By Roy L. Silverstein, MD
2008-05-01
Performance-enhancing drugs have been a central issue on Capitol
Hill in recent months, with scandals in professional baseball leading
to congressional investigations into the illegal use of both anabolic
steroids and, more recently, human growth hormone (HGH). In the midst
of all the controversy, another substance with supposed
performance-enhancing properties began to interest Congress: vitamin
B12. Most notably, pitcher Roger Clemens claimed that his trainer Brian
McNamee injected him with B12, rather than with the more dangerous (and
illegal) HGH.
For insight into the effects of medically inappropriate use of B12
and other therapeutic agents, the House Committee on Oversight and
Government Reform contacted ASH. Several ASH members provided
background on the issue for congressional staff, including the economic
and medical impact of its inappropriate over-use nationwide, both among
athletes and non-athletes. Dr. Ralph Carmel, a hematologist at New York
Methodist Hospital, provided specific information on the taking of B12
by injection (as Mr. Clemens claims he did), including the specific
method of delivery and potential side effects.
The Committee also invited Dr. Susan Shurin, noted hematologist and
Deputy Director of the National Heart, Lung, and Blood Institute
(NHLBI), to testify at a hearing on February 12. Dr. Shurin emphasized
that giving B12 to healthy athletes is not medically sound, noting
that, while the vitamin is indeed useful in treating B12 deficiencies
that can lead to "pernicious anemia… [difficulty] with position sense,
nerve damage, depression, memory loss, and dementia," there is no
evidence linking B12 to improved athletic performance in an otherwise
healthy person. "Claims are made that vitamin B12 administration will
improve energy levels, memory, concentration, and mood. All of these
are true when persons deficient in vitamin B12 are treated; however,
there is no evidence at all of those clinical benefits when the vitamin
is given to persons who are not deficient," Shurin said. She also told
the Committee that, except in the case of specific medical conditions
such as inflammatory bowel disease that would prevent gastrointestinal
absorption of B12, there would be no reason to inject the vitamin
rather than take it orally.
The congressional hearing concerning the use of B12 was part of a
series of nationally televised hearings related to the use of
performance-enhancing drugs by major league baseball players. As a
result of these hearings, former NY Yankee Roger Clemens is under
investigation for perjury and Members of Congress have concluded that
there is a need for greater oversight of the way such agents reach the
public.
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