Hormones As Dope

Lab-generated testosterone is derived from plant compounds that scientists alter chemically. They're used to treat medical conditions such as insufficient testosterone production in males.

But when synthetic testosterone is taken -- in doping athletes, it might be administered as a shot, patch, gel, cream or lozenge -- the body compensates by cutting back its own production. This means dopers must replace the testosterone their bodies make naturally, plus more to achieve the desired higher level of the hormone.

That's not the end of the complications. When the body stops making its own testosterone, it stops making epitestosterone, too, Auchus explains. Since synthetic preparations generally don't contain epitestosterone, a doping athlete's T:E ratio gets out of whack.

That's why authorities measure the T:E ratio to detect possible doping. For most men, the ratio of testosterone to epitestosterone is between 1:1 and 3:1, Auchus says. A ratio of 4:1 or higher triggers suspicion of doping.

It's possible to be higher than that cutoff without doping, but "if you naturally exceed it, you'd be naturally exceeding it all the time," Goldberg says. Several tests over a period of time would verify this.

Landis's ratio went from below 4:1 after the Tour's 15th stage to 11:1 two days later, according to the reported results of testing on a urine sample collected on the Tour's 17th stage, a 200-kilometer event that took place on July 20. Within a day or two, it was back below 4:1.

Why They Call It Dope

Yes, but couldn't Landis's heroic ride itself have produced the spike in the manly chemical? Or how about the beer and whiskey power drinks he says he indulged in the night before the 17th stage?

Unlikely. Few things other than use of testosterone or other anabolic steroids are known to boost levels or change the T:E ratio significantly, Auchus says. Landis's testosterone also contained isotopes of carbon that indicated it was not made in his body.

Brief periods of "vigorous exercise might bump up your testosterone a bit, and so might a high-protein diet," Goldberg says. The physical stress associated with prolonged, intense exercise might eventually lower a person's testosterone level. But in either case, these changes would be minimal, he said.

As for drinking alcohol, there is some evidence (at least in females) it may increase the T:E ratio slightly, Wadler says. "But that wouldn't bring it from below 4 to 11," he adds.

Some athletes "cycle" or "pyramid" their use of anabolic steroids such as testosterone, experts say. That is, they use illegal substances episodically during training and then taper off before anticipated testing, to clear the substance from their systems.

Other athletes may use testosterone gel or cream or even lozenges (because they absorb through the skin in the mouth) judiciously throughout training and competition, with the expectation that small amounts will provide benefits without knocking their T:E ratio too far out of line. Testosterone applied via gels and creams leaves the body more quickly than that coming from shots, which is why many athletes prefer the transdermal forms.

So how could such circumspect cheaters get burned by a urine test they are expecting? Taking testosterone through the skin has unpredictable results, Goldberg says. "You might have applied more, or just absorbed more of it than usual. You might be flying under the radar and then, boom, you hit" a detectable level, he says.

Could a bit of carelessness or an unexpected bodily response to synthetic testosterone have unmasked Landis's deception? That's a question that remains to be answered. ·

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