Systematic review : the effects of growth hormone on athletic performance / Hau Liu, Dena M. Bravata, Ingram Olkin, Anne Friedlander, Vincent Liu, Brian Roberts, Eran Bendavid, Olga Saynina, Shelley R. Salpeter, Alan M. Garber, Andrew R. Hoffman. - (Annals of Internal Medicine 148 (2008) 10 (20 May); p. 747-758)

• PMID: 18347346
• DOI: 10.7326/0003-4819-148-10-200805200-00215

Abstract

Background: Human growth hormone is reportedly used to enhance athletic performance, although its safety and efficacy for this purpose are poorly understood.

Purpose: To evaluate evidence about the effects of growth hormone on athletic performance in physically fit, young individuals.

Data sources: MEDLINE, EMBASE, SPORTDiscus, and Cochrane Collaboration databases were searched for English-language studies published between January 1966 and October 2007.

Study selection: Randomized, controlled trials that compared growth hormone treatment with no growth hormone treatment in community-dwelling healthy participants between 13 and 45 years of age.

Data extraction: 2 authors independently reviewed articles and abstracted data.

Data synthesis: 44 articles describing 27 study samples met inclusion criteria; 303 participants received growth hormone, representing 13.3 person-years of treatment. Participants were young (mean age, 27 years [SD, 3]), lean (mean body mass index, 24 kg/m2 [SD, 2]), and physically fit (mean maximum oxygen uptake, 51 mL/kg of body weight per minute [SD, 8]). Growth hormone dosage (mean, 36 microg/kg per day [SD, 21]) and treatment duration (mean, 20 days [SD, 18] for studies giving growth hormone for >1 day) varied. Lean body mass increased in growth hormone recipients compared with participants who did not receive growth hormone (increase, 2.1 kg [95% CI, 1.3 to 2.9 kg]), but strength and exercise capacity did not seem to improve. Lactate levels during exercise were statistically significantly higher in 2 of 3 studies that evaluated this outcome. Growth hormone-treated participants more frequently experienced soft tissue edema and fatigue than did those not treated with growth hormone.

Limitations: Few studies evaluated athletic performance. Growth hormone protocols in the studies may not reflect real-world doses and regimens.

Conclusion: Claims that growth hormone enhances physical performance are not supported by the scientific literature. Although the limited available evidence suggests that growth hormone increases lean body mass, it may not improve strength; in addition, it may worsen exercise capacity and increase adverse events. More research is needed to conclusively determine the effects of growth hormone on athletic performance.

Growth hormone, IGF-I and insulin and their abuse in sport / R.I.G. Holt, P.H. Sönksen. - (British Journal of Pharmacology 154 (2008) 3 (June); p. 542-556)

• PMID: 18376417
• PMCID: PMC2439509
• DOI: 10.1038/bjp.2008.99

Abstract

There is widespread anecdotal evidence that growth hormone (GH) is used by athletes for its anabolic and lipolytic properties. Although there is little evidence that GH improves performance in young healthy adults, randomized controlled studies carried out so far are inadequately designed to demonstrate this, not least because GH is often abused in combination with anabolic steroids and insulin. Some of the anabolic actions of GH are mediated through the generation of insulin-like growth factor-I (IGF-I), and it is believed that this is also being abused. Athletes are exposing themselves to potential harm by self-administering large doses of GH, IGF-I and insulin. The effects of excess GH are exemplified by acromegaly. IGF-I may mediate and cause some of these changes, but in addition, IGF-I may lead to profound hypoglycaemia, as indeed can insulin. Although GH is on the World Anti-doping Agency list of banned substances, the detection of abuse with GH is challenging. Two approaches have been developed to detect GH abuse. The first is based on an assessment of the effect of exogenous recombinant human GH on pituitary GH isoforms and the second is based on the measurement of markers of GH action. As a result, GH abuse can be detected with reasonable sensitivity and specificity. Testing for IGF-I and insulin is in its infancy, but the measurement of markers of GH action may also detect IGF-I usage, while urine mass spectroscopy has begun to identify the use of insulin analogues.

