Skip to main content
SpringerLink
Log in

Hormones as Performance-Enhancing Agents

  • Chapter
  • First Online:
Endocrinology of Physical Activity and Sport

Part of the book series: Contemporary Endocrinology ((COE))

  • 2857 Accesses

Abstract

Success in sports is often defined by winning, which drives athletes to use performance-enhancing drugs to gain an advantage over opponents. The use of doping agents in sports has a long history, especially over the last years, secondary to scandals and controversy. Athletes and the general public are now more aware and educated about this issue. The World Anti-Doping Agency’s (WADA) mission is to lead a collaborative worldwide campaign for doping-free sport. A list of doping substances and methods banned in sports is published yearly by WADA (http://www.wada-ama.org). A substance or method might be included in the list if it fulfills at least two of the following criteria: enhances sports performance, represents a risk to the athlete’s health, or violates the spirit of sports.

The strategy to detect such drugs may be relatively easy as in anabolic steroids and erythropoietin (EPO) (urine) but sometimes is more difficult as in human growth hormone (rhGH) and insulin-like growth factor 1 (IGF-1) (blood).

The aim of this review is to discuss the rationale, physiology, performance enhancement, adverse events, and detection of doping in sports with insulin, rhGH, rhIGF-1, EPO, and anabolic-androgenic steroids. There are many detailed review articles presenting the details of analytic techniques; therefore, we shall just outline the general strategy for detection of classes of agents and some specific drugs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. http://www.wada-ama.org. Accessed 27 Aug 2011.

  2. Sjöqvist F, Garle M, Rane A. Use of doping agents, particularly anabolic steroids, in sports and society. Lancet. 2008;371:1872.

    Article  PubMed  Google Scholar 

  3. Parkinson AB, Evans NA. Anabolic androgenic steroids: a survey of 500 users. Med Sci Sports Exerc. 2006;38:644.

    Article  PubMed  CAS  Google Scholar 

  4. Cryer PE. Glucose homeostasis and hypoglycaemia. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, editors. Williams textbook of endocrinology. 12th ed. Philadelphia: Saunders/Elsevier; 2011. p. 1371–404.

    Google Scholar 

  5. Ho RC, Alcazar O, Goodyer LJ. Exercise regulation of insulin action in skeletal muscle. In: Kraemer WJ, Rogol AD, editors. The endocrine system in sports and exercise, in collaboration with The International Federation of Sports Medicine. Oxford, UK: Blackwell Publishing; 2005. p. 388–407.

    Google Scholar 

  6. Service FJ. Hypoglycemic disorders. N Engl J Med. 1995;332:1144–52.

    Article  PubMed  CAS  Google Scholar 

  7. Thevis M, Thomas A, Schanzer W. Mass spectrometric determination of insulins and their degradation products in sports drug testing. Mass Spectrom Rev. 2008;27:35–50.

    Article  PubMed  CAS  Google Scholar 

  8. Liu H, Bravata DM, Olkin I, et al. Systematic review: the effects of growth hormone on athletic performance. Ann Intern Med. 2008;148:747.

    PubMed  Google Scholar 

  9. Deyssig R, Frisch H, Blum WF, Waldhör T. Effect of growth hormone treatment on hormonal parameters, body composition and strength in athletes. Acta Endocrinol (Copenh). 1993;128:313.

    CAS  Google Scholar 

  10. Moller N, Jorgensen JO. Effects of growth hormone on glucose, lipid, and protein metabolism in human subjects. Endocr Rev. 2009;30:152–77.

    Article  PubMed  Google Scholar 

  11. Cameron CM, Kostyo JL, Adamafio NA, et al. The acute effects of growth hormone on amino acid transport and protein synthesis are due to its insulin-like action. Endocrinology. 1988;122:471–4.

    Article  PubMed  CAS  Google Scholar 

  12. Vigas M, Malatinsky J, Nemeth S, et al. Alpha-adrenergic control of growth hormone release during surgical stress in man. Metabolism. 1977;26:399–402.

    Article  PubMed  CAS  Google Scholar 

  13. Sachar EJ, Mushrush G, Perlow M, et al. Growth hormone responses to L-dopa in depressed patients. Science. 1972;178:1304–5.

    Article  PubMed  CAS  Google Scholar 

  14. Ho KY, Veldhuis JD, Johnson ML, et al. Fasting enhances growth hormone secretion and amplifies the complex rhythms of growth hormone secretion in man. J Clin Invest. 1988;81:968–75.

