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Dr Stephen Pomeranz
07-28-2010, 10:12 PM
Human growth hormone is a natural substance produced by the human body in the child and young adult. It
is actually secreted by a small gland in your brain called the pituitary gland. Up until recently, this hormone
could be replaced by injection when it was low or deficient. This condition might be seen in people with
short stature (another words they are abnormally short for their predicted age). You can somewhat reliably
predict what a persons height should be by their family's height and their overall growth curve.

Growth hormone has other roles in the human body. It can make cells grow, preserve muscle during
starvation, burn fat in favor of muscle in some situations, and assist in repair of damaged tissues. Here are
some reasons why growth hormone has become popular:

1: Some very low calorie diets (it preserves muscle rather than fat)
2: To enhance muscularity and
3: To assist in tissue repair after an injury.
4: Some centers that specialize in anti-aging have touted the use of growth hormone to
retard the aging process and preserve muscle.

The drug can also now be absorbed with drops, creams and gels as opposed to injection.

So....why shouldn't everyone take human growth hormone (GH) ? Well first, the word human is a bit
misleading. The growth hormone taken today is actually manufactured in laboratories using sophisticated "recombinant DNA" technology. The reason this is important is because it can now be reliably measured in the blood and....
separated from the growth hormone that we ourselves make naturally even as adults (we just make less
as adults than when we were young). In other words, laboratories that specialize in doping can
tell reliably when someone is taking growth hormone whereas in the past, this was difficult. One problem
with the detection tests is that they have to be performed very soon after someone takes the drug.
The longer you wait to test, the less reliable.

A major reason not to take growth hormone is that it is ILLEGAL to be in possession of the drug unless it is
prescribed by a doctor for conditions like short statue or chronic illness (like AIDS). Recent articles
have shown that in healthy adults, GH does not improve strength, power, or exercise capacity.
Long term use, on the other hand, can result in diabetes, arthritis, heart disease, fluid retention and
even cancer. Because it induces growth, it may cause cells to grow that are dormant or should be left
undisturbed. Prior to his death from lymphoma of the brain (a rare brain tumor) the imposing
defensive star for the Oakland Raiders, Lyle Alzado, genuinely believed that his growth hormone use
led to his death. Finally, growth hormane made in the laboratory is very
pure or uncontaminated but very expensive. Some athletes resort to "black market" GH which is made
from cadaver (dead people) brain tissue. This produces a serious risk of contracting fatal viral infections.

GH has an important role in medicine. It occurs naturally but can be made in a laboratory now so that it is
virtually identical to our own GH. But, the difference is just enough so that we can test for it. Because it
is illegal, expensive, has side effects when abused, and gives little advantage to the healthy adult - taking
it for athletic performance is ill-advised.

On the other hand, it may have an important role in certain weight loss programs, chronic diseases
that causes muscle loss, and in certain types of soft tissue injuries that are hard to heal. It is a proven
medication that should be given to children who are short AND deficient in the hormone but NOT to
youngsters of normal height who simply want to be taller or stronger. There are now trusted tests that allow its
detection in the blood so, if you are taking this drug for the wrong reasons, be prepared to get caught.

Stephen J Pomeranz MD Sports Medicine imaging Physician
Malcolm Shupeck MD Neurosurgeon
Margaret Phillips MD Advanced Medical Imaging Radiologist

Kosar19
07-28-2010, 10:56 PM
This is one of the best articles I've ever read. In six paragraphs you've done something that hasn't been done to this point...explain HGH, why it exists medically, and what the engative effects can be. Thank you.

Turk Schonert
07-28-2010, 11:03 PM
Human growth hormone is a natural substance produced by the human body in the child and young adult. It
is actually secreted by a small gland in your brain called the pituitary gland. Up until recently, this hormone
could be replaced by injection when it was low or deficient. This condition might be seen in people with
short stature (another words they are abnormally short for their predicted age). You can somewhat reliably
predict what a persons height should be by their family's height and their overall growth curve.

Growth hormone has other roles in the human body. It can make cells grow, preserve muscle during
starvation, burn fat in favor of muscle in some situations, and assist in repair of damaged tissues. Here are
some reasons why growth hormone has become popular:

1: Some very low calorie diets (it preserves muscle rather than fat)
2: To enhance muscularity and
3: To assist in tissue repair after an injury.
4: Some centers that specialize in anti-aging have touted the use of growth hormone to
retard the aging process and preserve muscle.

