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Why would athletes take HGH? continued...

Most athletes who abuse HGH take it along with testosterone. But in clinical studies of strength and endurance, HGH adds little to the boost in performance seen with testosterone.

These studies, however, were done in normal people. A difference that makes little difference to a normal person may mean everything to an elite athlete.

"Say you're running the 100-meter dash," Rogol suggests. "If you're just 1% better, you cannot tell the difference in an experiment. But for an elite athlete, that 1% improvement may mean the difference between winning a gold medal and never making it to the Olympics."

What are the risks of abusing HGH?

The short-term risks of rHGH are water gain and swelling, muscle pain, and joint pain. The only really serious short-term risk is an increase of pressure in the brain. This happens to about 1% of children who receive HGH replacement therapy.

In the long term, the risks of abusing rHGH are more serious. Muscles can become weak, there's a higher risk of heart disease, and there's a risk of developing high blood sugar and type 2 diabetes.

Are there tests to detect rHGH?

Yes. The most reliable test looks for evidence of the most common isoform of rHGH, called 22 kDa. This test measures the amount of 22 kDa and the amount of total HGH in the blood. In normal people the ratio of 22 kDa HGH to total HGH is about 0.6. If the ratio is over 1.0, an athlete is considered to be doping with rHGH.

There are drawbacks, however. Some people carry a gene that keeps HGH blood levels low. Even dopers test negative for rHGH if they have this gene.

And the test has to be done no more than 36 hours -- some say 24 hours -- after a person takes rHGH.

Other rHGH tests look for telltale "biomarkers" of body functions that have been altered by rHGH. Such tests have been used and have led to sanctions against athletes, Rogol says.

What are anabolic steroids?

Anabolic steroids are male sex hormones, or androgens. Androgens are the most commonly used performance-enhancing drugs. They account for half of all positive drug tests in the last decade, Bhasin says.

"Use has been growing since the 1980s. Elite athletes actually constitute a very small fraction of use," he says. "Many who use anabolic steroids use intramuscular injections. There are about 30 such compounds, although testosterone, nandrolone, and stanozolol are the most common ones."

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