Growth Hormone s Impact as a Safe Ergogenic Aid to Increase Body Size

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Growth Hormone s Impact as a Safe Ergogenic Aid to Increase Body Size Point Argument: Growth Hormone is a Safe Ergogenic Aid to Increase Body Size Monica Chauhan Carissa Eastwood Emily Lefler Mar. 28, 2018 BPK 312

Agenda 1. Hypotheses 2. Clinical Use 3. Mechanism 4. RDA and Safe Use 5. Points 6. Counterpoints 7. Conclusion

Hypotheses Point Hypothesis: Growth Hormone (hgh), or somatotropin, IS a safe ergogenic aid to increase body size by protein synthesis and mobilizing lipids. Counter-Point Hypothesis: Growth Hormone (hgh), or somatotropin, IS NOT a safe ergogenic aid to increase body size by protein synthesis and mobilizing lipids

Clinical Use Pure hgh: Leads to Creutzfeldt-Jakob disease Genetically engineered recombinant hgh(rhgh): Clinical Use: hgh deficiency Girl s with Turner s Syndrome Excessive burns Non- Clinical use: Ergogenic aid Saugey et al,2006

What is hgh? Naturally occurring peptide Secreted by somatotropic cells in anterior pituitary Regulated by two hypothalamic peptides: 1.Growth Hormone Releasing Hormone stimulates 2.Somatostatin inhibits Stimulated by: Exercise Fasting Stress Saugey et al,2006 Moller and Jorgensen, 2009

Mechanism Promotes Lipid Metabolism - Decreases whole body fat Works opposite insulin thus sparing glucose and protein use Promotes lipid utilization for fuel via adipocyte bonding: initiates lipolysis Promotes Protein Synthesis Increases lean body mass and protein storage Promotes insulin-like growth factor 1 (IGF-1) production Decreases breakdown of muscle protein, amino acid degradation and hepatic urea formation Moller and Jorgensen, 2009

RDA, Base Level, and Toxicity RDA: No RDA since not found in food Base level in body: Flux throughout day and life cycle 4800-5500 µg typically secreted/week in adults(crist et al, 1988) Toxicity: Excess amounts could potentially develop acromegaly Hard to determine excess due to pulsatile nature of GH Could determine by measuring IGF-1

Point 1 - Body Composition Methods: Double-blind, placebo-controlled experiment 8 trained subjects: 22 30 years old 5 male, 3 female Dosage: 2.67 mg met-hgh/0.5 ml diluent, 3 days/week for 6 weeks Total of 8,000 µg met-hgh per week Results: in met-hgh group: in LBM (lean body mass) in fat mass Adverse Effects: No adverse effects Crist et al. (1988)

Point 1 - Overall hgh will alter body composition in adults who are highly conditioned from years of exercise training.

Point 2 Body Composition Methods: Double-blind, placebo-controlled experiment 11 subjects: All male 6 in r-hgh group, 5 in placebo group Dosage: 0.067 mg/kg body weight r-hgh/day for 4 weeks 35,400 µg /week, 6 x average Results: in r-hgh group: in [IGF-1] in LBM Adverse Effects: Few adverse effects were seen Healy et al. (2003)

Point 2 Overall Acute GH excess may have short-term benefits for physical performance.

Point 3 Body Composition Methods: Randomized, placebo-controlled, blinded study 96 trained subjects: Mean age of 27.9 years (SD 5.7) 63 male, 33 female Dosage: 2mg hgh/day for 8 weeks 14,000 µg a week, 2x average Results: in hgh group: in LBM through extracellular water in fat mass in sprint capacity in [IGF-1] Total work during sprint cycle ergometry, a measure of anaerobic sprint capacity Adverse effects: Both groups had adverse effects Meinhardt et al. (2010)

Point 3 Overall hgh supplementation influenced body composition an increased sprint capacity when administered alone.

Counter Point 1 Body Composition and Adverse Effects Methods Double-blinded, placebo controlled 22 trained male subjects: 20 28 years old No change in exercise or diet Skin folds used to determine % body fat, subtracted from weight to get LBM Dosage:.09u/kg/day for 6 weeks With an average weight of 55.6kg this totals 35,028 µg/week About 6 times the average Results: No change in strength or body comp Adverse effects: One drop out in first week from carpal tunnel and fluid retention Two drop out from edema in fingers Two had edema in first week but dissolved with continued treatment Deyssig et al. (1993)

Counter Point 1 Limitations Body composition changes Skinfolds = doubly indirect method Itra-observer error in skinfold measurements Possibly significance in LBM with longer duration Adverse effects Possible predisposition not discussed in history Possibility it would have resolved if continued in 3 drop out like the two who didn t drop out

Counter Point 2 Body Composition Methods: Randomized, placebo-controlled, double-blinded, cross-over trial 7 trained male subjects: mean age of 26 years old Medical history and physical exam Serum nonesterified fatty acids (NEFA) = lipolytic marker Determined by a colorimetric method using a commercial kit Dosage: Single does of 2,500 µg was given 4 hours before 90 minutes of cycling. This is only an increase of about half the normal amount Results: Significantly higher NEFA levels in hgh group (3 fold) Despite this they concluded NEFA availability did not increase whole body fat oxidation during exercise Adverse effects: None Discussed Lange et al. (2002)