The drug can also now be absorbed with drops, creams and gels as opposed to injection.

So....why shouldn't everyone take human growth hormone (GH) ? Well first, the word human is a bit
misleading. The growth hormone taken today is actually manufactured in laboratories using sophisticated "recombinant DNA" technology. The reason this is important is because it can now be reliably measured in the blood and....
separated from the growth hormone that we ourselves make naturally even as adults (we just make less
as adults than when we were young). In other words, laboratories that specialize in doping can
tell reliably when someone is taking growth hormone whereas in the past, this was difficult. One problem
with the detection tests is that they have to be performed very soon after someone takes the drug.
The longer you wait to test, the less reliable.

A major reason not to take growth hormone is that it is ILLEGAL to be in possession of the drug unless it is
prescribed by a doctor for conditions like short statue or chronic illness (like AIDS). Recent articles
have shown that in healthy adults, GH does not improve strength, power, or exercise capacity.
Long term use, on the other hand, can result in diabetes, arthritis, heart disease, fluid retention and
even cancer. Because it induces growth, it may cause cells to grow that are dormant or should be left
undisturbed. Prior to his death from lymphoma of the brain (a rare brain tumor) the imposing
defensive star for the Oakland Raiders, Lyle Alzado, genuinely believed that his growth hormone use
led to his death. Finally, growth hormane made in the laboratory is very
pure or uncontaminated but very expensive. Some athletes resort to "black market" GH which is made
from cadaver (dead people) brain tissue. This produces a serious risk of contracting fatal viral infections.

GH has an important role in medicine. It occurs naturally but can be made in a laboratory now so that it is
virtually identical to our own GH. But, the difference is just enough so that we can test for it. Because it
is illegal, expensive, has side effects when abused, and gives little advantage to the healthy adult - taking
it for athletic performance is ill-advised.

On the other hand, it may have an important role in certain weight loss programs, chronic diseases
that causes muscle loss, and in certain types of soft tissue injuries that are hard to heal. It is a proven
medication that should be given to children who are short AND deficient in the hormone but NOT to
youngsters of normal height who simply want to be taller or stronger. There are now trusted tests that allow its
detection in the blood so, if you are taking this drug for the wrong reasons, be prepared to get caught.

Stephen J Pomeranz MD Sports Medicine imaging Physician
Malcolm Shupeck MD Neurosurgeon
Margaret Phillips MD Advanced Medical Imaging Radiologist

Excellent post doctor. I have 1 son playing high school football and all the written information(especially from a doctor) that I can show him regarding HGH, creatine, and steroids is great stuff. I also show his teammates when they come over. Thanks !!

msclemons
07-28-2010, 11:43 PM
Really great read. One question: the benefits seem to be very low considering the health risks and illegality. Why do athletes use it? Just because it's a perceived edge and hard to detect?

Also, black market GH from cadavers. *shudder* No way I'd touch that.

bluestree
07-29-2010, 12:09 AM
Also, black market GH from cadavers. *shudder* No way I'd touch that.

Don't they use cadaver tissue as replacements for damaged knees, etc, as well as cosmetic procedures? Guess you won't be kissing Angelina Jolie goodnight any time soon.

Andy Freeland
07-29-2010, 12:18 AM
Don't they use cadaver tissue as replacements for damaged knees, etc, as well as cosmetic procedures? Guess you won't be kissing Angelina Jolie goodnight any time soon.

I know cadavers are used for tendons and ligaments. But something tells me that the screening, testing and overall safety processes are a lot more rigid for legitimate procedures than for the manufacture of illegal, black market drugs.

darvon
08-04-2010, 07:18 PM
Hello Dr. Pomeranz,

I think HGH is a very interesting topic. Since your topics are medical in nature, and you are our in-house expert here, may we get citations for broad points that you make?

Also, the fact that HGH is one of very few drugs that are prohibited in the US from "off-label" use is intriguing. I believe the study that started the HGH controversy came out in 1991 and the law that made HGH illegal for off label use came down in 1992. That was VERY fast for federal legislation.


I think many sports fans don't realize how prevalent off label use is, and how very rare it is for drugs to be marked as illegal for off-label use.

I think there is a lot of details behind the curtain of the 1992 law, and wonder if they are ever coming out.

darvon
08-04-2010, 07:28 PM
A couple of points. Dr. Pomeranz, please correct any misstatements please.

