Overeem, TRT, and Drug Testing

If you don't follow MMA you might want to skip this post.

I'm writing this just as news of Alistair Overeem's failed Testosterone: Epitestosterone test are coming to light.  As of right now his B sample hasn't been tested, nothing's been confirmed - as far as I know this is a huge mistake (not that I think it is).

Having said that, I've already read a few comments (some posted by professional reporters) that indicate that the authors don't understand this test or what it means.  I thought I'd explain.

We're all probably familiar with testosterone, a sex hormone produced in naturally higher levels in males than in females.  Testosterone positively influences muscle hypertophy (how big your muscles can be), recovery (how fast you can recover from a tough workout), mood, health, and a bunch of other things.  People's levels vary naturally - men almost always have higher levels than women, levels tend to peak in early twenties or so then decline gradually, and levels can be affected by your genes, stress levels, sleep, nutrition, various legal herbs, and even looking at naked women (seriously).  How much those things can influence T levels is relative - if you're at a 400, watching a bunch of porn and getting a good night's sleep might get you  up to 500, but it won't get you to 1200.

Incidentally, one way to permanently decrease your T levels is repeated head trauma.  Think about that in terms of fightsports for a moment.  And one of the most serious consequences (in my opinion) of depressed T is increased risk for depression (along with heart disease)... think about that the next time a former fighter commits suicide.

So we can all imagine that if you're going to compete in almost any sport that involves strength and/or power, higher T levels, at least up to a point, are going to be beneficial.  They'll allow you to train harder, recover faster, hold more muscle in the face of high stress, and generally be, all else being equal, a better athlete.  How do you get higher levels of T?  Sleep, nutrition, porn - they'll all help a little bit, but the most effective way is to add testosterone to your system - inject it, use a cream, whatever.

Of course, that's against the rules.  Mostly.  There's an exception - Testosterone Replacement Therapy (TRT).

You see, if a normal joe (like me) has low T levels - that is, significantly lower than those of an average male of our age (roughly mid-600's are average) - we can go to our doctor and get a nice legal prescription for injectable T or a T cream.  Boom, levels go back up, but, depending on how much we take, our levels may not be very high - they may still be on the low side - just higher than they were.  If your T level is 200 and you use a cream or injections to get up to 500 your T level is still lower than the average guy on the street.

Now to compete in MMA there are all kinds of hoops you have to jump through - just because something is legal doesn't mean it's okay with the athletic commission (see Nick Diaz, marijuana).  They'll accept a fighter on TRT if they go to certain doctors, file specific forms, tell them ahead of time, etc. - like I said, there are hoops to jump through, but the use of TRT isn't banned outright.  In theory, they would test you to make sure you weren't on a high enough dose of TRT to give you a competitive advantage.  Basically, if I can show them that I'm using TRT to bring my 200 up to an 800 (still well within the range of "normal"), I'd be okay, but if I bring my 200 up to a 2000 I wouldn't be allowed into the cage.

There ARE tests that check your overall T levels - blood tests, not urine as far as I know - but that's not what Overeem failed.

You see, along with T, your body makes another hormone called Epitestosterone (E) that isn't very interesting - it doesn't do too much that we're aware of, and doesn't seem to help with athletic performance.  About the only reason we do care about E is that humans tend to make about as much of it as they do of T - in other words, for pretty much everybody, whatever your T levels are, your E levels will be almost exactly the same.  Have a lot of T (say, you're a teenager watching porn)?  You'll have a lot of E.  Have a low T?  Low E.  The ratio stays at around 1:1.  But what if you inject a bunch of extra T?  Well, the ratio gets out of whack, because it's the stuff your body makes that comes out in a 1:1 ratio - when you inject extra T there's no feedback loop that has your body ramp up its production of E.

Overeem's reported T:E ratio was 14:1.  If that's true it ONLY means that he had a lot of artificial T swimming around in his system.  As far as I know he doesn't have a TRT exemption - that information may be available - but we don't actually know if his T levels were really high OR if his natural T level was ridiculously low an he used supplemental T to get his overall levels to a high-normal range.  I'm not saying that is the case - I'm just saying that we don't know if his T levels were very high, offering him some competitive advantage - only that he was injecting (or smearing through cream) extra T.

Now if Overeem hadn't applied for a TRT exemption and was still applying/ injecting extra T then it doesn't matter if his overall levels were higher than normal or not - he broke the rules, he'll be punished for it.

Please note that I'm not arguing in favor of the current regulations (or against them), I only think we should be clear on what the various test results actually mean.  I'm a little sympathetic to the view that the athletes should be allowed to drug up however much they want to - we're not seriously worried about their health, are we?   If we cared about the long term health of athletes they'd all be in headgear, if combat sports were even legal.  Forget football.  Or marathon running.  High level sports is not good for people!

One last note - if you're an amateur athlete buying illegal drugs to improve your performance then you're an idiot.  Overeem makes hundreds of thousands of dollars to risk his health - if you're an accountant who trains in martial arts for fun, to risk your health at 60 for your hobby is just dumb.  When you buy steroids from some guy at your gym you don't know what's in them, the purity level, etc.  Now if you have low (or low-ish) T levels and you want to get TRT from your doctor, that's another story (the pharmacy will sell you real T, no rat poison in it).  I don't claim to be an expert on Hormone Replacement Therapy, but I suspect that artificically replacing your T levels back to where they were when you were in your mid-20's will have only positive side effects for most people (but I'm NOT positive about this).  

So, stay away from illegal drugs, but consider legal ones.  Osu!