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Human Growth Hormone Risks

I have to admit I was impressed with Sylvester Stallone’s appearance in his recent interview with Joe Rogan. The 61-year old actor is currently promoting his new Rambo film. His notable muscular appearance seemed less impressive to me when Mr. Stallone told Time Magazine of his use of hormonal supplements as a performance enhancer. "HGH (human growth hormone) is nothing…Anyone who calls it a steroid is grossly misinformed." Stallone further went on to comment that he believes use of HGH will soon be available over the counter.

Recently, celebrities like 50 Cent and Mary J. Blige have also reported HGH use.

The truth of the matter is that while human growth hormone is not a steroid, that fact does NOT mean that it comes free of risks. Serious side effects of HGH use include an increased risk of developing diabetes, heart problems and cancer.

In clinical environments, synthetically made growth hormone is used to treat both children and adults with severe growth hormone deficiencies. HGH functions by stimulating the release of insulin-like growth factor-1 (IGF-1). The main metabolic effects observed from HGH use include an increase of uptake of glucose (the major carbohydrate used by our bodies), and increase in the creation of proteins. This enhancement of protein building is one of the reasons why this supplement is used to try to promote muscle growth and development. [1]

Nowadays, HGH is the main doping agent of choice in the sports world. It attracts use because of its availability and because of the fact that it is not a steroid. Various side effects have been observed in both HGH treated patients and athletes. The following is a list of major risks associated with this hormonal supplement. [1]

• Intracranial hypertension (elevated pressure in the skull)
• Visual changes
• Headache
• Nausea
• Vomiting
• Myalgia (muscular pain)
• Peripheral edema (swelling of lower limbs)
• Carpal tunnel syndrome
• Arthralgia (joint pain)
• Increased growth of nose and jaw
• High blood pressure
• Increased diabetes risk
• Increased cardiovascular risk
• Increased cancer risk (colon cancer, breast cancer, prostate cancer)

Even clinical patients using prescribed hormones and growth factors as replacement therapy have an increased cancer risk. This risk is likely to be much higher in casual users of HGH since to see the desired performance enhancing effects, high doses over longer periods of time need to be injected.

Animal studies have shown that high doses of HGH can induce tumor formation in rats. Clinical studies have revealed that patients who have high levels of IFG-1 have an increase in diagnosis of malignant colon tumors. Women with breast cancer also have elevated growth hormone levels.

Long-term studies have been conducted on patients treated with growth hormone in childhood and early adulthood. The studies clearly show that these individuals with hormonal treatment had a greater incidence of colorectal cancer and Hodgkin lymphoma.

Even patients treated with hormones as replacement therapy to rebuild normal levels showed an increased risk of colorectal cancer.

There is also an overall increase in death rates for patients who are prescribed hormones as treatment. [2]

Both laboratory and clinical studies ultimately support the theory that both growth hormones and IGF-1 increase cancer risks. Evidence is not conclusive about whether or not these supplements influence cancer that has already developed.

In addition to the cancer risks, the potential cardiovascular side effects need to be addressed. Premature coronary artery disease has also been reported with HGH use. [3] All of the side effects mentioned above may contribute to the occurrence of different types of abnormal heart rhythms.

Because of the fact that HGH causes the liver to produce IFG-1, taking synthetic IGF-1 will have similar adverse side effects to taking HGH.

Any additional questions about hormonal therapies should be discussed with your own personal physician.

Questions/Comments?

fuelthefighter@gmail.com

References

1. Tentori, L., & Graziani, G. (2007). Doping with growth hormone/IGF-1, anabolic steroids or erythropoietin: is there a cancer risk? [Review]. Pharmacological Research, 55(5), 359-369.
2. Takala J, Ruokonen E, Webster NR, Nielsen MS, Zandstra DF, Vundelinckx G, Hinds CJ. Increased mortality associated with growth hormone treatment in critically ill adults. N Engl J Med 1999; 341:785–792
3. Furlanello, F., Serdoz, L. V., Cappato, R., & De Ambroggi, L. (2007). Illicit drugs and cardiac arrhythmias in athletes. [Review]. European Journal of Cardiovascular Prevention & Rehabilitation, 14(4), 487-494.

