Written by Tom Fahey
14 January 2010

The last notable benefit relates to athletes who might abuse GH in sports doping. At this time, the International Olympic Committee (IOC) doesn't ban GH secretagogues as they're not commercially available, though expect WADA and related groups to respond more pro-actively after the revelations exposed during the BALCO scandals. While it's obvious that GH secretagogues could be used by athletes for the purpose of increasing GH, it's also possible that GH secretagogues could be used, even at this time, to foil the proposed GH-detecting algorithms suggested by WADA, allowing athletes to use the more potent and effective method of recombinant GH injections.

Here's how it might work: Currently, it's impossible to detect exogenous GH doping, as the recombinant product is identical to one form produced in the body.22,23 WADA has proposed to test athletes' blood (as opposed to urine, which is used in nearly every other test) for two different sets of markers. First, WADA would check to see if the form of GH present in commercially available products is present in greater amounts, compared to the other forms, than is naturally seen.24 This is similar to the 4:1 ratio of testosterone:epitestosterone that's used in some screens and was defeated by use of the "the cream." The cream contained both testosterone and epitestosterone, which lowered the testosterone:epitestosterone ratio back down to accepted levels, preventing a positive drug test. [Author's note- the ratio of testosterone to epitestosterone is the doping detection screen that prompted the allegations of testosterone use by 2006 Tour de France champion Floyd Landis].25

GH secretagogues could stimulate the release of natural GH, including all the isoforms tested for by the proposed WADA plan, restoring isoform ratios back to accepted levels. Of course, this would have to be titrated individually with each athlete, making it expensive, unless they were willing to chance it on a general program. This assumes that illicit manufacturers aren't providing GH products that include a natural combination of the various isoforms. One deadly risk that WADA may actually be propagating is the return of cadaveric GH.

Prior to the discovery of a method of producing GH via recombinant methods (meaning in a laboratory), GH was obtained by extracting it from the pituitary of dead people. This now-banned source, while once valuable to children being treated with the extract, exposed them and doping athletes to the risk of contracting a deadly disease called Creutzfeldt-Jakob disease, similar to mad cow disease.26,27 There's been at least one case of a French bodybuilder contracting Creutzfeldt-Jakob, possibly from cow-derived, cadaveric GH extract or tainted meat imported from Great Britain (England had an epidemic of mad cow disease at the time) or sporadically- as others of that era caught the disease.28,29 The French bodybuilder died at the age of 26.

The second leg of the GH-detection algorithm wouldn't be circumvented, as it looks for markers of GH action to determine if supraphysiologic GH levels existed in an individual athlete, such as insulin-like growth factor-1 (IGF-1) and type III procollagen (P-III-P).30 Considering that most athletes are healthy, active and young, it's likely that the threshold will have to be set fairly high. This would limit the total benefit that could be attained through GH and GH secretagogue use, though the window of opportunity would be greater for older athletes. Many athletes are extending their careers into their late 30s and early 40s, making this more relevant with each passing year.