimately have a detrimental effect on anaerobic energy production (10).

However, there are also conflicting results on this point, such as those by Meinhardt et al. (12), who report a significant improvement in performance in the Wingate test thanks to growth hormone. It remains unclear to this day whether elevated lactate levels result purely from muscle metabolism or are due to impaired lactate clearance (12).

Things get interesting again in the studies by Meinhardt et al. (12) and Sönksen (13), as this is precisely where Parts 1 and 2 of this article converge. The discussion centers on synergistic effects resulting from the combined administration of growth hormone with anabolic androgenic steroids, which, on the one hand, induces increased androgen receptor gene expression and, on the other hand, leads to higher levels of muscle IGF-1 mRNA and, consequently, improved body composition. Accompanied by improved performance and faster recovery—sometimes via accelerated collagen synthesis—the effects here are thus already quite different (14, 15, 16). 

Anyone who uses exogenous growth hormone over an extended period risks developing insulin resistance as well as increased fluid retention, which often leads to edema, carpal tunnel syndrome, joint pain (arthralgia), or muscle pain (myalgia). Long-term use also increases the risk of sleep apnea, high blood pressure, osteoarthritis, or cardiomyopathy (a disease of the heart muscle) (17).

 

Summary

Athletes and scientists agree: “Growth hormone is more effective in terms of improved performance and muscle building when combined with anabolic androgenic steroids.”

It remains unclear to what extent growth hormone, anabolic-androgenic steroids, or certain training methods are actually capable of triggering hyperplasia—that is, an increase in the number of existing muscle cells rather than just a thickening of those cells (17). Those who plan to promote lipolysis can achieve this even without the concurrent administration of other substances; however, they face the challenge of actually burning the released fatty acids, since this does not appear to occur to a significant extent with growth hormone alone (contrary to what was claimed in Part 1).

While combined use with anabolic-androgenic steroids appears to be common and also sensible in terms of effectiveness, none of the reviewed literature indicates any additional benefit from using the active thyroid hormone T3. The concurrent use of insulin is also mentioned only in passing. It can be assumed here that sufficient insulin for IGF-1 production can be provided through the administration of carbohydrates at the right time, in the right amount, and of the right composition.

In conclusion, the following key points can be summarized from both sources:

• Growth hormone for muscle building and performance only works when used in conjunction with AAS
• Concurrent use of thyroid hormone is not, as claimed, absolutely necessary, as there is little to no documentation supporting this (if in doubt, check T3 levels regularly)
• The concurrent use of insulin is not, as claimed, absolutely necessary, as there is little to no documentation supporting this (balance insulin requirements)
• Growth hormone as a fat burner only works when accompanied by increased physical activity in the aerobic range, and there is a risk of developing insulin resistance!

 

Overall Conclusion

All in all, growth hormone is by no means the miracle cure it is often touted to be. Without the concurrent use of anabolic/androgenic steroids—which are also fraught with side effects—the muscle-building effect virtually disappears.

Furthermore, growth hormone should not be viewed per se as a powerful fat burner that can replace physical activity. Without simultaneous energy expenditure through aerobic exercise, no fat oxidation will occur, and the lipolytic effect will therefore be lost as well.

The costs, benefits, and alleged side effects of using growth hormone therefore seem to be out of balance, which is why its use is not recommended!

 

Best regards
, Holger Gugg

www.body-coaches.de

 

 

Sources

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657499/
(2) https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2265.2009.03592.x
(3) https://www.ncbi.nlm.nih.gov/pubmed/19508603
(4) https://www.wada-ama.org/sites/default/files/resources/files/wada-2016-prohibited-list-german.pdf
(5) http://www.tandfonline.com/doi/abs/10.3109/00365519509075396
(6) https://academic.oup.com/edrv/article-lookup/doi/10.1210/er.2008-0027
(7) http://jap.physiology.org/content/96/2/747
(8) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1474222/
(9) https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2001-011797
(10) https://link.springer.com/article/10.2165%2F00007256-200333060-00003
(11) https://link.springer.com/article/10.2165%2F00007256-200333060-00003
(12) https://www.ncbi.nlm.nih.gov/pubmed/20439575
(13) http://www.growthhormoneigfresearch.com/article/S1096-6374(09)00044-6/abstract
(14) https://www.ncbi.nlm.nih.gov/pubmed/24081158
(15) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821728/
(16) https://www.ncbi.nlm.nih.gov/pubmed/15998337
(17) https://www.nature.com/nrendo/journal/v3/n3/full/ncpendmet0429.html