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Committee Holds Hearing on Myths and Facts about Human Growth Hormone, B-12, and Other Substances

For the last three years our Committee has been investigating the use of performance enhancing drugs in professional sports and by high school children.

A lot of developments have surprised me, but none more than the amount of misinformation and widespread confusion that surrounds steroids, human growth hormone, vitamin B12, and other substances. Even highly paid, presumably sophisticated professional athletes often seem to know the myths - not the facts - about these substances.

That's why we are having today's hearing. It is an opportunity to provide essential and accurate information not just to professional athletes, but to high school kids, senior citizens, baby boomers turning 60, and everyone in between.

In previous hearings, experts have testified about the potentially deadly risks associated with steroid use. The side effects range from serious damage to the heart and liver to well-documented psychiatric problems. Steroids can be especially dangerous for children by impeding normal development and inflicting long-lasting harm.

We will discuss those issues again today, but we will also focus long-overdue attention on the growing use of other substances.

Senator Mitchell's report on the use of performance-enhancing substances in baseball found that the use of human growth hormone (HGH) by professional baseball players is rising. Just last week Sylvester Stallone seemed to be endorsing the use of HGH to reverse the aging process.

It is an unfortunate reality that what professional athletes and celebrities do serves as a health guide to millions of Americans. Even worse, there seem to be an almost unlimited number of unscrupulous scam artists ready to exploit this reality.

Here's an advertisement by Genf20 that reads: "HGH actually prevents biological aging! It's like your body is immune to the passage of time." Here are the frequently asked questions for another product, GrowLean 15, which says: "Our product can be taken at any age safely with no harmful side effects."

If any of us searched the internet this morning, we would find thousands of similar sites and a blizzard of confusing claims. It's no wonder that so many are confused by the facts about HGH.

Today we have a distinguished panel of experts who are going to tell us that while there are appropriate uses for HGH, there are also serious risks from abusing this powerful drug.

In adults, HGH is used to treat adult growth hormone deficiency and the wasting syndrome of late stage AIDS, both of which are relatively rare. When HGH is used to treat these conditions, there are extensive blood tests used to diagnose the patient, and patients being treated with HGH are closely monitored by physicians.

For children, HGH is approved to treat a few uncommon conditions, including idiopathic short stature, growth-hormone deficiency, and chronic (lasting a long time) kidney disease. It is also used to treat a few genetic diseases such as Turner Syndrome and Prader-Willi Syndrome.

In these cases, HGH can have a clear therapeutic benefit. But careful studies conclude that when it comes to reversing the aging process, HGH is more snake oil than cure. In 2002, the National Institute on Aging sponsored the most comprehensive single study of the anti-aging effects of HGH and found marginal benefits and significant side effects. It warned that HGH should not be widely prescribed and should be limited "to controlled research studies."

Another study, this one released in 2007 by researchers at Stanford University, concluded that "(H)GH cannot be recommended as an anti-aging therapy."

Many athletes believe they get an edge by using HGH, even though it is outlawed in all professional sports. They think it can make them faster and stronger. And they also think that it can help them heal more quickly. But there is only limited scientific evidence to support these beliefs. In fact, according to one expert, the best way to maximize growth hormone production is to get eight hours of sleep a night, not take injections.

Today we will hear from our experts that the increase in muscle mass that can result from taking HGH may actually be due to water retention.

There are real risks from the improper use of HGH. Human growth hormone can elevate blood sugar levels and cause diabetes. It can increase triglyceride levels in blood, which can contribute to heart disease. HGH can also result in fluid retention, which then can cause swelling, joint and muscle pain, and carpal tunnel syndrome.

We know that HGH can cause problems because it's actually a disease when the body produces too much HGH. Doctors call it acromegaly. It can lead to diabetes, heart problems, liver problems, kidney problems, cancer, and even death. It can also cause permanent changes in the face. We know what these changes looks like. The pro wrestler, Andre the Giant, died of complications of untreated acromegaly, and Richard Kiel, better known as Jaws from the James Bond movies, has publicly spoken about his experience with the disease.

There are also cases where body builders are injecting such large doses of HGH that they are seeing some of these same problems.

