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Adverse T:E Ratio: Possible Doping

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Although exogenous testosterone causes marked and characteristic changes in the pattern of steroids excreted in the urine and the formation of epitestosterone in inhibited by exogenous testosterone. By all sports authorities, it is agreed upon that above normal T: E ratio in the urine is a reliable indicator of testosterone doping. Results from anti-doping laboratories indicate that genetic, environmental, and dietary factors may affect this ratio leading to false-positive results. The implications are serious. This indicates additional criteria for testosterone doping detections are needed. Decreased urinary luteinizing hormone excretion or increased urinary T/LH ratio has been suggested to be another alternative for detection of anabolic steroid doping. Another strategy could be to measure the T: E ratio in urine samples collected at various intervals after the collection of the first sample with an increased ratio. The basis of this concept is that if testosterone has been administered, the T: E ratio is expected to change over time. Exogenously administered testosterone is converted to estrogen to some extent. An idea has been advanced in this context that urinary estrogen can be a marker of testosterone doping. Supplementary analysis of a serum sample can provide additional supportive and useful information. These methods can be useful to diagnose doping in the volleyball player, and before advancing recommendations, it is very important for the medical officer to take a cautious decision. For anti-doping work, it is important that the analytic procedure be as maximally accurate as possible. It is also important for the analytic process to eliminate all possible risks for false positive results. In all suspected cases of testosterone doping, some researchers have come up with suggestions of supplementary immunological analysis of 17OH progesterone, Testosterone, and LH. To this end, a highly sensitive immunoassay of 17OHP, preferably including an extraction step to improve specificity could be used.
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