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Old 04-30-08, 09:30 AM   #1
tekhna
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Well, this complicates testosterone testing...

http://www.nytimes.com/2008/04/30/sports/30doping.html

The 55 men in a drug doping study in Sweden were normal and healthy. And all agreed, for the sake of science, to be injected with testosterone and then undergo the standard urine test to screen for doping with the hormone.
Skip to next paragraph
Earl Wilson/The New York Times


The results were unambiguous: the test worked for most of the men, showing that they had taken the drug. But 17 of the men tested negative. Their urine seemed fine, with no excess testosterone even though the men clearly had taken the drug.

....

“It’s disturbing,” said Dr. Don Catlin, the chief executive of Anti-Doping Research, a nonprofit group in Los Angeles. “Basically, you have a license to cheat.”
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Old 04-30-08, 09:35 AM   #2
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I've got a blood test due in June when my Androgel script runs out. I'll ask to have it give the results for fake T/real T. Im curious what the ratio will be just going by the presribed amounts. UCI limit is 4:1 right?

Not that i'll ever be in a UCI race...
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Old 04-30-08, 09:52 AM   #3
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I've got a blood test due in June when my Androgel script runs out. I'll ask to have it give the results for fake T/real T. Im curious what the ratio will be just going by the presribed amounts. UCI limit is 4:1 right?

Not that i'll ever be in a UCI race...
Its not fake-T / real-T. Its T / Epi-T. Epitestosterone is naturally ocurring in a ratio close to regular testosterone, but it does not increase when testosterone is boosted, so the ratio increases. Of course it is also possible to take epitestosterone to mask the testosterone increase.
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Old 04-30-08, 10:12 AM   #4
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2/3 of Asian men, and 1/10 Caucasian men lack two copies of a gene that makes testosterone water soluble. Thus, these people can take testosterone without affecting their T/E ratio in a urine test.
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Old 04-30-08, 10:16 AM   #5
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I'm pretty satisfied with a 70% failure rate. I would've thought it's much worse (lower), given the theories of how much doping is going on.

A license to cheat? That's just a ridiculous conclusion, when you consider the shear number of tests that the more successful cyclists are tested. They're either doing less, something else, etc; or not doping. No one would take those odds.
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Old 04-30-08, 10:19 AM   #6
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Oops, actually looked at the article - this would imply that the 30% who passed, would pass every (most) times.

How much Testosterone is 500 mg, anyway?
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Old 04-30-08, 10:22 AM   #7
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I'm pretty satisfied with a 70% failure rate. I would've thought it's much worse (lower), given the theories of how much doping is going on.

A license to cheat? That's just a ridiculous conclusion, when you consider the shear number of tests that the more successful cyclists are tested. They're either doing less, something else, etc; or not doping. No one would take those odds.

Seriously? You'd be OK with a test that determined your career that had a failure rate like that?
Your safe white collar job demands a drug test every month for continued employment, and you would continue to work for that employed knowing they utilized a test that had an enormous failure rate? It's an inverted analogy, but the point stands.
It's not a ridiculous conclusion-Think about it. You can ingest all the testosterone you want, and your T/E ratio never changes, no matter how often you stick that patch on your balls after the race. Your body somehow just rids itself of it.
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Old 04-30-08, 10:33 AM   #8
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Seriously? You'd be OK with a test that determined your career that had a failure rate like that?

Absolutely. We're talking about false negatives, not false positives. From everything we hear about pro cycling the actual false negative % is much, much higher.
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Old 04-30-08, 10:38 AM   #9
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Absolutely. We're talking about false negatives, not false positives. From everything we hear about pro cycling the actual false negative % is much, much higher.
Sure, but it pokes holes in the idea of a testing regime. It's studies like this that make it clear that any testing regime is so rife with potential and actual failure to render the whole system moot. You'd have to make testosterone legal because there is a whole category of people for whom this test simply does not work. Of course if they were using synthetics, you might be able to test for the synthetic traces. What value does an anti-drug regime have if there is a genetic class that can simply laugh off the test?
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Old 04-30-08, 10:58 AM   #10
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How much Testosterone is 500 mg, anyway?
10x my daily dosage of 50mg or 10 Androgel packets.
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Old 04-30-08, 11:08 AM   #11
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Its not fake-T / real-T. Its T / Epi-T. Epitestosterone is naturally ocurring in a ratio close to regular testosterone, but it does not increase when testosterone is boosted, so the ratio increases. Of course it is also possible to take epitestosterone to mask the testosterone increase.
You can do a stable-isotope Mass Spec test to determine the difference between fake and real testosterone. They have differing amounts of 13-C, I think.
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Old 04-30-08, 11:53 AM   #12
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Trying to balance test sensitivity and selectivity is a very hard process to handle. You can try and get rid of the false negatives but you are going to be increasing the sensitivity and thus the number of false positives, which is likely an outcome that people don't want to have to deal with.
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Old 04-30-08, 12:05 PM   #13
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Exactly, the best practice is to find a quick screening tool that is highly sensitive and accept a few false positives in order to avoid any false negatives. You then use a second – and usually more labor intensive - validation method to verify the positives.

