New studies shed light on nandrolone

Nandrolone is a banned substance under the IOC Anti-Doping Code when it is found at levels exceeding 2 ng/ml in men and 5 ng/ml in women. Unlike most banned steroids, nandrolone occurs naturally in the human body. In a 1999 study, it was found that approximately half of the test subjects produced nandrolone metabolites at trace levels (on average, 6 ng/ml). It is also known that women produce higher levels of nandrolone metabolites than men.

This article is being written at the IAAF World Championships in Athletics in Edmonton, where the drug talk is all about the blood-boosting hormone EPO (erythropoietin). For the first time, the IAAF will introduce blood tests at this World Championships. Of the 350 doping tests being conducted here, 15 to 20 percent will test for EPO in an elaborate double positive system whereby an athlete must test positive in both urine and blood samples to incur a doping offense.

Meanwhile, controversies over the anabolic steroid nandrolone continue. In 1999, IOC-accredited labs worldwide detected 343 positive nandrolone findings, up from 259 the previous year. In the United Kingdom, nandrolone findings jumped sharply from four positives in 1998 to 17 in 1999. In Canada we have seen a growing number of nandrolone positives in the last four years, including two this summer alone. Three Canadian cases involving the steroid are presently in the process of adjudication.

On their own, these figures are not cause for grave concern. What has been alarming, however, is the sharp increase in the number of positive tests among big name athletes - the likes of Peter Korda, Merlene Ottey, Linford Christie, Doug Walker, Gary Cadogan, Dieter Baumann and Mark Richardson. The revelation during the Sydney Olympics that American shot putter C.J. Hunter, then-husband of sprinter Marion Jones, had tested positive four times in the year 2000 put the steroid nandrolone on the front page of newspapers around the world.

The recent so-called "rash" of nandrolone positive tests is odd, given that this close chemical cousin of testosterone has existed for a long time and is very easily detected. In other words, why would prominent and frequently tested athletes even consider using it? Observers point to two factors to explain this increase in positive tests: one, the steroid has recently become available in pill form and is more easily ingested and more quickly cleared from the system, thus increasing its usage by athletes; and two, the adverse findings may be the result of contaminated nutritional supplements.

This latter claim has resulted in the commissioning of at least three studies into the nandrolone situation. One of these studies was a general literature review by a panel of 35 British experts while the other two were laboratory-based studies exposing volunteer subjects to nutritional supplements to determine if these supplements could produce nandrolone metabolites.

The nandrolone review was commissioned by the U.K. Sports Council and was released in January 2000. It concluded that:

  • The sample collection and laboratory analysis procedures recommended by the IOC for testing for nandrolone were satisfactory;
  • Some dietary supplements may contain compounds similar to nandrolone or its metabolic precursors and these are not always included in the product labeling;
  • Athletes are advised to steer clear of eating the offal of boar and horse, as these foods were known to contain low levels of nandrolone; and
  • There existed no evidence to suggest that dietary substances could influence the production of nandrolone in the body.

The study properly concluded that the sports community must maintain a high level of awareness of the hazards of nutritional supplements and herbal products, and that further research should be carried out on the factors that influence the endogenous production of nandrolone in humans.

The two other studies were carried out at the University of Aberdeen under Professor Ron Maughan (a world-recognized expert on sports drinks) and at the IOC-accredited laboratory in Cologne under the supervision of Dr. Wilhelm Schänzer of the German Sports University. The first study was partially funded by the IAAF and the latter study by the IOC.

In the Aberdeen study Professor Maughan concluded that athletes taking dietary supplements that did not contain prohibited substances "could when combined with vigorous exercise, stress and dehydration, result in production of higher concentrations of nandrolone metabolites in the athlete's bodily fluids".

In the Cologne study, it is reported that Dr. Schänzer found that of 100 common nutritional supplements purchased in Europe and the U.K., 16 were contaminated and three led to adverse findings for nandrolone in volunteer subjects. Dr. Schänzer has said he intends to test 600 more commonly available nutritional products.

