I have been asked about the use of food supplements, HGH (Human Growth Hormone), Creatine and Androstenedione. For those who don't know me (see About), I am a physician specialized in Internal Medicine, and am a Fellow of the American College of Physicians (I coach for fun!).
I have summarized some of this info from "The Medical Letter", an authoritative, unbiased panel of prominent American physicians and pharmacists... Vol 40, Nov 6, 1998 issue.
An additional personal note:
It is my opinion that you will not get an unbiased answer from the companies that manufacture and sell these supplements, as they are profiting on the sales. Many of their claims are not supported by authentic scientific studies. Nor will you get an unbiased report from magazines that depend on these companies for advertising revenues.
I hope this information helps you make the correct decision in regard to the use of these drugs.
James A. Gels MD, FACP (aka "Coach" Gels)
HGH - Human Growth Hormone
A very timely detailed, scientific review article on this subject has recently appeared in the medical journal "Annals of Internal Medicine" (Vol 148, number 10, pp 747-758), the official journal of the American College of Physicians. The article reviewed and incorporated essentially every scientific study to date on this subject.
Effects on Performance
There is no scientific evidence that indicates HGH improves athletic performance or strength. There are however, no long-term studies available yet. Initial reports that HGH increases lean body mass are tempered by the facts... much of the increase in lean body mass induced by HGH is caused by increased fluid and water retention, not by increased muscular hypertrophy. There was a study done on college football players and weightlifters who were given HGH... there were no increases in protein synthesis or muscular strength.
In terms of aerobic endurance and enhancement... surprisingly, HGH did not improve, and in fact, tended to worsen exercise capacity. Athletes on HGH had higher rates of fatigue, and much higher exercise lactate levels.
Most of the studies were only three months in duration, so long-term data is not yet available. And essentially no data is available regarding female athletes... as most of the study participants were male. So there is no hard data on how HGH affects healthy, physically-fit young women.
Athletes who took HGH had a higher rate of side-effects compared to those who didn't take anything. The main side effects were fluid retention and swelling, joint pains and carpal tunnel syndrome.
The bottom line...
From the article... "Claims that growth hormone enhances physical performance are not supported by the scientific literature."
Comment for Coach Gels... the only real indication for Human Growth Hormone is for the treatment of those persons who truly have a diagnosed endocrine growth hormone deficiency.
Creatine is a natural amino acid derivative (not a steroid). It is made in the liver, kidneys and pancreas, and is in food sources such as meat and fish.
Effects on Performance
In one study, creatine led to an increase in body mass, mainly through water retention. A 28 day trial at 20 grams/day dose in 8 weight-lifters (a very small number for a study), showed some increases in strength, weight and fat-free mass. A summary of 31 short term studies (using the drug for one week) indicated that creatine may "modestly improve performance" in short duration (less than 30 seconds) bursts, but not in sustained activity... and this was only in a laboratory setting. No definite benefits were shown in actual field studies. Other studies showed "no consistent advantage during aerobic exercise".
Adverse effects (side effects):
One person with a kidney problem who took creatine developed kidney failure. While most patients taking creatine had no short term side effects, the long term effects are not known, and some patients reported some side effects including skin rash, shortness of breath, vomiting, diarrhea, nervousness, fatigue, headache, muscle soreness and weakness, convulsions and heart irregularity. Whether these effects were directly related to the creatine or not is debatable.
Creatine may mildly improve performance in brief aerobic activities in the laboratory. Whether this translates into improvement in an actual athletic competition is unknown, and has never been proven. No data is available yet on long term safety. The potency and purity of creatine sold as a dietary supplement is unknown since it is not under FDA control, and many users tend to exceed the recommended doses.
Creatine does not replace conditioning, weight training, practice, and hard work in achieving athletic success. Any benefits are probably minimal, and could be achieved by weight training and practicing more. Certainly when a young player sees Mark McGuire using it, it is a powerful influence for him to try it also. Mark McGuire's success I believe relates mainly to his hard work, great hand-eye coordination, training, etc. Who knows if creatine really helped him hit all those homers. If, instead of using creatine, he put a plug of chewing tobacco in his mouth as he walked up to the plate, would we all think that it was the tobacco that gave him his great success? If you use it, do not exceed dosage, and drink plenty of fluids, and don't whine if you develop side effects 10 years from now, because the long term effects are not known.
Androstenedione is an androgen (male hormone). It may cause an increase in the male hormone testosterone. There are no proven data showing that it definitely increases muscle mass or performance. If it did increase muscle mass, it would be in a way similar to taking androgenic steroids and would probably carry all the same long-term side effects: prostate cancer, liver tumors and liver failure, loss of male fertility, behavioral changes. Women who use testosterone become more male-like with deeping voice, cessation of menstrual periods, scalp hair loss, acne, facial hair growth. In adolescents, stunting of overall height can occur. Androstenedione has been banned by the IOC, NCAA, NFL and many other athletic organizations. Again, its long term effects are not definitely known.