For many years HGH used normally in hostpitals and by doctors was gotten from cadavers. Standard practice. They started producing it artificially for more stability in the manufacturing process and also the issue of psidoviruses ("mad cow disease") which highlighted the risks into eating/using cadaver brains. Lots of pharmaceuticals are made through animals/et al. Don't even ask where estrogen doses come from. Drugs are "harvested" all the time.

Second issue, the health risks are WAAAY understudied. Studies need to be funded and since the Feds are stridently against HGH for reasons unclear, who is going to write the check? BTW, benefits are waaay understudied also. Could be huge benefits for most people, could be negligible.

Why do atheletes do it? Why does Stallone use it? They perceive a benefit of consequence from the data available to them.

darvon
08-04-2010, 07:41 PM
I know cadavers are used for tendons and ligaments. But something tells me that the screening, testing and overall safety processes are a lot more rigid for legitimate procedures than for the manufacture of illegal, black market drugs.

Andy, I don't know about this. Black Market drugs doesn't mean garage manufacture. HGH was produced by standard Pharmaceutical manufacturers around the globe for many years by cadaver. Because it is cheaper, it probably still is in many countries (others please chime in here with details). Drugs "harvested" from animals et al are normal. A drug sold illegally in this country doesn't necessarily mean that is made in a different factory than one sold legally in Canada. Black Market refers to Merchandising, not Manufacturing.

The Sony Plasma TV that Vinny sells from the back of his truck is still a Sony.

darvon
08-04-2010, 07:48 PM
A question for the group:

Why is off-label doctor-prescribed HGH use legal in Canada and illegal in the US?

I don't have the answer, but I would love to hear and join in the discussion.

Dr Stephen Pomeranz
08-11-2010, 12:02 AM
There are many off label uses that are legal in the United States for HGH in the hands of a qwualified doctor. for instance, it is used in some very low calorie diets by weight loss and ,etabolic experts.

The benefits of HGH to the athlete are more perceived than real with one exception, recovery and especially recovery from a soft tissue injury

Yes, it is true, that originally HGH , was made from ground up cadaver brain tissue but....that was before we knew about the risk of slow acting viruses like HIV/AIDS and Mad Cow Disease

Any black market drug or medication not manufactured according to usual standard procedure (usp0 and not vetted by the FDA is risky
All the best
Dr Pomeranz

darvon
08-15-2010, 10:17 PM
"There are many off label uses that are legal in the United States for HGH in the hands of a qwualified doctor. for instance, it is used in some very low calorie diets by weight loss and ,etabolic experts."

That's contradictory to what I have been hearing. Such as the following:

===================
"The Federal Food, Drug, and Cosmetic Act prohibits knowingly distributing or possessing with intent to distribute human growth hormone for any use in humans other than the treatment of a disease or other recognized medical condition that has been authorized by the Secretary of Health and Human Services pursuant to 21 U.S.C. § 355. 21 U.S.C. § 333(c). The Food and Drug Administration (FDA) has approved human growth hormone only for the following uses: short stature in children with growth hormone deficiency, ideopathic short stature in children, short stature in children with Turner or Prader-Willi syndrome, short stature in children with chronic renal insufficiency, adults with biochemically documented growth hormone deficiency (GHD) diagnosed either in adulthood or childhood, adults with wasting disease associated with AIDS, and adults with short bowel syndrome." http://www.mesomorphosis.com/blog/off-label-use-of-hgh-to-treat-tendon-and-ligament-injuries-remains-illegal/718/

darvon
08-15-2010, 10:17 PM
"The benefits of HGH to the athlete are more perceived than real with one exception, recovery and especially recovery from a soft tissue injury"

Thank you for posting, Dr. Citation please?

GoBigOrGoHome
08-04-2011, 08:49 PM
This was a good read when Dr. P posted it last summer. Seeing as though blood testing for HGH is part of the new CBA, I thought this should be revived.

brauneyz
08-04-2011, 08:53 PM
This was a good read when Dr. P posted it last summer. Seeing as though blood testing for HGH is part of the new CBA, I thought this should be revived.

Well, between this and the players caving on allowing GODdell to retain all his ridiculous, inconsistently-applied power, I cannot say I am any more sympathetic to players than I was in March. What a bunch of dingleberries! They get what they deserve now.

GoBigOrGoHome
08-04-2011, 09:34 PM
Well, between this and the players caving on allowing GODdell to retain all his ridiculous, inconsistently-applied power, I cannot say I am any more sympathetic to players than I was in March. What a bunch of dingleberries! They get what they deserve now.

