Testosterone

Interesting read about testosterone in sport. From Drugstore Athlete, originally printed in The New Yorker, September 10, 2001.

Perhaps the best example of the difficulties of drug testing is testosterone. It has been used by athletes to enhance performance since the fifties, and the International Olympic Committee announced that it would crack down on testosterone supplements in the early nineteen-eighties. This didn't mean that the I.O.C. was going to test for testosterone directly, though, because the testosterone that athletes were getting from a needle or a pill was largely indistinguishable from the testosterone they produce naturally. What was proposed, instead, was to compare the level of testosterone in urine with the level of another hormone, epitestosterone, to determine what's called the T/E ratio. For most people, under normal circumstances, that ratio is 1:1, and so the theory was that if testers found a lot more testosterone than epitestosterone it would be a sign that the athlete was cheating. Since a small number of people have naturally high levels of testosterone, the I.O.C. avoided the risk of falsely accusing anyone by setting the legal limit at 6:1.

Did this stop testosterone use? Not at all. Through much of the eighties and nineties, most sports organizations conducted their drug testing only at major competitions. Athletes taking testosterone would simply do what Johnson did, and taper off their use in the days or weeks prior to those events. So sports authorities began randomly showing up at athletes' houses or training sites and demanding urine samples. To this, dopers responded by taking extra doses of epitestosterone with their testosterone, so their T/E would remain in balance. Testers, in turn, began treating elevated epitestosterone levels as suspicious, too. But that still left athletes with the claim that they were among the few with naturally elevated testosterone. Testers, then, were forced to take multiple urine samples, measuring an athlete's T/E ratio over several weeks. Someone with a naturally elevated T/E ratio will have fairly consistent ratios from week to week. Someone who is doping will have telltale spikes--times immediately after taking shots or pills when the level of the hormone in his blood soars. Did all these precautions mean that cheating stopped? Of course not. Athletes have now switched from injection to transdermal testosterone patches, which administer a continuous low-level dose of the hormone, smoothing over the old, incriminating spikes. The patch has another advantage: once you take it off, your testosterone level will drop rapidly, returning to normal, depending on the dose and the person, in as little as an hour. "It's the peaks that get you caught," says Don Catlin, who runs the U.C.L.A. Olympic Analytical Laboratory. "If you took a pill this morning and an unannounced test comes this afternoon, you'd better have a bottle of epitestosterone handy. But, if you are on the patch and you know your own pharmacokinetics, all you have to do is pull it off." In other words, if you know how long it takes for you to get back under the legal limit and successfully stall the test for that period, you can probably pass the test. And if you don't want to take that chance, you can just keep your testosterone below 6:1, which, by the way, still provides a whopping performance benefit. "The bottom line is that only careless and stupid people ever get caught in drug tests," Charles Yesalis says. "The lite athletes can hire top medical and scientific people to make sure nothing bad happens, and you can't catch them."