    Article  PubMed  CAS  Google Scholar 

  15. Kreitschmann-Andermahr I, Suarez P, Jennings R, Evers N, Brabant G. GH/IGF-I in obesity—mechanisms and practical consequences in children and adults. Horm Res Paediatr. 2010;73:153–60.

    Article  PubMed  CAS  Google Scholar 

  16. Calfee R, Fadale P. Popular ergogenic drugs and supplements in young athletes. Pediatrics. 2006; 117:e577–89.

    Article  PubMed  Google Scholar 

  17. Birzniece V, Nelson AE, Ho KK. Growth hormone administration: is it safe and effective for athletic performance. Endocrinol Metab Clin North Am. 2010;39:11–23.

    Article  PubMed  CAS  Google Scholar 

  18. Meinhardt U, Nelson AE, Hansen JL, et al. The effects of growth hormone on body composition and physical performance in recreational athletes: a randomized trial. Ann Intern Med. 2010;152:568–77.

    PubMed  Google Scholar 

  19. Christ ER, Cummings MH, Westwood NB, et al. The importance of growth hormone in the regulation of erythropoiesis, red cell mass, and plasma volume in adults with growth hormone deficiency. J Clin Endocrinol Metab. 1997;82:2985–90.

    Article  PubMed  CAS  Google Scholar 

  20. Thuesen L, Jorgensen JOL, Muller JR, et al. Short and long term cardiovascular effects of growth hormone therapy in growth hormone deficient adults. Clin Endocrinol. 1994;41:615–20.

    Article  CAS  Google Scholar 

  21. Graham MR, Baker JS, Evans A, et al. Physical effect of short-term recombinant human growth hormone administration in abstinent steroid dependency. Horm Res. 2008;69:343–54.

    Article  PubMed  CAS  Google Scholar 

  22. Jørgensen JO, Thuesen L, Müller J, et al. Three years of growth hormone treatment in growth hormone-deficient adults: near normalization of body composition and physical performance. Eur J Endocrinol. 1994;130:224–8.

    Article  PubMed  Google Scholar 

  23. Svensson J, Sunnerhagen KS, Johannsson G, et al. Five years of growth hormone replacement therapy in adults: age- and gender-related changes in isometric and isokinetic muscle strength. J Clin Endocrinol Metab. 2003;88:2061–9.

    Article  PubMed  CAS  Google Scholar 

  24. Karila TA, Karjalainen JE, Mäntysaari MJ, et al. Anabolic androgenic steroids produce dose-dependant increase in left ventricular mass in power athletes, and this effect is potentiated by concomitant use of growth hormone. Int J Sports Med. 2003;24:337–43.

    Article  PubMed  CAS  Google Scholar 

  25. Mark PB, Watkins S, Dargie HJ. Cardiomyopathy induced by performance enhancing drugs in a competitive bodybuilder. Heart. 2005;91:888.

    Article  PubMed  CAS  Google Scholar 

  26. Ho KKY, Nelson A. Growth hormone in sports: detecting the doped or duped? Horm Res Paediatr. 2011;76 Suppl 1:84–90.

    Article  PubMed  CAS  Google Scholar 

  27. Bidlingmaier M, Suhr J, Ernst A, et al. High sensitivity hemiluminescence immunoassays for detection of growth hormone doping in sports. Clin Chem. 2009;55:445–53.

    Article  PubMed  CAS  Google Scholar 

  28. Erotokritou-Mulligan I, Bassett EE, Kniess A, et al. Validation of the growth hormone(GH)-dependent marker method of detecting GH abuse in sport through the use of independent data sets. Growth Horm IGF Res. 2007;17:416–23.

    Article  PubMed  CAS  Google Scholar 

  29. Le Roith D, Bondy C, Yakar S, et al. The somatomedin hypothesis: 2001. Endocr Rev. 2001;22:53–74.

    Article  PubMed  CAS  Google Scholar 

  30. Chernausek SD, Backeljauw PF, Frane J, et al. GH Insensitivity Syndrome Collaborative Group. Long-term treatment with recombinant insulin-like growth factor (IGF)-I in children with severe IGF-I deficiency due to growth hormone insensitivity. J Clin Endocrinol Metab. 2007;92:902–10.

    Article  PubMed  CAS  Google Scholar 

  31. Richmond EJ, Rogol AD. Recombinant human insulin-like growth factor-I therapy for children with growth disorders. Adv Ther. 2008;25:1276–87.

