Here is my problem with the idea of legitimate health concerns and age-appropriate levels. Unless you have been testing the entire population at nice five or ten year intervals, we don’t really know what is appropriate. I have thought about this a few times as I get older and my wife has teased me about “going to see a doctor.” So let us consider one hypothetical situation:
Me and my buddy have been racing each other in duathlon (yeah, I know, who does that anymore?) for fifteen years. For the most part, when we are both fit, I win about 80 percent of the time. Then age 40 rolls around and things start changing. We both are training the same as we used to—well, maybe a little less, we are old after all—and now he starts beating me. Now he is winning 80 percent of the time. That rankles, of course, so I go to the doctor and he tells me, “Yeah, your testosterone is a little low.” He prescribes me something and in a reasonable amount of time I am feeling better and back to beating my buddy, as it should be. Except, it really is not as it should be. I had the good fortune in my prime of having the genetics to be faster than my friend, but he had the good fortune to be hit much less by the aging problem and so he slowed down a lot less and now he is faster than me. That is just the genetic breaks, but I am sure there are hundreds of men out there with money to burn telling themselves they are just making things right again, as they should be.


When I first saw the poster-child doctor for the ‘anti-aging’ movement on TV, I was just dying. He was a fat 50 something guy who started working out, “supplementing”, and oddly, going to the tanning booth. The others were like, “Man you look great for 72!” Of course, he did, he was a doctor prescribing himself the good stuff to get him back to his age 45 levels. Could a 72 year old get there on his own? Probably not. He was so vain and puffed up about himself his very positive message about changing your lifestyle was mostly lost, at least to me.



Which is why I would never agree with anyone who is supplementing back to “age appropriate levels.” Maybe your age appropriate level just does not cut it anymore and it is time for someone else to shine.
Chad

I would tend to agree. As soon as you open the door, it's a Pandora's box. "Leveling the playing field" is a red herring. I think most who use that phrase or concept are being utterly disingenuous.

That said I have no problem with people arguing that masters should be able to compete while taking various "lifestyle enhancement" drugs. As long as they're transparently lobbying for change, and not racing while doping. Anyone "lobbying-for-change-through-cheating-because-they-know-they're-right" is a POS.

I agree with your post. My other issue is that let's suppose I am a guy who is below my age appropriate T level, but I am training like a fiend, and I have other genetic benefits that allow me to beat my competitors who are also below their age appropriate T level (assuming such a thing even exists).

So then all my competitors go on T to get their levels up to age appropriate levels (not even back to their 20 year old level), and now they start beating me.

If I want to beat them, I am now basically forced to take T to keep up. But maybe I don't want to take it. Maybe I think it is bad for me - who knows. It basically means there is a good chance a bunch of athletes that were doing just fine on their own, are suddenly stuck doing T just to keep up.

I also wonder why we don't apply this to other things - like height in basketball. If I am below the average height of the NBA, can I buy some really tall shoes to get me to the league average and join the league?

simple question, how old are you and what is your competitive level?

---

Mike Plumb, TriPower MultiSports
Professional Running, Cycling and Multisport Coaching, F.I.S.T. Certified
http://www.tripower.org

I realise your scenario is hypothetical, but in my experience changes in the pecking order of who's fastest as we get older are entirely explained by lifestyle and training approach, not different rates of aging. I think a lot of stuff you can get away with in your 20s if you have enough talent - poor nutrition, not enough sleep, booze, too much intensity work - catches up with you increasingly through your 30s, 40s and especially 50s. Out of hundreds of long-term friends, training partners and club mates going back nearly 3 decades I honestly can't think of anybody who has slowed down at a noticeably higher rate than their peers without there being associated lifestyle, training or injury factors that explain the drop in speed. Or conversely any increases in speed can be explained by people cleaning up their lifestyle or training harder/smarter.

Also, just to echo a comment earlier in the thread, if some of the anti-aging treatments were shown to genuinely slow down physical decline of the body with no adverse side effects, then screw competitive sport, I'd be taking them in a flash and quitting racing if need be. Health trumps hobbies for sure (though I'd still train so not sure where I'd draw the line on "competitive" sport - is it still OK to try and set PBs on local hill climbs on Strava, or to participate in the sprints on club rides???). Problem is that as far as I can tell every single treatment comes with possible negative side effects. So they're not really anti-aging in the truest sense of the word, they're maintaining an outwardly younger appearance/performance, while putting unseen additional strain on your body which could actually shorten your lifespan.

I 100% agree with not being allowed to use it for the simple fact that it is banned.

