In Part 1, I provided what I think is a not entirely uninteresting insight into the explanations of the use of exogenous growth hormone as published in the book "Anabolic Steroids - The Black Book".
Apart from the fact that the authors state that 4 exogenous substances (growth hormone, thyroid hormone, insulin and testosterone) must be used for full effectiveness, what one can apparently hope for sounds rather euphoric.
It seems that it is "all or nothing" when it comes to the use of growth hormone, unless you "only" want to use it for slightly improved fat burning.
Prolonged use is also recommended, as the real effects only become apparent within a few weeks. Today I would like to present the results of a recent study by Hermansen et al, which included data from a total of 11 scientific studies and 224 test subjects.
All of them dealt with the influence of growth hormone administration in young healthy adults. Are all the effects mentioned in the black book confirmed today or is the picture completely different? Let's find out...!
Introduction
The illegal use of growth hormone by both elite and recreational athletes is not uncommon. Surveys show that between 3.5 and 5% of all college athletes regularly use several milligrams of growth hormone either daily or divided into several weekly doses. 25% of users report using anabolic androgenic steroids at the same time (18). Whereas in 2006 there were still problems with the unequivocal detection of GH doping offenders (1), more than 10 years later this is no longer a problem and is part of the IOC's standard testing repertoire (4).
Note: To date, doping in bodybuilding is only really controlled in a few exceptions at national and sometimes international level!
Studies on people suffering from physiologically low levels of growth hormone clearly show positive effects of exogenous administration, including improved aerobic capacity and increased muscle volume (2), while at least in the meta-analysis by Rubeck et al (3) there were no significant effects on muscle strength.
The administration period of the studies involved ranged from 3 to 12 months. What did occur was sometimes a normalization of lowered IGF-1 levels, as found in placebo groups.
Positive changes in the use of growth hormone in GH deficiency are certainly a great thing, but strictly speaking say nothing about what happens when growth hormone is administered at a normal physiological level.
The study
The studies involved in the paper by Hermansen et al were all of course human studies, randomized, double-blind and placebo-controlled. All participants were found to be healthy in terms of growth hormone levels. They were over 18 and under 45 years of age.
All studies evaluated specific data on body composition, muscular characteristics and exercise capacity and also provided information on metabolic changes.
It should be noted that two of the studies involved only examined the changes of a single GH injection.
In the other studies, the duration of application of 2 to 12 weeks was unfortunately also not in the range commonly used in sport as doping. An average of 36.5 mcg per kilogram of body weight was administered subcutaneously.
Based on an 80 kg athlete, this would be the equivalent of 2.9 mg and thus about 8.7 IU, which would be considered a moderate to even high amount in the scene (5).
The results
The evaluation of changes in body composition and fluid balance is very interesting at this point.
Note: As we know, an increase in LBM does not equal an increase in muscle mass. As we have already read in Part 1, growth hormone is also known in practice to increase water retention.
As the attached diagram shows, the administration of growth hormone increased body weight and, to a somewhat greater extent, the percentage of fat-free mass (LBM). After deducting the increased values for extracellular and intracellular water, there was only a statistically insignificant increase in BCM (muscle mass) of 0.9 kg, but the fat mass percentage decreased significantly by an average of 1.22 kg.
With regard to fat metabolism, acutely more glycerol and free fatty acids were measured in the blood after administration of growth hormone compared to placebo. In terms of metabolism, however, there was NO increase in lipid oxidation.
From all available data, it could be concluded that the administration of growth hormone had no significant influence on strength values, and oxygen uptake and aerobic performance remained unaffected by the administration in a large proportion of the studies involved.
Conclusion
Sobering results for the time being. No major muscle growth, no increase in strength, no better performance and increased lipolysis, but no increased fat burning - it couldn't be worse!
Discussion
Despite the sobering conclusion, the study shows that the administration of growth hormone also produces effects in healthy test subjects. At first glance, a noticeable increase in fat-free mass appears on closer inspection to be less a genuine increase in muscle mass and more a retention of fluid, accompanied by only a very small amount of genuine muscle mass (5). One noticeable effect is an increase in lipolysis, measured by an increased amount of glycerol and free fatty acids in the blood (6).
Unfortunately, the increased elimination of triglyceride components was not accompanied by increased fat oxidation. Hansen et al (9) also rule out a noticeable effect in connection with sporting activity (aerobic training), which is why initially there appears to be no benefit at all from the lipolytic effect.
