Athletes are always looking for an edge on the competition. So when diet and exercise don’t cut it, the competitive nature of sports pushes some to bold extremes. Performance enhancing drugs range from mild energy boosters, such as ginseng derivatives, to potent hormones. While steroids are hormones naturally produced within the body, when artificially enhanced they can provide users with an unfair advantage by boosting levels of performance and fitness.

Much media attention has been devoted over the past few decades to steroids in the domain of sports. These drugs have been officially banned since the 1989 Olympics, with mandatory testing in almost every sport. Another hormone, called Human Growth Hormone (HGH), is now taking its place. HGH is naturally produced within the body, used as early as the 1960s for treating children for stunted growth. It stimulates the growth of bone, cartilage and muscle tissue, hence its importance to muscle development in children as well as the adult metabolism. Prior to the advent of genetic engineering, the sole source of HGH was cultivated from human corpses. Synthetic HGH can now be made in laboratories.

While this hormone might not do much for strength, HGH acts to decrease body fat and increase lean muscle tissue. Its correlation between muscles and strength makes the hormone an attractive alternative to steroids, allowing athletes to train harder and longer. Tired muscles are able to recover more quickly, hence its role in “reversing” the aging process. In a study conducted at the Medical College of Wisconsin, men over the age of 60 benefited from regular dosages of HGH, since normal hormone levels naturally produced in the body decline with age. After a six month period of HGH injection, subjects had denser bones, less fat, thicker skin and leaner body tissue. In 1996 the FDA approved HGH as a replacement therapy drug for adults whose secretions were below normal. It has also been used in patients suffering from injury, due to its benefit in tissue growth and repair.

While HGH doesn’t pose the same risks as steroids, it still has a plethora of potential side effects. Acromegaly, a disease which results in the visible enlargement of hands, feet and face, as well as thickening of the skin, is associated with high HGH levels in the body. Internal organs, such as the heart and kidney also experience growth, disrupting normal bodily processes and functions. Any type of abnormal cell growth in the body is dangerous, as this translates to an increased risk of cancer.

Unlike steroids, HGH is more difficult to test for as the hormone already occurs naturally within the body. The blood stream concentration of HGH varies, depending on a multitude of factors such as diet, fitness and sleep. Therefore, determining normal or above average HGH levels is almost impossible. HGH release in the body is pulsatile and follows a circadian rhythm as the body increases its HGH level up to 100-fold depending on bodily needs and condition. These complications reveal why a reliable testing method has yet to be found.

According to the Journal of Medicine and Science in Sports and Exercise, “what many athletes and coaches have failed to understand is that athletes can employ specific training regimens and dietary strategies to optimize their natural secretion of HGH, so inducing those very adaptations to training [can provide the results] that others are cheating to achieve.” HGH is believed to only benefit sports which require short and explosive bursts of energy, such as sprinting. Such increased strength doesn’t automatically translate into better cardiovascular fitness or enhanced performance. Regardless, many athletes swear by this drug.

So why do so many athletes take HGH when there’s no concrete evidence that it even enhances performance? Some would say superstition. While HGH doesn’t necessarily improve performance, many athletes may be willing to give it a try, because if banned, it must have some exclusive benefits.