But all the arguing about how it is terrible for you, I don't think there is proof of that. For example, from Mayo:

"However, more recent studies show no increase in cardiovascular disease in men taking testosterone therapy. Some research even shows a lower risk of death in men receiving testosterone therapy compared with those not receiving therapy. A large 2016 study following more than 1,000 men for three years found that testosterone therapy did not increase the risk of cardiovascular events."

I have also yet to see a wild outbreak of heart disease and cancer in pro cycling or any other pro sport for that matter, where this and other drugs are obviously rampant.

Just to be clear, so Dessert doesn't throw a fit, I am 100% against the use of any substance that is banned if you choose to compete. Simple. And totally in favour of harsh penalty for those caught. But drop the holier than thou attitude regarding the choices other (non-competitive) people make.

Playing a little bit of Devil's Advocate, but what about other drugs that make people feel like a normal person? Anyone who has ever been legitimately clinically depressed, they know what I'm talking about. You don't have the energy to train, not because your body is physically unable, because the neural receptors in your brain have gone sideways and are not receiving/producing the transmitters you need to in a way that allows you to even function in the world, let alone train.

In cases like that, medication can allow you to recover from and correct abnormal brain function. Some people have to take these medications for a little while to reset their brain, and then they're able to go off and resume normal life, but without it they literally are unable to function at all.

Is that performance-enhancing?

I think the argument that certain drugs allow people to function as they should normally be able to is a pretty strong one, when it's medically necessary being the huge caveat.

That said, I think the testosterone "Clinic" explosion in recent years is not fueled by people who medically need it any more than the Obesity epidemic is a result of people with physiological issues that prevent them from losing weight.

Hello cartsman and All,

The following information generally does not consider the fact that the drugs being discussed are illegal for venues that subscribe to the rules promulgated by WADA and USADA and other organizations.

It appears that it is too early to say what effect various drugs (such as testosterone, growth hormone, and EPO) will have on longevity and we will need to wait until the human 'early adopters' get sick, die, or survive ...... or perhaps get some clues from animal studies.


I find very little information about effects of EPO on longevity .... searching various PubMed articles.


Regarding EPO with renal and AIDS patients ...

"The overall-incidence of side effects occurring in either group of these two studies was of approximately 83% and 95%, respectively. In contrast to these results the data published for the dose finding/treatment studies is approximately 30% for development of arterial hypertension, approximately 5% for occurrence of cerebral convulsion/hypertensive encephalopathy, approximately 10% for thrombo-embolic complications/clotting of vascular access, approximately 50% for development of iron deficiency, and approximately 10% for symptoms summarized as influenza-like syndrome."

And a novel use for EPO ....

"Globally, greater than 30 million individuals are afflicted with disorders of the nervous system accompanied by tens of thousands of new cases annually with limited, if any, treatment options. Erythropoietin (EPO) offers an exciting and novel therapeutic strategy to address both acute and chronic neurodegenerative disorders." (Alzheimer's, Parkinson's, and other nervous system diseases.)


Human Growth Hormone:


https://www.ncbi.nlm.nih.gov/...articles/PMC2682398/


"Although advanced age or symptoms of aging are not among approved indications for growth hormone (GH) therapy, recombinant human GH (rhGH) and various GH-related products are aggressively promoted as anti-aging therapies. Well-controlled studies of the effects of rhGH treatment in endocrinologically normal elderly subjects report some improvements in body composition and a number of undesirable side effects in sharp contrast to major benefits of GH therapy in patients with GH deficiency.

Controversies surrounding the potential utility of GH in treatment of a geriatric patient are fueled by increasing evidence linking GH and cancer and by remarkably increased lifespan of GH-resistant and GH-deficient mice. Conservation of cellular signaling mechanisms that influence aging in organisms ranging from worms to mammals suggests that at least some of the results obtained in mutant mice are applicable to the human.


We suggest that the normal, physiological functions of GH in promoting growth, sexual maturation and fecundity involve significant costs in terms of aging and life expectancy. Natural decline in GH levels during aging likely contributes to concomitant alterations in body composition and vigor but also may be offering important protection from cancer and other age-associated diseases." [emphasis added]


The effects of testosterone has several studies published (but not regarding longevity)

https://www.ncbi.nlm.nih.gov/...articles/PMC3897047/

Excerpt:

"Testosterone replacement therapy (TRT) is a widely used treatment for men with symptomatic hypogonadism. The benefits seen with TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscle as well as cardioprotective effects, have been well-documented. TRT is contraindicated in men with untreated prostate and breast cancer. Men on TRT should be monitored for side-effects such as polycythemia, peripheral edema, cardiac and hepatic dysfunction."


