Commentary: Risking Well-being for Short Term Gains – Alarming Increase in Teen hGH Use

The use of performance-enhancing drugs by our youth is an important public health issue which has been unequivocally shown to extend beyond elite and professional level sport. Recent findings from the Partnership Attitude Tracking Study showed that in 2013, 11 percent of teens reported using synthetic human growth hormone (hGH) at least once within their lifetime without a doctor’s prescription – a significant twofold increase compared to the approximately 5-6 percent consistently reported over the past five years. The root of this significant increase remains unclear. However, it presents an alarming trend toward youth engaging in potentially detrimental behavior to health and long term well-being during critical years in physical and mental development.

Growth hormone is produced naturally by the body to maintain a number of vital biological functions. But the use and abuse of synthetic hGH as a performance- and image-enhancing drug, as well as its marketing to healthy individuals as a drug that will improve “lifestyle” and well-being, is increasing. Synthetic hGH has reportedly long been used as a performance-enhancing drug in sport and is frequently used in combination with other performance-enhancing drugs, such as steroids.

Congress specifically gave the U.S. Secretary of Health and Human Services the authority to approve the medical use of synthetic hGH and prohibited any off-label uses. The limited number of approved medical uses include muscle-wasting disease associated with HIV/AIDS, adult deficiency due to rare pituitary tumors or their treatment, adult short bowel syndrome, and long-term treatment of short stature in children and adolescents. Prescribing or distributing synthetic hGH for performance or image enhancement is not only dangerous, it is illegal.  Supplementation with synthetic hGH leads to increased skeletal muscle mass, decreased weight, enhanced delivery to the tissues of nutrients necessary to build or repair tissue, and altered energy metabolism. Although these short term consequences may appear beneficial, they are not without extreme short-term and long-term health risks.

Potentially adverse effects, which may be irreversible, include stimulation of abnormal growth of major organs including the brain, increased risk of diabetes or glucose intolerance, joint and muscle pain, elevated triglycerides, and possible impacts on encouraging inappropriate growth signaling of cancer tumor growth. It is unfortunate that young people and the public at large are unaware or indifferent to these harmful consequences.

Online suppliers and those making marketing claims about the benefits of synthetic hGH therapy, which include dietary supplement products, may also be distributing products which are not what they claim and are potentially extremely harmful to health. More education is required by appropriate channels to increase overall youth awareness, and counter the convincing and largely misleading message delivered by those touting the perceived benefits of synthetic hGH supplementation. Although mainstream media often limits news coverage of use of synthetic hGH to sport doping scandals, more needs to be done to highlight the adverse consequences to an athlete’s health and the negative impact cheating has on personal and professional well-being.

The mission of the U.S. Anti-Doping Agency (USADA) is to protect and preserve the health of athletes, the integrity of clean competition, and the well-being of sport by deterring and detecting doping. The fact that youth are willing to take extreme shortcuts for short-term gains is greatly concerning and undermines the intrinsic value of sport and devalues athletes and healthy competition.

Dr. Matt Fedoruk
Science Director
U.S. Anti-Doping Agency