To make matters worse, two of the studies involved report an increase in plasma lactate levels (8, 9), which could ultimately also have a detrimental effect on anaerobic energy supply (10).
However, there are also contrary results, such as those of Meinhardt et al (12), who report a significant improvement in performance thanks to growth hormone in the Wingate test. It is still unclear whether increased lactate levels result purely from muscle metabolism or are due to poorer lactate clearance (12).
Meinhardt et al (12) and Sönksen (13) are interesting again, because this is where parts 1 and 2 of this article meet. We are talking about synergistic effects, based on a combined administration of growth hormone with anabolic androgenic steroids, which on the one hand causes an increased androgen receptor gene expression but also an increased occurrence of muscle IGF-1 mRNA and consequently an improved body composition. Accompanied by better performance and faster regeneration, sometimes via accelerated collagen synthesis, the effects here are significantly different (14, 15, 16).
Those who use growth hormone exogenously over a longer period of time risk developing insulin resistance and an increased accumulation of fluid, which often leads to oedema, carpal tunnel syndrome, joint pain (arthralgia) or muscle pain (myalgia). Long-term use also increases the risk of sleep apnea, high blood pressure, osteoarthritis or cardiomyopathy (disease of the heart muscle) (17).
Summary
Athletes and scientists agree: "Growth hormone works better in terms of improved performance and muscle building when it is combined with anabolic androgenic steroids."
It is still unclear to what extent growth hormone, anabolic androgenic steroids or certain training methods are actually able to trigger hyperplasia, i.e. an increase instead of just a thickening of the existing muscle cells (17). Those who intend to promote lipolysis can do so without the accompanying administration of other substances, but are faced with the task of actually burning released fatty acids, as this does not seem to occur to an increased extent with growth hormone alone (contrary to what was claimed in Part 1).
While a combined use with anabolic, androgenic steroids seems to be common and also useful in terms of effectiveness, there is no additional benefit of using active thyroid hormone T3 in all the literature reviewed. Parallel use with insulin is also only mentioned in passing. It can be assumed that sufficient insulin for IGF-1 production can be provided in the right quantity and quality at the right time by administering carbohydrates.
In conclusion, the following key points can be summarized from both sources:
- Growth hormone for muscle building and performance only works with parallel use of AAS
- Parallel use of thyroid hormone is not absolutely necessary as claimed, as it is poorly documented or not documented at all (if in doubt, determine T3 value regularly)
- Parallel use of insulin is not absolutely necessary as claimed, as it is poorly or not at all documented (balancing insulin requirements)
- Growth hormone as a fat burner only works with concomitant increased physical activity in the aerobic range and there is a risk of insulin resistance occurring!
Overall conclusion
All in all, growth hormone is by no means the miracle cure that it is often advertised as. Without the accompanying consumption of anabolic/androgenic steroids, which are also associated with side effects, the muscle-building effect almost evaporates.
Growth hormone should also not be seen as a strong fat burner per se that can replace physical activity. Without a simultaneous consumption from aerobic physical activity, no fat oxidation will take place and the lipolytic effect will also fizzle out.
The costs, benefits and supposed side effects of using growth hormone therefore appear to be out of proportion, which is why its use is not advisable!
Sporting greetings
Holger Gugg
www.body-coaches.de
Sources
(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657499/
(2) https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2265.2009.03592.x
(3) https://www.ncbi.nlm.nih.gov/pubmed/19508603
(4) https://www.wada-ama.org/sites/default/files/resources/files/wada-2016-prohibited-list-german.pdf
(5) http://www.tandfonline.com/doi/abs/10.3109/00365519509075396
(6) https://academic.oup.com/edrv/article-lookup/doi/10.1210/er.2008-0027
(7) http://jap.physiology.org/content/96/2/747
(8) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1474222/
(9) https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2001-011797
(10) https://link.springer.com/article/10.2165%2F00007256-200333060-00003
(11) https://link.springer.com/article/10.2165%2F00007256-200333060-00003
(12) https://www.ncbi.nlm.nih.gov/pubmed/20439575
(13) http://www.growthhormoneigfresearch.com/article/S1096-6374(09)00044-6/abstract
(14) https://www.ncbi.nlm.nih.gov/pubmed/24081158
(15) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821728/
(16) https://www.ncbi.nlm.nih.gov/pubmed/15998337
(17) https://www.nature.com/nrendo/journal/v3/n3/full/ncpendmet0429.html
