Elevated Levels Cause Problem

Question: Why was Floyd Landis’ Tour de France victory thrown into question?

Answer: A test of Landis’ urine showed 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. 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.

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Q: How do athletes hide their use of performance-enhancing anabolic steroids?

A. Users often also take synthetic epitestosterone to equalize the ratio, said Charles Yesalis, a recently retired Penn State professor and doping expert. There is no medical use for synthetic epitestosterone; it is used “to cheat drug tests,” Yesalis said.

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Q: When was Landis’ urine tested?

A: Landis was tested after his performance in Stage 17 of the Tour de France last Thursday.

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Q: What were his test results?

A: The usual ratio for both testosterone and epitestosterone 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 four parts testosterone over one part epitestosterone, he said. Officials have not said what ratio Landis’ test showed.

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Q: Landis, who suffers from a degenerating arthritic hip, said during the Tour de France that he has had injections of cortisone, a medically used steroid drug to treat pain. Did the cortisone change his test numbers?

A. Doctors said that cortisone would not affect Landis’ test results.

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Q: What happens next?

A: 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.