I don't know, ever since I started training to be a MOP age grouper, I haven't gotten morning wood. I think I might qualify for T therapy.

OR

We can go with...it's against the rules of the sport I want to play, therefore I will not use. Screw the morning wood, it wasn't good for anything anyways.

Doctors are prescribing the drug because it is a lucrative practice. People are clinging to low T because they are afraid of aging. I won't go into how they could prevent this by eating better and being in better shape to hang on to the muscle, but it's all built on people wanting to never get old.

John

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Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |

How is this related to whether the drug should be legal or not? I don't see you saying that the doctors are endangering these people.

Totally ignoring the performance argument, the fact that doctors are prescribing a drug in great numbers is no assurance at all that the drug is safe or the regimen is not harmful.

One only needs to look at history for confirmation of that.

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I feel like we are slowly being brainwashed by advertising. All day on sports radio, magazines, its a constant message to get yourself checked out and that its the fountain of youth. Stupid me did get checked out few months back for the hell of it. Yeah it was on low side, who's isnt after 40, but no way was i going to get a shot FOR REST OF MY LIFE, let alone the whole cheating factor if you dont get a TUE which most likeky would not past mustard. Can we a new Masters division for those on T?

Sidebar, i noticed you can get Clenbuterol and steroids Andriol and Deca-something OTC at the airport in Cozumel?

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Do you think hormone replacement therapy for women is bogus? After all menopause is a natural occurrence of aging.

Your assumption that taking Testosterone isn't dangerous is wrong. It has significant impacts to your body, a lot of them, good, but it also shuts off whatever natural production of T you already had. You're stuck supplementing the rest of your life.

I had mine tested, and it was very low for a 30yr old. Right at 300. Doctor would have given me T, but there was no way I'm going down that road. I plan on living a lot longer and I'm going to do it naturally...

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-Andrew

Hmmm, maybe I didn't make my case as well as I could have....what about FDA approval then? This stuff was double blind tested and approved by the FDA. There is no higher standard for safety to my knowledge. I would think that would qualify, at least, as "some assurance".

I'm not saying that you have to like it and use it. I'm not saying it's for everyone. I'm just saying that what you wrote isn't, in my opinion, a good reason to make it illegal. You seemed to be saying "I evaluated the pros and cons and decided against it, personally. Therefore, it should be illegal for everyone."

I think one thing to keep in mind when evaluating if "doctors are endangering ... people," is that no medical intervention is without risk. The key is that a treatment is useful (and indicated) when the benefits outweigh the risks. Extreme example: a diabetic patient with an infection of the bones in the foot is often unable to clear the infection with antibiotics. As long as the infected area persists they are at risk of the infection spreading which could potentially lead to death. Therefore a surgeon can perform an amputation to treat the infection. The risks of an amputation are obviously high, but the potential benefit: preventing sepsis and death, means that in this case it is an indicated and useful intervention. I think the ethically confusing issue related to testosterone is that the benefits of supplementation are often not to treat or prevent disease, but rather to augment performance or quality of life beyond that which is considered normal for a given patient.

Testosterone deficiency syndrome is now becoming a newly accepted medical issue. It's very controversial and I treat men everyday with this issue. I won't get into details about the diagnostic process but there is legitimacy in using testosterone replacement in the appropriate individual.

Prescribing testosterone replacement is not lucrative for physicians. It is for pharma, but not for physicians, not in Canada anyway.

HRT in women is also a very well researched and common practice for the appropriate individual with functionally impairing symptoms in the post-menopausal part of life. It's not fighting against nature, it's more about offering a safe treatment option to someone that is suffering from hot flashes, for example.

I agree with Dumples. Any medication or therapy that is offered, benefits should clearly outweigh risks.

Well, I can agree with both of you, too. However, the issue is, after your doctor decides that the benefits clearly outweigh the risks, should USAT decide that you cannot compete in a triathlon ever again?

I don't believe that to be the case. It's an ethical standpoint.
Athlete A takes performance enhancing drug X.
Athlete B must then do the same to compete.
As must athlete C.
After a while the field is level and the only benefactors of the drug are the doctors and the drug companies.

Introduce Drug Y.
Athlete A takes it.
Athlete B...
...

Introduce Drug Z
...

It is not a desired sporting framework.

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Post: Do you think hormone replacement therapy for women is bogus? After all menopause is a natural occurrence of aging.


Post: Testosterone deficiency syndrome is now becoming a newly accepted medical issue. It's very controversial and I treat men everyday with this issue. I won't get into details about the diagnostic process but there is legitimacy in using testosterone replacement in the appropriate individual.

Prescribing testosterone replacement is not lucrative for physicians. It is for pharma, but not for physicians, not in Canada anyway.

HRT in women is also a very well researched and common practice for the appropriate individual with functionally impairing symptoms in the post-menopausal part of life. It's not fighting against nature, it's more about offering a safe treatment option to someone that is suffering from hot flashes, for example.

Thanks, that was my point. I was posing the question to Devilin because it seems no one questions hormone replacement for women which is also a quality of life issue and poses some risks along with the benefits just like male hormone replacement.

Huh?

In the same way that just about any potential PED has legitimate therapeutic uses, so does testosterone. Hypogonadism is a real problem, and I assure you that someone with true symptoms of hypogonadism who's getting exogenous T isn't going to suddenly show up at a tri and stomp his AG.

The wave of "ask your doctor about condition X" commercials only means that there's a new/better drug available for condition X. Nothing more. Sometimes that means that there's better awareness, conditions get diagnosed more readily, etc., and sometimes it means that doctors will be over-treating.

Not everyone who uses a drug that's on the banned list is cheating. That's what TUEs are designed to cover. I don't think the dialysis patients getting weekly EPO shots are going to hurt your chances at Whateverman this year.

Yes, it is. And there was a clinical study recently showing that for one type of HRT in women, risks hugely outweighed the benefits. HRT dropped significantly.

Am I against HRT in men or women? No, if it is medically necessary. By that I mean abnormally low, posing a health risk. The ads for "Low T" therapy are aimed at people who have 350 on a scale of 300-600 as normal, and think that more T is going to be a life fixer.

And honestly, many of the benefits that the low T ads promise (More energy! Better sex! etc) are also side effects of ...what was that...oh yeah, healthy eating and exercise.

John

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Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |

Well said, the question should be whether WADA should change the TUE rules for testosterone, not whether testosterone should be allowed at all. Bottom line though, you'd still need a TUE.

You also forgot, there is NO performance enhancement gained from taking estrogen. If so, after 15 years on it, if there is some sort of performance enhancement, I sure as shit have not gotten it. I just don't get hot flashes, insomnia, migranes, bloating, bitchiness / general psycho crazy time (oops, okay maybe not) anymore.

FWIW, I would be ON estrogen even if I were not a triathlete, as I started early menopause (at age 30) before I really got into endurance sports.

Susan

Testosterone is legal for use in sports if your levels are low enough that your health is in jeopardy (and there aren't any viable alternative treatments that aren't prohibited) and thus it is a medically necessary and unavoidable treatment. Testosterone is not legal for use in sports if you are a "low normal."

Summary: if your life is in danger and T is your only option you should theoretically be allowed to get a TUE and continue competing. If your T is low enough that your quality of life isn't as good as it could be, but your life isn't in danger, you have options:
1. Continue competing without T.
2. Take T and continue competing (i.e doping).
3. Quit the sport, take T, cease T therapy, rejoin the sport.
4. Quit the sport forever.

In my mind, only two of those are conscionable. Remember, your life isn't in danger, your quality of life is simply suboptimal. Choosing option 2 in this case is pretty clearly unethical because if violates the rules of the sport, and puts your interests above the interests of others in spite of ample dissuasion and naysaying. Option 3 is more of a gray area--the therapeutic use exemption is in place to allow athletes to use drugs in specific circumstances until their values reach the low-normal. The WADA literature specifically prohibits an athlete who is deficient from using a TUE to achieve high-normal levels. There is no excuse in my mind for taking option #2. #3 is a gray area that will probably never be policed.

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It's not illegal. My point is that it's a drug with negative side effects and it's been determined that it's safe only with a doctors supervision. Just like EPO and many other pharmaceuticals.

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-Andrew

FDA approved means nothing on its own. Clinical trials are designed with respect to a target population. In the case of doctors supplementing middle-aged guys with low-T, in the range encountered typically in triathletes, you're not talking about the target population...The large majority of the folks exercising a lot will have total T and free T well outside the inclusion criteria for the clinical trials. Therefore, the argument that it's FDA approved can't be made.

http://www.navarra.es/...297/Bit_v20n4_e1.pdf

PEDs don't have to be dangerous to be illegal for use in sports. The rules are also there to create a level playing field. There are many PEDs which could be taken safely but that doesn't make them legal.

A level playing field is whatever we define it to be. If we include drugs safely administered by our doctor, then that would be part of the level playing field.