HGH purchased from the internet may carry additional risks. It may not be made in FDA-approved plants and it may not even be HGH. In many cases it is contaminated with other drugs, including steroids.

Because of these dangers, HGH is subject to special scrutiny by the Food and Drug Administration. HGH is unique in that doctors are actually prohibited from prescribing it for any use that has not been specifically approved by the FDA. This means that doctors who are prescribing the drug to enhance performance or to reverse aging are actually breaking the law.

We will also focus today on the use of injectible vitamin B12. There seems to be a widespread myth that B12 injections can increase energy, fight off colds, and generally promote good health.

The reality is that B12 injections are useful for those who suffer from pernicious anemia or have difficulty absorbing B12 from their food or from B12 tablets. For everyone else, injectible B12 appears to be an unnecessary needle and a waste of money.

When we began our investigation into steroids in baseball three years ago, the Committee's primary focus was the health of teenagers who emulate their sports heroes. That remains my focus today. And that is why this hearing is so important.

I want to thank our witnesses for being here and I look forward to their testimony.

• The following witnesses testified:
  • Dr. Susan Shurin, Deputy Director, National Heart, Lung and Blood Institute, National Institutes of Health
  • Dr. Thomas T. Perls, MD, MPH, Associate Professor of Medicine and Director, New England Centenarian Study, Boston University School of Medicine
  • Dr. Alan D. Rogol, MD, Ph.D, Professor of Clinical Pediatrics, University of Virginia; Professor of Clinical Pediatrics, Indiana University School of Medicine, also representing the Endocrine Society
  • Dr. Todd Schlifstein, Department of Rehabilitation Medicine, Hospital for Joint Diseases

Hearing Summary

Vitamin B-12 and human growth hormone (HGH) are touted by some as miracle drugs that will increase energy and will counter the effects of aging. However, there is scant scientific evidence to support these claims and there is evidence of potential harm resulting from their use. The Committee held a hearing to examine the myths and facts about these substances. Four distinguished medical experts testified.

Dr. Susan Shurin, the Deputy Director of the National Heart, Lung, and Blood Institute at the National Institutes of Health, described the state of the science on Vitamin B-12. She testified that injectable B-12 is typically necessary only when there is a problem with the intestinal tract, and excess B-12 does not improve health or performance. Dr. Shurin also testified that adverse effects of a B-12 shot are very uncommon.

Dr. Thomas T. Perls, the Director of the New England Centenarian Study at Boston University School of Medicine, spoke about the "growth hormone craze." Dr. Perls testified that based on unsubstantiated claims of reversing aging and enhancing sports performance, HGH has become widely and inappropriately used in an industry estimated at $2 billion each year. He testified that there are only a few rare conditions that merit the use of growth hormone in adults, noting that HGH is the only drug subject to a statutory prohibition against use for unapproved indications. Finally, Dr. Perls noted that HGH may in fact shorten lifespan and is associated with certain cancers, problems with the heart, liver, and diabetes.

Dr. Alan D. Rogol, a pediatric endocrinologist, discussed the appropriate uses of HGH in children, which are quite rare. He testified that there is no data to suggest that HGH enhances performance, though it may enhance appearance by breaking down some fat tissue. Dr. Rogol discussed survey data which suggest that as many as 12% of high schoolers are using what they believe to be HGH, but that much of this may in fact be other products of unknown derivation. He noted that the immature brains of young athletes may not be as equipped to understand the future consequences of such actions: "if they could win a gold medal, they didn't care what happened 10 or 20 years down the road."

Dr. Todd Schlifstein, a practicing sports medicine physician at the Hospital for Joint Diseases in New York City, described the use of HGH among his athlete patients. He testified that there is widespread belief amongst athletes that HGH enhances performance when used in conjunction with steroids. He also testified about the use of lidocaine, an injectable drug that temporarily numbs an area and is usually only used in combination with a cortisone shot. According to Dr. Schlifstein, a trainer should not be performing these injections because lidocaine, when used improperly, can cause arrhythmias and seizures.

Hearing avaiable online at http://oversight.house.gov/story.asp?ID=1740

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