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Old 07-27-06, 09:11 AM   #1
billallbritten
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DrPete, other MD's - what is the normal range of testosterone measurements? Lab

cutoff for abnormally high readings that flagged Landis? I came across a 2002 CS Monitor article which briefly discusses testosterone doping and the difficulty in determing whether doping has occurred given the wide naturally found variation in men.

Reference: http://www.csmonitor.com/2002/0726/p...p.html?s=widep

Thanks,

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Old 07-27-06, 09:28 AM   #2
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The Mayo Lab manual has its reference values for total testosterone, men 19-40 years at 300-950 ng/dL.

Last edited by pathdoc; 07-27-06 at 09:40 AM.
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Old 07-27-06, 09:36 AM   #3
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There is an abstract on pubmed here: http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Evidently this test isn't black and white.
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Old 07-27-06, 12:06 PM   #4
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Quote:
Originally Posted by flythebike
There is an abstract on pubmed here: http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Evidently this test isn't black and white.
That abstract is interesting. The CS Monitor also mentioned the wide variance within the normal (non-doping) male population.

Thanks for the info.

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Old 07-27-06, 12:26 PM   #5
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All humans have testosterone in their body. To detect possible cheating, WADA had instituted a standard based on the ratio of testosterone to a cousin found in the body. That ratio is the "T/E" ratio. Most guys have a "T/E" ratio of around 1:1, but for some guys their natural ratio might be as high as 4:1, and in rare cases, someone might have a natural T/E ratio as high as 6:1.

WADA had previously set a standard that tests showing a T/E ratio above 6:1 would be flagged for further testing. In 2005, WADA reduced its standard to 4:1. If a test shows a T/E ratio above 4:1, the "B" sample is tested. Then, the person tested is notified and allowed to present evidence that they had been granted a medical exemption for a medicine that might impact the T/E ratio, and may also present evidence that their natural T/E ratio sometimes is above 4:1.

So, if it turns out that the test results show that Landis had a T/E ratio of 5:1 after Stage 17, the "B" sample would also be tested. And, at that point, Landis would have the right to show that his T/E ratio was increased by approved medication, or is a level he sometimes naturally reaches during a race.
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Old 07-27-06, 12:26 PM   #6
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For an adult the "normal" ratio of the 2 hormones is about 1:1 However, it's not uncommon for the ration to be somewhat higher. During puberty the ratio is higher.....it can also be higher due to several physiological reasons. The standard course is to take multiple, unannounced samples from the person over a period of the next few months to see what the ratio is. Additional medical tests can be done to determine if the unusual ratio is indeed a medical issue, or rather simply doping. If in subsequent test the ratio remains high, that would be an indicator that something medical is going on.....if the ratios fall back down to more "normal" values of 1:1, well then, as Ricky Ricardo would say: "someone has some 'xplaining to do".......

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Old 07-27-06, 12:36 PM   #7
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if they take other random samples, but they aren't when he is competing at a high level can they really be compared? i'm sure the levels would be very different if he was just laying on the couch out of competition compared to when he was doing the ride of his life. i'm beginning to see why they have a hard time nailing anyone with this test.
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Old 07-27-06, 12:40 PM   #8
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A more recent article provides some background:

Br J Sports Med. 2006 Jul;40 Suppl 1:i21-4.

Testosterone and doping control.


Saudan C, Baume N, Robinson N, Avois L, Mangin P, Saugy M.

Swiss Laboratory for Doping Analyses, Institute of Legal Medicine, Lausanne, Switzerland. martial.saugy@chuv.ch

BACKGROUND AND OBJECTIVES: Anabolic steroids are synthetic derivatives of testosterone, modified to enhance its anabolic actions (promotion of protein synthesis and muscle growth). They have numerous side effects, and are on the International Olympic Committee's list of banned substances. Gas chromatography-mass spectrometry allows identification and characterisation of steroids and their metabolites in the urine but may not distinguish between pharmaceutical and natural testosterone. Indirect methods to detect doping include determination of the testosterone/epitestosterone glucuronide ratio with suitable cut-off values. Direct evidence may be obtained with a method based on the determination of the carbon isotope ratio of the urinary steroids. This paper aims to give an overview of the use of anabolic-androgenic steroids in sport and methods used in anti-doping laboratories for their detection in urine, with special emphasis on doping with testosterone. METHODS: Review of the recent literature of anabolic steroid testing, athletic use, and adverse effects of anabolic-androgenic steroids. RESULTS: Procedures used for detection of doping with endogenous steroids are outlined. The World Anti-Doping Agency provided a guide in August 2004 to ensure that laboratories can report, in a uniform way, the presence of abnormal profiles of urinary steroids resulting from the administration of testosterone or its precursors, androstenediol, androstenedione, dehydroepiandrosterone or a testosterone metabolite, dihydrotestosterone, or a masking agent, epitestosterone. CONCLUSIONS: Technology developed for detection of testosterone in urine samples appears suitable when the substance has been administered intramuscularly. Oral administration leads to rapid pharmacokinetics, so urine samples need to be collected in the initial hours after intake. Thus there is a need to find specific biomarkers in urine or plasma to enable detection of long term oral administration of testosterone.

