'Living in the Dark Ages': Why Scientists Say the NFL's hGH Test Is BS

As NFL commissioner Roger Goodell was coming under fire for his disastrous handling of Ray Rice's domestic violence suspension in September, a minor headline caught the attention of Scott Fujita, retired league linebacker and former elected officer of the NFL Players Union.

Sen. John McCain (R-AZ) had penned a letter serving notice to both Goodell and NFLPA executive director DeMaurice Smith, demanding that the league begin testing players for human growth hormone (hGH), a performance-enhancing drug prohibited by the NFL and many other sports organizations.

"I write to express profound disappointment," McCain wrote, "that random testing for human growth hormone has still not been implemented in the NFL despite all sides committing to it more than three years ago in the 2011 collective bargaining agreement."

Disappointment aside, McCain's grandstanding masked his profound ignorance. Since its inception in 2004, hGH testing in sports has been an abject failure, dogged by ongoing scientific dispute and a near-total inability to identify doping athletes. Roughly 15,000 athletes have been subjected to hGH blood tests over the last decade; only 10 reportedly have been suspended for positive results, and two of those have been overturned through science-based legal appeals.

Nevertheless, McCain wanted action. A week later, Goodell and Smith, management and union, jointly announced hGH testing of NFL players would begin immediately.

Fujita, who had been a part of past NFLPA resistance to the implementation of a dubious hGH test, said he didn't know what sort of influence McCain's letter—and with it, perhaps, the unspoken threat of MLB-style Congressional hearings—had on recent negotiations between the NFL and its players. Nor did Fujita understand why the NFLPA would agree to testing now, given that the science behind it remains sketchy and that Goodell has been both besieged and distracted.

"I was really surprised to see the union be in a position to even having engaged conversations about it," Fujita said. "I mean, if everything in the negotiation is all about leverage, I thought the union and the players were in a pretty good position, where they didn't have to bend to anybody's will.

"This struck me as obviously the league wanted to have a deal in place, and regardless of the issues."

On the surface, it seems obvious why the NFL and the players' union would want to finalize testing they tentatively agreed to during 2011 CBA negotiations: illicit growth hormone use in American football goes back decades, from 1970s hearsay accounts to 1980s published allegations involving both the NFL and college football.

None of that should be particularly surprising. After all, chemically-enhanced athletes flooded the 1984 and 1988 Olympics, powered by new drugs—such as recombinant human growth hormone [rhGH]—pouring forth from emerging biotech pharmaceutical companies. Shredded champions and also-rans alike evaded testing through the premier undetectable combo for performance and recovery: low-dose synthetic testosterone "stacked" with rhGH.

Juicing football players likewise rode the stacking wave, beating the simple steroid tests adopted by the NFL and NCAA between 1986 and 1989. The stealthy mix of "Test" and "Growth" remained doping S.O.P. in the NFL at least through 2005, as both components

played a role in football's first documented team scandal for hGH, surrounding independent physician Dr. James Shortt. DEA and media investigations found that Dr. Shortt, who was convicted for drug trafficking, supplied at least 18 Carolina Panthers players with prescription quantities of growth hormone, testosterone and anabolic steroids.

Elsewhere, NFL players were named in criminal probes involving rhGH sales from corner pharmacies, internet vendors, and guru-fronted performance outlets, like BALCO. Records of online dealers also led federal investigators to question a Pittsburgh Steelers internist, Dr. Richard Rydze, for charging $150,000 in wholesale scripts to his credit card during 2006. Rydze's purchases were for growth hormone and testosterone—sound familiar?—but he insisted active NFL players were not among his customers at the University of Pittsburgh Medical Center.

Ultimately, no charges were filed. Nevertheless, speculation over banned hGH use in the NFL continues. Fujita estimates that very few players use hGH, perhaps less than 10 percent, while retired lineman DeMarco Farr has estimated at least half of the league's players inject growth hormone.

Last year, an anonymous NFC player came down in the middle, telling the Milwaukee Journal-Sentinel that 10-15 players per team use the substance.

"It's like clockwork nowadays," the player said. "Not tested and it's easy to get. Nowadays, dude? In 2013? (Expletive) yeah. I'm just being real."

Whatever the actual figures are, the NFL's new—and lousy—blood testing won't provide clarity. Because like Fujita says, hGH testing has issues.

The primary blood test for banned hGH is the "isomer" method, first introduced at the 2004 Athens Olympics. It works by looking for an out-of-whack ratio of different types of growth hormone, called "isoforms," in the body.

Two of the main growth hormone isoforms differ by atomic weight: one is 20 kilodaltons (kDa), the other is 22. The synthetic growth hormone used to dope—the aforementioned rhGH— usually comes at the 22kDa weight. So if a World Anti-Doping Agency (WADA) blood test determines that an athlete has a high ratio of 22kDa-to-20kDa isoforms, currently about three times the level considered normal, that test will come back positive for hGH use.

Sounds reasonable, right?

