Testosterone to Epitestosterone Ratios: Cheater or not?

The Floyd Landis announcement today, and the sports radio coverage of it sent me to the internet. One of the radio reports says the discrepancy was in the ratio of epitestosterone (E) to testosterone (T) in the urine, about which I was ignorant.

So, off to MD Consult, where Primary Care: Clinics in Office Practice, Volume 32 • Number 1 • March 2005 says the difficulty catching athletes abusing T for performance enhancement was cracked by:

…measuring the ratio of testosterone to epitestosterone, with a result of greater than 6:1 considered suggestive of exogenous testosterone administration [34].

[34] was a reference to Issues in detecting abuse of xenobiotic anabolic steroids and testosterone by analysis of athletes’ urine. Catlin DH – Clin Chem – 01-JUL-1997; 43(7): 1280-8 which says:

…The process of determining if an athlete has used testosterone (T) begins with finding a T to epitestosterone (E) ratio > 6 and continues with a review of the T/E-time profile. For the user who discontinues taking T, the T/E reverts to baseline (typically approximately 1.0). For the extremely rare athlete with a naturally increased T/E ratio, the T/E remains chronically increased. Short-acting formulations of T transiently increase T/E, and E administration lowers it. ….

So, what’s to be done? It’s not only a retesting of the ‘backup sample’ but a comparison of ratios from previous samples. Landis has been racing long enough there’s probably 200 gallons of his pee in little bottles available for comparison.

I should note this is from a 15 minute session looking at the first literature hits; also, I don’t have anything to do with drug testing in sports. I’m waiting with you to see what happens.


Comments

  1. Doc,

    This is crushing, heartbreaking news, if it holds up. From my understanding the B sample, or back-up, almost always tests the same as the A sample. I’m also a little disappointed that Floyd hasn’t addressed this news already. This all leads me to believe that he probably doped.

    Having watched nearly every minute of OLN’s TdF coverage, and cheering Landis along the way, I’m feeling horribly cheated at the moment … Let us hope that this is not the sad denouement to what had heretofore been one of the greatest stories in recent memory.

    Eric

  2. I don’t remember where I heard it, but one of the shows today said ‘athletes who appeal testosterone infractions’ usually win.

    But, even if he isn’t stripped of the title, we’re back to an asterisked win.

    Was it Shakespeare? ‘(They) must not only be innocent, they must appear to be innocent’ (poor paraphrasing).

  3. Beary Potter says:

    The day of his “come back” I said out loud that I hoped he hadn’t taken something to “help” him. I REALLY want it to be a “clean” victory! Time will tell…

  4. Ihor Kinal says:

    I’m confused – I presume Landis was tested
    several times during the race [the winner of
    each day’s is tested, I read], so his levels
    should be known. [He claims that these levels
    are what he normally has.]

    But, assuming that he was clean prior, what
    would the effect of ingesting testosterone?
    Would it immediately improve performance?

    Just wo
    ndering

  5. I’m giving him the benefit of the doubt. For now. But I’m not entirely optimistic.

  6. Landis was tested six other times during the race, not because he won a stage-he won only
    stage seventeen, the test he failed- but because of the random testing that occurs.
    Taking testoterone during the race would have had no discernible effect. It does not
    work as a stimulant but similarly to an anabolic steroid, gradually increasing muscle mass over time. Increased mass is of course the bane of mountain climbing cyclists!
    However there are supplements that act as an ergogenic aid that when metabolized
    disturb the T/E.
    From my quick 15 web search–fpnotebook.com–first listing following a yahoo search for
    testosterone epitestosterone ratio.

  7. If you read farther down in that article, it claims that ethanol administration can increase T/E ratios by as much as 60%. We (the public) have too little information by which to condemn Mr. Landis. I personally would like to know, the ratio measured, his previous ratios and his ratios after ingestion of alcohol & exercise. Granted we may never know this information, but it sure would be nice.

    Vince Cammarata
    Professor of Chemistry

  8. What it will likely lead to if nothing else is a better understanding of the scientific basis for this ratio. It may turn out this was a hypothesis or theory based on a different population (nonatheletes).

  9. In hearing about the Landis issue I was both intrigued and couldn’t help but believing him to be a liar when seeing him on TV claiming his innocence. Search any bodybuilding forum and find that the T/E ratio test is one of the simplest doping tests to pass while doping with test. In the literature, it is found that T/E ratio tests yield a high percentage of false negative tests (says dopers aren’t doping), yet a very small percentage of false positives (saying non dopers are doping).

