ABSTRACT
The search continues for ways to improve athletic performance. In earlier times, athletes consumed strychnine and brandy or concoctions containing heroin and cocaine for a perceived competitive edge or to delay fatigue and pain. Athletes today may be more sophisticated—or not, as reports surfaced in 2013 about extracts from deer antlers being used as a spray to provide insulin-like growth factor-1. When Lance Armstrong finally admitted to using banned substances in 2012/13, it became clear that he had avoided detection for years, until his story unraveled, with many of his former associates and team members providing important evidence that allowed investigators to make their case.
Anabolic steroids clearly can increase muscle cell size, muscle mass, and strength, especially in conjunction with a vigorous training program. Human growth hormone stimulates cell division and an increase in cell number. It increases levels of insulin-like growth factor-1, another powerful hormone involved in growth. Human growth hormone use probably speeds tissue repair and recovery, a very attractive property for professional athletes, who have intense training and game/competition schedules. Erythropoietin increases the oxygen-carrying capacity of the blood, a major factor in maximizing oxygen utilization—a key part of exercise performance. All three of these agents have therapeutic value for individuals who suffer from a deficiency in their production. All three of these hormones are prototypes for performance-enhancing substances: they allow athletes to get bigger and faster, recover faster, and increase VO2max. Future athletes will likely continue to look for the edge, whether or not the means are legal and ethical. Keeping sport clean will require a significant cultural change, as appreciation for the benefits of participation, inclusion, and enjoyment must overcome the attitude of winning at all costs.
