Combined administration of microdoses of growth hormone and erythropoietin: Effects on performance and evaluation of GH detection capability using anti-doping methods

Combined administration of microdoses of growth hormone and erythropoietin : Effects on performance and evaluation of GH detection capability using anti-doping methods / Alexandre Marchand, Jean‐Antoine Martin, David Collot, Olivier Hoang, Ingrid Roulland, Florian Semence, Pierre‐Edouard Sottas, Michel Audran, Emmanuelle Varlet‐Marie. - (Drug Testing and Analysis (2019) 13 July; p. 1-16).
- PMID: 31301268.
- DOI: 10.1002/dta.2674


The combination of growth hormone (GH) and recombinant erythropoietin (rEPO) is thought to be used particularly in endurance sports. Our objective was to reproduce a 2‐week administration of rEPO microdoses alone or in combination with GH microdoses (three times a week) on healthy and athletic male subjects and to evaluate if GH had any additional effects compared to EPO treatment alone. The effects of the treatments on hematological parameters and VO2max were studied as well as the detection of GH in serum. While the rEPO microdose regimen was associated with a significant increase in reticulocytes, no clear elevation in hemoglobin concentration (HGB) was observed. Using a correction by plasma volume did not reveal more effects of EPO on HGB. Our results did not show any additional effect when the GH microdoses were co‐administered. In addition, no clear increase in VO2max was observed after treatment, with an elevation in only half the subjects in both groups (EPO and EPO+GH). A clear effect of GH on insulin‐like growth factor I (IGF‐I) was seen but it was lower on procollagen III amino‐terminal propeptide (P‐III‐NP). GH detection using the direct isoform test identified only one subject 24 hours after receiving GH. The GH biomarker test combining IGF‐I and P‐III‐NP was not able to detect the GH administration. However, a longitudinal follow‐up of the intraindividual variations showed a significant increase in IGF‐I 24 and 48 hours after GH administration in most subjects, while the effect of GH microdoses on P‐III‐NP was less straightforward.


Research / Study
13 July 2019
Audran, Michel
Collot, David
Hoang, Olivier
Marchand, Alexandre
Martin, Jean-Antoine
Roulland, Ingrid
Semence, Florian
Sottas, Pierre-Edouard
Varlet-Marie, Emmanuelle
Other organisations
Agence Française de Lutte contre le Dopage (AFLD) - French Anti-Doping Agency
Institut des Biomolécules Max Mousseron (IBMM)
Université de Montpellier - University of Montpellier
Paris, France: Agence Française de Lutte contre le Dopage (AFLD)
Doping classes
S2. Peptide Hormones, Growth Factors
Erythropoietin (EPO)
Growth hormone (GH)
Insulin-like Growth Factor-1 (IGF-1)
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9 September 2019
Date of last modification
18 September 2019
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