Absolutely true. But they didn't do that for testosterone so it's illegal to use unless you get a TUE. You can still drink coffee though.

I'm not an expert in TUEs, but it would seem reasonable that individual circumstances guide who gets an exemption. For instance: if 2 men of the same age, weight, etc both have identical borderline low lab values, but one is a professional triathlete and the other is a recreational or bop "participant;" then it would be my opinion that the pro should not get a TUE while the other guy maybe should. I know some may argue that if he beats even 1 person as a result of his juice then he is performing unethically, but I just find it unnecessary that he should be forced to choose between a potentially indicated treatment and participation in a healthy and fun activity. Whereas the pro or a competitive racer could be expected to have to make this choice, and therefore sacrifice one or the other (testosterone or competition)

Look, I don't know about getting this drug. I'm not "about" to get it either. I was under the impression the many, many people who determine, with their doctor, that the benefits of testosterone therapy outweigh the risks will not be able to receive a TUE. If that is wrong, then I apologize. However, if it is correct, then you are missing my point.

I misunderstood what you meant by "governing bodies." I was still stuck in medicine, when you were talking about USADA. My mistake. It was a long day. :) I agree that either you should have a system in place that's available to provide TUEs that are actually evaluated and not rubber-stamped. If not, then the rules should be different on the amateur level or something. For instance, a physician's prescription could serve as a de facto TUE so that USADA can focus on testing the athletes that they need to focus on, i.e. pros and top AGers. Sure, there'll be some folks whose doctors are overusing testosterone, but I'd rather accept that some people are willing to do anything for 35th place and pay a reasonable USAT/race fee than pay tons of money to bust every middle-aged guy who sees the "anti-aging specialist."

Totally disagree.

This creates a nightmare for enforcement and a slippery slope that leaves everyone worse than before. What do you do with the naturally talented low-T guy that's supplementing his way up the ranks, then shuts down as he gets up near the pro ranks? That fitness isn't exactly going to leave him after he goes off T (if he even can). Disaster ensues.

If you wish to argue that the amateur ranks should be entirely unregulated, then so be it, but that change must happen at the NGO level. TUEs should be very difficult to get (read: targeted for those that *truly* need them). Until those rules are changed, being on a non-permitted drug without a TUE means one should not participate in the sport. There are a thousand other things he/she can do; go enjoy them instead if being on testosterone (or whatever it may be) is so important.

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The question of who is right and who is wrong has seemed to me always too small to be worth a moment's thought, while the question of what is right and what is wrong has seemed all-important.

-Albert J. Nock

I don't have a problem with this outlook actually. I just think it's on the wrong side of history. Drugs are going to get better and safer. They will help us more and harm us less. Prejudice against performance and life enhancement will give way. I am leading the way. =)

The bolded part simply isn't true. The conditions for granting a TUE are based on a biological reason for the deficiency. Functional deficiencies are not granted a TUE under any circumstance.

And the biological reason for the deficiency results in...?

I think you/we are splitting hairs.

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This is from the TUE


USADA is splitting hairs.

+1. it's part of the medicalization of life. and of course testosterone is pro growth (in terms of certain cancers) similar to estrogen.

Interesting discussion. A few additional thoughts:


I agree with previous comments about individuals with true hypogonadism (and subsequent testosterone deficiency syndrome - TDS), even with testosterone replacement they will not have performance enhancing effects in this group.


A question was asked before about whether or not someone on testosterone should be banned from USAT triathlon. VERY interesting question, more importantly...how is testosterone measured by the triathlon governing bodies? Is it truly a 8am total and free testosterone? Near impossible that someone with TDS will have supra-therapeutic levels of testosterone with testosterone replacement therapy.


I disagree with HRT (estrogen) study confirming that it is unsafe. You are likely referring to WHI (Women's health initiative) trial which was largely misinterpreted. Medical community is well aware of this. Certain populations definitely will benefit from HRT safe and effectively.

This is an over simplified and inaccurate statement.

Estrogen may feed certain estrogen-related cancers - endometrial and breast, for example. HRT is contraindicated if someone has breast cancer or undiagnosed vaginal bleeding. Again, risks would outweigh benefits and thus not indicated. In someone with no strong risk factors for breast cancer, and in right age group, HRT is definitely safe. Let's not forget major risk factors for breast cancer - obesity, smoking, family history, personal history, BRCA1/2 mutation. HRT itself doesn't come close to those.

Exactly. In another thread on this I compared the practice to alchemy. It's a practice as old as humanity; except that instead of scruffy dudes mixing potions in shadowy dungeons we now have squeaky clean MDs in lab coats giving injections. But the aim is the same: to outfox aging, and by extension death.

I also think its yet more proof of the baby boomer's entitlement culture; it started with unlimited sex in the 60s and 70s, evolved into unlimited money in the 80s and 90s, and now we have them claiming the right to eternal youth. None of these wishes are new by the way. But all this is Lavender Room.

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Citizen of the world, former drunkard. Resident Traumatic Brain Injury advocate.

Estrogen and testosterone replacement therapy don't improve mortality rates. No evidence to suggest it prolongs life. Only indication is to improve quality of life in appropriate patients that fit certain criteria.

People are often way to accepting of diagnosis, and treatment of the latest "problem".

I would be devestated if I was diagnosed with anything that required me to take a drug for the rest of my life. To hell with any performance gains.

I can buy a and ticket to Vegas or Hawaii anytime I want to enjoy a qualifying race that I wasn't able to qualify for.

I think I agree sort of. From a medical standpoint: if someone with a low T is supplemented they will come up to a "regular" T level. Testing will reveal when they cross that threshold (if they abuse) and because T is a regulated (scheduled) drug it can't be prescribed without clinical indication - in short the person who was "low" who isn't low anymore can't get more T, at least legally. Now, to complicate - as a person supplements with natural or manufactured T, the body will indeed shut down or decrease the amount of natural T, so that if someone supplementing were given a blood test, they would actually appear low, since only naturally produced T shows up in blood testing. A saliva test, on the other hand, will show total accumulated T. BTW - once someone stops supplementing, the body goes back to baseline - there is no residual decreased effect on hormone production. If the person was low before they will be low after, if they were borderline normal before they will return to borderline normal.

For women, there are clear and significant health risks of low estrogen (and progesterone, which is actually a bigger deal). It is indeed a case of weighing potential bad outcomes - for both supplementing and not. I think the medical evidence is moving to the position that natural hormone therapy for women is much safer than synthetic HRT WRT adverse outcomes from therapy.

I would like to hear from providers (FP, IM) who are practicing - what do you think clinical indications are? What are you seeing in your clinical practice?

Of course. But that's not the point. The point is that there are a large number of slightly over-the-hill men, that think that there *must* be some magic potion that will keep their belly from sagging, their face from wrinkling, their biceps from shrinking, and their morning wood from softening. And some of those will think that T is that potion. But this is a philosophical standpoint I hold; I don't claim to know for how many of those T is in fact a legitimate drug. I only know that ever since Ugh the Caveman 52 year old guys with softening morning wood and the fear of death in their minds have been looking for that potion.

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Citizen of the world, former drunkard. Resident Traumatic Brain Injury advocate.

Indications for HRT - hot flashes that are functionally impairing. Topical vaginal estrogen cream for atrophic vaginitis. Natural HRT is not safer than estrogel or Premarin tablets. No evidence to suggest this. I use HRT a lot in my practice and frequently attend gynaecology conferences.

Fair point. I see what you're saying.

You've conveniently ignored my post about testosterone clinical trials and the inclusion/exclusion criteria to be in the trials. Is it because it shoots a big hole in your conjecture?

Nobody says it does, but that's part of the perception. Just look at the commercials, and see what they are promoting. They are promoting a return to a persons youth, showing more energy, more sex drive, etc etc. And there are doctors out there (IIRC there is even one on the board that promotes it) that are more than willing to treat/prescribe for T that is within normal levels, even if on the low side.

As far as the TUE's for testosterone, they are notoriously difficult to get by all accounts. Simply having a level on the low side of normal will not get a TUE. Ask TravisT, evidently he knows a pro with a true biologically low T that can't get a TUE.

John

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Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |

I ignore a lot of posts that seem tangential to the primary purpose of the thread. Near as I can tell, you don't have a point other than to just argue with me. Your argument is analogous to saying that viagra isn't safe for men who DON'T have E.D. because that group was never tested. Yes, we can't double blind test across every possible group attribute, but we do have a lot of knowledge and experience to add onto these studies.

I'll give you a chance... Are you just nit-picking about the gradations of safety claims here or are you arguing that the doctors prescibing for "low T" are unnecessarily endangering their patients? The former doesn't mean much to the thread. The later would be a pretty bold statement, and would put you on the side arguing against the doctors and the "low T" marketing campaign.

First, I thought that it was understood that drugs were illegal, not because they helped us, but because they were dangerous.

I thought it was because these substances have the *potential* for harm, are expensive to administer properly, and are usually illegal to administer without a definite medical reason.