Alternatives to Steroids

As UFC 80 approaches in mid January 2008, the MMA world can’t help but think about the absence of Sean Sherk. After being stripped of his lightweight championship title in December by the California Athletic Commission for the use of steroids, BJ Penn and Joe Stevenson will battle on January 19^th for the now vacant title. The use of steroids in competitive athletics has been a topic of much consideration over the past few decades. While the adverse effects of steroids are well documented, and testing for illegal performance enhancers is often expected, competitors are still tempted to resort to these risky behaviors to optimize their athletic abilities.

In order to understand why a successful professional fighter like Sherk would practice steroid use, it’s necessary to understand the intense physical pressures that are the hallmark of MMA training. Mixed martial artists have to prepare their entire bodies for severe impact. Due to the “mix” of the martial arts involved in the sport, this preparation goes far beyond what is necessary for the individual martial arts. For example, a Muay Thai fighter doesn’t need to condition his neck, back and shoulders in the same way that is necessary for a Brazilian Jiu Jitsu artist, and vice versa. Due to the fact that these ultimate athletes need to be prepared for just about anything, the intensity of their training is extreme, probably more so than other endurance sports because of MMA’s versatility. Long distance runners never have to worry about the road countering a slow jab with a quick right hook.

While athletes have long used steroids to increase muscle mass and strength, fighters who use these enhancers often do so to improve their recovery time between training sessions. Evidence from animal studies suggests that steroid use can improve the speed of recovery for injured muscles. [1] Nandrolone, the specific steroid that Sherk was reported to have used, also has the ability to not only delay exercise induced heart rate and lactate levels, but it also enables these parameters to return to baseline at a faster than normal rate. [2] Therefore a steroid user could afford to let his body train longer and harder for an upcoming fight. It seems that with steroid users, the pressure to perform and win can overcome worries about risks like hypertension, atherosclerosis, blood clotting, jaundice, tendon damage, psychiatric and behavioral effects, and reduced fertility. [3] Since these are very serious health risks, much research has gone into studying nutritional regimens that optimize a quick recovery time.

Muscles have the convenient ability to store sugars in the form of glycogen. These sugars remain in storage until they are needed to provide energy to the muscle. After intense exercise, it is necessary to replenish this supply of stored sugar as quickly as possible if a second training session is fast approaching. In order to recover the glycogen stores, a carbohydrate intake of 1.5 grams per kg of body weight is recommended during the first 30 minutes after exercise, and then every 2 hours for up to 6 hours after the workout. An athlete that trains without full glycogen storage will have early muscle fatigue. Keep in mind that protein intake is also necessary to help repair muscle tissue. The types of carbohydrates consumed also contribute to recovery. Foods that have what is known as a “high glycemic index” are best to restore sugar reserves. These are the types of foods like white potatoes and watermelon that have a tendency to digest quickly and peak blood sugar levels. (High fiber foods are therefore not ideal to have immediately post exercise since they digest slowly and thus have a “low glycemic index.” Unless an athlete has special dietary needs, a healthy diet with varied foods will supply all of the necessary vitamins and minerals needed for recovery. [4]

Often professional athletes do not consume enough fluid during an exercise session to replace the water lost through sweating. Post workout hydration is therefore essential. While electrolytes like sodium and potassium are not often lost in excess in training sessions under 3-4 hours, including low levels of sodium in the rehydration process by means of a meal or beverage is a helpful technique since it promotes the desire to drink more. [4]

Discussions about recovery time are not complete without going into the field of nutritional supplements, often called “ergogenic supplements” after the Greek word “ergon” meaning work. It is difficult to make any solid conclusions about the validity of most of these supplements because the research thus far in the subject has yielded conflicting results. The influence of the placebo effect may very well account for some of the research discrepancies. The following is a list of common supplements that are cited because of their presumed efficacy. Recent research does not totally support nor totally deny the effectiveness of these micronutrients. [5]

Arginine: This amino acid releases a compound called somatotropin when taken as large oral doses. Somatotropin is also known as insulin-like growth factor which promotes protein production. Arginine is beneficial for resistance training.