It was in part on the strength of the results of the Cologne study, released in the spring of 2001, that U.K. 400-metres runner Mark Richardson was reinstated by the IAAF in June of this year, enabling him to compete at the 2001 World Championships. On the other hand, the University of Aberdeen study was discounted by an IAAF arbitration panel for a variety of scientific reasons, including the fact that Professor Maughan was not independent as he subsequently was part of the U.K. Athletics disciplinary committee that considered favourably the cases of Christie, Walker and Cadogan.

Upon the release of the Cologne study results, David Moorcroft, CEO of U.K. Athletics stated: "in terms of guilt or innocence it doesn't change a great deal, because the athlete is still responsible for what's in his body. But it does put the degree of guilt in some form of context".

Upon his reinstatement, Mark Richardson stated to fellow athletes and the public: "My advice is simple - don't take supplements. Until the supplement industry is regulated, then it's a lottery as to what is in the supplement".

These are wise comments from both men. The results of the Cologne study might suggest "reasonable doubt" as to whether athletes exhibiting low concentrations of nandrolone actually cheated. However, the "strict liability" basis of the IAAF and Canadian doping control programs do not accommodate "reasonable doubt" or even "a balance of probabilities". The presence in the body of a banned substance, or the presence in the body of a naturally occurring substance at levels deemed to be banned, is a doping offense, period. Accidental ingestion or intent to cheat are irrelevant considerations.

This notion of strict liability can be explained to the layperson in terms of commonly understood drinking and driving laws. In Canada, it is a criminal offense to operate a motor vehicle with a blood-alcohol level exceeding .08. At this level some individuals will be roaring drunk while others will be mildly impaired - the threshold does not take into account such differences from one person to the next. As well, the law doesn't care how the alcohol entered the bloodstream - even if it was forced down the driver's throat or introduced into the body through intravenous while the driver was asleep - its presence there above the level of .08 is against the rules.

In sport, it is against the rules to have more than 2 ng/ml (for a man) or 5 ng/ml (for a woman) of nandrolone metabolites in one's urine. The mere presence of such metabolites above these levels is a doping offense. This is true whether the levels are low (such as they were for Canadians Robin Lyons, Theresa Brick and Carolyne Lepage) or astronomically high (such as they were for Linford Christie and C.J. Hunter, who recorded one hundred and one thousand times the legal limit, respectively).

For these reasons, the adjudicators who are presently hearing and deciding three of Canada's nandrolone cases face a difficult task. Any one of the athletes appearing before them might present a convincing case that their nandrolone consumption was inadvertent, and it doesn't make a bit of difference. Intent to cheat, an otherwise clean history, credibility and compassion are not part of the equation … but perhaps they should be.

In doping, as in sport, the rules are the rules. When the IAAF declined to reinstate Linford Christie, Doug Walker and Gary Cadogan it stated in its August 2000 Newsletter that the decision was not made to defend the current system, "it was made to respect and apply the current rules".

Until those rules are changed, the nandrolone issue will remain difficult and controversial. The rules say where the blue line is on a hockey surface and if we don't like the resulting offside call there's not much we can do about it unless we're prepared to move the blue line. The IOC hasn't moved on nandrolone and until it does, the IAAF as well as domestic doping control and adjudication systems must respect the rules.

For athletes, the clear lesson in this is to heed Mark Richardson's advice and avoid nutritional supplements. With proper sports nutrition, they aren't necessary for athletic performance. The supplement industry is unregulated and the consumer of these products has no assurances as to what's in the bottle or package - either because labeling is inaccurate, or because the supplement has been contaminated during the manufacturing process.

In the last 18 months, the Canadian Centre for Ethics in Sport has issued no fewer than five Advisory Notes cautioning athletes about nutritional supplements. Despite these frequent cautions, high performance athletes continue to consume nutritional products in alarming amounts and combinations. It has been suggested (but by no means scientifically proven) that such "cocktails" of legal nutritional supplements combined with vigorous exercise may produce illegal results.

As we have stated before in the pages of this magazine, athletes are responsible for what's in their bodies and they play Russian roulette when they fail to be utterly diligent about the contents of their dietary and nutritional supplements.

Originally published: Coaches Report (2001) Vol. 8(2)

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