IMO, T is way over prescribed. You know all those drug ads that have a half page of fine printing detailing all the possible adverse side effects? Down the road we'll just pump them up with other drugs to counteract all the crap they took before. The drug companies and too many docs are pushers...

As I was reading this thread, a commercial cme on for Axiron, THE ONLY UNDERAM APPLICATION FOR LOW-T!!!

Pretty length list of possible side-effects at the end of that commercial. As someone who is on blood thinners because of previous DVT's, sounds like I'll never have to make this choice. ;-)

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"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams

From USADA's website:

So how does a substance or method make its way onto the WADA Prohibited List?

Typically, a substance or method will be considered for the WADA Prohibited List if the substance or method meets any two of the following three criteria:

1) It has the potential to enhance or enhances sport performance
2) It represents an actual or potential health risk to the athlete
3) It violates the spirit of sport

Testosterone, especially in the older age groups, clearly gets a little checkmark next to 1 and 3.
I think people get confused by the term "illegal." The conversation is best served by the use of the more precise "banned" or "prohibited."

I think people get confused by the term "illegal." The conversation is best served by the use of the more precise "banned" or "prohibited."

Yes, I agree. I don't talk or write about this much and chose a word that isn't exact enough.


Testosterone, especially in the older age groups, clearly gets a little checkmark next to 1 and 3.

Thanks for finding this info. I guess I am saying that I don't agree on #3. Although, I realize that #3 can have a pretty wide range of interpretation. Also, there seems to be group here saying #2 is still in play.

If we include drugs safely administered by our doctor, then that would be part of the level playing field.

I'd be against that. For one, most health insurance wont pay for blood transfusions or small dosing of EPO, both are likely safe if you dont go overboard. So only the wealthy could compete.

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Styrrell

Has USADA actually commented specifically on testosterone replacement in presumably testosterone deficient men? I'm curious to hear their position (sorry if this was already stated!)

I'm not sure what coimments they would make. WADA makes the rules and USADA enforces them. Right now the rules is you can use T if you get a TUE (a bit simplified).

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Styrrell

Forgive me...what does 'TUE' mean?

Theraputic Use Exemption. It means if you have a disease and a drug is necessary, you can use it. For T it has to be an actual disease. Feeling a little tired or being a little low doesn't count.

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Styrrell

Thanks for clarifying.

I'd be against that. For one, most health insurance wont pay for blood transfusions or small dosing of EPO, both are likely safe if you dont go overboard. So only the wealthy could compete.

Are the poor buying super-bikes and $600 wetsuits, getting coaching, and heading out to Kona? With drugs the person is actually performing better (well, with coaching it's the person performing better, too). That has a certain appeal beyond just a bike being more aero or a wetsuit allowing easier strokes.

Now that I think about it, coaching seems to have many key similarities to drugs. To wit...

1.) Coaching is expensive.
2.) Coaching boosts performance.

If you take a person that doesn't have a coach and doesn't do drugs and want to give them the biggest advantage you would give them a coach first.

When testing for doping with testosterone, I don't think they are looking at total levels (or at least not just that), I think they are looking for synthetic/exogenous testosterone... But I could be wrong!

My argument was an answer to what you said...You argue that T is fine because it's FDA approved. That was one of your points to wonder why not allow it. Therefore I explained to you what it means FDA approved...You ignore it, and now write this...Now that is bloody funny...OK. Believe whatever the hell you want. Many here work in healthcare and have explained a few things to you...but you seem to know better. You'll give me a chance? Let's take that the other way around...you were given all the info to realize that using testosterone outside of the inclusion criteria is dangerous, because it has side effects without benefits (use pubmed instead of making your own theories about what is safe and what isn't).

Ahhh the ST experts...always entertaining.

There...I'll give you a chance...


http://www.ncbi.nlm.nih.gov/pubmed/22430839

By the way, clinical trials are ongoing right now at NIH on T supplementation for males with 'lowish' testosterone, rather than for those it is usually
recommended for. Feel free to go over pubmed and look at the current evidence. Yes...when a doctor recommends testosterone for a male with a value around
250-300ng/dL (usually, ignoring whatever the values of free Ts are), this doctor is taking an unnecessary risk.

So what if the level is more like 150ng/dL? Where do you draw the line of what is unnecessary?

It's almost funny when I watch these commercials. Almost. The other day I saw one for a runny nose, but the side effect was diarrhea. So now I gotta decide if I want a runny nose, or a runny ass.

People will always find an excuse to skirt the rules, having the cake & eating it too. I thought this fountain of youth concept was only in cartoons, but it turns out I'm living in one.

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1. Coaching doesn't have to be expensive. There are plenty of affordable coaches around.
2. Coaching doesn't boost performance. Doing the workouts boosts the performance.

John

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Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |

You draw the line when the risks outweigh the benefits. You draw the line when there is a real medical condition that requires testosterone supplementation.
I never said it was never to be taken. All I'm saying is that if you take it outside of the inclusion criteria, you're creating an unnecessary risk. Funny how people are
quick to bash FDA whenever convenient, and quick to ignore FDA when taking a drug outside of it's recommended usage...sigh...

Happy to revise all my statements when the NIH large cohort study on T-supplementation in middle-aged males comes out and supports that it's safe, in the short
term and the long term. However, given the previous studies, it's reasonable to assume that the answer is going to be negative. And currently, given the guidelines,
and data, it's dangerous when taken outside the recommended usage.

It's not unlike what has happened with antibiotics that were overprescribed and now in many instances, we fail to treat bacterial infections. When many 40yo start
using testosterone with just a punctual low total T, you'll just have to wait 20 years to see a large proportion of males with boobs, heart problems, permanent ED, etc.

The line is already drawn. It's called the normal range. If you are on the low side of normal, or under the normal, then you have to decide for yourself if the health risks are needed/necessary to maintain your quality of life.

If you want to find a doctor to prescribe you testosterone for levels that are on the low side of normal or below the normal, go ahead. Nobody is saying you can't. If you feel the health risks are worth what the T supplementation might give you, great. Go ahead. Just don't expect to compete, or if you do, take your lumps if you get caught. If you truly have a hypogonadal condition where you NEED T supplementation, odds are you know it already.

John

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Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |

While the chances of most side effects being prevalent within the population are damn near impossible, the side effects listed for T are pretty severe....including blood clots in the leg, not to mention the possible effects of non-users through contact with the user.


Some pretty serious stuff.....

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Chicago Cubs - 2016 WORLD SERIES Champions!!!!

"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams

The National Institute of Health questions it..
http://www.nia.nih.gov/...can-we-prevent-aging

"For middle-age and older women, the decision to take hormones is far more complex and difficult than ever before. Questions about MHT remain. Would using a different estrogen and/or progestin or different dose change the risks? Would the results be different if the hormones were given as a patch or cream, rather than a pill? Would taking progestin less often be as effective and safe? Does starting MHT around the time of menopause, compared to years later, change the risks? Can we predict which women will benefit or be harmed by using MHT?"

For testosterone:
"The bottom line: there is no scientific proof that testosterone treatment in healthy men will help them age better. Until more scientifically rigorous studies are conducted, it is not known if the possible benefits of testosterone therapy outweigh any of its potential risks. NIA continues to conduct research to gather more evidence about the effects of testosterone treatment in aging men."

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"It is a good feeling for old men who have begun to fear failure, any sort of failure, to set a schedule for exercise and stick to it. If an aging man can run a distance of three miles, for instance, he knows that whatever his other failures may be, he is not completely wasted away." Romain Gary, SI interview

Fair enough.
Don't get me wrong, I don't have the answer. I just wonder, if levels are truly low, as in well below normal range (as opposed to the low side of normal), does one take it only if it is causing a genuine medical issue, or at a certain point to they take it to get to normal levels in hopes of simply having more energy, better QOL..
And......what is a 'medical issue' caused by low T? If QOL doesn't count, what true medical issues are there?
Totally agree that it is over-prescribed. Just wondering when it is justified...

It's a difficult question to answer, and currently the evidence tells us that for the real medical cases, it makes sense, but that's it. See the link posted by Doug.

And this:

http://www.nia.nih.gov/...-testosterone-report

So, I reiterate: prescribing testosterone for a 50yo with 300ng/dL, or even 150, assuming a healthy male (the causality isn't clearly established) is an unnecessary risk.
Just wait a few years, and we'll see a bunch of lawsuits from males with cancers, heart problems, sex drive at 0, against the doctors who gave them the T, when they
probably asked for it.

1) It has the potential to enhance or enhances sport performance
2) It represents an actual or potential health risk to the athlete
3) It violates the spirit of sport

Testosterone, especially in the older age groups, clearly gets a little checkmark next to 1 and 3.

I'd say 3 is pretty ambiguous, but T definitely gets a check by 1 and 2.