The problem is, if they are using this as the screening tool, the samples will never make it to the validation level (eg GC-MS/MS).

The answer is simple, yet costly, discard the screening tool entirely.
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Old 04-30-08, 01:00 PM   #14
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Exactly, the best practice is to find a quick screening tool that is highly sensitive and accept a few false positives in order to avoid any false negatives. You then use a second – and usually more labor intensive - validation method to verify the positives.

The problem is, if they are using this as the screening tool, the samples will never make it to the validation level (eg GC-MS/MS).

The answer is simple, yet costly, discard the screening tool entirely.
I'd rather a bunch of false negatives to any false positives.
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Old 04-30-08, 01:02 PM   #15
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I'd rather a bunch of false negatives to any false positives.
The validation method discards the false positives. If they aren't reported, they never existed.
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Old 04-30-08, 01:08 PM   #16
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The validation method discards the false positives. If they aren't reported, they never existed.
That I think is part of the problem
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Old 04-30-08, 01:37 PM   #17
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Bingo.


Of course I haven't heard about a positive that HASN'T been confirmed, so maybe I'm wrong.
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Old 04-30-08, 03:49 PM   #18
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I'd rather a bunch of false negatives to any false positives.
But if you read a more complete summary, you would have seen that in addition to the 30% false negatives, the test also gave 14% false positives. Why the N.Y. Times completely dropped this aspect of the study is beyond me. http://jcem.endojournals.org/cgi/rap...jc.2008-0218v1
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Old 04-30-08, 03:55 PM   #19
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They're idiots?
They're incompetent?
They're biased?
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Old 04-30-08, 03:56 PM   #20
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But there's a larger issue here. WADA rules say that once a test is accepted, an athlete can not challenge the scientific validity of it; only the procedures under which it was carried out. So as it stands today according to WADA, the testosterone test is absolutely accurate and an athlete can not raise the issue of a false positive due to genotype. So you have to wonder how many of the other so-called fool proof tests WADA uses will be shown to be flawed in the future, or more dangerously never shown to be in error because there's no reason to study them.
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Old 04-30-08, 03:58 PM   #21
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Of course I haven't heard about a positive that HASN'T been confirmed, so maybe I'm wrong.
Mary Slaney
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Old 04-30-08, 06:21 PM   #22
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Hmmm... being of Asian descent, this brings up some interesting possibilities. <JK>

Adding testosterone to my physiology would just make me better pack fodder.
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Old 04-30-08, 06:32 PM   #23
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Mary Slaney
Yeah, I figured there were, but I hadn't heard of any.
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Old 04-30-08, 06:36 PM   #24
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But there's a larger issue here. WADA rules say that once a test is accepted, an athlete can not challenge the scientific validity of it; only the procedures under which it was carried out. So as it stands today according to WADA, the testosterone test is absolutely accurate and an athlete can not raise the issue of a false positive due to genotype. So you have to wonder how many of the other so-called fool proof tests WADA uses will be shown to be flawed in the future, or more dangerously never shown to be in error because there's no reason to study them.

Combined with the scary-er: Assuming two tests, and the 14% is randomly distributed... you'd have a 2% chance of failing both.

Of course, it probably isn't random, and the second test probably confirms the first. Is the fake-testosterone test required in every case? Some cases? Whenever the testing-people feel like it?
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Old 04-30-08, 06:37 PM   #25
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But if you read a more complete summary, you would have seen that in addition to the 30% false negatives, the test also gave 14% false positives. Why the N.Y. Times completely dropped this aspect of the study is beyond me. http://jcem.endojournals.org/cgi/rap...jc.2008-0218v1
Huh. Great find, have you submitted a note to the editor?

If someone doesn't want to dig for it:
Quote:
Today a T/E ratio cut-off limit of 4 gives cause
for suspicion of testosterone doping. This test
would misjudge over 40 % of the del/del
subjects even on the day when the average ratio
was the highest after a single dose of
testosterone (fig 3, left panel). The genetic
variability within and between ethnic groups is a
confounder, particularly when testing individuals
of various ethnic descents.
On the contrary, in the ins/ins group 14 % had
baseline T/E ratios above four. In our previous
study (15) of a population sample of 122 young
men this limit would give a false positive rate of
9 %. False positive results are not only of
concern for the legal rights of the sportsman;
they also yield extra workload for the doing
laboratories.
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