In December, stories of steroids and athletes were again in the headlines with a report that human growth hormones (HGH) shipped to the home of NFL quarterback Peyton Manning in 2011 while he was trying to recover from neck surgery. Manning fiercely refuted the charges. However, even if he did take them, he certainly wouldn’t have been the first.
Despite a lack of evidence to back up HGH’s impacts, superstars from Tiger Woods to Barry Bonds to Jose Canseco have been linked to them, and increasingly many recreational athletes are now seeking them out.
The use of HGH to build muscle mass and boost performance has long been controversial, and even less is known about whether the substance can help people recover from injury.
American sports journalist Bill Simmons talked about HGH on a recent podcast, saying he’d contemplated taking it for a basketball injury. He decided against it, though, once he discovered that HGH can trigger seemingly benign cancer cells in the body.
Two Canadian sports-medicine doctors say Simmons made the right decision, and that “weekend warriors” considering taking the growth hormone should be aware of the many associated risks.
HGH is only approved for use by Health Canada for specific conditions, including growth failure and muscle-wasting conditions; it is usually prescribed by endocrinologists.
However, people who think that HGH will help them gain a competitive edge, gain muscle, enhance their sports performance, or recover faster from injury seek out “off label use”.
“Unlike the United States, in Canada—I’m not sure why—there is no restriction against off label use,” says Dr. Tim Rindlisbacher, director of sports health at Cleveland Clinic Canada in Toronto, “This is how you have some greater access to HGH. If the doctor wants to… prescribe the medication knowing it’s not meant for that patient, the doctor is taking a risk. It’s another, separate question whether the patient is also taking a risk, which they are.”
Aside from the chance of infection from the hormone being injected into the body, there are far more serious potential effects of taking HGH.
“You can run the risk of diabetes, hypertension, heart muscle disease, kidney disease, joint pain, fatigue, and the potential risk of creating a cancer,” Rindlisbacher says. “All of us have dormant cancer cells and those cells will only express or cancer will only be evident if a trigger comes along and wakes them up, causes them to grow uncontrollably, and that’s what cancer is.
Doses are important to consider as well. Amounts of HGH used for performance enhancement or injury recovery are typically much higher than for clinical applications.
“When you have high doses that are beyond not your natural physiological level, there certainly is a risk of creating a cancer,” Rindlisbacher says.
“Some people call it a wonder drug,” he adds. “I’d like to call it that too, only in terms of ‘I wonder how people can be so stupid.’ How can you be duped by sports physicians who are also convicted felons?”
He’s referring to the likes Anthony Galea, a disgraced Toronto-based sports medicine physician who was convicted in the United States in 2011 for importing unapproved and mislabelled drugs, including HGH, and making house calls to stars like Alex Rodriguez.
[Dr. Anthony Galea, a sports medicine specialist, at his clinic in Toronto on Dec. 14, 2009. Galea has treated hundreds of professional athletes across many sports.]
While it may be easier to see why professional athletes are willing to take HGH—they’re desperate and will do anything to get back to their sport, given that so much rides on their performance—weekend warriors have no good reason to take HGH, Rindlisbacher says.
“There is a wide base of knowledge that you can improve your performance or recover from injuries quickly in a way that is safe and tried and true and that has science behind it,” Rindlisbacher says. “If you’re a young or recreational athlete, you really are very dumb to be taking those kind of risks.”
Dr. Tanya Cabrita, sport medicine physician at Fortius Sport and Health in Burnaby, B.C., notes that the source of off-label HGH is another reason to be wary. Derived from human cadavers and animal carcasses, it’s available online from countries all over the world.
“If you’re not getting it from a doctor, then you’re not sure what you’re getting,” Cabrita says. “It’s also a really high cost so there’s a lot of counterfeit, a lot and fake stuff, and it’s not regulated, so again you don’t know what you’re getting.”
Other side effects, she notes, include swelling and nerve and muscle pain.
“As far as published articles go, there is insufficient medical and scientific evidence to support the use of HGH [outside of its clinical applications],” Cabrita says. “It is not prescribed by physicians for healing.”