If Kevin Moats is anything to go by then it appears to do the trick so long as it's bakced up with hard work in training, that guy looks simply awesome for his age whether we like it or not. Interestingly this is a very American discussion as I've certainly never seen ads for T suppliments in any other country in the world and it is simply illegal in the region I live. As a European the threads on this over the last few weeks have been quite an eye opener. I'm not saying that there aren't Europeans in the age groups who dope, there may well be but it would be considered very covert doping but in the US seems you can do it legally with the help of a friendly doc....amaing for us! One thing I think that has not been addressed here though is if they can prove that taking T does indeed give you a better standard of life on various factors and can be done safely then what the governing bodies and WADA are doing is essentially stopping people from being the absolute best they can be.

I've had read the arguements in this thread the eating well and training hard is the same as taking T, that is simply not true. Sure it will (and does) keep me healthier and younger in many ways than the vast majority of my peers but from what I understand taking T has a whole different effect as you would expect if you chemically enhance your T levels back to those of a 25 year old. Perhaps one option is simply for races to have 2 divisions for the 40+ catagory, those on T and those not on T. Until then though as mentioned many times previously it is cheating in sanctioned races and we all know that ao if caught then there can be no complaints.

Just wait a few years, and we'll see a bunch of lawsuits from males with cancers, heart problems, sex drive at 0, against the doctors who gave them the T, when they
probably asked for it.

Do doctors pay different insurance rates based on the sorts of treatments they do/don't prescribe?

Who is minding this profession?

Christ... just read that over 20% of the population is on psychiatric drugs. Can that be true?

I am responding to your post for no particular reason, but it seems pertinent here as much as any other post. I just thought I would throw an idea out for discussion. What if USAT gave the 50+ YO athletes on Low T therapy an 'out' and gave them a TUE with a critical condition? You have to compete 2 AGs lower than your actual AG. Of course, this still relies on the athletes coming forward and admitting they are on T, but at least the honest participants would have a way to race under the rules without fear of getting caught and banned.

With the rising popularity of T therapy, this is simply going to come up more and more until USAT finds a way to accomodate it.

Greg

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If you are a Canuck that engages in gratuitous bashing of the US, you are probably on my Iggy List. So, save your self a bunch of typing a response unless you also feel the need to gratuitously bash me. If so, have fun.
"Don't underestimate Joe's ability to f___ things up" - Barack Obama, 2020

I have very little to do with the billing at the clinic, and academic medicine is governed by different rules. Physicians cannot see drug reps directly etc.

That said, a large part of the blame is on the patient, not the physician. We have an incredible amount of people coming just to get drugs. Most of them
are here because of issues related to overweight and obesity. They could address their own issues (high BP, type II diabetes, etc.) by taking responsibility
for their health, but they just want a pill to control hypertension, and a pill to control the side effects of hypertension, etc. etc. The same is true with testosterone.
Very few males (see NIA links) actually need supplementation. ED is in general a blood flow issue...lose the weight...

Many of the doctors end up just giving in.

Most of my work is to develop tools to triggers the appropriate behavioral changes to health care in general (although my focus is on cancer early detection,
and obesity). And it truly is unbelievable to see the level of irrationality when making medical decision making. That's why NIH is currently pushing for funding
research supporting translation research, something that helps informed decision making, shared decision making etc.

Holy cow, do you love to be a douche. Ever since I rubbed your nose in your own shit, you've been dying to get back at me. So now you are fabricating this strident position for me so that you can be all self righteous? How pathetic. Go read the original OP. To quote me, I am saying that "the docs and the governing bodies (like WADA) have got to fight this out". If someone gave me a smug answer from the "low T" side I would have mentioned that WADA sees all this "low T" stuff as a bunch of crap. As it was, I got the smug answer from the the "it's just too dangerous, period" side so I mentioned the doctors and the FDA.

I am not saying that testoterone is safe. I knew that there are studies that show testosterone shortens life span before I even started this thread. I see no reason why testosterone therapy wouldn't shorten the life span of ANY user -- even those with hypogonadism. What I'm pointing out is that doctors -- and the FDA -- are saying that under certain conditions administering testosterone has benefits that outweigh those risks. I don't know what those certain conditions are -- I'm not an ST expert. I'm just seems to me that WADA and the docs aren't in agreement or going in the same direction on this one.

You're the one insulting, and I'm the douche? Interesting perspective...

Yes, it's true. If you really want to be alarmed, take a look at how many of those are under 21 and/or under 18.

John

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I'll address the last bit (the non insulting part...) nonetheless.

Actually, yes, to a large extent WADA and FDA and NIA agree. To be granted a TUE for testosterone by WADA pretty much means that you fall within the strict guidelines to go ahead with testosterone supplementation therapy, meaning very low testosterone levels (total and free). Off the top of my head, I can't remember what the values were. Consistently low. Hypogonadism. And a bunch of other symptoms associated with low T. They also come with exclusion criteria (prostate cancer, heart condition, etc.)
These are essentially the recommendations made by the various federal medical bodies to justify T-supp. They happen to coincide very nicely with WADA.

USAT doesn't have to accommodate anything. It is already provided for in the USADA TUE process. All of these 50+ athletes on "low T" therapy are on it for vanity, not because it's medically necessary for quality of life. Just because it's popular among a group of people afraid of growing old doesn't mean that it needs to be accommodated for in a voluntary activity.

John

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It's not really surprising. http://www.ncbi.nlm.nih.gov/pubmed/20194822

34% Americans are obese. 70% are overweight. So the increase in psychotropic drugs is not surprising.

In this whole mess, the crazy thing is that many of these issues can be addressed without drugs...
Eat healthy and move. Do it consistently.

In this whole mess, the crazy thing is that many of these issues can be addressed without drugs...
Eat healthy and move. Do it consistently.

Of course. So why is our system pushing drugs so hard?

And I don't blame the patients so much... they are bombarded and brainwashed by advertising 24/7, and taking a pill is the "easy" way out. Eating healthy and moving their bodies would require that they actually *change* something. "Indulge in all your f'ed up habits and addictions... and here is another pill you can be addicted to that makes it all ok".

I don't cut any of the doctors an ounce of slack on this one. I'm not talking about the smarmy ones who don't give a shit, but the ones who supposedly have some ethics. Why the hell does a doctor need to "cave" to a patient's desire for something they don't need and will likely do them harm?

Additional testosterone will also increase your chances of getting prostate cancer. It is dangerous. Good decision!

I do think a lot of these issues could be solved with what I've proposed in numerous other threads regarding doping.

Two separate racing classes:

Competitive division, eligible for awards, qualifying for championships, etc. They are the only athletes that can be drug tested in or out of competition.

Recreational division, that gets timed and ranked in a completely separate scoring sheet. This division includes those not only that may be taking T therapy but a majority of participants that are there to just that, participate in a fun, healthy event, with the benefits of a safe, supported course. This division is not some no holds barred, body building freak show but rather represents about 80%+ of people doing triathlons. This group will not be drug tested. Not because they are doing something explicitly against the doping rules but aren't serious enough about their hobby to worry about testing positive for something that MAY be in a supplement, don't want to do the research and don't want to risk the ramifications of a failed drug test.

By reducing the testing pool it could cut down on the costs associated with testing too.

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Formerly DrD

You need to go to a medical practice one day to have a bit more perspective.
You're free to blame who you want, but to a large extent, the patients are responsible.

In the case of testosterone, it's both the patient and the physician. The patient for insisting, and
the physician for caving in. However, it's a very small portion of the issues in healthcare. In this
case, yes, they are both responsible.

In the case of obesity, diabetes etc. the doctors cave in because they see that the patients don't
take responsibility, don't go on a diet, don't exercise. So, what should they do? Let the patients die?
No...they give drugs. In most practices, a FP will have about 12min with a patient, sometimes less.
Have you tried to convinced an obese person to lose weight in just 12min?

But many of the patients are to blame for not respecting their health. It's very naive to believe that
it's the system pushing things onto patients. It's human nature to find a short cut.

That will never work, separating folks into different groups. Look what happens when the swim is rough and they give everyone a chance to opt out, almost everyone except for a very few opt to do the swim, even though they really do not want to. They do this because they want to be in the real race no matter what, even scared shitless. Folks just want to be in it all together, and giving some division that would set them apart, or put them in the fun run division, is just not going to happen. I can see the water cooler discussions now, did you do the real triathlon yesterday, or the fun tri? Kind of the same thing that goes no now, did you do an ironman, or just a sprint triathlon?? People now have done an ironman by doing a 1/2, and now it even includes some olympic distance races too put on by ironman. They want bragging rights afterwards and your fun run will be less than 5%..

