by Richard Todd, December 19, 2007

Unfortunately, from a physiological perspective, growth hormone (GH) is generally a beneficial substance. Much as I hate to say this, it's all too easy to understand why ballplayers are tempted to artificially increase the levels that their bodies produce naturally.


GH is a protein hormone secreted by the pituitary gland which stimulates growth and cell reproduction. The primary benefit is height because it stimulates cell multiplication in the growing ends of children's long bones (it is called "growth" hormone, after all).  But GH also has a growth effect on other tissue: it increases calcium retention for bone mineralization; increases muscle mass by creating new muscle cells; promotes the reduction of body fat. It influences the function of the liver for various biochemical conversions, and stimulates the growth of internal organs.

It's not all good news. Unless the body properly regulates GH secretion - which it will usually do on its own, but might not be able to do if overloaded (i.e. by doping) - a GH excess could result in a pituitary tumor, and something called acromegaly which is an excess thickening of fingers, toes and the jawbone. Other problems can include carpal tunnel syndrome, muscle weakness, insulin resistance or even a rare form of type 2 diabetes, and reduced sexual function. Severe headaches, nausea and vision problems have been noted due to an effect on the brain. GH excess has also been claimed to be linked to everything from pancreatitis to leukemia and colon cancer, but these have been questioned.


The body produces growth hormone during both exercise and sleep and by getting the proper dietary protein. So proper nutrition matters, and just so we're clear "sleep" means real sleep - not being a couch potato playing video games. But unless an individual has a medical condition that inhibits GH secretion, the body - with the right genetic make-up, and the right balance of the above activities - should produce what it needs of GH.

Now we come to HGH which is the term used for synthetic humane growth hormone injected under the skin by syringe. Several brands are manufactured and HGH is a legitimate therapy for GH deficiency - if and when prescribed by a doctor for a valid reason. Otherwise it's illegal. Body building and fat reduction would not be considered legit uses - both the Olympics and MLB have banned HGH.

However, while HGH doping is expensive, so is the testing for abuse. And unless testing is affordable and unpredictable, it's unfortunately easy to cheat. Plus there is far from total consensus on the physiological harm. With so much uncertainty, we have to get away from the medical discussion and into the ethical issues surrounding HGH doping.


The only thing we now for certain is that there is a moral high ground on the topic of HGH. Just as with steroids - whether detected or not - the use of something which gives a ballplayer an unfair advantage is depriving someone else of a legitimate opportunity. It's cheating.

It's also worth noting that WADA (the World Anti-Doping Agency) has a somewhat different list of risks: "Commonly reported side effects for hGH abuse are: diabetes in prone individuals; worsening of cardiovascular diseases; muscle, joint and bone pain; hypertension and cardiac deficiency; abnormal growth of organs; accelerated osteoarthritis." They do also mention acromegaly and metabolic problems such as glucose intolerance.

While WADA is one of the few organizations that is actively committed to staying ahead of the cheaters, and developing meaningful testing, Major League Baseball has not yet (as of this writing) invited them to become part of the MLB clean-up mandate.

As I have said elsewhere, at some point our moral compass needs to start working. We need to know right from wrong. Actually, I'm willing to bet that everyone one of us does know the difference from a very early age. What we really need is to accept personal responsibility for choosing right over wrong. When we all do that, then the testing isn't necessary.

In the meantime, until we have a reliable ethics test, I hope coaches and parents remain vigilant. And I trust players to understand that the risks are real and will sneak up on you. And the greatest risk of all is to be branded a cheat - that's something which will stay with you your entire life.

I welcome your comments.