Ornithine: Oral doses of this compound also release somatotropin, but such high doses may result in diarrhea. Ornithine is therefore also useful in resistance training

Branched-Chain Amino Acids: (Isoleucine, leucine, and valine). These types of amino acids found in animal products are in some cases reported to inhibit fatigue. They achieve this means most likely by blocking the amino acid tryptophan from entering the brain. The Thanksgiving turkey rumors are indeed true, foods like turkey that contain tryptophan cause fatigue, so blocking tryptophan entry into the brain is ideal for athletes. They also help endurance events by providing energy directly to muscles.

Antioxidants: Foods containing vitamin C, vitamin E and selenium, all help to minimize muscle damage. Endurance exercise causes an increased amount of oxygen to move into the muscle, which can cause fatigue and damage the tissue by forming what is known as “free radicals.” (These are electrons that are damaging because they do not behave normally.) Antioxidants like those mentioned above have the ability to neutralize these free radicals.

Ginsengs: These are the most widely used and studied herb. The following are some reported benefits. The benefits are more consistently reported following use of the herb for 8 weeks.

· Increased run time to exhaustion (three out of seven studies)

· Increased muscle strength (one out of two studies)

· Improved recovery from exercise (three out of four studies)

· Improved oxygen metabolism during exercise (seven out of nine studies)

· Reduced exercise-induced lactate (five out of nine studies)

· Improved auditory and visual reaction times (six out of seven studies)

Caffeine: This compound has benefits when used for endurance events. The largest impact in athletic performance from caffeine use is observed in competitors who do not consume caffeine on a regular basis. Caffeine stimulates the central nervous system and thus increases blood flow to the kidneys. It also stimulates the release of fatty acids from stored fat tissue that can be used for energy. There are some sport regulatory bodies that have set an upper limit for the permissible level of caffeine intake.

Bicarbonate: This is a natural buffering compound found in the body. Short anaerobic exercises can cause a buildup of lactic acid in the blood which causes the pH (measurement of acidity) of the blood to drop. This drop in pH is one factor that leads to fatigue. Taking bicarbonate as a supplement before a workout theoretically helps to delay the drop of pH.

Carnitine: This compound in the body helps to take fat into cells to use as energy. Research theorizes that supplying the body with more carnitine will help to speed up this process and allow the body to use fat as energy instead of the precious sugar reserves that can deplete so easily. Professional literature is divided in findings about the efficacy of this supplement for athletes, but clinical research has shown that it is safe to use to treat cardiovascular disease.

Creatine: Muscle creatine helps to provide the initial energy burst during the first few minutes of exercise. The theory behind supplementation of this compound is that adding creatine as a nutritional supplement will help to increase the amount of creatine in the muscle, thereby supplying additional stores of initial energy bursts. Be aware that risks are involved though. Creatine users can add up to four pounds of water weight, and dehydration is a possibility when taking this supplement in humid environments. There have even been deaths reported from creatine use.

References

1. Vignaud, A., Caruelle, J. P., & Ferry, A. (2005). Effects of nandrolone and salbutamol on the functional recovery of the skeletal muscle after injury. [Article]. Science & Sports, 20(1), 41-44.

2. Hartgens, F., & Kuipers, H. (2004). Effects of androgenic-anabolic steroids in athletes. [Review]. Sports Medicine, 34(8), 513-554.

3. Mottram, D. R., & George, A. J. (2000). Anabolic steroids. [Article]. Best Practice & Research Clinical Endocrinology & Metabolism, 14(1), 55-69.

