FanPost

Testosterone Testing/Flaws in the T/E test

To avoid further speculation, I decided to do some research on testosterone testing.  I happened upon a great (but very scientific) article entitled, "EVALUATION OF INFLUENTIAL FACTORS ON THE T/E RATIO AS DETERMINED IN DOPING ANALYSIS."  article link here.  While I am NOT a physiologist, I do have a nursing degree, so I though I would share some of the article's highlights.

below the fold...

The T/E test
1.  The most widely used and accepted method of testing for testosterone abuse.  From the article, "The ratio of the concentration of testosterone glucuronide to the concentration of
epitestosterone glucuronide (T/E ratio) as determined in urine is the most frequently used
method to prove testosterone abuse by athletes. A T/E ratio higher than 6 has been
considered as proof for abuse in the past; however, cases of naturally occurring higher T/E
ratios have been described."

  1.  The test is very accurate (I do not have the actual accuracy percentages, though).  However, false positives (meaning the T/E ratio IS elevated, but due to some other cause besides doping) do occur.
  2.  Many factors can influence the T/E ratio
Factors influencing T/E ratios

Lab inconsistencies
A collaborative study of international lab testing facilities showed variations both between labs and within the same lab in regards to T/E ratio results.  At the time the article was written, there was no standardization of testing methods for the T/E test.  I am not sure of how standardized the testing procedures are currently.

Microbial degredation
The article claims, "Bacterial activities in urine may cause significant changes in measured steroid profiles, as was brought forward in the Diane Modahl case in 1994 [48-49]. Because
urine samples are collected under unsterile conditions, bacteria have the chance to
grow when samples are stored too long at a too high temperature."  So, storing urine at improper temperatures can change test results.  However, it has never been proven that bacterial "activities" have caused an initially negative result to turn into a positive.

Endogenous factors:

  1.  Several endocrine disorders can raise a T/E ratio
  2.  T (testosterone) levels change throughout the day.  T levels are highest in the morning, between 6-8 a.m., and T levels are lowest between 8-10 p.m.
  3.  Asians have a lower T/E ratio.  Only caucasians were used for the T/E ratio guidelines  that the IOC uses.  Until Asians are factored into the population used to figure acceptable T/E ratios), an Asian could potentially be taking testosterone and still come out with a negative test result.
**4.  As quoted from the article, "The influence of exercise on the T/E ratio is still unclear."  Several studies have been done producing conflicting results.  However, the point I want to make is that a person's T/E levels remain relatively CONSTANT.  A rider's body does not just start cranking out a bunch of excess testosterone (even if it is the penultimate stage).  Some studies showed that exercise (performed by conditioned athletes on a tour de france style course) lowered T/E levels, some showed exercise increased the ratio, and some studies showed the ratio remained unchanged.  Clearly more research needs to be done.

Exogenous factors

  1.  Many medicines/hormones can influence T/E levels.  Flagyl (an antifungal) raises T/E ratios, while hCG (a hormone normally secreted by pregnant women) lowers T/E ratios.  hCG is commonly used by athletes who are trying to mask a high T/E ratio (due to testosterone abuse).
  2.  For those of you wondering about Floyd's beer, ethanol does SLIGHTLY increase the T/E ratio.  HOWEVER, it takes a LOT, not just a single drink.  The article states, "the increase was observed at dosages higher than 1 g/kg
bodyweight. A dose of 2 g/kg bodyweight resulted in an increase of 30-90%, which was, however, insufficient to reach the IOC criterion of 6."  So one beer  is not enough to raise Floyd's T/E level to above 6.
3.  Steriods (especially anabolic steroids) alter T/E ratios.  However, I could not find out any specific information on cortisone (the steroid Floyd was using for his hip) and T levels.

Other tests

  1.  T/LH ratio--another test as old as the T/E ratio.  Can only be done with males.
  2.  GC-combustion-isotope ratio MS (GC-C-IRMS).  Very expensive time consuming test. Differentiates between endogenous T (produced by the the body) and exogenous T (from plant sources).  Can only be performed by certain certified labs.  This is the test is the most widely accepted test for confirming a positive test result.  More studies need to be done on the effects of ethnicity and diet on test results using this method.
  3.  Hair analysis
  4.  High-performance liquid chromatography-mass spectrometry (HPLC-MS)--a new technique.  Faster and cheaper than GC-MS.
Final thoughts
I hope and pray that the lab performing Floyd's tests is reliable, accurate, and honest.  We must now wait for the test results from sample B before we jump to any conclusions.  The number of factors that can influence a test is HUGE--this is a very complicated matter.