20/20 Vision: Chael Sonnen's PED Test Appeal Hearing Should Open Your Eyes To TRT

Here we are a mere 5 or so hours after the California State Athletic Commission hearing for Chael Sonnen's appeal for a failed drug test. While watching the hearing and observing Chael's testimony and the testimony of his doctor, Sonnen claimed that his use of testosterone was for a valid medical reason called Testosterone Replacement Therapy caused by hypogonadism. It is my belief that TRT should not be allowed in the sport of MMA. It is not allowed in the NFL, MLB, and the NBA. It's not even allowed in pro wrestling. This is going to require your thinking caps. 

Testosterone replacement therapy is a valid medical treatment for men who have reduced testosterone due to old age, medical illness or past hormonal drug abuse (we'll get back to that in a second). TRT is fine for your average male who isn't in a competitive environment, however inside of a competitive environment, the chance of abuse increases exponentially.

Let's take a trip to the world of professional wrestling shall we. A few years ago, it was common for many wrestlers (such as Chris Benoit) to use TRT as a valid reason to obtain prescriptions. Essentially, all you had to do was show a low testosterone level and a doctor would put you on TRT.  So how did you do that? It usually occured one of two ways, either your body's natural testosterone production was permanently damaged due to years of steroid abuse or your temporarily damaged your body's testosterone production by coming off a steroid cycle and getting tested right when your body was still dependent on the exogenous testosterone. You walk into a doctor (usually hand-chosen), he draws your blood, surprise, your levels are low. He prescribes you testosterone and now you have a valid reason to have a high T:E ratio. Of course, in the effort to clean up their company after Chris Benoit's double murder/suicide, they began to crack down, and ultimately ban, prescriptions for testosterone, TRT or not. Yes, you read that right. The WWE, once seen as the Valhalla of steroid usage in the 80's and 90's has outright banned TRT due to its abusive potential. 

Back in real fighting, you have a fighter who wants to get a prescription for testosterone. He simply has to undertake those same steps as the pro wrestler. Obtain that artificially low testosterone level, get a doctor to sign off on it and you're good to go. You've got a prescription. Now you've got a cover in case you ever get popped for a bad urine test. I say urine test because no commission tests for blood. What's the difference? Well, with a urine test, all you're going to be able to test is the ratio of testosterone to epitestosterone, whether the testosterone is endo- or exogenous, and the presence of steroid metabolites (to determine what type of steroid it is).  

How is that significant? Essentially, you can get popped for a ratio of 20:1 which clearly indicates drug usage, but you can claim that you still test within the normal testosterone ranges. You see, there's a difference between T/E ratio and total testosterone. The urine test can't test for total testosterone (which is why we need blood testing).  

So basically you can have three fighters.

• Fighter A (legit need for TRT) - T/E ratio =15:1 (at time of test), total testosterone (at time of test, but not tested for) 800 ng/mL
• Fighter B (guy who wants to cheat) - T/E ratio = 15.1 (at time of test, total testosterone (at time of test, but not tested fr) 5500ng/ML
• Fighter C (guy also wanting to cheat) - T/E ratio of 3.5:1 (at time of test), total testosterone (at time of test, but not tested for) 3500ng/dl*

Now to the commission, it looks like both fighters are the same with the same ratio, but that is not true. Without knowing the total testosterone, you have no idea that Fighter B produces the normal amount of testosterone as indicated by his normal amount of epitestosterone contained and his high testosterone level. Since no blood was actually taken at the time of the test and since drug tests come weeks after the fact, he can claim that he does have a high T:E ratio but that's only because his natural testosterone production is so low and that his total testosterone levels are normal, supplementing it with tests taken by his own doctor. Of course, he knew when those tests were being taken and thus, could alter his testosterone level. 

In addition, you also have Fighter C who is taking testosterone as a PED and only does enough to raise his T/E ratio to within the "normal" ratio, but he still has a total testosterone way outside the range of normal which benefits him and places him at an advantage to other fighters.

TRT is subject to abuse by your average male who is not in competition who loves the side effects it provides. Many males on TRT see a resurgence in strength, youth and vigor. They are more aggressive and get back some of that sexual fire they've been missing. A percentage of these men begin to increase their dosages in order to see added benefits. Adding athletics to this equation produces a greater risk for abuse. He's in competition and the desire to win and succeed takes over. Athletes that spend hours a day training, weeks and months preparing, watching their diet, exercising and feeling the effects of the prescribed testosterone, it's like a wonder drug. And that's for athlete without nefarious purpose. The athlete who purposefully sought out a doctor to prescribe testosterone will undoubtedly abuse it. 

With the lack of blood testing and and the lack of cooperation between the separate Athletic Commissions, TRT should not be allowed. If the commission is unable to to determine the total testosterone levels through bloodwork, they have no ability to determine whether or not the athlete is abusing. Also, each state seems to have their own standards for approval. Some rely on the fighter's chosen doctor which opens it up to more abuse as you can get your doctor to, within reason, ultimately prescribe anything, ask those in California smoking the finest weed for "legit medical reasons". If all the major sports have banned it and even pro wrestling has, why is it allowed in MMA? When will MMA start taking drug testing seriously?

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