Why?

brauneyz
08-04-2011, 09:42 PM
Why?

Because early on the players had all these demands about safety, autonomy, etc. and they just sold out to the $$$. I have no problem with that, I just wish they'd have been upfront about it. Nobody, and I mean nobody, except Vegas (and we're certainly not about to have a legitimate discussion about that here) gives a rat's patootie about safety or integrity of the game except with regard to the bottom dollar. Protect the NFL shield at all costs. Never mind that every single Sunday we tune into games we hope resemble those played in the Roman Coliseum of old.

GoBigOrGoHome
08-04-2011, 09:46 PM
Because early on the players had all these demands about safety, autonomy, etc. and they just sold out to the $$$. I have no problem with that, I just wish they'd have been upfront about it. Nobody, and I mean nobody, except Vegas (and we're certainly not about to have a legitimate discussion about that here) gives a rat's patootie about safety or integrity of the game except with regard to the bottom dollar. Protect the NFL shield at all costs. Never mind that every single Sunday we tune into games we hope resemble those played in the Roman Coliseum of old.

And HGH and testing for it factors into that how?

brauneyz
08-04-2011, 10:11 PM
And HGH and testing for it factors into that how?

From what I recall, the players were adamant about not submitting to that invasion. Voila! Less than a week and it's all bygones.

My bottom line is that all this crap, the extended negotiations, yada, yada, was always, only, ever about $$$ and could have been dealt with by middle of March. The players want to dope themselves into oblivion and play themselves into early death and destruction, what do I care? At this point, all sides are in the know, and in on the scam. Brauneyz's not falling for that crap anymore, nor spending any $ there.

Back to my man cave ...

GoBigOrGoHome
08-04-2011, 11:32 PM
From what I recall, the players were adamant about not submitting to that invasion. Voila! Less than a week and it's all bygones.

My bottom line is that all this crap, the extended negotiations, yada, yada, was always, only, ever about $$$ and could have been dealt with by middle of March. The players want to dope themselves into oblivion and play themselves into early death and destruction, what do I care? At this point, all sides are in the know, and in on the scam. Brauneyz's not falling for that crap anymore, nor spending any $ there.

Back to my man cave ...

So why direct yor ire at one side? I'm not trying to pick a fight, I honestly do not understand. From what you have said, both the players and owners are greedy bastards. Why choose sides?

brauneyz
08-04-2011, 11:39 PM
So why direct yor ire at one side? I'm not trying to pick a fight, I honestly do not understand. From what you have said, both the players and owners are greedy bastards. Why choose sides?

I do not care that they are both greedy. I care that the players appear to have lied thru their teeth about this. The owners have always been on board with making money. They went for the jugular. The players wussied out on everything. For the right amount of money, I think they'd play 30 games a season under incredibly unhealthy conditions. Plus, they sound like idiots.

Amy
08-05-2011, 07:20 PM
From what I recall, the players were adamant about not submitting to that invasion. Voila! Less than a week and it's all bygones.

My bottom line is that all this crap, the extended negotiations, yada, yada, was always, only, ever about $$$ and could have been dealt with by middle of March. The players want to dope themselves into oblivion and play themselves into early death and destruction, what do I care? At this point, all sides are in the know, and in on the scam. Brauneyz's not falling for that crap anymore, nor spending any $ there.

Back to my man cave ...

What choice did the players have?? The whining about HGH in any sport is lame. Really, the whining about any form of performance enhancers in any sport is lame. But, because of Baseball's 'scandal' there's the media/fan desire to have the testing for 'cheaters.'

So, if the the players hold out on the HGH issue, and the CBA does not get signed, who gets the blame? The owners? No The media? No. The NFLPA. The players eat the blame totally. So, of course they signed even with the provision for testing.

But, that testing will likely never happen. Why? Because a) Each player can only be tested one time per year. So, if they are using, they can likely cycle past it. b) Because both sides have to agree on the lab used and that the test is actually valid. Since there is currently just one lab that does it, it will be a while before tests can happen.

Also, on a side note, the players did get significant safety considerations, especially in off season activities. While I do think they gave up more then I liked, I think the CBA, overall, is a good deal for both sides.

msclemons
08-05-2011, 11:57 PM
I wonder if Extenze™ is considered a human growth hormone? Goodell might have to fine Jimmy.