In theory, at least, IGF-1 seems almost too good to be true.
It can, at least in animals, heal tendon injuries and build muscles. Available at anti-aging clinics, IGF-1, or insulinlike growth factor-1, has also found favor among athletes for the same reasons that its better-known relative human growth hormone has: it is believed to make an athlete bigger, faster and stronger. It may boost muscle, reduce fat and improve endurance.
IGF-1 came to foreground Tuesday when it was mentioned among the performance-enhancing drugs that a South Florida clinic provided to six baseball players and other professional athletes, according to a report in the Miami New Times newspaper. Sports Illustrated also reported Tuesday that some football players used a substance taken from deer-antler velvet that contains IGF-1.
Although IGF-1 is unknown to most sports fans, for years the drug has been a mainstay in the constellation of banned performance-enhancing drugs. It has long been on the World Anti-Doping Agency banned substances list, alongside human growth hormone.
There is no widely available urine test for IGF-1, but like human growth hormone, IGF-1 can be detected in blood tests. However, until this month, Major League Baseball and its players union had not reached an agreement to conduct in-season blood testing for human grown hormone.
IGF-1 is made in response to growth hormone and is needed for growth hormone to have its effects on muscles and other tissues. Growth hormone, synthesized in the pituitary gland, travels to the liver, which then responds by producing IGF-1.
The Food and Drug Administration has approved IGF-1 for children with a rare condition in which they fail to make enough of it. Their bones do not grow sufficiently and the children are very short. The drug, sold by Ipsen, is injected under the skin and travels through the blood to bones, stimulating them to grow.
IGF-1 and deer-antler sprays have drawn attention among elite athletes in recent years. St. Louis Rams linebacker David Vobora won a $5.4 million judgment against Sports With Alternatives to Steroids, or S.W.A.T.S., over the use of one of its sprays, which reportedly contained banned substances including IGF-1. The IGF-1 that the company sells is "natural, not synthetic," said Mitch Ross, the founder of S.W.A.T.S., adding that it is "a raw food, not a drug."
IGF-1 is "just like giving someone human growth hormone," said Don Catlin, the former head of U.C.L.A.'s Olympic Analytical Lab, best known for breaking the Bay Area Laboratory Co-operative doping ring. "It goes to the same kinds of receptors and turns them on."
The S.W.A.T.S. Web site promotes the company as being for "athletes competing without cheating" and its Facebook page lists "IGF-1 Supplement (Deer Antler Velvet)" among its products. Online message boards brim with commentary about its effectiveness, but doctors have called into question whether IGF-1 works in spray form.
Ross, of S.W.A.T. S, said that while he had not tested the long-term effects of natural IGF-1, he maintained that the drug was safe. "If you abuse it, you could have side effects," he said.
While IGF-1 could help athletes in theory, said Dr. Alan Rogol, a vice president of the Endocrine Society, there are no scientific studies with humans to show the expected effects actually occur. In animals, he said, if IGF-1 is injected into the body, muscles grow. If an animal is produced with genes that cause one muscle to overproduce IGF-1, that muscle grows, and if a tendon is injured, IGF-1 speeds healing.
One of the two tests used to detect growth hormone should also detect abuse of IGF-1. It's called the marker test and what it actually measures is not growth hormone but growth hormone's effects — an increase in IGF-1 and an increase in one of the metabolites released when a tendon is being repaired. The other growth hormone test, the isoform test, looks directly for the hormone and so it would not pick up IGF-1.
Rogol, among a small group of doctors who evaluate therapeutic exemptions for the antidoping agency, said the marker test has picked up a few athletes who tested positive, and most admitted growth hormone abuse.
Both growth hormone and IGF-1 are expensive, he added. Each may cost more than $25,000 a year for a child who is using one of the drugs for legitimate reasons. Athletes may use five or 10 times as much IGF-1 or growth hormone because they are bigger and use higher doses.
For professional athletes making millions of dollars a year, "that cost may be trivial," Rogol said.
Still, the age-old temptations to pursue the use of performance-enhancing drugs remain and make IGF-1 still relevant, doping experts said.
"The only sport where you may not want to use it is curling," Charles Yesalis, a professor emeritus of health policy and administration at Penn State, said of IGF-1. "In what sport does not being bigger and faster help you do better?"
Given the lags in implementing blood testing for the drug and number of anti-aging clinics sprinkled throughout the country, Yesalis said he was far from surprised when he heard about the wave of headlines Tuesday about IGF-1.
"I think this goes on all the time," he said. "My response to this one is kind of a yawn. Drug tests didn't bust these guys. It's just business as usual."
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