    Article  PubMed  CAS  Google Scholar 

  32. Pollak M. Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer. 2008;8:915–28.

    Article  PubMed  CAS  Google Scholar 

  33. Chernausek SD, Backeljauw PF, Frane J, Kuntze J, Underwood LE. Long-term treatment with recombinant insulin-like growth factor (IGF)-I in children with severe IGF-I deficiency due to growth hormone insensitivity. J Clin Endocrinol Metab. 2007;92:902–10.

    Article  PubMed  CAS  Google Scholar 

  34. Moore EM, Bellomo R, Nichol AD. Erythropoietin as a novel brain and kidney protective agent. Anaesth Intensive Care. 2011;39:356–72.

    PubMed  CAS  Google Scholar 

  35. Jelkmann W. Erythropoietin. J Endocrinol Invest. 2003;26:832–7.

    PubMed  CAS  Google Scholar 

  36. Elliott S. Erythropoiesis-stimulating agents and other methods to enhance oxygen transport. Br J Pharmacol. 2008;154:529–41.

    Article  PubMed  CAS  Google Scholar 

  37. Egrie JC, Browne J, Lai P, et al. Characterization of recombinant monkey and human erythropoietin. Prog Clin Biol Res. 1985;191:339–50.

    PubMed  CAS  Google Scholar 

  38. Lamon S, Robinson N, Saugy M. Procedures for monitoring recombinant erythropoietin and analogs in doping. Endocrinol Metab Clin North Am. 2010;39:141–54.

    Article  PubMed  CAS  Google Scholar 

  39. Birkeland KI, Stray-Gundersen J, Hemmersbach P, et al. Effect of rhEPO administration on serum levels of sTfR and cycling performance. Med Sci Sports Exerc. 2000;37:1238–43.

    Google Scholar 

  40. Ashenden MJ, Hahn AG, Martin D, et al. A comparison of the physiological response to simulated altitude exposure and r-HuEpo administration. J Sports Sci. 2001;19:831–7.

    Article  PubMed  CAS  Google Scholar 

  41. Eichner ER. Blood doping: infusions, erythropoietin and artificial blood. Sports Med. 2007;37:389–91.

    Article  PubMed  Google Scholar 

  42. Trial J, Rice L, Alfrey CP. Erythropoietin withdrawal alters interactions between young red blood cells, splenic endothelial cells, and macrophages: an in vitro model of neocytolysis. J Investig Med. 2001;49:335–45.

    Article  PubMed  CAS  Google Scholar 

  43. Lippi G, Franchini M, Salvagno GL, et al. Biochemistry, physiology, and complications of blood doping: facts and speculation. Crit Rev Clin Lab Sci. 2006;43:349–91.

    Article  PubMed  CAS  Google Scholar 

  44. Leuenberger N, Saugy J, Mortensen RB, et al. Methods for detection and confirmation of hematide/peginesatide in anti-doping samples. Forensic Sci Int. 2011;213(1–3):15–9.

    Article  PubMed  CAS  Google Scholar 

  45. Spiering BA, Kraemer WJ, Vingren JL, et al. Elevated endogenous testosterone concentrations potentiate muscle androgen receptor responses to resistance exercise. J Steroid Biochem Mol Biol. 2009;114:195–9.

    Article  PubMed  CAS  Google Scholar 

  46. Basaria S, Wahlstrom JT, Dobs AS. Anabolic-androgenic steroid therapy in the treatment of chronic diseases. J Clin Endocrinol Metab. 2001;86:5108–17.

    Article  PubMed  CAS  Google Scholar 

  47. Kawada S, Okuno M, Ishii N. Testosterone causes decrease in the content of skeletal muscle myostatin. Int J Sports Health Sci. 2006;4:44–8.

    Article  Google Scholar 

  48. Woodhouse LJ, Reisz-Porszasz S, Javanbakht M, et al. Development of models to predict anabolic response to testosterone administration in healthy young men. Am J Physiol Endocrinol Metab. 2003;284:E1009–17.

    PubMed  CAS  Google Scholar 

  49. Sinha-Hikim I, Artaza J, Woodhouse L, et al. Testosterone-induced increase in muscle size in healthy young men is associated with muscle fiber hypertrophy. Am J Physiol Endocrinol Metab. 2002;283:E154–64.

    PubMed  CAS  Google Scholar 

  50. Tamaki T, Uchiyama S, Uchiyama Y, et al. Anabolic steroids increase exercise tolerance. Am J Physiol Endocrinol Metab. 2001;280:E973–81.