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
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Old 07-27-06, 12:44 PM   #9
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Ok, but wouldn't they have a baseline of absolutes and ratios for Floyd since he has been tested a lot and specifically during the TDF. . .don't they test riders that are in the MJ every day and the 1, 2, 3 place finishers for each stage, in addition to some random tests? If so, it would seem easy to look back and see what his normal range was and if there was a sudden spike for stage 17 that would be indicative but not conclusive evidence.
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Old 07-27-06, 12:44 PM   #10
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He was approved for taking cortisone for his hip during the race, would that have an adverse effect on his testosterone?
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Old 07-27-06, 12:55 PM   #11
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read the section on testosterone, particularly the bottom part:

http://coachsci.sdsu.edu/csa/vol116/kraemer.htm
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Old 07-27-06, 12:57 PM   #12
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No, it wouldn't...

Thanks for mentioning me in the title, and sorry I chimed in late. The real point is that the ratio is what's being measured, and with the recent change in the cutoff value there may be some "normal" variation.

At least that's what I'm hoping. I want to believe that people can still achieve great things without the juice.
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Old 07-27-06, 01:03 PM   #13
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This was posted in another thread..... any validity, or is this bunk?

Quote:
For all that talk about what kind of beer Floyd drank, and was it the beer that made floyd fast? Take a look at this: http://www.crainsmuscleworld.com/new...news071601.htm

Scroll down to the heading "The Effect of Alcohol Consumption on the Urinary Testosterone / Epitestosterone Ratio"

I'm not sure if the current tests still have this deficiency.

Could a couple of Amstels be to blame? My non-medical background makes me very skeptical...
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Old 07-27-06, 01:05 PM   #14
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what is the 'B' sample going to tell us? it's the same urine as the "A" sample, right? if so, then it still leaves the question of what is natural\unnatural still open. seems like the "A" and "B" sample just determines if there was a testing error or not.
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Old 07-27-06, 01:25 PM   #15
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Quote:
Originally Posted by timmhaan
what is the 'B' sample going to tell us? it's the same urine as the "A" sample, right? if so, then it still leaves the question of what is natural\unnatural still open. seems like the "A" and "B" sample just determines if there was a testing error or not.

exactly...thats the reason to take a B sample. Scientists like to have duplicate samples....not only in the world of cycling, but in all areas too. Since we are dealing with exceedingly small amounts of a compound, we always have to be concerned with sample integrity. Hence the "B" sample. If "B" comes back with the same unusually high ratio, then it is confirmed to be high. Investigation proceeds forward.... If "B" ratio comes back drastically different, i.e., "normal" then we lean more towards a lab issue. Sadly, that would cloud all results from the lab designed to keep athletes clean.

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Old 07-27-06, 01:26 PM   #16
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Quote:
Originally Posted by DrPete
Thanks for mentioning me in the title, and sorry I chimed in late. The real point is that the ratio is what's being measured, and with the recent change in the cutoff value there may be some "normal" variation.
But how to differentiate these scenarios:
1. Naturally high ratio and sample A happened to be within normal range of variation for Landis, but just over the line into "testing positive".
2. Doping aimed at keeping the ratio within legal ratio, but one sample slipped over the line.

If sample B comes back negative what does that automatically absolve him?
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Old 07-27-06, 01:46 PM   #17
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If the A and B samples were drawn at the same time (which I'm pretty sure they are), it just serves to verify the A result. It'll be interesting to see what kind of evaluation Floyd will have to undergo if the B sample is positive.

