by Mike Arnold
Anyone who is familiar with my writings will immediately recognize my proclivity for the use of performance enhancing drugs in sport. Aside from their ability to radically improve the composition and performance of the human body, as a whole they are a fascinating set of compounds, with potential applications extending far beyond our little world of bodybuilding. Yet, for all the wonderful things they can do, they are not without their shortcomings. While this holds true for all PED’s and drugs in general, I want to explore this notion within the context of growth hormone and insulin use in today’s BB’r.
In comparison to AAS, the amount of information available concerning the prevention and treatment of GH & insulin induced side effects is relatively scarce. BB’rs have been left to scavenge for themselves whatever information they can find regarding the safe application of these drugs. This has left many in a precarious situation, afflicted with undiagnosed medical conditions which affect not only their overall health, but their BB’ing progress as well. Up until this point, most of the information available on these two drugs has been tailored towards maximizing their perceived benefits, while many of the associated risk factors have been largely ignored. This is in stark contrast to AAS, which have received a tremendous amount of research in the areas of prevention/treatment.
There is one side effect in particular associated with these drugs which has reached near epidemic proportions, causing it to take precedence over the rest and thereby warranting its own discussion. Not only has it had a significant impact on BB’rs world-wide, but most aren’t even aware the problem exists, let alone taking steps to protect themselves from its ill effects on the body. I am referring to a condition known as insulin resistance. Insulin resistance is defined as a state in which a person’s body tissues have a lowered level of response to insulin. In order to gain a more comprehensive understanding of this issue, I will provide a brief explanation as to how insulin works in the body.
When we eat, juices in the small intestine (pancreatic juice & bile) break down the food into glucose, a simple sugar, which is then diverted into the bloodstream. When the concentration of glucose in the bloodstream exceeds a certain level, the pancreas is stimulated to release insulin into the blood. As the insulin travels through the bloodstream and comes in contact with muscle and fat cells, it attaches itself to the insulin receptor sites on those cells. Once activated, the insulin receptor initiates a series of complex biochemical signals within the cells that allows it to absorb the glucose and convert it to energy. If the pancreas is unable to secrete adequate quantities of insulin and/or the insulin receptors are not operating properly, the cells will be unable to absorb the glucose and blood levels of glucose remain elevated. In the beginning stages of insulin resistance the pancreas increases its production of insulin in an effort to more effectively manage the increased levels of glucose in the blood. As a result, it is not abnormal for those affected by this condition to exhibit high blood sugar levels in tandem with high blood insulin levels (a condition referred to as hyperinsulinemia).
If insulin resistance is not diagnosed and treated, as is often the case with GH & insulin abusing BB’rs, the individual will eventually be exposed to a variety of metabolic dysfunctions associated with or contributing to a broad range of serious health problems, such as increased visceral fat storage, pre-diabetes, high blood pressure, high triglycerides, and lowered LDL. Together, these make up a constellation of health problems normally referred to as Metabolic Syndrome. Unfortunately, this may not be enough to sway the success-minded BB’r away from his destructive habits, as they are frequently (and foolishly) more concerned with their BB’ing progress than their long-term health. However, these individuals should not be deluded into thinking they can simply ignore this problem, while continuing to reap maximum benefit from their BB’ing efforts. No, sir…the negative effects of insulin resistance on muscle growth are well documented. In addition to a reduced capacity to deliver amino acids and glucose into the muscle cell (which can adversely affect growth through several direct and indirect mechanisms), there is a growing body of evidence which suggests that certain, key signaling pathways necessary for the growth process to occur are inhibited by insulin resistance. This alone should be enough to get any BB’rs attention.
Along with steroids, growth hormone and insulin have become staples in the drug-using community, rounding out what have now become known as the “Big-3”. When combined, a synergistic effect is witnessed, allowing the individual to improve not only his growth rate, but his ultimate level of development as well. The allure of this promise is too much for many BB’rs to ignore, so they begin to include these drugs in their program, while frequently following the application guidelines handed down to them by friends or other internet authorities. While the recommendations provided may appear to be sufficient from a results perspective, they most often focus on short-term results, with little to no consideration given to long-term results or health.
Although GH is known to modulate tissue sensitivity to insulin, the sequence of molecular events leading to these changes is poorly understood. Some of the mechanisms by which GH is hypothesized to adversely affect insulin sensitivity are as follows: disruption of carbohydrate and lipid metabolism, direct effects on the insulin receptor, convergence of GH & insulin signals at the post-receptor level, and the increased expression of cellular proteins known to inhibit insulin receptor signaling, among others. While the medical community may still be unclear regarding the exact mechanisms by which GH interferes with tissue sensitivity to insulin, one thing they are 100% sure about is that growth hormone can and does cause a decrease in insulin sensitivity in a dose-dependent manner, which has often lead to full blown insulin resistance at higher dosages.
Inevitably, one of the first questions to be asked is “How much GH can I use without experiencing this problem?” Generally speaking, any dose beyond 3 IU per day can have deleterious effects on insulin sensitivity and as the dose continues to rise, the worse the issue becomes. I realize that most readers would like to me post a graph showing a direct correlation between specific dosages of growth hormone and degrees of insulin resistance/sensitivity, but that is not possible. Not only is there considerable variance in personal response between the different dosages of GH, but there are several other factors which can influence one’s level of sensitivity/resistance. This can drastically affect the outcome, making any type of formalized graph an impossibility. However, for those of you who are wondering if you may have inadvertently exposed yourself to this condition, I will make the following generalized statement. Doses as low as 3IU per day have been show to adversely affect insulin sensitivity, while in my own personal practice I have seen several examples of individuals who at just 5-6 IU per day, have meet the clinical definition of insulin resistance. The official criteria for insulin resistance has been arbitrarily defined as the requirement of 200 or more units of insulin per day to attain glycemic control and to prevent ketosis. However, in order to determine if one is officially insulin resistant, it will typically require the assistance of a physician, who may conduct multiple tests, in addition to gathering personal background and family history information.
Continued in See Part 2.