    PubMed  CAS  Google Scholar 

  51. Hall RC, Hall RC. Abuse of supraphysiologic doses of anabolic steroids. South Med J. 2005;98:550–5.

    Article  PubMed  Google Scholar 

  52. Pope Jr HG, Katz DL. Psychiatric and medical effects of anabolic-androgenic steroid use. A controlled study of 160 athletes. Arch Gen Psychiatry. 1994;51:375–82.

    Article  PubMed  CAS  Google Scholar 

  53. Parssinen M, Kujala U, Vartiainen E, et al. Increased premature mortality of competitive powerlifters suspected to have used anabolic agents. Int J Sports Med. 2000;21:225–7.

    Article  PubMed  CAS  Google Scholar 

  54. Glazer G. Atherogenic effects of anabolic steroids on serum lipid levels. A literature review. Arch Intern Med. 1991;151:1925–33.

    Article  PubMed  CAS  Google Scholar 

  55. Hoffman JR, Kraemer WJ, Bhasin S, et al. Position stand on androgen and human growth hormone use (National Strength and Conditioning Association). J Strength Cond Res. 2009;23:S1–59.

    Article  PubMed  Google Scholar 

  56. Thevis M, Schanzer W. Analysis of low molecular weight substances in doping control. In: Kraemer WJ, Rogol AD, editors. The endocrine system in sports and exercise, vol XI of the Encyclopaedia of sports medicine. Oxford: Blackwell Publishing; 2005. p. 47–68.

    Google Scholar 

  57. Aguilera R, Chapman TE, Starcevic B, et al. Performance characteristics of a carbon isotope ratio method for detecting doping with testosterone based on urinary diols. Clin Chem. 2001;47:292–300.

    PubMed  CAS  Google Scholar 

  58. Friedmann T. How close are we to gene doping? Hastings Cent Rep. 2010;40:20–2.

    Article  PubMed  Google Scholar 

  59. Barton-Davis ER, Shoturma DI, Musaro A, et al. Viral-mediated expression of insulin-like growth factor-I blocks the aging-related loss of skeletal muscle function. Proc Natl Acad Sci U S A. 1998;95:15603–7.

    Article  PubMed  CAS  Google Scholar 

  60. Schuelke M, Wagner KR, Stolz LE, et al. Myostatin mutation associated with muscle hypertrophy in a child. N Engl J Med. 2004;350:2682–8.

    Article  PubMed  CAS  Google Scholar 

  61. McKanna TA, Toriello HV. Gene doping: the hype and the harm. Pediatr Clin North Am. 2010;57:719–27.

    Article  PubMed  Google Scholar 

  62. Carter A, Flueck M. A polymerase chain reaction-based methodology to detect gene doping. Eur J Appl Physiol. 2012;112(4):1527–36.

    Article  PubMed  Google Scholar 

  63. Beiter T, Zimmermann M, Fragasse A, et al. Direct and long term detection of gene doping in conventional blood samples. Gene Ther. 2011;18:225–31.

    Article  PubMed  CAS  Google Scholar 

  64. Kohler M, Thomas A, Walpurgis K, et al. Mass spectrometric detection of siRNA in plasma samples for doping control purposes. Anal Bioanal Chem. 2010;398:1305–12.

    Article  PubMed  CAS  Google Scholar 

  65. Baoutina A, Coldham T, Bains GS, Emslie KR. Gene doping detection: evaluation of an approach for direct detection of gene transfer using erythropoietin as a model system. Gene Ther. 2010;17:1022–32.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, National Children’s Hospital, San Jose, Costa Rica

    Erick J. Richmond MD

  2. Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Charlottesville, VA, USA

    Alan D. Rogol MD, PHD

Authors
  1. Erick J. Richmond MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alan D. Rogol MD, PHD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alan D. Rogol MD, PHD .

Editor information

Editors and Affiliations

  1. , Department of Orthopedic Surgery, Hadassah-Hebrew UMC, 4 Ha'razim St, Jerusalem, 91120, Jerusalem, Israel

    Naama Constantini

  2. , Applied Physiology Laboratory, UNC at Chapel Hill, 203 Fezter Hall, Chapel Hill, 27599, North Carolina, USA

    Anthony C. Hackney

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Richmond, E.J., Rogol, A.D. (2013). Hormones as Performance-Enhancing Agents. In: Constantini, N., Hackney, A. (eds) Endocrinology of Physical Activity and Sport. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-314-5_28

Download citation

  • DOI: https://doi.org/10.1007/978-1-62703-314-5_28

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-313-8

  • Online ISBN: 978-1-62703-314-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation