Performance Enhancing Methods and Drugs

1. Performance Enhancing Methods and Drugs Past and present illicit abuse, Current research and Justified Use PRESENTED BY: Rance Terry

2. Purpose of this presentation: • To inform the audience of… • The methods in which athletes use performance enhancing drugs to gain an edge • The original use of the drugs and how they also increase performance • Whether or not these methods work and if the positive’s outweigh the negative’s sufficiently enough to justify use

3. What are the current enhancement methods? • Exogenous Human Growth Hormone • Testosterone Supplementation • Erythropoietin Injection • Stem Cell Therapy Hua. (2008)

4. Human Growth Hormone • A hormone that stimulates growth, regeneration of cells and is secreted by somatotropic cells of the anterior pituitary. • Used in competition since the 1970’s • Most widespread use of sports doping • Exercise and sleep are the two biggest natural stimuli Healy, Gibney, Russell-Jones, Pentecost (2003)

5. According to Studies… • hGH can mediate muscle hypertrophy in response to an exercise • Load and frequency of exercise can determine the secretion regulation • Main contributor to protein synthesis is insulin-like growth factor-1 or IGF-1 • Most of the protein synthesis stimulus comes from IGF-1 with GH receptors having little effect Solberg & Ringer (2011)

6. Double Blind Results • hGH did not improve bicep strength • Produced significant gains in lean body mass with decrease in overall fat mass • Higher basal metabolism rate • Lowered respiratory exchange ratio • Raised lactate, free fatty acid and glycerol levels • VO2 max, speed expenditure, power output, and cycling speed remained unchanged Denham (2000)

7. Evidence Based Conclusions • hGH has a significant effect on protein anabolic ratio’s on resting metabolism and during exercise • A net reduction in absolute leucine production loss, showing signs of the anabolic effect. • Short term hGH administration shows an anabolic effect during exercise and at rest • This supports the idea that a short-term exogenous dosage of hGH may be beneficial to physical performance • Positive results can not lend to recommendation of use with the legal consequences that can come as a result of use Solberg & Ringer (2011) Hoffman (2010)

8. Testosterone Supplementation • Testosterone is an androgenic hormone produced in the testes and ovaries of humans and is the main sex hormone • Classified as a natural anabolic steroid • Effects are growth of muscle mass and strength, bone maturation and increases in bone density and strength • Usually very prevalent in puberty and then gradually taper off to low levels but can be revitalized jjHoffman, 201Hoffman, Hoffman, 2010). , 2010). Hoffman (2010)

9. Original Use • Testosterone became an alternate and somewhat better option to muscle stamina and growth as early as the 1980’s • Recognized in 1990 as a controlled substance by Congress • Four exogenous forms of the hormone including intramuscular injection, implantable pellet, and patches or gels • Continued use of the hormone results in what is know as the Farquharson phenomenon Crewther, Cook, Cardinale, Weatherby & Lowe (2011)

10. According to Studies • Testosterone dosed non-exercise groups had greater increases in muscle size in their arms and legs, with as much as a 3 inch mean change • Also had significant increases in full body squat and bench press • Group dosed and prescribed exercise routine had greater increases in fat free mass and muscle size • The increases in fat free mass were as much as 6 pounds and the increase in muscle size was as great as 104 millimeters Hoffman (2010) )

11. Dosed group increased bench press at one repetition max by as much as 22 pounds • Increased one repetition full body squat by as much as 38 pounds • Neither mood nor behavior was changed in any group, the only difference being a slight excess of acne and breast tenderness by a small number of subjects Bhasin, Storer, Berman, Callegari, Clevenger Et. Al (1996)

12. Conclusions • Supraphysiologic doses of testosterone, combined with strength training can increase muscle size and fat-free mass in normal men • Acute changes in physiological hormones can offer long-term adaptations and short-term benefits for training performance • Evidence also shows that higher concentration levels of these hormones can support the performance of the neuromuscular system as well as motor function and energy metabolism Emmons & Brown (2012)

13. Exogenous delivery alone can increase back squat, power clean, vertical jump, split jerk and standing press maximum repetition • Exogenous administration along with resistance training can increase these as well as a reduction in plasma volume, lactate stimulated secretion and adrenergic stimulation • Is not as easy to discern between exogenous and natural testosterone as hGH is • Continued use results in higher levels in tests and also results in suspension and can not be recommended in Organized sports Emmons & Brown (2012)

14. Erythropoetin • EPO is glycoprotein hormone that controls red blood cell production, also medically known in it’s natural form as erythropoiesis • Produced in the kidneys and helps with the healing of the body’s wounds • In very heavy physical exercise, the kidney secretes EPO to increase red blood cell production Juhn (2003)

15. According to Studies • The major factor that limits muscles in their ability to endure for long periods of time depends on blood-oxygen levels, lung function, heart stroke volume and vascularization • EPO improves the body’s oxygen delivery to muscles, which greatly improves endurance capacity Sefiha (2012)

16. Sixteen athletically fit cyclists were split into two groups, eight being injected with EPO and the other eight in the control group being injected with placebo • 13-week period of testing resulted in a 54% increase in performance for the EPO injected group • The peak power output after 13 weeks increased by 13% and the time to exhaustion increased to a point where riders could continue 12 more minutes than before the study began • Dual Energy X-ray Absorptiometry was conducted to back up these results and measure them accurately Sefiha (2012)

17. Conclusions • It is impossible to recognize the possibility of EPO to increase performance outputs • If an athlete only gains a 25% increase in power and endurance instead of a 54% increase like the riders in the study, that is still a huge difference • Heart attack and other medical problems can arise from elevating levels in the blood, and can be very dangerous and can not be recommended Callaway (2011) Juhn (2003)

18. Stem Cell Therapy • Defined by the World-Anti Doping Agency as “the non therapeutic use of genes, genetic elements and or cells that have the capacity to increase athletic performance • Began in the 1970’s when modern medicine found a way to treat human disease by attacking the underlying genetic defects causing the disease • Produced effective treatments for neurodegeneration, genetic forms of blindness, pediatric immune deficiency and a number of other diseases Tynes (2006) Romani, et al (2003)

19. According to Studies • The committed precursor cells taken from the host muscle had the potential to proliferate, self renew and repair damaged muscle before being introduced into the new muscle • Cells also had the ability to differentiate into both myogenic and non-myogenic lineages • The integration of the viral vectors into the host genome carries the risk of insertional mutagenesis • Can cause abnormal regulation of the cell’s growth and toxicity from the chronic over expression of the growth factor and cytokines, as well as malignancy of cells Mcgrath & Cowan, 2008

20. Conclusions • According to the US Anti-Doping Agency, there is currently no way to test for gene doping because it is the athlete’s copies of genes that are naturally present in the body and cannot be distinguished • Can have a great potential to revolutionize medicine and the way it cures disease and how it improves quality of life

21. Main cause for concern in gene doping is the unknown risks associated with it, it is very likely that introducing new genes can bring many health problems, but it is not certain • Artificially increasing levels of anything in the body can result in heart attack or even paralysis • Being able to increase production of genes does not mean they will stop once a person wants them to either, muscles can become disproportionate and can pull on tendons and ligaments causing tears that would not otherwise happen

22. Recommendations • Only exogenous Testosterone supplementation can be recommended to noncompetitive athletes because of the gains that can come from it without significant negative effects • hGH and EPO have positive effects on the body but are not sufficient enough to outweigh the negative possibilities • Stem cell therapy can never be recommended because of the unknown danger associated with it

23. Bibliography