As someone who would definitely qualify for HRT (and if you're really interested, we've had a recent thread in the Womyns about it) I don't think it is bogus at all but I do think that US culture is more reliant on quick fixes for natural issues. I, personally, am more of a "let nature take its course" kind of person but when I read about all the lack of symptoms the HRT taking women have (and this has VERY LITTLE to do with triathlon, just QOL) I'm sorely tempted. If I were certain there were no risks, I'd most likely go for it though. The brain death, the confusion, the bone-deep fatigue, the hot flashes, the awful insomnia, are just some of the perks. The difference between T supplementation and HRT, however, is, IMO apples to oranges. There are no direct performance benefits (IMO) from HRT and certainly nothing that can be compared to the performance enhancement of T. I imagine that to get to the point of performance enhancement with HRT you'd have to be doing T and maybe estrogen to a very dangerous (cancerous) level.

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"USAT doesn't have to accommodate anything. It is already provided for in the USADA TUE process. All of these 50+ athletes on "low T" therapy are on it for vanity, not because it's medically necessary for quality of life. Just because it's popular among a group of people afraid of growing old doesn't mean that it needs to be accommodated for in a voluntary activity."

John, I agree with everything you said. I also do not advocate T therapy, and I am 55, the target group for these products. However, the USAT TUE does not allow people on T for quality of life reasons to compete at all. They can't get a TUE as already mentioned in several posts. That's a good thing since I wouldn't want to compete with them. However, this issue is going to grow into a big problem for USAT. They don't have the funds to pay for adequate testing. I was just proposing a method for people on T to compete under some sort of handicap, like pushing them down two AGs. It wouldn't bother me to compete with a guy that was 65 and on T.

Greg

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If you are a Canuck that engages in gratuitous bashing of the US, you are probably on my Iggy List. So, save your self a bunch of typing a response unless you also feel the need to gratuitously bash me. If so, have fun.
"Don't underestimate Joe's ability to f___ things up" - Barack Obama, 2020

Usually the test for Testosterone is a 2 stage test. The first test they do is a E/T Ratio test. If the E/T ratio is out of line with norms they then progress to the Carbon Isotope test which determines if they have synthetic testosterone in their system. Many athletes have discovered that you can administer low dosages of T without upsetting the E/T ratio. Really the E/T Ratio test should be abandoned for the Carbon Isotope test.

Testosterone also goes out of your system pretty quickly while the effects are pretty long lasting. You can aggressively use T up until about 2 weeks before your test and still pass the E/T and possibly pass the Carbon Isotope test. The performance increases last for much longer than that.


Really all PED testing is a mess. WADA allows 2 missed random tests in 18 months, so athletes will misreport where they are training and dope until they have 2 missed tests and then go clean for the balance of the 18 months. That's why you see athletes do things like lock themselves in their safe room when the testers show up. Also there are some drugs that you don't reach peak performance until you've been off of the drugs for a few weeks. How nice is that? You're clean and you're peaking at the same time.

It's human nature to find a short cut.

That is only a small part of human nature that is constantly being reinforced via advertising. Instead, we could reinforce more intelligent behaviors... but where would the profit be in that?

It's "human nature" for the drug companies to get as many people hooked on their product as possible. It used to be illegal to advertise this stuff. I'm so glad I ditched the TV 25 years ago... when I accidentally see/hear the sort of crap that most people are exposed to for hours every day, it nearly makes my head explode. It doesn't surprise me that the majority in our society are insane.

For sure and that's why this issue bothers me, as a 44 year old, so much. It's going to be next to impossible to police for USAT considering how rampant and wide spread this issue is amongst companies like WRC target demographic. The only hope I see is to not even try and do random testing but instead tests a larger sample of those that qualify and accept Kona slots. Then perhaps that race has a fighting chance to be contested within the confines of the established rules.

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The immense majority of doctors have nothing to do with the advertising...you've got the wrong target there.

I'm not so sure. Lots of bike riders do centuries and other events. Some of them are competitive but they just don't want to both with the rules that USCF racing has.

You see this a lot at tris. Many people want to do the event but they clearly aren't racing and would really rather use a wetsuit, ride together and walk together, rather than race. Instead of BLG two divisions I propose that the competitive divion be AG ranked and the tourist division be timed but thats it, no awards (other than for finishing) and they should be listed randonneur style ie in alphabetical order.

Maybe only 2% of the field would enter but maybe not. I'd like to see a RD try it.

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Styrrell

I definitely see your point Monty but that may change if more thorough testing is eventually put into place. Get more than a few MOP/BOP Agers inadvertantly testing positive and it may be more plausible.

I'm in no way condoning illegal doping. I just feel most people do events because it's a fun, healthy hobby, not because they want to go to Kona.

I'm 100% for ag testing at the pointy end.

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Formerly DrD

Agreed. Testing all athletes who accept Kona slots will go a long way in resolving the problems in amatuer ironman racing.

I'm not so sure. Lots of bike riders do centuries and other events. Some of them are competitive but they just don't want to both with the rules that USCF racing has. //

But your example is not really the same, in a century everyone does the same ride under the same rules. Everyone gets the same bragging rights after it is over, whatever they are.

A better example would be a USCF age group bike race where you had a separate category for dopers and fun riders. You can call it whatever you like, but that is what it would be. Now how many want to do that race? I think the century rides and gran fondos are perfect for those groups(except Uli's of course). I think the triathlons we are speaking of(big races with pro purses and AG awards), are closer to what i described.

  I'm not writing from a PED perspective or anti-aging perspective but I do think there are some similarities between HRT for women and men. Some women have pronounced effects from menopause and HRT could be miraculous in changing how they feel and worth the risk. i.e. ( If this is how I'm going to feel the rest of my life I hope I don't live long kind of symptoms ) . I think likewise some men ( probably a small number ) may feel tired, depressed for no reason, unmotivated ect. and in the course of medical investigation if no other explanations surface and they have hormone levels that put them in the low range it should be a medical option. It will be evident in short order ( minimal investigatory risk ) if this is an effective treatment and if not discontinue. If pronounced turn around then measure your quality of life pretreatment and make the determination if it's worth the risk long term.
Now as to the Tri component what probably rubs people the wrong way and is true for a majority of aging Triathletes is they are experiencing a loss of performance, recovery, drive, motivation ect. just do to "normal" aging. There is a lot of fudge room because the Testosterone range is broad. The 5th to the 95th percentile is in the 300 to 900 ng/ml range. There is a lot of grey area and it's not unreasonable to say ok if taking testosterone is dramatically improving the quality of your life then not competing USAT races shouldn't be to big of a price to pay because if your low T was impacting your life that dramatically to start with you wouldn't be racing anyway.


Post:

NormM wrote:

As someone who would definitely qualify for HRT (and if you're really interested, we've had a recent thread in the Womyns about it) I don't think it is bogus at all but I do think that US culture is more reliant on quick fixes for natural issues. I, personally, am more of a "let nature take its course" kind of person but when I read about all the lack of symptoms the HRT taking women have (and this has VERY LITTLE to do with triathlon, just QOL) I'm sorely tempted. If I were certain there were no risks, I'd most likely go for it though. The brain death, the confusion, the bone-deep fatigue, the hot flashes, the awful insomnia, are just some of the perks. The difference between T supplementation and HRT, however, is, IMO apples to oranges. There are no direct performance benefits (IMO) from HRT and certainly nothing that can be compared to the performance enhancement of T. I imagine that to get to the point of performance enhancement with HRT you'd have to be doing T and maybe estrogen to a very dangerous (cancerous) level.

I think I like the idea of having T users race 2 AG's down, but you're right, it requires the competitor to fess up. Some would openly acknowledge their use, some would keep quiet until the unlikely event they get tested, and some would actively use and try to avoid detection.

Unfortunately, the issue isn't as straight forward as doping in the conventional sense where the only intent is to gain an unfair advantage. There are 3 groups of users; medical necessity, age defiers, and dopers (by that I mean the guys whose purpose is sport focused, not QOL). Then there is AG performance; FOP, MOP, BOP. Then there is level of competitive drive; hypercompetitive, enthusiast, participant. Do we really want to prohibit or discourage a T using, BOP, participant from being able to come out and play? Then again, there are doping, MOP, hypercompetitive types. You can't make an effective rule giving an out for intent.

Really, I'm ok with the way the rules are now, even though there are gaping holes in enforcement. I'm a little bothered by the idea that I may place lower than I should because someone uses (or drafts, etc), and I would definitely be bothered a lot if I were in Joe Bonness's position. As you say, it's going to come up more given the increasing use, but I'm not sure there's a satisfactory way to accomodate the can of worms.

Still blows me away that the FDA will allow your standard FP doctor to prescribe a drug that will greatly enhance a patient's risk for cancer and heart issues. Why doesn't he just prescribe smoking, sounds like the same long term effects.

Your standard FP has usually done 4 years in college, 4 years in med school, 3 years of residency, and often times, a fellowship. A family practitioner, is more often than not, a very well trained professional. Also, they tend to be far more cautious than say an endocrinologist (who are typically who you will see if you want little magic T pills). And if a patient wants T supplements, they will most of the time refer them to a specialist.