Counter Point 2 Limitations Sample size Small sample size Dosage Low single dose Methods Did not directly measure fat oxidation

Counter Point 3 Adverse Effects Methods: Double blind placebo controlled 18 untrained male subjects: 21 34 years old Medical history and physical exam before testing Heavy-resistance regimen 5 days a week of all major muscle groups Moderate to high intensity, low reps Hydrodensitometry Dosage: 40 ug /kg/day, 5 days a weeks for 12 weeks 14,740 ug/week, about 3 and a half times the normal amount. Results: No significant increase in strength or decrease in fat mass. Significant increase in LBM in hgh group (p<.01) due to water retention not protein synthesis Adverse effects: Two hgh subjects developed carpal tunnel symptoms that subsided after discontinuation from both hgh and resistance training. Yarasheski et al.

Counter Point 3 Limitations Carpal tunnel could have been caused by other factors New workout regime Predispositions or prior symptoms

Findings Study Meinhardt et al, 2010 Amount/ Week Duration Results Adverse Reaction 14,000 µg 8 weeks in LBM through extracellular water in fat mass in sprint capacity in [IGF-1] Too small sample to conclude on safety Healy et al, 2003 35,400 µg 4 weeks in [IGF-1] in LBM R-hGH Patient 1: Ankle swelling & transient arthralgia R-hGH Patient 2: General fatigue & reduced concentration Crist et al, 1988 Yarasheski et al, 1992 8,000 µg 6 weeks in LBM in fat mass 13,000 µg 12 weeks No in strength No in fat mass in LBM in hgh group (p<.01) due to water retention not protein synthesis No adverse effects Two hgh subjects developed carpal tunnel, subsided after discontinuation Deyssig et al, 1993 35,028 µg 6 weeks No change in strength or body comp R-hGH Patient 1: Drop out in first week from carpal tunnel and fluid retention R-hGH Patient 2&3: Drop out from edema in fingers R-hGH Patient 4&5: Edema in first week but dissolved with continued treatment Lange et al, 2002 2,500 µg Single Dose NEFA levels NEFA availability did not increase whole body fat oxidation during exercise Safety not discussed

Conclusion Growth Hormone (hgh), or somatotropin, IS a safe ergogenic aid to increase body size by protein synthesis and mobilizing lipids. Point Findings Increased LBM and decreased % body fat No adverse effects at a dosage of ~8000 µg excess for 6 weeks. Few adverse effects seen in both groups with higher dosages Counterpoint findings: Does not increase LBM or decrease % body fat Adverse effects Counterpoint limitations: Small sample size and low dosage Unreliable measurement of change in body composition Possible bias in adverse findings hgh benefits > possible symptoms

References 1. Crist, D M., G.T. Peake, P.A. Egan, and D. L. Waters. Body composition response to exogenous GH during training in highly conditioned adults. J Appl Physiol. 65(2): 579-584, 1988. 2. Deyssig, R., Frisch, H., Blum, W. F., and Waldhör, T. Effect of growth hormone treatment on hormonal parameters, body composition and strength in athletes. Acta Endocrinologica. 128(4): 313-318, 1993. 3. Healy, M.L., J. Gibney, D.L. Russell-Jones, C. Pentecost, P. Croos, P.H. Sonksen, and A.M. Umpleby. High Dose Growth Hormone Exerts an Anabolic Effect at Rest and during Exercise in Endurance-Trained Athletes. J Clin Endocrinol Metab. 88: 5221-5226, 2003. 4. Lange, K. H. W., Larsson, B., Flyvbjerg, A., Dall, R., Bennekou, M., Rasmussen, M. H., Orskov, H., and Kjær, M. Acute growth hormone administration causes exaggerated increases in plasma lactate and glycerol during moderate to high intensity bicycling in trained young men. The Journal of Clinical Endocrinology & Metabolism. 87(11): 4966-4975, 2002.

References 5. Meinhardt, U., A.E. Nelson, J.L. Hansen, V. Birzniece, D. Clifford, K. C. Leung, K. Graham, and K.K.Y. Ho. The effects of Growth Hormone on Body Composition and Physical Performance in Recreational Athletes. Ann Intern Med. 152(9): 568-577, 2010. 6. Moller, N., and J.O.L Jorgensen. Effects of Growth Hormone on Glucose, Lipid and Protein Metabolism in Human Subjects. Endocrine Reviews. 30(2): 152-177, 2009. 7. Saugy, M., N. Robinson, C. Saudan, N. Baume, L. Avois, and P. Mangin. Human growth hormone doping in sport. Br J Sports Med. 40: i35- i39, 2006. 8. Yarasheski, K.E., J.A. Campbell, K. Smith, M.J. Rennie, J.O. Holloszy, and D. M. Bier. Effect of growth hormone and resistance exercise on muscle growth in young men. American Physiological Society. E261-E267, 1992.