Headlines are designed to get the potential reader’s attention, but they can also be misleading.
The article, titled “National Study: Teens Report Higher Use of Performance-Enhancing Drugs,” certainly grabs one’s attention. The headline is also followed by a prominent subheading that reads “Dangerous Trends Reinforce Need for Tighter Regulation of ‘Fitness Products’.”
Wow, am I ready for some significant information!
However, the devil is in the details, and those details are important. When one speaks of human growth hormone (hGH), many clinicians, including myself, think of the biosynthetic recombinant (r)hGH. This is an FDA-approved pharmaceutical agent indicated for children, adolescents and adults that is administered by injection. An effective dose for an adolescent weighing more than 50 kg would cost upwards of $20,000 per year.
So what are these adolescents taking to “improve” athletic performance or to “look good”?
That is a good question. The article draws on data from the latest Partnership Attitude Tracking study done in collaboration with the Partnership for Drug-Free Kids. The study is described as follows:
“The 25th annual Partnership Attitude Tracking Study (PATS) of 3,705 teens in grades 9-12 and 750 parents is nationally projectable with a +/- 2.1 percent margin of error for the teen sample and +/- 3.6 percent for the parent sample. Conducted for the Partnership at Drugfree.org and MetLife Foundation by GfK Roper Public Affairs & Corporate Communications, the 2013 PATS teen survey was administered in private, public and parochial schools, while the parent survey was conducted through in-home interviews by deKadt Marketing and Research, Inc.”
In the study, the adolescents were asked what they “think” they are ingesting or injecting. The astounding result, at least in my opinion, is that 11% reported having ever used synthetic hGH without a prescription. What’s more incredible is that this percentage more than doubled from the 5% reported in 2012.
Where do 11% of adolescents find the money or means to access rhGH?
I submit that they do not. Rather, they are victims of hucksterism. For example, ads found in some airline magazines tout the anti-aging and bodybuilding properties of rhGH and products containing substances that can “release” one’s own hGH and offer information on how and where to purchase these products.
But this is also where the data become murky.
As one example, amino acids such as arginine or ornithine are legitimate releasers of endogenous hGH in humans, but it takes boatloads, often administered intravenously, to have an effect. The products advertised likely contain these amino acids, but in miniscule quantities, compared with a GH secretagogue test, and are ingested orally.
Nevertheless, although these products are not FDA-approved drugs, they contain amino acids that are legitimate supplements found in many proteins in the normal diet. Thus, they are subject to the Dietary Supplement Health and Education Act (DSHEA), and the manufacturer is not required to demonstrate efficacy. The FDA can only ban a supplement if the FDA finds proof that the supplement is dangerous.
In a similar manner, analogues of GH-releasing hormone or ghrelin might be present in some of these products in subclinical quantities. Both will release endogenous hGH when administered orally or parenterally in large enough quantities.