And it doesn't 'greatly' enhance risks of cancers and heart issues. It does to some extent. I'm strongly opposed to using T when not necessary, but no need to make it sound even worse than it already is.

I don't think that we should make any concessions for people that take performance enhancing drugs for vanity reasons. If you medically, legitimately need T therapy, go get a TUE. If you really want to take T because you don't like being old, that's fine by me. Just be man enough to accept that you can't compete. Or, if you choose to compete (And lets be honest, the vast majority of the low T takers are never going to be at a level where it matters), accept the fact that you may get tested/banned. All of these "fixes" just create logistical nightmares in a system that is already built to accommodate it as it should be.

John

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clarified thanks.

Exactly. I have said it before on here, I'm not advocating for mass testing. I think it would be unwieldy, intrusive for the vast majority, expensive, etc.

But, among the KQ, the perennial All American, top amateurs, etc., I am all for them being in the random testing pool. I'm not going to pry, but you have been a Zoot sponsored athlete for a while now, I would be willing to wager that you get a significant chunk of change in the form of shoes, gear, travel, etc. each year. While not enough to live on, it's certainly a level of reward that a lot of people would only be too willing to dope for.

John

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I am a 58 year old competitive cyclist. I suffer from age-related low T (<200 ng/DL). I have been treated for this condition by my primary physician since my 50-year old annual physical. He said that whether I was an athlete or not, there are all sorts of reasons that men want their T in a normal range. When treated my T returns to the normal range and usually settles at 280 which is still low but in range. Other than the T and some vitamins, I take no other drugs or supplements.

With that said, I stopped my T prescription from December 2009 - October 2011. At that time, I had decided to make a cycling comeback and try to win the National Championships. When I left the sport in 1984, there was no drug testing. I had been away from the sport since then and had no idea that drug testing was now part of day-to-day competition nor that it applied to old guys like me. So, it took me awhile but I eventually learned that I was going to be drug tested. I then started determining if anything I was taking - vitamins, prescriptions, over the counter - was illegal. I soon found out that T was a banned substance in- and out- of competition.

I met with my doctor and he explained that it would not be wise for my long-term health to stop my T supplementation. With his urging, I did some research, found USADA and contacted them. They explained I could apply for a Therapeutic Exemption of Use and sent me the paperwork which I took to my doctor. He reviewed it and told me that to comply with their testing requirements (complex endricrinology testing and consultation with high-end endicrinologists) I would have to spend about $20k (his estimate) out of pocket because my insurance would never cover these tests.

I contacted USADA and while sympathetic, they had no alternative. They said there was no provision written in the regs for aged athletes; we meet the same standard as a 20-year old who needs T supplementation. A 20-year old that needs T definitely has some sort of medical condition. A 58-year old that needs T is probably just an aging man. I thanked them, stopped my T and competed. When done, I started back up on my T under my doctor's supervision and urging.

Conclusion: masters men just have to live with this reality. We are not a big enough nor important enough for USADA to expend the energy and resources to update the regs to better match with medical realities. I commend USADA for what they have done to clean up sport and I absolutely think athletes should compete clean. So, I just let them do their thing (which they do well and for a great purpose) and if I want to compete, I have to comply with their regulations. Simple as that.

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bill
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So, you can still compete without testosterone supplementation? Do you have any symptoms aside from a low total T? Was there a free T test done also?

You are an honorable man Bill, I congratulate you on your decisions. I'm only a year behind you and would like to think i would make the same decisions you have in your shoes. Thankfully I do not have low T, but I do have issues with my growth hormones. Mostly it is just getting old and i'm learning how to deal with those realities. But if i had to go to the drug back for my health, i'm pretty sure i would also relegate myself to fun runs and participatory sports. I just wish that the others in our AG taking the drugs and competing at very high levels, would find the courage that you have and step out of the way of us racing naturally, so that we might know for real what old guys can really do..

Yes, I competed during that time without T supplementation. Even won the Nationals. No, no other symptoms other than low T - pretty healthy albeit old. Yep, did a free T test but at this moment, don't remember the results.

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life's short. ride hard.
bill
mobile: 404-242-5966
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So...why did your doctor recommend T? Kind of makes a point against it...as I've said several times already.

T in the normal range is part of the healthy male. There are numerous peer-reviewed medical studies documenting the longer-term effects on men with chronic low-T. T supplementation is not just for good athletic performance; rather it is a base from which to build the intricate male hormonal structure and balance. But, as with any treatment protocol, there are surely those who do not support T supplementation. I did not begin a T regimen blindly and did my own research and got a 2nd opinion. But I was comfortable enough with the other doctor's thoughts and the literature to agree with my primary care doctor's thought process and original recommendation.

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life's short. ride hard.
bill
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These peer-reviewed studies are done based on the current FDA inclusion and exclusion criteria for testosterone supplementation, and a 50+ yo male with a total T level
in the 200 range does not fit these. The large cohort studies done on supplementation for folks that are otherwise healthy are...currently done by NIA, and the data aren't
published yet.

Anyhow the bottom line is that people can rationalize whatever they want if they really want to do it.

I may have flipped too quickly through this thread but did not find any specific reference to the FDA study you just mentioned in your reply. So, I do not know what range the FDA would consider normal but I am pretty sure most studies and labs would agree that Normal is 250-1100 ng/dL for Total T. Again, I am not a doctor or researcher and might only know enough about this to sound like I know something at a cocktail party. Just sharing form my own experiences for what it may be worth.

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bill
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John,
I am not proposing a concession, I am proposing a predetermined PENALTY of two AGs for anyone on T therapy. If someone wants the quality of life they had when they were younger and is willing to take T to get it, then let them compete with those that are...well...younger. I don't think it's a logistical nightmare. Could just be a simple form.

Last, I completely understand the hard line approach and telling the T therapy patients they can't compete. I am a rule follower, big time. However, right now, these people are forced to keep their mouth shut and compete in their AGs because getting a TUE is either way too expensive or unobtainable in their circumstances. The T patients are going to be showing up at triathlons all over the country in increasing numbers whether you and I like it or not. If a provision like this is in place, it makes it much easier to ban them if they are caught competing in their own AG. However, as mentioned earlier, many will not raise their hand and admit they are on T therapy. Most would probably not want to publicly admit they were doing it simply out of embarrassment.

Greg

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If you are a Canuck that engages in gratuitous bashing of the US, you are probably on my Iggy List. So, save your self a bunch of typing a response unless you also feel the need to gratuitously bash me. If so, have fun.
"Don't underestimate Joe's ability to f___ things up" - Barack Obama, 2020

"First, I thought that it was understood that drugs were illegal, not because they helped us, but because they were dangerous. I don't understand making something illegal just because it makes you better. "

To believe that government actors make illegal certain things for your betterment is a dangerous way to live. First, it puts faith in narcissists whose only goal is the betterment of their own egos and wallets. Now, there's nothing wrong with being selfish and wanting to advance one's self. You and I do that every day. But to trust those people as if their lawmaking has your personal safety in mind is hazardous for your self. This is 101 stuff that should be learned upon becoming an adult.

As for testosterone, why is it dangerous? Why do you call it a drug? And why are drugs dangerous? This is stuff that sounds to have been fed to you, and you've accepted it without question. If testosterone is dangerous, why is it more dangerous than the ozone you breathe every day? The sunlight at 12 noon in July? Ibuprofen? Cap'n Crunch cereal? Many older men have low testosterone, and supplementation has increased their happiness and zest for life with no medical detriment. I have older family members who have been reborn following testosterone supplementation. As soon as I'm in my 40's, 50's, or 60's, and my levels are low, I'll get the prescription. If that bans me from Ironman, so be it. I'll have had many years of legitimate competition under my belt and I can retire at ease.

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Speed Concept 9 (race)
Madone 5 (training)
Trek 1000 (rain/snow/sleet/monsoon)

Testosterone replacement is NOT doping. Testosterone is given in doses of 20-60 mg compared to the thousands used by doping. It is used to correct low levels NOT get supra physiologic levels. It has been shown o decrease heart disease, depression, and muscle loss over time. I am a very natural doctor, using diet whenever possible. That being said if I have someone with low physiologic T levels AND symptoms I would not hesitate to treat. If they compete in sports I may be slightly leveling the playing field for them but, in no way, am I giving them an unfair advantage.

Testosterone replacement is NOT doping. Testosterone is given in doses of 20-60 mg compared to the thousands used by doping. It is used to correct low levels NOT get supra physiologic levels. It has been shown o decrease heart disease, depression, and muscle loss over time. I am a very natural doctor, using diet whenever possible. That being said if I have someone with low physiologic T levels AND symptoms I would not hesitate to treat. If they compete in sports I may be slightly leveling the playing field for them but, in no way, am I giving them an unfair advantage.

Nice speech. Your patients to whom you prescribe the T treatments and who compete will be cheating. PERIOD!

I'm confused, is taking any synthetic T illegal, or is it having above a certian level of T?