(Testosterone and other androgens have an erythropoietic stimulating effect that can cause polycythemia, which manifests as an increase in hemoglobin, hematocrit, or red blood cell count. The incidence of polycythemia secondary to testosterone use ranges from 2.5% to 40% depending on the testosterone dose and formulation and is less common with transdermal vs injectable formulations.[2[/url],3[/url],4[/url]] Definitions in men vary, but polycythemia generally occurs when hemoglobin is above 18.5 g/dL or hematocrit is above 52%.

Polycythemia is sometimes called erythrocytosis, but the terms are not synonymous because polycythemia refers to any increase in red blood cells, whereas erythrocytosis only refers to a documented increase of red cell mass. The increase in hemoglobin and hematocrit secondary to testosterone use is usually accompanied by an increase in the red blood cell count, which can lead to an increase in blood viscosity. This increase in blood viscosity can reduce cerebral blood flow which could theoretically be a risk factor for thrombosis and stroke.[3[/url]]) [emphasis added]

https://www.ncbi.nlm.nih.gov/...articles/PMC4650486/

Excerpt:


"For several decades any diagnosis of prostate cancer (PCa) has been considered an absolute contraindication to the use of testosterone (T) therapy in men. Yet this prohibition against T therapy has undergone recent re-examination with refinement of our understanding of the biology of androgens and PCa, and increased appreciation of the benefits of T therapy. A reassuringly low rate of negative outcomes has been reported with T therapy after radical prostatectomy (RP), radiation treatments, and in men on active surveillance. "

https://breakingmuscle.com/...iving-everybody-else

https://breakingmuscle.com/...-our-double-standard

Excerpts:

"So when you look at a sport like cycling, which comes complete with crashes at high speeds wearing nothing other than Lycra and a history of prolific drug use, it’s hard to believe that top cyclists actually outlive their countrymen by an average of five years.

This is the conclusion researchers came to and shared in a recent study published in the European Heart Journal. What makes this study even more extraordinary is that the study was not just an examination of elite cyclists, but Tour de France cyclists who participated in the event during the years of 1947 to 2012.

"I would also point out that the study on the Tour cyclists doesn’t really take into account riders who went through the EPO and growth hormone era. These cyclists were included in the test, but most are not yet at an age where their previous lifestyle has come back to bite them. In the generation of older cyclists, such as those who raced during the steroid and amphetamine era, there have been suicides linked to depression. The most notable of these was Marco Pantani, himself a former Tour de France winner. I’d suggest that the statistics might need to be revisited in a decade’s time when we can get a better look at the longer-term results.


Having said that, endurance athletes run a higher risk of having enlarged chambers of the heart, which can in turn lead to atrial fibrillation. In fact, I can name three high-level Australian triathletes (Greg Welch, Brad Bevan, and Emma Carney) who all suffered from this and had to retire because of it. So it’s not like elite endurance racers are immune to heart problems, just that they avoid the problems associated with a sedentary lifestyle.

The overall message of this new study is very positive, though. Endurance activity, even extreme activity such as the Tour, is not bad for you. In fact, it may help you live longer than those who don’t engage in regular aerobic activity."

https://www.ncbi.nlm.nih.gov/pubmed/19574095

"It appears that elite endurance (aerobic) athletes and mixed-sports (aerobic and anaerobic) athletes survive longer than the general population, as indicated by lower mortality and higher longevity. Lower cardiovascular disease mortality is likely the primary reason for their better survival rates. On the other hand, there are inconsistent results among studies of power (anaerobic) athletes. When elite athletes engaging in various sports are analysed together, their mortality is lower than that of the general population. In conclusion, long-term vigorous exercise training is associated with increased survival rates of specific groups of athletes." [emphasis added]

---

Cheers, Neal

+1 mph Faster

I think the argument is that if you do not have an issue, an anti-depresent will not help your performance. T on the other hand will help pretty much anyone. So no real argument to ban anti-depresents because they are not going to make anyone perform better, unless they have an issue.

Good point with boosting your brain activity....giving the popularity of Alderall et al. particularly in Tech circles.

I do not think improved brain activity can be directly linked to endurance exercise performance....which is mostly limited by cardiovascular system performance. Although there certainly are indirect benefits that are harder to quantify.

But you have to draw the line somewhere, and that is why brain-doping is so far not an issue for endurance sprots such as Triathlon, whereas it should be of center concern for other sports (sports shooting etc.).


for other

If health is the aim, then people could consider castration rather than testosterone supplementation:
https://www.huffingtonpost.com/...s-men_n_1910455.html

...good point. Not sure I would bet my balls on some historic eunuch life expectancy data though. Now the question comes to my mind if eunuchs could adopt a more aero position, that would of course change things. As here on Slowtwitch I have read many times: aero trumps everything ;-)

Pretty obvious that...