4. Nutrition and athletic performance. (2000). [Review]. Medicine and Science in Sports and Exercise, 32(12), 2130-2145.

5. Gropper, S.S., Smith, J.L., Groff, J.L., ( 2005). Advanced Nutrition and Human Metabolism (4^th ed.)

Belmont, CA: Thomson Wadsworth

Navigating the Protein Scene

Protein Demystified

Mixed martial artists are among the most inspiring athletes in the world. In addition to the intense cardio endurance that is necessary to survive numerous rounds of fighting, these athletes require impressive musculature. This physique is not only crucial for delivering powerful strikes; it also plays a vital role alongside smooth technique in developing solid Jiu Jitsu and wrestling skills. Anyone who has attempted to submit an opponent in an arm bar or a rear naked choke knows that practically all muscles in the body work in conjunction to control the fight. In order to tone and build muscle, dietary protein intake becomes of key importance. It’s nearly impossible nowadays to peruse a health store or watch sporting event commercials without being inundated by a broad spectrum of protein products. It can be difficult in this media driven Alice in Protein-land to obtain a true understanding of what proteins are, how they function, and what kinds athletes like MMA fighters should seek out for maximum performance.

Don’t be intimidated or impressed by the scientific terms that companies use to market their products. Slogans like “special peptides” and “complex amino acids” are often used to sell protein powders and power bars. The language of proteins can be simplified as follows. Proteins are nutrients composed of strings of compounds called amino acids. There are twenty amino acids available to build proteins, some of which the body can produce, and some are essential to consume since the body is unable to construct them. Smaller fragments of amino acids that are not full proteins are called peptide chains, or simply peptides.

Proteins are vital parts of a diet since they serve numerous functions. They form hormones, immune system components, and they help to speed up bodily processes. They are also involved in the structure of bodily tissues, including muscle which accounts for close to 40% of body weight. Therefore protein becomes crucial in the process of building muscle. Since there is no storage form of protein, the absence of this nutrient in a diet will cause the body to break down muscle tissue.

Protein for Athletic Performance

The average American consumes over 100 grams of protein per day. This is often in excess of the minimum amount required for normal metabolic functions. The current recommended daily allowance for protein in adults is determined by weight. For every kg of body weight, 0.8 grams of proteins should be consumed. The average westerner consuming this amount of protein has more than enough to really pack on muscle. So in opposition to all the ads that promote incredibly high protein intake, studies suggest that the most important factors for building muscle are the types of proteins ingested, and the timing of their consumption. Athletes therefore must consume the right proteins as soon as possible after exercise to maximize muscle development. While there is not a consensus regarding maximum protein intake limits, it should be noted that extreme protein consumption puts extra pressure on the liver and kidneys.

The goal of bodybuilding is muscle growth, sometimes referred to on bodybuilding websites as muscle hypertrophy. For this to occur, the amount of protein found in the muscle needs to be increased. Proteins in the body are constantly breaking down and being created. In order for muscles to grow, the rate of protein production needs to be greater than the rate of protein breakdown. After exercise, it is more common for proteins to break apart than it is for proteins to be produced. Without food directly after a workout of resistance training, more protein will be broken down than created. Proteins and complex carbohydrates eaten right after exercise will ensure that there will be enough protein available to let muscles grow even though some protein will still be broken down. Eating glucose, the most common type of carbohydrate found in most food, increases insulin levels which help to reduce protein loss. It is ideal to consume 30-40 grams of protein right after intense resistance training. Even consuming as little as 15 grams of protein after training can be influential. Essential amino acids also greatly contribute to protein assembly in the muscles.

Of the essential amino acids, the three “branch chain amino acids”, leucine, isoleucine and valine are key players to promote growth of muscle. These are often abbreviated on food labels as BCAAs. While most amino acids are processed by the liver, these three are brought directly in the muscle, and leucine in particular can be completely broken down to supply energy for the muscle directly. High doses of leucine have been shown to help prevent the breakdown of protein. Dairy products, whey and eggs are good sources of this trio of amino acids. [1]