I don't know the specific UCI/WADA/whoever rule, but I think he'd be off the hook with a normal B sample as I understand it.
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Old 07-27-06, 02:11 PM   #18
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I'm replying here as this thread seems to be a little saner than some others

It appears that most of the press is misrepresenting (at least in the headlines) the test by reporting Landis had "high levels of testosterone". That is not what the test said. It said he had a high ratio of testosterone to epitestosterone, which is presumed to be due to artificial introduction of testosterone into the body.

However, there is a mention in ESPN's coverage (at http://sports.espn.go.com/oly/tdf200...ory?id=2531225) from John Eustice claiming that Landis' testosterone level in the test was actually low. As forensicchemist correctly points out, it's hard to do a good job of accurately measuring the ratio between two small quantities, since it's hard to measure those quantities accurately.

This leaves me a little surprised that the UCI regs address only the ratio and not the levels. And it makes me wonder what possible benefit there would be from taking such tiny amounts of testosterone that you still end up with a "low level" afterwards!

I don't know whether Landis is clean or not and I'm trying to keep that particular speculative flame war out of this thread. But it is really disappointing to see such a serious error in the headlines reporting the problem (so go ahead and tell me I shouldn't be surprised )
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Old 07-27-06, 02:19 PM   #19
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Is there any pysical reason that the ratio may be off due to his body responding to the constant pain of his hip? I think that is somewhat untested territory - combining the physical stress of the tour with the stress of his body respnding to pain from the hip injury? I find it very interesting that the UCI is talking about the ratio, while they are actually saying his actual testosterone levels are low.

Are testosterone or other hormone ratios messed up when a body trys to compensate for pain?
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Old 07-27-06, 02:57 PM   #20
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If his actual testosterone level was low, would a high ratio of testosterone to epitestosterone even indicate any "advantage" was gained, assuming the test is accurate?

IOW, isn't the ratio test designed to "catch" high levels of testosterone - which would be indicative of doping? At low levels, what does this test actually "prove"?
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Old 07-27-06, 05:00 PM   #21
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good point allen h - what if landis had an very low level of epitestosterone due to his hip, thyroid, some other condition? that would throw the ratio out of wack. i will be EXTREMELY disappointed if his ratio is between 4:1 and 6:1 meaning that prior to the 2005 threshold lowering this is not even an issue.
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Old 07-27-06, 05:08 PM   #22
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To Z MDs..Presumably they got a sample from stage 15.. Say they test it and the levels are normal.. Is it possible that the human body can produce that much more Testosterone over the period of 2 days that you could trigger a positive test?.. In some sense how often is Testosterone produced.. What is the time constant of such a process and is the production isntantaneous or spread out over several days..
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Old 07-27-06, 05:33 PM   #23
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Okay ........ How many times has Floyd been tested and his elevated results weren't known before hand? If he is someone who has a naturally occurring high ratio then we can always back tract use his others results for a gauge and then go from there........ pretty simple stuff. But if his levels went from 1:5 then to 1:3 as the accpetable ratio's were trimmed then ....... well it looks like we may have been hood winked at best.
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Old 07-27-06, 05:48 PM   #24
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I thought he was being tested nearly every day since the win. Don't they test the top GC guy every day? If the other tests were negative and this test was the only positive one, how could it be doping? Does testosterone really clear the system that quickly anyway? I just don't think so.

Test all his samples since stage 17 and do a comparison. At least they'd get a clearer picture of what's going on with that one particular sample.

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Old 07-27-06, 06:48 PM   #25
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Quote:
Originally Posted by koffee brown
I thought he was being tested nearly every day since the win. Don't they test the top GC guy every day? If the other tests were negative and this test was the only positive one, how could it be doping? Does testosterone really clear the system that quickly anyway? I just don't think so.

Test all his samples since stage 17 and do a comparison. At least they'd get a clearer picture of what's going on with that one particular sample.

Koffee

actually depending on the actual type of testosterone, (there are several that are typically used, each differening only slightly in chemical structure) half life can be as little as 10-15 minutes. The primary use would be that it increases protein synthesis....i.e., muscle repair. SO yes, its very possible that all prior tests could be normal, then we have 1 that is positive.

What we have not seen anywhere, is the actual data. What were the actual values for the previous tests. What were the ratios for tests later in the tour? Historically, what is normal for Landis? As I mentioned in an earlier post, there are multiple conditions where one has elevated ratios between these 2 naturally occuring hormones. Before we, or the press, convict him of doping, there must be several other questions answered. Once those answers are in, then and only then will we be able to draw real conclusions.

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