Docherty JR. Pharmacology of stimulants prohibited by the World Anti-Doping Agency (WADA). Br J Pharmacol. 2008 Jun;154(3):606-22.

Dopingautoriteit jaarverslag 2007 / Dopingautoriteit. - Capelle aan den IJssel, 2008

This is the second Annual Report from the Anti-Doping
Authority of the Netherlands. The organisation was
established on 23 June 2006 with the merger of the
Netherlands Centre for Doping Affairs and Doping
Control Netherlands.
The merger has become more than just the sum of
the parts: the activities of both merger partners will be
recognisable in this report, but the new structure has
changed the way those activities are positioned in the
organisation and had an impact on their implementation.
In addition to the two operational departments dealing
with Prevention and Control, the Doping Authority has a
staff which serves both departments and the management.
This grouping of knowledge and expertise is one
of the added values generated by the merger.
We hope that this annual report will provide you with a
clear picture of the work our organisation has done in
the first complete reporting year of our existence.
The board of management

This is the third Annual Report from the Anti-Doping Authority of the Netherlands. The organisation was established on 23 June 2006 with the merger of the Netherlands Centre for Doping Affairs and Doping Control Netherlands.

The Doping Authority has now proven that housing Prevention and Control in a single organisation was an important step. The merger has allowed us to operate more effectively. Public awareness of the organisation and the organisation’s profile also received a major boost.
Changes in policy were introduced in 2008 in areas where the Doping Authority is active, largely as a result of the decisions taken in late 2007 by the General Meeting of the NOC*NSF. Those decisions constituted the basis for the formation of the ‘registered testing pool’ and the obligations incumbent upon the people included in that testing pool.

As a result, it was possible to conduct doping controls in a more targeted and effective way and our educational activities reached many more elite athletes than in previous years.
The changes in the regulations have resulted in an increasing number of protracted follow-up investigations so that it can sometimes take more than six months before definitive decisions can be made about the result of a doping control. That is one of the reasons it was not possible to publish this annual report earlier.
We hope that this annual report will provide you with a clear picture of the work of our organisation.
The board of management

Dopingautoriteit jaarverslag 2009 / Dopingautoriteit. - Capelle aan den IJssel, 2010

This is the fourth Annual Report from the Anti-Doping Authority of the Netherlands.

In recent years, our organisation has proven increasingly able to fulfil effectively the responsibilities delegated to us by the government and organised sports. At the same time, it undeniable that this increased efficacy – and our associated reputation and high profile – are powering opposing forces in our society as a whole and in the world of sports in particular.
In 2009, there was a broad – and necessary –public discussion about the anti-doping policy and the way it is implemented. A range of groups in society criticised the global policy and – albeit to a lesser extent – the way in which that policy is implemented in the Netherlands. In a number of complex and high-profile cases, that policy and that implementation have been, and continue tobe, tested.

These developments will all contributeto our ultimate objective: clean, fair sport.
Despite the efforts that went into dealing with doping violations, our organisation continues to focus to an important extent on preventing cases of this kind. Prevention and education continue to be of undiminished importance.
We hope that this annual report will provide you, once again, with a clear picture of the work of our organisation.

The board of management

Dopingautoriteit jaarverslag 2010 / Dopingautoriteit. - Capelle aan de IJssel, 2011

Annual Report 2010
This is the fifth Annual Report from the Anti-Doping Authority of the Netherlands.

In several respects, 2010 was a transitional year. First of all because it became clear during the course of the year that the Doping Authority will not escape government cutbacks.
As a result, in the years to come, we can expect to get smaller rather than grow.

2010 was also a transitional year: the basic principles were drawn up for changes in the national doping policy and they will affect the work of the Doping Authority in 2011, and later, in several respects.

We look back with satisfaction at a fruitful year and we hope that this annual report will provide you, once again, with a clear picture of the work of our organisation.