Testing procedures can detect athletes' steroid use, By: Lindsey Tanner

July 28, 2006

Questions about possible banned steroid use by Tour De France champion Floyd Landis were raised in a urine test that spots elevated levels of performance-enhancing testosterone.

The test detects both testosterone and a related steroid called epitestosterone, which is not performance-enhancing. Both are produced by the body and are also made in synthetic form.

Landis' team said his urine sample showed "an unusual level of testosterone/epitestosterone" when he was tested after his amazing come-from-behind performance in stage 17 of the race last Thursday.

The usual ratio for both substances is about 1:1 or 2:1, said Dr. Gary Wadler, a member of the World Anti-Doping Agency and a spokesman for the American College of Sports Medicine.

Suspicions for improper steroid use arise when the ratio climbs above 4 parts testosterone over 1 part epitestosterone, Wadler said. Officials have not said what ratio Landis' test showed.

Athletes who use performance-enhancing anabolic steroids often also take synthetic epitestosterone to equalize the ratio, said Charles Yesalis, a recently retired Pennsylvania State University professor and doping expert.

There is no medical use for synthetic epitestosterone; it is used "to cheat drug tests," Yesalis said.

Testosterone creams, pills and injections can build muscle and strength and improve recovery time after exertion when used over a period of several weeks, Wadler said. But if Landis had been a user, his earlier urine tests during the tour would have been affected, too, Wadler said, and Thursday's was the first reported abnormal result.

One-time use of steroids could result in an abnormal test, but it would have no effect on performance and could not account for Landis' astounding feat Thursday. "So something's missing here," Wadler said. "It just doesn't add up."

Alcohol can influence testosterone-epitestosterone levels, but more often in women than in men and it would be unlikely to have a huge effect, Wadler said.

Some men have naturally occurring high levels of testosterone and/or epitestosterone, but there is a sophisticated lab test called a carbon isotope ratio test that is often used to detect synthetic forms.

Landis said in an interview during the Tour de France that he has had injections of cortisone, a medically used steroid drug to treat pain from a degenerating arthritic hip, but doctors said that would not affect his test results.

The typical procedure for urine-testing of athletes involves taking two samples at the same time and bottling them separately. The "A" sample is tested first, and if it is normal the "B" sample is discarded. If the "A" sample shows elevated testosterone levels, the "B" sample is tested, and its results are used to confirm use of a banned substance, Wadler said.

The same "B" sample is also often subjected to the carbon isotope test, said Dr. Don Catlin, director of a World Anti-Doping Association-accredited Olympic lab at UCLA. Landis' Phonak team suspended him pending results of the backup "B" sample.