The Explainer: Riding the high horse?
A reader considers using human growth hormone to fight aging and argues doping rules are just plain wrong
I read with interest your column on supplemental testosterone therapy for older men and the impact it might have on the aging process. I usually like your column, except when you get on your high horse on the subject of doping.
I am a 57-year-old masters’ racer and can probably say I am basically just a “weekend warrior” and not looking to make a living off of my riding. First off, it seems unfair to apply the anti-doping rules used for professionals to a bunch of older riders whose lives include more than just racing.
Even then though, I think professionals should be allowed to dope, too. As one of the comments said at the end of your column last week, open doping would “level the playing field” and it would stop all of these stupid guessing games about whether someone has doped or not.
I have friends who’ve been using supplemental testosterone for years now and they look healthy and strong and say they feel great. I had considered it, but my doctor says that my levels are not all that low and she doesn’t want to run the risk.
I have been asking her about using human growth hormone as well, but she seems reluctant. I live close enough to Mexico that I have thought about traveling there to make an appointment to see a doctor about buying hGH and maybe testosterone there. If I get caught, then fine. I’ll just ride on my own.
Does cycling even have a test for hGH?
To be honest, I was tempted to just delete your email, largely because you seem to be advocating practices and arguments that I find to be both medically dangerous and morally abhorrent. Whoa, I just used “morally abhorrent” to dismiss your argument … okay, okay, so maybe I am riding a high horse.
So, instead of deleting your email, let’s take a look at what you’re suggesting.
I often receive emails and see comments from those who want sport to take a sort of laissez-faire approach to the question of doping. For a lot of reasons, I’ve never been able to buy into that kind of thinking.
Rules are rules
In your case, let’s start off with the most obvious. Doping is against the rules. Yeah, I see that you’re a 57-year-old masters’ racer and, frankly, no one outside of a really small circle of participants, friends and family is ever going to take notice of race results turned in by guys in our age groups.
Nonetheless, you’ve chosen to engage in a competition with a specific set of rules with which every participant, either explicitly or implicitly, has agreed to comply. That may not seem like it’s important when you’re riding in the Men’s 55+ division at the local Tour de Office Park, but it is.
When others are complying with the rules and you don’t, you’re not participating in the same event. By suggesting that you might dope and ride until you are caught, you’ve pretty much abandoned the whole concept of what makes a sport a sport. Operating under a commonly accepted set of rules is the very essence of sport. Think about the alternative for a moment.
I could, for example, quite easily win the Masters Golf Tournament this coming April. I would crush Tiger Woods and the rest of the professional field with a series of guaranteed holes-in-one. Of course, in my case, a Kim-Jong-Il-like golfing performance could only come about if Woods and others followed the rules and I simply carried the little white ball from the tee and dropped it into each hole.
Under the current rules, doping is just a subtler version that obvious (and admittedly ridiculous) strategy. Raymond, aside from the medical risks (which we’ll touch upon in a minute) of your planned foray into Mexico, you risk cheapening the experience of competition for yourself and for those against whom you would be “competing.”
Dope for one, dope for all!
But aside from suggesting that you are thinking about cheating until caught, you’ve also raised the common argument that doping shouldn’t be part of the rules governing sport – especially ours.
I’ve heard that a lot and the argument usually comes down to the advocates of performance-enhancing drugs (PEDs) saying that getting rid of doping rules would, as you said, level the playing field. They summarize their argument with a variant of the old NRA bumper sticker, suggesting that “when PEDs are outlawed, only outlaws will use PEDs.”
In my book, that’s a surrender to the belief that dopers will always be a step ahead of the testers, so we should just give up. It’s an argument that may have once carried weight, but the progress since the creation of WADA and increased funding for research has narrowed the gap. I honestly believe sports in general, and cycling in particular, are cleaner now than they have been since advent of blood-manipulating drugs, like EPO.
When discussing the scourge of sports doping in historical terms, we often hear of early efforts dating back to the ancient Olympic Games. But honestly, the real impact of doping in sport wasn’t felt until the development of exogenous hormones that allow competitors to alter the fundamental structures of their bodies, artificially stimulating muscle growth and, above all, altering the composition of their blood.
When recombinant erythropoietin began to make its appearance in cycling, the early mistake some athletes made was to operate on the belief that if a little is good, more must be better. We’ve all heard anecdotes about riders jacking their hematocrits up to and beyond 60 percent in the early days. We also all heard some reasonable speculation that the spate of cardiac deaths that affected riders in the early 1990s were not merely coincidental.
Despite Michele Ferrari’s now-infamous pronouncement that if properly administered EPO is quite safe, the drug, even in moderate doses, poses some serious risks, including cardiovascular complications and elevated rates of some types of hormone-sensitive cancers.
As EPO use in the peloton became more common – and more sophisticated – once-dominant riders were finding themselves struggling. Some were soon faced with that Faustian choice of whether to dope or to retire.
In the pre-Festina-scandal world of cycling, teams were actively engaged in promoting drug use by riders and, to some new recruits, it was made clear that they could either dope … or go back home and become a bricklayer.
After that infamous 1998 Tour scandal, the pressures remained, but were far more subtle. Your argument in favor of “leveling the playing field” would return us to a point where athletes would essentially be required to dope in order to compete. Were such doping without medical risk, that might be a valid point, but it isn’t without risk.
What you’re offering is a world in which we’d be asking 20-year-olds to make decisions whose consequences may not manifest themselves for years. For what? For our entertainment? So that Phil and/or Paul can happily declare that a certain rider just turned in “an unbelievable performance!” (without the slightest hint irony)? Unbelievable, indeed.
The law of unintended consequences
As a recent chemotherapy patient, I was a little disappointed to learn that EPO and other erythropoeisis-stimulating agents (ESAs) were not an option for me, even when my hematocrit dropped from its normal 48 to less than 30. For years, such chemo-induced anemia was casually treated by oncologists who saw ESA use as a logical response to declining red blood cell counts. As it turned out, though, there was a significantly higher rate of cancer recurrence in those patients receiving ESAs than in those who did not. Oops.
I am not suggesting that well-monitored use of ESAs will automatically lead to higher rates of heart disease and cancer among otherwise healthy populations. What I am suggesting, though, is that we are at a point in modern medicine where even our most sophisticated methods are still quite crude. We simply do not know what the long term consequences are in many cases.
You know, back in the old days – the late 1960s and ’70s – hGH was only available by removing it from donor cadavers. In 1985 doctors began diagnosing and reporting cases of patients, who had received hGH treatments 15 or 20 years earlier, developing Creutzfeldt–Jakob disease – also known as Mad Cow Disease. It was enough to prompt the removal of cadaver-sourced growth hormone from the market. Oops.
These days, recombinant growth hormones are produced by several pharmaceutical companies, using sophisticated genetic engineering techniques. Your risk of exposure to Creutzfeldt–Jakob or some other transmissible spongiform encephalopathy is pretty much nil. Of course, there are still increased risks for other things like headaches, impaired vision, a rare form of diabetes, Hodgkins lymphoma and – just like last week – sexual dysfunction. Oops.
In your case, you’re considering the use of human growth hormone despite there being very little peer-reviewed evidence of its potential benefit and ample evidence that it carries with it significant risk. Again, you’re a masters’ racer. Your decision isn’t going to change the world, nor will it place the onus of making a similar decision upon a 20-something rider trying to make his or her way in the world of professional sport.
In your case, it’s just a risky – and potentially stupid – move that will probably only affect you. Do yourself a favor, though, and read an interesting 2003 article in the British Journal of Sports Medicine, which concludes that “the over exaggeration of the effects of growth hormone in muscle building is effectively promoting its abuse and thereby encouraging athletes and elderly men to expose themselves to increased risk of disease for little benefit.”
That “over exaggeration” is the result of a burgeoning industry of hGH advocates who see it as another in a long line of “cures” for the aging process. There is a lot of anecdotal evidence out there, but there haven’t been comprehensive, double-blind studies of the anti-aging effects of hGH. A valid study would examine both its purported anti-aging effects and the potential for negative side-effects. Simply put, at this point there is little evidence to suggest that hGH is either safe or effective when it comes to athletes or those of us who dream about being young again. Despite the absence of compelling evidence that it provides a competitive edge, WADA has included hGH on its banned substances list.
Look, Raymond, we all get older. Like you, I miss being 25 and fast. Unlike you, I am not willing to tamper with my body chemistry in a seemingly futile effort to turn back the clock. Let’s just roll with it.
And, yes, WADA does have an hGH test. Watch out.
The Explainer is now a weekly feature on Red Kite Prayer. If you have a question related to the sport of cycling, doping or the legal issues faced by cyclists of all stripes, feel free to send it directly to The Explainer at Charles@Pelkey.com. PLEASE NOTE: Understand that reading the information contained here does not mean you have established an attorney-client relationship with attorney Charles Pelkey. Readers of this column should not act upon any information contained therein without first seeking the advice of qualified legal counsel licensed to practice in your jurisdiction.