    A 1:1 T/E ratio is considered normal. The study I read actually said ethanol could increase this ratio at a mean of 41%! This looks good for Landis. However, in “normal” men this is only an increase from, well,… 1 to 1.41. An increase from 1 to say 4.5 would be a 450% increase. Bad for Landis. Furthermore, the study administered up to 160 grams EtOH to participants (about 13 beers worth). I find it hard to believe that Landis, (while claiming to have been drinking pre-sample) drank 13 beers the night before, hopped on his bike and rode to victory. (Check it at Clinical Chemistry 34: 1462-1464, 1988)

    The second test that will be tested after Landis’s B’samples (assuming the B-samples confirm the elevated T/E ratio) will be a radio isotope test. This test is used to confirm the presence of non-endogenous testosterone or testosterone administered in an injection, tablet, gel, patch or by any exogenous means. Gary Wadler from WADA explains this well in an interview on National Public Radio’s website. Failing this test would almost unequivocally verify doping. (Unless of course the sample was tampered with, which will probably be the next argument after the T/E ratio argument tanks b/c all his previous hundreds of samples had normal T/E ratios. See O.J. Simpson for further refrence)

    I hope Floyd Landis is innocent. I don’t think he is. I believe that even if found guilty, half the public will still think he’s innocent because the years of litigation and court appeals that will be made “clouding” the issue. However if Landis is found guilty I urge people to understand and know that he is indeed guilty. Not only would he have had at minimum a 400% increase in the normal T/E ratio, but the verification of manufactured testosterone present in his body would confirm guilt.

    Thanks
    Dan

  10. rockhead222 says:

    I think the problem is in the testing. The baseline used for testing was the level of testosterone in a European male, primarily and probably a French male.

  11. Jim in Texas says:

    What struck me was the use of the “exogenous” in Landis’ denial

    “”But it was not from an exogenous outside source of testosterone.”

    At the time I thought it was an odd word for him to use.

    And now the use of the same word in the text you found.

    Coincidence? or a sign that he’s well read up on the critical causal factor of the sin he is accused of?

    Or is it just an example of the inside arcane common knowledge of all competitive bike riders?

    Oh well, when I was a criminal investigator we had a saying:

    ” In God we trust, all others we polygraph”

  12. NOEL A. MADDOX says:

    I was born hypo pit(pan hypo pituitarism)and have taken synthetic testosterone for almost 60 years now. I am objectively and subjectively familiar with the affects of it.

    TESTOSTERONE WILL IMPROVE MUSCLE TONE OVER TIME (WEEKS, MONTHS, OR YEARS), BUT IT DOES NOTHING IN 48 HOURS. SOMETHING IS WRONG WITH THE FLOYD LANDIS STORY, ASK ANY ENDOCHRONOLIGIST.

    FLOYD HAD 8 PREVIOUS NEGATIVE TESTS INCLUDING A NEGATIVE TEST 48 HOURS EARLIER. THE “A” TEST ON THE NINTH REVEALED A NORMAL LEVEL OF TESTOSTERONE BUT A LOWERED LEVEL OF EPITESTOSTERONE. A LOWERED LEVEL OF “E” DID NOT HELP FLOYD WIN EITHER.

    IT MUST HAVE BEEN THE BEER?

    THE WORLD ANTI- DOPING AGENCY WANTS TO “LEVEL THE PLAYING FIELD”.

    MAY I SUGGEST “THE PLAYING FIELD HAS NEVER BEEN LEVEL”.

    BALD MEN UNDER THE AGE OF 35 HAVE HIGHER TESTOSTERONE LEVELS.
    HORN DOGS HAVE HIGHER TESTOSTERONE LEVELS
    YOUNG MEN HAVE HIGHER “T” AND “TE” RATIOS (as much as 12/1 TE)
    HYPO-PIT AND HYPO THALAMUS PATIENTS (FROM BIRTH) HAVE ZERO “T”

    WE ARE NOT BORN ON A LEVEL PLAYING FIELD, WE DON’T GROW UP ON A LEVEL PLAYING FIELD, AND WE SURE AS HELL DON’T PLAY ON A LEVEL PLAYING FIELD.

    I SMELL A CONSPIRACY

    NOEL

  13. What I don’t understand is how can Testosterone be normal and Epitestosterone be abnormally low to give the elevated T/E Ratios? A normal level of testosterone indicates NORMAL, not doping! A abnormally suppressed level of epitestosterone (to achieve the 11:1 Ratio) indicates sample tampering to achieve a desired result. Can an expert on the subject please comment?

    Kev

  14. Darryl Petrak says:

    The B sample is guaranteed to match. Landis was painfully realistic to expect it. Think about it. The lab finds “B” is “clean as the driven snow.” They now have a) admit the samples do not jive, AND b) reverse a worldwide furor! This over a sample that ONLY THEY KNOW ABOUT! We already know they are dishonorable enough to release information that is not be be released, using unnamed person(s) of unspecified position. They are unable to even just not say anything! Do you really think they would suddenly be this honest? (They have made verified errors in the past). Dreamers! The paperwork would be altered. If any sample remains, it would be dumped or doped in-house so that if it were removed to another lab it would indeed match.

    I do not know the truth. There is no way to verify the truth. If there was, neither the lab or associations or media would come forth with anything not already released, legally or not!

    I have sent a nine-step set of changes that would eliminate most of the administrative built-in errors to UCI, TAS-CAS, USADA and US Cycling. Ten to one they do nothing, and this debacle will repeat, and repeat, and repeat, and get worse, get worse . . .

    Darryl