Problem No. 1: In 10 years of use, only 10 athletes—total, in the entire world—have flunked hGH tests, across sports such as rugby, cycling, skiing, and Canadian college football. Two of those suspensions have been overturned or dropped, with an Olympic skier and a MMA fighter successfully challenging the isomer method.

In other words, the current gold standard for hGH testing has a real-word failure rate of 20 percent.

Moreover, the test's one-year, one-positive-test rate isn't a misprint: in 2013, 2,798 isomer tests were given and no athletes were suspended, good for a batting average of .000.

Why is the isomer test so useless? Start with detection windows. Depending on which scientific experts you ask, the test only works if administered between 10-20 hours after an athlete injects hGH—a limitation that led performance-enhancing drug testing pioneer Dr. Don Catlin to tell me in 2010 that the isomer screen was "simply not a useful test, no matter how you cut it or spin it."

Per the new NFL policy, five teams are selected weekly for hGH testing, with eight players from each team required to give blood. Players can be tested at any time while at team facilities—except on game days—or away from team facilities with 24-hour advance notice.

As a result, players basically can inject hGH on game days with impunity. As for off-days and the offseason? They're safe doping zones as well, given the 24-hour advance notice and isomer test's 10-20 hour detection window. "Well, if you know the guy's going to shoot up in the morning, and you [test] at noon, okay," Catlin said. "Glad it works that way."

Masking techniques also can hide hGH use by fooling the isomer test, according to a 2011 report atironmagazine.com by Anthony Roberts, who has written extensively about PED testing flaws. How so? Simple. Roberts says that athletes are now shooting up with synthetic 20kDa isoforms, as well as the 22kDa variety.

"You just inject the [20kDa] type of GH along with your regular type, and keep the ratios in sync," Roberts told VICE Sports in an email, describing a technique that is being "used successfully."

While doping athletes can beat the isomer test, biostatisticians argue that the method also is liable to produce "false positives"—that is, flunked tests for athletes who aren't actually using hGH. Why?

Again, go back to the isomer ratio. Critics contend that the isomer test lacks valid population research and reliable data to confirm its human baseline for naturally occurring hGH, a hormone secreted irregularly from the pituitary gland at the base of the brain in amounts affected by factors like age, ethnicity, and physical activity.

WADA officials formerly claimed the isomer test had no chance of false-positives, but in the face of mounting criticism, they now say the probability of a false-positive is around 1 in 10,000 tests.

Even that's "quite remarkable"—note: not in a good way—according to a scathing 2014 review of the isomer test co-authored by biostatisticians Krista Fischer and Donald Berry, two international authorities on vetting faults in sports anti-doping.

Fischer and Berry cite numerous errors in athlete population studies conducted by WADA allies who essentially say "trust us," claiming that they have validated the isomer test on their own. The two authors also contend that a test relying on fixed bio-levels invites "many sources of uncertainty and variability in data."

"The major challenge in developing a doping test for hGH is that the level of total concentration of hGH in a human's blood varies naturally and substantially over the course of time," wrote Fischer and Berry. " … Developing a test based merely on the measurement of the total hGH concentration is, in practice, impossible."

The isomer method got tested itself, legally, for the first time two years ago—and it lost, along with WADA, in the appeal of an hGH suspension by Estonian skier Andrus Veerpalu.

Judges for the international Court of Arbitration for Sport (CAS) in Switzerland ruled that the test wasn't valid, a ruling that stunned sports doping observers because: (a) overturning an athlete's drug suspension was unprecedented for the CAS; (b) like WADA, the CAS was founded by the International Olympic Committee, making it something of a legal home court for the international anti-doping agency.

Also understand: the instrumentation and protocol for the hGH isomer test comes from behind WADA's closed doors, without the open peer review that is a cornerstone of legitimate science, but with aggressive marketing of the test to sports organizations and governments.

The isomer test was supposedly developed and validated—and is certainly patented, promoted, and sold—from within the guarded worldwide network of anti-doping agencies. These quasi-governmental organizations are publicly funded and include the United States Anti-Doping Agency, which operates on money from taxpayers and contributions from the NFL, MLB, and other leagues which it supposedly helps police.

Veerpalu's case was presented by Fischer and Berry, who detailed how WADA inappropriately set up and conducted validating research. For example, there were no random control groups in WADA's hGH test-validating "population studies" from 2009 to 2011. Nor were subjects and researchers "blinded" regarding drug use, dosages, and administering times.

Thousands of blood samples were used, from athletes worldwide, creating a likelihood of duplicates from same individuals. Many samples were tossed out because of problems with distribution models in different sessions. Intuitive assumptions, not proven science, guided WADA researchers regarding the effects of age, ethnicity, gender, diet, exercise, season, and time of day on natural hGH secretion.

Fischer and Berry demonstrated that even the handling of blood samples was suspect in WADA's research.

"Doping tests should not be used in practice until they have been shown to be scientifically valid, and that has not yet occurred in hGH testing," Fischer and Berry wrote in their aforementioned article. "Doping research cannot be exempt from the generally accepted view that science must be open. Science in a closet is not science. Doping research must be published, including data, along with the protocols and prospective data analysis plans for conducting the research."

