A. There has been a great deal of information about anabolic steroids and human growth hormone (hGH) in the news lately, and many professional athletes have claimed to have used these substances to recover from injuries. While high doses of anabolic steroids have been shown to increase lean muscle mass when combined with high-intensity exercise, the data on hGH has not been very convincing.

Studies have failed to show significant muscle gains with hGH alone, and there have not been any definitive studies with respect to injury recovery. Unfortunately, this lack of scientific information has not stopped athletes from trying it. The use of hGH has spread beyond elite athletes, and, as this question indicates, a whole host of people have become interested in hGH. A quick Google search of "buy human growth hormone" yields about 1 million Web sites! Clearly these sites are not just pandering to elite athletes.

Before considering trying hGH or anabolic steroids, there are a few things one should know. First, these drugs have the potential for significant adverse effects. Anabolic steroids can cause heart disease by lowering HDL or good cholesterol and many types of liver problems. In men, anabolic steroids can cause testicular shrinkage, impotence, reduced-to-absent sperm counts, potential for prostate cancer and gynecomastia (overdevelopment of male breasts). Women can experience even more devastating effects with deepening of the voice, menstrual irregularities, hirsutism and clitoromegaly (enlargement of the clitoris). The use of high doses of hGH can cause carpal tunnel syndrome, coarsening and swelling of the hands, feet and face, diabetes and potential for cancers of the GI tract.

Secondly, these drugs can only be legally used for a small number of medical indications. Anabolic steroids are a Schedule III drug and can only be prescribed for conditions such as hypogonadism (low functioning testicles) in men, certain types of anemias, some advanced forms of breast cancer, and a few other rare conditions. A physician who prescribes them for any other purpose is potentially violating the law and is committing a felony. Human growth hormone has similar restrictions and can only used for approved uses, such as growth hormone deficiency and a few relatively rare conditions. A prescription for any other use, even by a licensed physician, is not valid under the United States Code. That means that all of the "anti-aging" clinics around the country that are dispensing hGH are operating illegally. Many of these operations have been recently indicted along with the compounding pharmacies that were working in conjunction with them. A few hundred years ago, Ponce de Leon died trying to find the Fountain of Youth. A similar search today might result in significant medical and legal problems and probably prove just as fruitless as old Ponce. Even with the Internet.

Gary A. Green, MD, is a clinical professor in the UCLA Division of Sports Medicine and the consultant to Major League Baseball on anabolic steroids and performance-enhancing drugs. He is in private practice at the Pacific Palisades Medical Group, a clinical affiliate of the UCLA Medical Group.

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