1.) Unapproved TRT is cheating.
2.) Extra T does improve training, recovery, and race performance.
3.) The "there's no proof that TRT up to a level lower than another guy's T ever helped anyone beat the other guy" argument is stupid.

On the other hand...

4.) TRT prescribed my a knowlegable doctor doesn't seem to be very dangerous.
5.) There are many people that swear by TRT's capacity to improve quality of life.

The underlying issue here is that triathlon simply doesn't want TRT to become table stakes for successfully competing in triathlon at the age group podium level. TRT is outlawed for that reason alone. Yes, this is a case of the "convenient for triathlon" tail wagging the "overall quality of life" dog, but that's the way it is right now.

TRT gives you a choice with respect to triathlon: get the TUE or don't race.
Hmmm... Maybe triathlons should have a division for juicers?

Well, there's only so much real estate on this planet, so I guess this self-inflicted reduction is not necessarily a bad thing. Nature's a bitch init.

---

29 years and counting

I'm aware of that, but I was using it as an analogy. There are *some* people out there with depressed levels of testosterone due to medical issues, issues that may prevent them from being able to train or perform the water people with normal levels do. It does beg the question of if they deserve to be able to supplement it to get up to normal levels.

That said, I believe the people with true medical issues out there are a tiny fraction of the people who are actually taking testosterone.

I guess my question would be more accurately phrased as: "Is there a true medical condition where it should be allowed?"

In genuine medical circumstances, why not. But if you have a genuine medical need, then you probably shouldn't be racing triathlons.

---

29 years and counting

If your T levels are low due to hard training, I suggest 4-6 weeks of rest will bring your T levels up nicely.

It does beg the question of if they deserve to be able to supplement it to get up to normal levels. //

These don't exist so this argument is pointless..

I'm not totally against the idea of TUEs for things like T. Say some soldier gets his balls blown completely off. And comes back and wants to enter a sprint tri or parking lot crit while on TRT. I'd sign that THE. I'm not going to be butthurt if he beats me. What am I going to say? "Thanks for serving, but sorry, you're upsetting the purity of this 40-45 age category."

But my idea of where to draw the line is about 12 light years from Ralph20's line.

I’d make the ineligible for awards... Yeah that sucks, but you’re taking a supplement with performance enhancing effects.

This is exactly the sort of situation where a TUE for T will be issued. If you lose them, or were somehow never born with them (or they were too underdeveloped or something) then yes you can get a TUE for T. There is no other situation, though, where you can get it.

This guy is local to me, and although I never raced against him since he's in the geezer categories, there's obviously been a lot of discussions on the local message boards about this. Consensus that came out of it was that yes, #1 definitely happened where he had a medical condition that F'ed him up, and for which his doc prescribed some meds that went against USADA. With the combination of the meds and recovering he just didn't race for the first half of the year, and decided to wait long enough for all drugs to clear his system as opposed to dealing with the paperwork to get a TUE (which he may or may not have gotten, no idea how that works). Obviously while he and his doc thought the drugs would have cleared by the time he raced track nats, they obviously didn't. The track wrinkle thing is interesting as he hadn't been a track guy previously, but supposedly started exploring it more this year as it better suited his pack-sprinter(ex-track runner) physiology and aptitudes.

Again, this is what has been going around here, I don't really believe it personally (nothing with this guy personally, just geezer doping skepticism), but thought I'ld share some light. A lot of people here in the race scene who have raced against him regularly just can't see him as the intentional doper type. Who knows....

and if people are really hungry for a 'twitch hunt, I can copy/paste the pages and pages worth of FB comments here. Is there a post size limit on ST?

"OR...
There has been a documented decrease in sperm levels (over 50% in the last 30 years) and a documented decrease in testosterone levels in men over the last 20 years. So chemicals in our environment are interacting with our body in unknown ways. There is also ZERO proof that supplementing testosterone back to age appropriate levels leads to any increase in performance. So the evidence is entirely against your claim that "these guys are doping". In fact, they may be looking to lead a normal life prior to pollution/chemicals wrecking our endocrine system."


Sounds like someone's been drinking good, old-fashioned Kool-Aid.

If you keep stopping by the barber, sooner or later you're gonna get a haircut.

Keep talking to "anti-aging" docs and sooner or later you're gonna start believing that tripe.

Here are his race results: https://www.usacycling.org/...compid=john+schiefer
He raced in every month this year except April (up to his positive test in July). There may be more to this story, but this is not it.