The CAS announced the Veerpalu decision in March 2013, citing "procedural flaws have been found in the statistical side of the WADA studies establishing" a human hGH baseline.

In the wake of the Veerpalu case, some in anti-doping circles have pinned their hopes on a second hGH test, a "biomarker" screen that measures other indicators of synthetic growth hormone presence, such as skewed levels of insulin and collagen.

Unlike the isomer test, peer review of the biomarker method has been positive for a decade, including review from scientists outside WADA circles. However, this test also can be beaten by industrious dopers, provided they microdose telltale substances like insulin as well as actual rhGH.

Moreover, bio-marking to detect rhGH is sputtering so far. Introduced at the 2012 London Olympics, the test has only nabbed two Paralympians.

Nevertheless, lead test engineer Dr. Peter Sonksen told VICE Sports in an email that the method is "alive and well." He wrote that the two biomarker hits from London were "better than none" because the isomer test—apparently in its false-negative mode—did not detect rhGH in the same Paralympians.

Sonksen, an endocrinologist and hGH researcher funded for decades by the IOC and WADA, claims he has had no contact with the NFL or its players union. He expresses confidence that the biomarker test can tackle hGH use in the league, and contends that reliable human baselines for both the biomarker and isoform tests have now been scientifically determined by WADA, which has conducted ongoing research.

"We have increased the numbers to just short of a thousand each for men and women—that should be enough to satisfy [critics]?" Sonksen wrote.

No, says Berry.

"I have no faith in whatever WADA does," Berry told VICE Sports in an email. "In particular, increasing sample size does not make up for lack of science."

VICE Sports asked Sonksen if his biomarker test could withstand a legal challenge from an NFL player, particularly an upper echelon one, someone who commands a salary and endorsements contracts commiserate with WADA's entire budget.

"I'm not familiar… who would be [defendants] in court?" Sonksen wrote in reply. "I presume WADA? Or USADA? Both have concerns about legal proceedings against them, hence the long 'gestation, validation and verification' stage [for bio-marking]."

Fujita, the NFL retiree, sees a strong potential for arbitration clashes over hGH blood testing.

"Now [suspended] players have [the] right to challenge the science," he said. "They're going to fight this thing tooth and nail."

Last year, the NFL and the NFLPA jointly retained Berry and Al Rogol, a growth hormone researcher, to conduct research and observe new population studies by WADA.

That assignment ended quickly, Berry told VICE Sports, for undisclosed reasons.

"After our initial work the NFLPA seems to have caved because we never heard from them again," said Berry, who chairs the Division of Quantitative Sciences at M.D. Anderson Cancer Center at the University of Texas in Houston.

"I don't know the eventual resolution, but I was disappointed by the possibility that the NFLPA seemed to have abandoned its previous stance—completely correct and prescient—that there was no science to WADA's approach."

The CAS recently upheld the suspension for Juha Lallukka, an Olympic skier, after a Finnish appeal board exonerated the athlete for an adverse analytical finding from the isomer test.

According to the Associated Press, "WADA says the new ruling 'means there is no doubt surrounding the validity and reliability' of hGH testing."

No again, Berry says.

"WADA's entire approach is bereft of science," he wrote. "They're living in the dark ages. They seem to think that getting more [population study] makes their test valid.

"Biased data in, biased data out."

News of the latest CAS ruling caught the attention of NFLPA executive director DeMaurice Smith, who responded to a query from VICE Sports after ignoring a previous one.

Curiously, Smith portrays the union as concerned about the same tests it agreed to implement, and perhaps even ready to fight.

"We have an appellate system that puts the burden on WADA and the NFL to substantiate any positive test," Smith wrote in an email, "and if an NFL player tests positive we will hold them to their burdens of proving the validity of [WADA] baselines, the science underlying their assertions, and their methodologies."

If Fujita expects the first NFL player who flunks a questionable hGH test to "fight tooth and nail"—and Smith sounds ready to support that fight—then why did the NFLPA agree to testing in the first place, particularly when the union already had reached out to critics like Berry?

Doping expert Charles Yesalis, a Penn State professor emeritus of public health policy, suspects that union officials decided to just take their chances in accepting a bunk test. Perhaps it's better to surrender the rare "positive" result for growth hormone, accurate or not, in exchange for resolving CBA discord, and/or keeping people like McCain from getting involved.

"I am a little surprised the Players Association bought into this," Yesalis said. "But maybe they know the test is so bad it's not going to catch anybody, anyway."

Berry cautions that accepting a flawed test may be a losing strategy.

"With the exception of Veerpalu, that has failed," he said. "Conventional wisdom seems to be that Veerpalu was a statistical fluke. With the recent ruling of the Finnish skier we may be back to days of WADA being judge, jury, and executioner.

"Without external funding to carry out real scientific experiments, such as the NFLPA was pushing a year and a half ago, athletes will continue to be at the mercy of voodoo science."