Former Steelers doctor embraced HGH
Even before the controversy surfaced involving Dr. Richard Rydze and human growth hormone, the Pittsburgh Steelers had a history of associations with performance-enhancing drugs. For Mike Fish's chronicle of that past and what former Steelers' lineman Steve Courson called "the conspiracy of silence" concerning steroids and the NFL, click here.
Fish will discuss his stories about Rydze and the Steelers on "Outside the Lines" on ESPN on Friday, Jan. 15, at 3 p.m. ET.
I know [HGH] has caused me a lot of grief, simply because I believe in it and I know what it does.” --Dr. Richard Rydze
"The off-label use is illegal," said Travis Tygart, chief executive of the U.S. Anti-Doping Agency. "It doesn't happen. Using [HGH] for tendon repair, he has admitted to a crime."Indeed, experts make the point that pro athletes would be lined up outside league offices seeking therapeutic exemptions to use the banned drug after everything from Tommy John elbow surgery to an ACL knee operation if HGH could be injected legally to hasten recovery from tendon and ligament injuries. But that isn't the case. NFL spokesman Greg Aiello said the league has never granted a therapeutic use exemption for HGH, including for healing purposes. Nor has Major League Baseball been inclined to hand out exemptions. "There are very limited purposes for which growth hormone can be legally prescribed," said Rob Manfred, MLB's executive vice president of labor relations and human resources. "I mean, you have got to be a dwarf or have wasting disease. We don't have a lot of people with AIDS or who have dwarfism in our game." Synthetic growth hormone originally came on the medical scene for the treatment of dwarfism in children. According to medical experts, excessive use of HGH is thought to cause the enlargement of organs, especially the heart, which can be dangerous and sometimes fatal. It also has been linked to diabetes, muscle and joint pain and hypertension, and some researchers believe it can accelerate cancer. Rydze, though, said the danger of low-dosage growth hormone therapy is vastly overstated, and that HGH is wrongly associated with steroids. And although he acknowledged the sports community likely won't permit its use any time soon, he said athletes should be allowed access to HGH to heal injuries. "I know it has caused me a lot of grief, simply because I believe in it and I know what it does," Rydze said. "And to deny people the effect to heal better -- that is the art of medicine, to make people heal. And using something off-label, which we use for many, many drugs I don't see how someone can single out one thing and say you can't use it for off-label use. And you show me there is one side effect, and I'd be a believer. But I have never seen a side effect. And I just think it is just ignorance of people who don't know. They just hear about it, and they assume it is bad." Rydze isn't alone among doctors in his liberal off-label approach to HGH, which has become increasingly controversial because of growing usage by practitioners of anti-aging medicine. Other advocates note its value as a healing agent. Even a medical consultant to pro sports leagues who asked not to be identified said he believes that in time, after emotions settle and adequate research is done, HGH could play a larger role in mainstream medicine because of its apparent ability to accelerate healing. Off-label use for many drugs -- in other words, prescribing a drug for a purpose that differs from the one for which the product is approved -- is a widely accepted practice. Under current law, though, the FDA spells out the unique status of human growth hormone. In an e-mail to ESPN.com, another FDA spokeswoman, Susan Cruzan, wrote, "Human growth hormone is the only drug for which Congress has expressly prohibited the off-label distribution or possession with intent to distribute, making such distribution a crime under 21 USC 333." Rydze described his research as "kind of a project of mine" to determine the healing effects of HGH, acknowledging he did not seek an FDA exemption. Nor, he said, has he compiled any research data yet.
But ESPN.com found that in an apparent conflict with NCAA doping rules, an orthopedist referred an injured soccer player at a top collegiate program to Rydze for separate rounds of growth hormone therapy -- including during the weeks just prior to the start of a season.Rydze initially said the athlete didn't compete after receiving the treatment, but later said he couldn't recall details. According to Mary Wilfert, staff liaison to the NCAA's Committee on Competitive Safeguards and Medical Aspects of Sports, the governing body issues "about five or seven or maybe even 10" medical exceptions each year for athletes to use growth hormone or testosterone. Wilfert declined to say whether the use of HGH has ever been allowed to aid in healing injuries, adding, "We don't have published lists of what would qualify for an exception." Rydze indicated one NFL team orthopedist referred at least 25 patients -- none of whom was an active professional athlete -- to him for growth hormone therapy. In one instance, Rydze wrote a note that a patient was referred "to begin him on growth hormone therapy in order to expedite the healing and strengthening of his shoulder girdle prior to his return to work as a police officer." One patient is the father of a current NFL player.
If information came forward about a team doctor prescribing to his other non-NFL patients those types of substances, it would raise concerns and questions.” -- NFL spokesman Greg Aiello
Several others, according to Rydze, had lesser ties to the sports world: a marathoner suffering chronic hamstring injuries and another with Achilles tendinitis, a personal trainer with chronic hamstring woes, a former karate champion with bum elbows and knees and a Frisbee golf player coming off surgery.An attorney received injections to relieve knee pain and, according to Rydze, wrote a letter to him before another round of treatments in March in which he said he hoped the "stupid publicity" wouldn't stop the doctor from prescribing HGH. Rydze also indicated at least five other doctors, as well as the wife of a sixth, received growth hormone therapy from him. "The orthopedic people sending people to me obviously believe it works, 'cause they see it work," Rydze said. "And if I can help people, then I am going to help them." Aiello, the NFL spokesman, said clubs have been "advised" that team doctors should not use illegal steroids or growth hormone, particularly with an active player or his family. "If information came forward about a team doctor prescribing to his other non-NFL patients those types of substances, it would raise concerns and questions," Aiello said. "And we would deal with it on a case-by-case basis, in this case as the Steelers did."
