The testosterone:epitestosterone ratio (T:E ratio) test is a commonly used test designed to catch athletes who artificially manipulate their testosterone levels (usually with exogenous testosterone). The T:E ratio is routinely used in doping protocols around the world at all levels of sport.
Unfortunately, the T:E ratio is not very effective. This has been common knowledge among drug tested athletes for some time. Dan Duchaine first alerted athletes decades ago with Victor Conte concurring more recently. Anti-doping experts such as Charles Yesalis and Don Catlin have reluctantly acknowledged that this is true.
It is not very reliable. It is flawed. The T:E ratio test results in a lot of false negatives (athletes use testosterone but don’t get caught) as well as false positives (innocent athletes test positive for steroid use).
A recent study that we learned about on Trust But Verify and reported on at Steroid Report explains why the test is unreliable and ineffective.
It appears that certain genotypes are more likely to have false negatives (athletes use testosterone but don’t get caught)and other genotypes are more likely to have false positives (innocent athletes test positive for steroid use) (”Doping Test in Sports Confounded by Common Genetic Trait,” March 21).
If you’re a genetically gifted athlete (i.e. you lack the gene that produces the enzyme UGT2B17), you can take an whopping injection of at least 360 milligrams of testosterone without getting caught by the testosterone:epitestosterone ratio test (T:E ratio). This testosterone loophole in drug testing has been known by athletes for decades (anecdotally). It is nice to have solid scientific evidence to confirm it.
The 360 mg corresponds to a 500 mg intramuscular injection of testosterone enanthate. Yes, many athletes can take this quantity of the anabolic-androgenic steroid testosterone and still pass current WADA doping controls.
The T:E ratio test discriminates based on the ethnicity of the athlete subjected to the doping protocol. This little bit of information is impossible to overlook.
So, which ethnic groups are most likely to have false negatives on the T:E ratio test?
The latest study suggests as many as 40% of athletes with UGT2B17 homozygous deletion/deletiongenotype can take at least 500 mg of testosterone enanthate and still maintain a 4:1 T:E ratio. The following lists various ethnic groups with the estimated percentage that possess the “doping friendly” genotype (data extracted from here and here).
78.0% - Mulatto (Brazilian)
66.7% - Eastern Asian (Korean)
57.3% - Cape Colored (Cape Town, South Africa)
37.6% - Mexican Mestizo
30.4% - Asian Pacific (Southeast Asian/Southern Chinese, Asian Indian, Japanese)
29.1% - Black (African Americans, African Blacks, South/Central American Blacks)
9.3% - White Caucasian (Swedish)
3.5% - White Caucasian (primarily European)
Yes, athletes with UGT2B17 homozygous deletion/deletiongenotype are much more likely to pass a doping test if they choose to cheat (false negative). And yes, certain ethnic groups are much more likely to possess this genotype.
What should WADA do about this? Is this a problem for professional sports or high school districts that routinely use the T:E ratio test?
Two of my favorite steroid writers are John Hoberman, PhD and Charles Yesalis, PhD. I read their books. I read their articles. I have “Google Alerts” set to notify me when they are quoted by the media. I have even invited them to write for my website (and I’ve been fortunate to have Dr. Hoberman write a few feature articles for me).
Several of my friends and colleagues wonder why I enjoy works from these “anti-steroid guys.” While I may have a different perspective regarding the use of performance-enhancing drugs in sports, Dr. Yesalis and Dr. Hoberman represent the few prominent “steroid experts” that generally stay above the histrionics and scaremongering. Dr. Yesalis recently discussed the topic of steroids in an interview published on Testosterone Nation website:
[S]teroids pose primarily an ethical, rather than a public health problem. The
biggest issue is that using steroids is against the law, and against the rules
of sport. These rules are what define sports, and using drugs to gain an advantage
is tantamount to cheating.
On dangers of steroids:
As I mentioned in my book, the health risks
have been greatly overstated. Hypertension, for example, is widely claimed to
be a side effect of taking androgens. This is one of the most exaggerated claims.
And as for users becoming sterile, there has never been a single reliably documented
case of irreversible infertility as a result of androgen administration.
Think about it: medical science has been using
steroids safely in a clinical setting for the last 70 years. Anabolic steroids
can be used relatively safely, but at even low doses they can have side effects.
No drug, supplement, or substance is totally “safe.” Heck, you can even overdose
on water.
My personal opinion is that if one uses these
drugs at high dosages, over a long period of time, then yes, they’re too powerful
to fool Mother Nature. And it’s the oral (hepatoxic) steroids that can potentially
be the most harmful. But should they be placed in the category of “killer drugs”?
Absolutely not. Not even close.
On steroid “roid rage”:
But let me put this whole “rage” thing into
perspective for you, Chris. You’ve been to Penn State home games. If you told
me you’ve never seen outbursts of “rage” at a football game, then I would have
to call “bullshit.” They happen all the time. And that’s not steroids, that’s
alcohol. It’s not even in the same ballpark.
But what about the children?!
One of
the biggest issues with young people in sports concerns their often fanatical
coaches and parents. If a kid is constantly being told that he has to do “whatever
it takes” to win that game, or to win that scholarship, or to get that start
on the team, well, guess what? That kid is going to do
whatever it takes.
From a moral and ethical standpoint, how you
raise a child will determine that child’s behavior. If you instill certain standards
in them, then they won’t cross certain lines. If parents want to make sure that
their kids are not crossing lines, they need to be paying attention to who coaches
their children, and what’s being told to them, and then they need to step back
and re-examine their own relationship with their kids as well.
Whether you identify yourself as “anti-steroid”
or “pro-steroid”, there is a lot to be learned from Dr. Yesalis in his
books, recent
interviews and older
interviews
on the internet.