Plant vs. Animal Protein- Preventing Bone Weakness

Animal protein has been shown to be 90% to 99% digestible, whereas plant protein is about 70% to 90% digestible. Despite this difference, a balance of plant and animal protein is important. For example if an athlete consumes high amounts of animal products immediately following exercise to promote muscle growth, the rest of the protein intake for the day should include plant sources of protein. The reason for this has to do with the fact animal protein is more acidic than plant protein. A diet with mostly animal protein and low in plant protein can lead to the weakening of bones. With so much acid buildup in the blood from animal protein, calcium will seep out of bones to help buffer and neutralize the acidity. Calcium loss from bone tissue results in substandard bone quality. [2]

While strong bones are important for any sport, they are particularly important for MMA training. Throughout history martial artists have trained their limbs to become accustomed to intense impact. The tiny micro-fractures that result from this impact training actually help to fortify the bone and make it denser and stronger. This is why highly trained mixed martial artists don’t even flinch when they use their shins to block Muay Thai style leg kicks. Calcium loss to a fighter’s bones can be avoided by making sure to include a variety of protein. In addition to the protein sources mentioned in the vegan section below, other sources include natural peanut butter, lentils, quinoa, and even broccoli.

Protein for Vegans

The quality of protein is for the most part assessed with regards to its amino acid composition. A high quality protein food contains what is known as “complete protein.” This means that all of the essential amino acids are present. Foods with complete protein include animal products like milk, yogurt, cheese, eggs, meat, fish and poultry. While most people consume animal products regularly, consuming the right proteins can be problematic for vegans. The practice known to vegans as mutual supplementation is a method that combines forms of incomplete plant protein within meals to create a complete protein source. It is generally accepted that vegans should obtain 60% of protein from grains, 35% from legumes (seed pod plants like beans), and 5 % from leafy greens. For an average 155 lb (70 kg) vegan, a days worth of proper protein intake would include four slices of whole wheat bread, 2 ½ cups of grains from oatmeal, brown rice, and cracked wheat, ¼ cup nuts or seeds, 1 ¼ servings of beans, and 2 cups of vegetables, half of which should be leafy greens. [3]

The Disturbing Truth About Soy

Hailed as the high protein miracle food of our generation, there is a much darker side to soy products that is unknown to the general public. Perhaps this is because soy is crop grown with government subsidies used as a cheap protein source for factory farm animals. While it is true that soy beans have high protein content with essential amino acids, there is much evidence to suggest that soy products should not be a staple of any diet.

The most important enzyme that aids in protein digestion is trypsin. Soy products when taken in excess slow down this enzyme and interrupt proper protein digestion. While this fact is true for many other healthy veggies, the cooking process prevents them from interfering with digestion. Cooking soy on the other hand does little to stop it from disturbing digestion. The safest form of soy is tempeh, because the fermentation technique use to make this food deactivates most of the harmful effects of soy. Soymilk and tofu on the other hand are less processed soy foods so they are more likely to cause problems.

Another issue with soy is that it interferes with hormone production. Soy contains phytoestrogens which in structure are very similar to human estrogen. When consumed, these compounds act as if they were real human estrogen. Obviously excess estrogen is the last thing that fighters want to bring into the ring. As if this weren’t enough, studies have shown that soy can also block the construction of the thyroid hormones which helps to regulate metabolism of all foods.

Keep in mind that these problems occur when soy is consumed in excess. There are many other healthy vegetables that can cause the same problems as soy, but they pose less of a threat because they aren’t eaten as often. Between soy milk, protein bars, soy protein powder, soy fortified breads and tofu, there are many Americans that consume large quantities of soy in every meal. Soy doesn’t need to be eliminated from the diet, but it needs to be monitored. Throwing tofu chunks into a salad a few times a week and having some edamame with sushi or even a soy latte on occasion will not be harmful. Any food when eaten in excess can have negative consequences. Variety they say is the spice of life, and it is also the best way to maintain a healthy diet. [4]

References

1. Koopman, R., Saris, W. H. M., Wagenmakers, A. J. M., & van Loon, L. J. C. (2007). Nutritional interventions to promote post-exercise muscle protein synthesis. [Review]. Sports Medicine, 37(10), 895-906.