As Rydze spoke to ESPN.com in his Pittsburgh office, wearing a black knit shirt and casual slacks, he didn't appear to be flustered by inquiries about his practice. In a soft, calm tone, he denied any impropriety in his prescribing of HGH, noting he used it with patients deficient in growth hormone, which he believes is linked to slow healing. However, Dr. Thomas Perls, a specialist on aging who has written articles on the subject for the American Medical Association, said that measuring insulinlike growth factor-1 (IGF-1) levels, as Rydze does, is not an adequate test in the proper diagnosis of adult growth hormone deficiency. (Growth hormone stimulates the liver and other tissue to secrete the hormone IGF-1, which in turn leads to bone growth and plays a key role in muscle and organ growth.)
Initially, Rydze's name surfaced in connection with the investigation into wholesale purchases of HGH from Signature Pharmacy in Orlando, but ESPN.com has learned he also bought the drug from College Pharmacy in Colorado Springs between 2004 and 2007. The owner of that compounding pharmacy and one of its sales representatives have been indicted and are scheduled for trial in the spring. As in the Florida case, Rydze and others who purchased the drugs from College Pharmacy were not targeted. An official close to the federal investigation of College Pharmacy said of Rydze, "He was one of the customers. [He] showed up on the pharmacy client list." The official declined to address the number of purchases or the quantity of HGH Rydze made from College Pharmacy. Investigators working the Signature Pharmacy case thought they'd found a major mover in the world of sports when Rydze's name first popped up in billing records. Here was a highly credentialed doctor, a team physician for an NFL franchise, purchasing bulk orders of growth hormone and testosterone from an online pharmacy under investigation. They didn't know to whom Rydze was giving the drugs. They knew from records only that the FedEx shipments from the pharmacy went to Rydze at his UPMC office: 339 Sixth Avenue, fifth floor.
We did not receive one outside inquiry from anybody. Here we spent an hour with this guy. Nobody was concerned. The hospital never contacted us. Nobody cared what he said to us.” -- Mark Haskins of New York State's Bureau of Narcotic Enforcement
Rydze told ESPN.com the price of the drugs was the reason he purchased from the Colorado and Florida compounding pharmacies rather than locally, saying, "I don't know how these pharmacies got their prices down so low."Often, he said, HGH treatment is not covered by insurance, so his patients paid him directly. Rydze said he learned about the online pharmaceutical vendors during conventions in Las Vegas of the American Academy of Anti-Aging Medicine (A4M). Rydze was an A4M member, as is Dr. Joseph Maroon, the Steelers' neurosurgeon and another UPMC physician. Maroon recently was appointed an A4M senior vice president. The Chicago-based A4M advocates the use of testosterone and human growth hormone as levels decline with age. Steelers spokesman Dave Lockett indicated the team has no issue with its doctors' affiliations with A4M. "Really, there are a lot of people who are members of that organization," Lockett said. "We do not have any concerns about Dr. Maroon." When Rydze was asked whether he'd entertained concerns about the pharmacies from which he was ordering, he said, "No, I guess I was naive about it. They seemed like legit people. And they were advertising in the A4M magazine. I never heard anyone say a bad word about them until this all came down." Haskins said neither New York nor Florida authorities are pursuing a further investigation of Rydze, but he acknowledged he spoke briefly about Rydze with NFL security chief Milt Aldrich after the Pittsburgh meeting. Aiello, the NFL spokesperson, confirmed Aldrich had spoken with investigators. The two investigators said they are surprised that neither the Steelers nor UPMC followed up with them once Rydze's name was made public in connection with the investigation. "We did not receive one outside inquiry from anybody," Haskins said. "Here we spent an hour with this guy. Nobody was concerned. The hospital never contacted us. Nobody cared what he said to us."
Rydze's new office is home to a private practice occupying the second floor of the Hartley-Rose Building, which is on the National Register of Historic Places. The entry on a narrow downtown cobblestone street leads to what once served as a factory and warehouse. The original red brick is exposed on the walls of the renovated office, and hardwood planks cover the high ceiling. Rydze opened Optimal Health Center, LLC in September 2007. The scope of the practice ranges from corporate medicine/wellness and sports medicine to geriatrics and hormone therapy. Most days, he's in and at work by dawn, he said. The waiting room is decorated with a pair of black-and-white photos of a young Rydze diving from a platform. In his youth, Rydze was an accomplished athlete. He won a silver medal in platform diving at the 1972 Munich Olympics, accomplishing the feat on the eve of the darkest day in Olympic history -- a Palestinian terrorist attack that left 11 members of the Israeli team dead. He wears an Olympic ring on his left hand. He mentions he is one of only two people who have earned both an Olympic and Super Bowl ring, the other being the late Bob Hayes, who won Super Bowl VI as a wide receiver with the Dallas Cowboys and Olympic gold in the 100-meter dash and the 4x100-meter relay in 1964 in Tokyo. Rydze's father was an international chairman for U.S. Diving. His brother, Bob, is the longtime diving coach at the University of Iowa and was the team leader for U.S. divers at this past summer's Olympic Games in Beijing.