Q&A: Natural or Synthetic Testosterone?
Top 5 questions about testosterone testing and T/E ratios
Drug Free Sport assists clients by providing results interpretation. Explaining the results for many substances (e.g., marijuana, ecstasy, boldenone, stanozolol) is fairly straightforward.
However, explaining results for a few substances can be more complicated. Case in point: anabolic androgenic testosterone.
Here, Drug Free Sport Vice President Andrea Wickerham (right), takes us through the top five questions regarding testing and managing results for testosterone.
1. What is testosterone?
Testosterone is the principal male hormone that stimulates the development of the male secondary sex characteristics. However, both males and females have testosterone production areas in their bodies (males in the testes and females in the ovaries).
2. Why do sport organizations ban testosterone?
Synthetic testosterone is an anabolic androgenic steroid. As such, it produces muscle growth and is performance-enhancing. Athletes who use synthetic testosterone gain an unfair performance advantage, which is cheating.
3. If testosterone is produced endogenously (naturally in the body), how do laboratories analyze samples for synthetic testosterone?
Synthetic testosterone is detected in urine by the T:E ratio test using high resolution gas chromatography/mass spectrometry (GC/MS).
The “T” stands for testosterone and the “E” stands for epitestosterone, a natural steroid in the body that is not affected by the administration of exogenous (from outside of the body) testosterone.
An elevated T:E ratio may be an indicator of the use of a prohibited substance. If the total concentration of testosterone to that of epitestosterone in the urine is greater than 6:1, the NCAA will deem it to be an adverse analytical finding unless there is evidence that this ratio is due to a physiological or pathological condition. The World Anti-Doping Agency (WADA) defines an adverse analytical finding using a lower T:E ratio of 4:1.
Although the T:E ratio is a good indicator of testosterone use, it is not a definitive test because a few individuals who have not used synthetic testosterone have a natural T:E value > 6:1. In addition, other factors may influence the T:E ratio.
4. Are there other methods that can help determine the origin of the testosterone?
Yes. A longitudinal testing history should be gathered and subsequently evaluated. Additional urine samples may be collected from the athlete if no previous data exist.
WADA recommends three further unannounced tests should be carried out, preferably within a three-month period following the adverse analytical finding.
5. Are there other analytical tests that can help determine whether a doping violation has occurred?
Yes. Isotope Ratio Mass Spectrometry (IRMS) is a technique used for measuring the quantity of stable carbon isotopes in a sample in order to determine the composition and the origin (e.g., endogenous or exogenous).
The urine sample’s composition is measured and compared to that of a variety of urinary reference steroids. When the sample’s value differs significantly from that of the urinary reference steroid chosen, the result will be reported as consistent with the administration of a steroid.
The result of the IRMS analysis and/or the longitudinal testing history shall be used by the sport organization to draw conclusions as to whether a doping violation has occurred.
*WADA Technical Document – TD2004EAAS