The Outside magazine article a few years ago brought this up as well, but that guy didn't have to take a lifetime of shots or pills, he just had cream. So I don't understand the "in it for life" argument.

that is just stunning. I guess. I suppose I shouldn't be surprised.

People look for answers in eliminating doping from pro cycling. They need to look no further than crap like this to understand that it will never go away as long as there is underlying thinking like this among people in general. In essence ... this is what Lance said to Oprah -- leveling the playing field but not giving an unfair advantage.

So ... maybe the 50% dopers in AG triathlon mentioned recently is not an exaggeration.

How on earth is a testosterone level of 300-400 doping. I treat people with weight gain, impotence, depression, and incredibly low testosterone level for their age. I check levels to make sure they never get above PHYSIOLOGIC range. Lance and others were going for super human ranges. Physiologic dosing is just that: NORMAL levels.

are you a doctor? are you on T as well? What else are you on? Interested in your stats... name, age, etc. I see you're going to IMTX... any hopes of a KQ?

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I am a doctor. Not ever going to qualify and not really concerned about it. Not on T. I am a surgeon but specialize in weight loss surgery and nutrition. If I was T deficient and had any chance of qualifying I would notify WTC with lab values and doctors notification of treatment. You should not be the least bit threatened by an athlete who has the same T value as you. There is ZERO advantage to small doses of testosterone to return someone to a normal expected level.

Theories abound as to why some people are low in T. One theory is that years of meat and dairy consumption loaded with steroids suppress natural testosterone release. In fact vegans, which I am, tend to have higher levels. Of course, there are many meat eaters with normal T levels.

In our sport there is a suspicion that high stress levels from long hours of exercise creates high cortisol which interferes with T production and/or metabolism.

Regardless, low T is a problem. Is it doping if an athlete with asthma takes asthma meds? Is it doping if someone gets cortisol injections into a sore shoulder? Same thing here. If you have low T you should be allowed to return to normal. This in no way compares to someone trying to cheat and get supra physiologic levels.

Doc, I am racing in the 55-59 age group. I am sure my testosterone levels are less than 10 years ago and probably a lot less than 30 years ago. I have not had it checked because I feel my T levels and most other levels decrease with age. I am competing with guys who also have lost some hormone level.
If you "pep" them up to levels above mine, how is that fair?
I am not sure you are doing that, but that is the tone I am getting????

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Well the obvious answer is that it's doping because the rules say that it is doping.

But aside from the rules, this sort of argument necessarily must raise the question of what is normal, who decides it, and why should we take the position that every athlete is allowed to manipulate themselves into what has been defined as a normal range?

If the population of Cat 1 racers in the US has an average Hct of 47 and mine is 39, does that mean I should be able to do 'physiologic dosing' (your words) of EPO to raise mine to what is 'normal' for that population? I'm 50+ now, so shouldn't I be able to raise mine to be on a level field with the younger guys?

yes, you'll come back and make the argument that you're treating abnormally low levels, blah blah blah. But the overall question remains, and there is no answer that satisfactorily justifies the doping.

You should not be the least bit threatened by an athlete who has the same T value as you.

An athlete who has their T value *boosted* to the same level...

Why don't we just say that a T value at the 90%ile level is ok for anyone to boost to? We only have an issue if someone is above that and boosted to get there. Seem fair?

Well... I don't think it's fair. I naturally already have a >90%ile T level... but my HCT is below average, and so is my VO2max, and for some reason I have more trouble recovering than the average person, and I could stand to lose 10 lbs. Should I be able to take drugs to fix all these "deficiencies"? If someone else can take T, why can't I take whatever I "need"?

Actually it is legal to take testosterone for low levels provided that governing bodies are forewarned with medical evidence and thereby exempted. Low testosterone levels has been labeled a disease process. Low levels have been associated with a symptom complex, and those often debilitating, and sometimes deadly (heart disease) effects actually gets better with treatment.

A hematocrit of 39 or 40 is not associated with a disease process and would not qualify for treatment by a physician. The only reason to take epo would be for athletic superiority and that is cheating.

people who suffer from low T levels and want/need to take them to ameliorate symptoms should not be ban from sports.

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But then why are inhalers and cortisone injections allowed?

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I'm not clear if you're having a problem with what I said or with what was said by the poster I quoted.

As was said by others after me (and probably before, as well ... I haven't read everything in the thread), who's to say what's normal when you're talking about aging athletes? The way I see it, normal is what you have at any given moment without any boosting. That's your normal. Deal with it.

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I agree but sadly it seems this whole "doping" madnees is starting to get out of hand.It would be a tragedy if people now have to choose between treatment for a condition and the ability to participate in a recreational sport (notice I did say "participate" and not race)

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So asthmatics should just deal with it then as well and people with joint injuries should not be able to have cortisone shots to enhance their abilities at that time?

There are too many condtradictions..

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agreeing with you.

I have read a lot about this as well.

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https://www.strava.com/...tes/zachary_mckinney

no one says you can't participate in anything you want. But if you are racing under a federation with doping rules, then you are expected to follow them or don't race.

As has been said over and over and over ... if you want to get a prescription for "low T" then fine, get the TUE from the federation. But good luck to you in getting that.

The bigger question that still goes unanswered by the "anti-aging" folks (who also to fail to acknowledge the conflict of interest that they make their livelihood off this) ... is who is to answer the question of what is normal, and why should we even take the position that everyone is allowed to manipulate themselves into a normal range ... in the context of competition?

Your attitude is sickening and ignorant. Good luck with anyone having a non-zero testosterone level getting a TUE. Aging is not a disease process.

I don't care is someone has no naturally occurring testosterone: if he takes exogenous testosterone, he shouldn't be allowed to compete. Period. Participate without competing, maybe, but not eligible for any results/prizes/accolades.

I'm 54, and I would like to think that the guys I compete against are playing the cards they were dealt.

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"Go yell at an M&M"

I'm 54, and I would like to think that the guys I compete against are playing the cards they were dealt.
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Ken L. /


You would like to think that, but like i have been saying for about 10 years now, you guys have no idea how many AG'ers are doping. And this doc here is a prime example of how it all gets justified, in their minds and their docs. He has no clue what we are talking about here, to him fair play is not about the natural process in humans. He is right in that if people would be helped by drugs to live a better life, they should take them if they choose. But he is dead wrong that they should be allowed to compete in sport. They can participate all they want, but competition should be a sacred arena where normally aged humans compete for top honors. He uses the old and tired slippery slope argument too, what about asthma and some other ailments that are routinely medicated without any problems? It's easy, we make up rules to govern the sport and competitors and follow them. If in the future sometime T is determined to be in that category, then fine. But it is not as of yet, unless you are "REALLY" low. He mentioned that you can get a TUE, but neglects to say how hard it is, he probably does not even know himself. Just prescribes it to his patients, tells them it is like taking asthma medication(It is not) and they go about their merry way to races to thinking everything is hunky dory.


It was bad 10 years ago here in LA, i knew of docs doing what this guy is doing for just about everyone that walked through the door, I can only imagine how much worse it has gotten since then. And it is really hard to blame most of the athletes when there are docs like this guy justifying it to them that it is ok, when it clearly is not..

What if they were dealt a bad knee? Or dealt asthma? What if they have surgery to relieve a bulging disc that then makes them run faster? You are also completely wrong that you need a level of zero to get a TUE.

Let me also tell you that testosterone, ESPECIALLY at the doses prescribed, would make absolutely no difference to performance. People that dope take MUCH higher doses. In the thousands of mg compared to the 30-60 mg commonly used with low levels. My patients that take T do not become Lance Armstrong. They don't go from BOP to FOP. To be worried about the guy next to you taking a small physiologic dose of testosterone is completely ignorant. Worry about your own performance and not the unfortunate disease that may affect others.

It was bad 10 years ago here in LA, i knew of docs doing what this guy is doing for just about everyone that walked through the door, I can only imagine how much worse it has gotten since then. And it is really hard to blame most of the athletes when there are docs like this guy justifying it to them that it is ok, when it clearly is not..

Not to mention all the ads for Androgel and all those kinds of products that make it sound like if you're a little tired or maybe you didn't get a boner this morning when you woke up then you may have a "treatable condition" called "low T." Uh ... how 'bout you might just bet getting older! DEAL WITH IT! ON YOUR OWN! WITHOUT A PRESCRIPTION AND WITHOUT SOME "DOC" WHO'S JUST OUT TO LINE HIS POCKETS WITH A KICKBACK FROM THE PHARMA COMPANY.

You are probably right. I'm sure the 40+ crowd only uses it for the right reasons.