2. Sellmeyer DE, Stone KL, Sebastian A, Cummings SR. A high ratio of dietary animal to vegetable protein intake increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group. Am J Clin Nutr 2001; 73: 118-22.

3. Gropper, S.S., Smith, J.L., Groff, J.L., ( 2005). Advanced Nutrition and Human Metabolism (4^th ed.) Belmont, CA: Thomson Wadsworth

4. Daniel, K.T., (2007). The Whole Soy Story: The Dark Side of America’s Favorite Health Food. Washington, DC: New Trends Publishing Inc.

The Tale of the Scale (Cutting Weight)

Mac Danzig’s dominant victory over Tommy Speer in The Ultimate Fighter season 6 finale was far from unexpected. As a veteran well rounded fighter, many expected him to out-strike and out-grapple the ginger haired farm boy. Yet in spite of Danzig’s clear advantage in MMA technique, there were many who believed Speer’s massive size and strength would overcome the humming-bird loving vegan. Newbie followers to MMA might ask how such a disparity could occur between two 170 lb welter weight fighters. The truth of the matter is that a fighter’s weight class status can go out the door after the 24 hour pre fight official weigh in.

Now in theory the notion of separating fighters into weight classes ensures a fair fight. Although it might be interesting to imagine a fight between light weight Kenny Florian and the light heavy weight giant Tim Sylvia, that tale of tape will never be featured. Those of us who remember being picked on by that tubby bully in grade school know first hand how differences in weight can skew a fight.

When fighters enter the ring their bodies rarely reflect the weigh in of the previous day. In order to gain a size and strength advantage, it is common practice for these athletes to “cut weight.” This process involves rapid body water loss that results in a physiological state known as hypohdration. Essentially this is the step down the ladder after dehydration. Almost no fat loss is achieved in this way. Since our bodies are mostly made up of water, it’s possible to shed many pounds of water weight in just a few days. Common practices for weight cutting involve the restriction of calories and fluids, over exercising in extreme heat with layers of clothing, or even the use of laxatives and diuretics. Followers of TUF season 5 will remember Gabe Rudiger’s desperate and ultimately failed efforts in the sauna to make weight for his preliminary fight.

Once a competitor manages to excrete 10 or 20 lbs of water, he has a full 24 hours to regain those additional pounds. During that time he rehydrates and eats to prepare for the upcoming brawl. This process means that a fighter’s true weight may not be regulated. But more importantly to consider are serious side effects that might influence the fighter’s performance and health.

Research indicates that it may take up to 48 hours for an athlete to properly rehydrate. The recovery time depends on the duration of the dehydrated state. The longer the body has been dehydrated, the longer the recovery. In addition, Weight loss from laxative or diuretic use will take longer to overcome than weight loss from exercise.

Studies on the influence of dehydration on athletic performance show a clear reduction in muscle strength and a decrease in aerobic capacity. Significant decreases in endurance performance are also common. In order for the body to return to a normal healthy condition, muscle protein is broken down to create energy for repair. While these factors may prove to be unfavorable to fight performance, the health effects are even more important to consider. Impaired kidney function may result and blood will not filter properly. Electrolyte imbalances cause impaired muscle function, and cardiac arrhythmia (irregular heart beat) is possible. Severe cases involve damage to the immune system and the pancreas, as well as an altered hormonal status. Many sport organizations like the American Chiropractic Board of Sports Physicians recommend that fighters weigh in both 24 hours and 1 hour before competitions to encourage healthy weight management techniques that do not involve rapid weight loss.

The sport of mixed martial arts does not come without risks. Injuries are expected and dealt with. But for those young fighters who dream of a long term career, attention to healthy weight management is essential. Just as Danzig showed Speer in his UFC debut at a true 168 lbs, having a 10, 20 or 30 lb size advantage coupled with all the risks of cutting weight is no match well oiled technique. Let’s hope that he continues to maintain this healthy lifestyle as he drops down to the 155 lb division.