Mile High Sports

Al Jazeera America report on doping outlines medical uses for HGH

Feb 2, 2012; Indianapolis, IN, USA; Ashley Manning wife of Indianapolis Colts quarterback Peyton Manning hosts the NFL wives fashion show at Keystone at the Crossing in preparation for Super Bowl XLVI between the New York Giants and the New England Patriots. Mandatory Credit: Brian Spurlock-USA TODAY Sports

TV news network Al Jazeera America and news website Huffington Post set off a firestorm among professional sports circles in North America on Saturday night with news of a forthcoming investigative report that implicated numerous MLB and NFL stars, including Peyton Manning, in a doping ring. Manning, specifically, was reportedly using growth hormone, more commonly referred to as human growth hormone, or HGH, officially a banned substance by the NFL. The report aired Sunday night on the tv network.

(VIEW OUR FULL COVERAGE OF BOTH REPORTS, AS WELL AS REACTION FROM MANNING AND THE DENVER BRONCOS AND RECANTED STATEMENTS FROM SOURCES IN THE REPORT.)

A source in the report who helped supply one of the Al Jazeera investigators with numerous banned substances claimed that both Manning and his wife, Ashley, received after-hours treatment at the Guyer Institute, an Indianapolis anti-aging clinic, and that HGH was shipped via the clinic throughout 2011, the year Manning was recovering from neck surgeries, to Ashley. The implication was that the drug was being used by Peyton, although being shipped to his wife.

In response to the source’s claims, Manning’s spokesperson called the insinuations “baseless and absolutely false … The treatment he received at the Guyer Institute was provided on the advice of his physician and with the knowledge of team doctors and trainers … Any medical treatment received by Ashley is a private matter of hers, her doctor and her family. Any medication shipped to her was prescribed by her doctor and taken solely by her.”

But the limited nature of HGH’s treatment purpose make the matter far from private, based on an expert cited in the report. HGH, according to the report, has an extremely limited number of conditions it treats in adults and is one of the few drugs that cannot be prescribed for anything other than its explicit purposes, under penalty of law including incarceration for prescribing or trafficking the drug off label.

In the report, Al Jazeera America cited “one of America’s leading experts” in the use of HGH, Dr. Alan Rogol, an endocrinologist and professor of pediatrics at the University of Virginia School of Medicine whose research is in growth and development at puberty, per the university’s website. He “has advised governments and sporting communities on [HGH’s] misuse,” says the report.

Rogol says in the report that HGH is one of the few drugs in the United States that cannot be prescribed off label. Off label prescriptions allow a doctor to prescribe a drug for something other than its intended (on label) purpose if the doctor believes there is evidence it will help with another illness. According to Rogol, “[HGH] is one of the only drugs that I know of that is in that way – off label prescription – illegal, not just not a good idea. It’s illegal.”

Rogol stated in the report there are three conditions for the prescription of HGH in adults: “One is growth hormone deficiency, either carrying over from a child, or an adult who has had a serious condition of a pituitary tumor, surgery or radiation therapy in that area. The other two are short bowel syndrome, which is simply bowel cut out from a patient who’s had cancer or another bowel disease. The third is HIV wasting; so these are people who have HIV and not doing well. They are wasting away. Those are the only three that are appropriate indications for growth hormone in an adult patient.”

In Rogol’s opinion, there would “never” be reason to seek a prescription of growth hormone from an anti-aging clinic for any of those conditions. “The growth hormone deficiency would be an endocrinologist who takes care of adults,” he said. “The HIV wasting would be an infectious disease clinic, perhaps a gastroenterology clinic. And the short gut certainly be gastroenterology, gut surgery-type clinics. They would not be anti-aging clinics.”

There are, however, other reported medical uses for HGH not outlined by Dr. Rogol in the Al Jazeera report. In this report from The Atlantic in 2013, Shawnee Barton describes her own use of the drug as prescribed by a reproductive endocrinologist to improve fertility.

She says the drug has been vilified because of reports like those surrounding Barry Bonds, Jose Canseco, Mark McGwire and Alex Rodriguez. “People start saying the word ‘drug,'” she writes, “with a tone that has nothing to do with prescriptions and everything to do with a Nancy Reagan-type shame campaign.”

In her report she concludes, “… I understand when people look shocked after I tell them that I took HGH.  When they ask, ‘Where did you get it?’ I can tell that they expect to hear ‘In an alley in Mexico,’ instead of the boring, less provocative truth—from the pharmacy around the corner.”

With the Al Jazeera America report, what the Mannings hoped would be a private manner between the family and Ashley’s doctor now has a very public spotlight cast upon it.

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