The strangest thing is your belief that we in any way get kick back for treating people with meds. It is so unbelievably illegal to take any kick back in any form. I can't even get a pen from a pharmacy company. I get nothing for prescribing a med. Furthermore, people don't come to me for low testosterone. They come to me because they are sick. There are multitude of reasons, the main being diet. My treatment consists of diet intervention, exercise programs, vitamin supplementation, treatment for high cholesterol and hypertension and diabetes. If they have an abnormally low testosterone and lack of libido, impotence, high waist to hip ratio, high lipids, and/or depression I give them testosterone to bring them to normal levels BECAUSE SCIENCE SHOWS THIS IS EFFICACIOUS. My job is to make people healthy and fixing low testosterone levels is part of that process.

Except many are ALREADY not playing the cards they were dealt and doing so legally. The asthmatics, the joint folks, the low vitamin D folks, the depressed folks, the heart diseased folks, the diabetic folks. All these folks are allowed to change their "dealt cards" and improve their abilities - albeit, the improvement is simply a leveling of the playing field, and in the case of diabetics, they are constantly just trying to reach that level playing field - they're almost always still disadvantaged. You've got a doctor here saying that bringing someone to a heart-healthy situation without increasing his T over the norm (and honestly just barely TO the norm) will not give him superhuman abilities but *you* (in general) seem Stuck on the illegality of T regardless of the logic. I recently got tested and I'm at 0 T. Zippo. My quality of life has sucked for a while now but I'm trying to figure a way out if it without hormone supplementation. HOWEVER, I wouldn't think twice about HRT if that became the choice I had to make because triathlon is just a SPORT, a HOBBY and FUN and my quality of life is so much more than that.

It seems you guys just cannot reason at all and are stuck at the "illegal" and can't see the forest you're in. Can you explain to me how, when 200 ng/mL is the low end of normal, supplementing with T to reach the absolute bottom of normal is giving someone an advantage over someone else in the normal range of T? The logic simply Does Not Follow. Unless the only logic you can follow is "it's illegal".

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It seems you guys just cannot reason at all and are stuck at the "illegal" and can't see the forest you're in.

You ran down a lengthy list of medical conditions that are not necessarily a natural part of the aging process whereas declining T levels are a natural part of the aging process. Most of the things you mentioned are things a few people here and there are dealt, not things that are dealt to every male on the planet.

But hey ... thanks for playing.

This guy gets tired when training 30 hours a week? Not natural. He defnitely should take some drugs so he can easily put in thoae hours like all the rest of us!

Most doctors I know are very concerned with the negative side effects of testoserone and avoid prescribing it specifically because the they feel the risks usually outweigh the rewards. They say the people most often asking for it have poor health because they have not taken care of themselves and are looking for a fix that requires no work.

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Ed O'Malley
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Founder of VeloVetta Cycling Shoes
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Asthmatics take medicine so they don't die while exercising. "Joint folks" get treatment to allow them to participate at all. All those examples you cite take treatment to allow them to participate. T supplementation allows guys to compete *at a higher level*. Do you see the difference? There is a reason by inhaled asthma medication is allowed, but T supplementation is not.

You don't know what "the norm" is for any given individual, nor does anyone else. There are ranges of "normal." You don't know what the minimum is for a given individual or age group. Following your logic, people should be allowed to supplement with EPO to bring their hematocrit up to "the norm."

I'm not stuck on the "illegal:" I'm stuck on the "unfair."

I don't take supplements, vitamins, or anything other than "food" (excepting my infinIT mix in races). No medicines, no chemicals, no drugs. I sweat like a pig, thereby restricting my ability to do longer distance races. Perhaps I should supplement with glycerol to bring my ability to retain water up to "the norm." You okay with that? It's against the rules, but heck, I'm only bringing myself up to the absolute bottom of normal for sweat rate, so I should be good to go.

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"Go yell at an M&M"

Check out his results on athlinks.com. Methinks he is doing his training wrong. Or he counts sleeping as training hours, or something.

But hey, he's buff and a Christian, so it's all good.

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"Go yell at an M&M"

I refrained from judging his truthfulness regarding training hours...

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Ed O'Malley
www.VeloVetta.com
Founder of VeloVetta Cycling Shoes
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Funny you didn't mention "surgery" as one reason people come to see you....I thought you were a surgeon.

Huh.

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I am a surgeon and do plenty of surgery too. My specialty is weight loss both surgical and medical

It's not getting a "kickback". It's that a whole industry has sprung up around the idea of aging-as-a-disease. So that means people like you are staking their livelihoods on convincing people of that.

From what I've seen and read many doctors involved in this have absolutely no training in endocrinology. They just cite some studies that fit their view, while developing their "anti aging" clinics and playing on fear of aging and death.

See, that's what I think is wrong AND what the docs have also stated. T does not let the guys complete at a higher level WHEN dosed correctly - just like with albuterol. I am allowed my puffer before during and after races (and have used it before and after but never during) but I'm not legally allowed to nebulize myself with the SAME medication. So we already have an example of a med that is allowed at low levels (inhaler) but not high (nebulizer). The same situation exists with T. I see the difference but i'm not arguing to allow high levels of T (i.e. nebulizer in the asthma example) but simply leveling (inhaler in the asthma example) levels for overall quality of life and heart disease issues.

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I was somewhere around 300th overall in my first IM event. If I find out that the guy who was 299th was on TRT, god help that fucker!!!
;)

Actually, I have to agree with the doc. After being involved in many sports and knowing lots of 'dopers', I don't believe that TRT doses of testosterone would give anyone any real advantage over me. And in some cases, could even give them a disadvantage.
Cheating? Maybe, because the rules say so. Fair enough. But I ain't gonna lose any sleep over it, because I know its not why someone will beat me....

We have this type of stuff all over Dallas. The local radio guy, Russ Martin, is in his mid 50s and is sponsored by a local HGH therapy place. He was telling someone that his doctor has his levels in the 1,300 range. Seems legit.

The question you can't answer is "is that T level normal for them?" This was the lie lance told everyone when he "told the truth". Lance's VO2 Max is ~82. Lemonds' was ~95. Lance doping so that he could perform at the same level as Lemond "leveled the playing field" between them, but one is cheating and the other is not.

You are the exact reason why USAT hardly ever gives out a TUE for Testosterone and you clearly don't understand the process, because filling out the paperwork to give to WTC isn't going to do any athlete you're treating any good.

Forewarned isnt enough. it has to be an approved TUE and for Testosterone that is extremely rare at least in triathlon and cycling.

do me a favor and differentiate between race and participate in a USAT sanctioned event under existing rules, thanks.

I am just glad I am not in ur AG although u are usually playing for overall and not AG :0)

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I've been expanding my research and visiting some of the seedier parts of the internet. There are people with user names like "ironman07" "tri guy" "swimbikerun" and others talking about EPO microdosing in various steroid forums on the web....way back in 2007! It's mind boggling. They talk about process, recovery, even the brands of drugs, everything except their sources of course, because no one wants to let that out. With the newer forms of EPO and other new drugs these days... i haven't looked into some of the stuff that's been hinted at recently in the cycling news. But this testosterone thread... T is the gateway drug of endurance doping; people get it legally prescribed, doctors like this schmuck are a dime a dozen, and the people who operate the clinics often arent even doctors, they're basically doping pharmacists while the doctor they work with just fills out pad after pad of prescriptions.

If you actually are zero T (and im not doubting you, doctors prescribing low T i distrust), you have a good shot at getting a TUE approval from USAT and should be able to race. The issue comes down to that USAT has to draw the line somewhere and with Testorerone easily available, especially in comparison to other drugs, and no exact number a person should be in, it's better to have a strict limitation than no enforceable limitation because the range is murky and what normal is varies from person to person. if I always sat at 150 should I be able to treat up to 200?

At my current rate, I'll never qualify for supplimentary Testosterone. I get wood just thinking about my wife naked. And she's old an almost as fat as I am!

Training at swim squad in winter is an exercise in not looking or even thinking about the hotties in my lane! I remember reading an interview with some porn star years ago. He said he'd think about war atrocities, or his grandmother naked, to prevent going off too soon. I use that same line of thinking to be able to go out in public!

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TriDork

"Happiness is a myth. All you can hope for is to get laid once in a while, drunk once in a while and to eat chocolate every day"

 If you read the TUE, unless he can prove WHY he needs the Testerone, he has 0 chance of getting approved. Regardless of his testosterone level. Even IF he can prove why he needs to take it, it must be an Organic cause, read something like a anatomical problem. If it's a Functional cause, you're completely screwed. If a guy is taking TRT just to get to a 500 to 700 ng/mL level isn't cheating plain and simple.

People will disagree with that and it's their right to do so. But I, for one, don't see USADA/WADA as a body capable of rightly determining what the cutoff level is for medical treatments of any variety and then enforcing it consistently. They've proven that they can't do so already. Hope Solo, Levi, entire sports like cycling et al... They bust who they want, when they want, and how hard they want. If someone they don't want to get busted tests positive, they make it go away or give them a wrist slap.

What was wrong with the hope solo incident? She'd been seeing the same doctor for years (as opposed to some doctor she went to looking for some extra help), the prescription was for an item on the specified list, which USAT/USADA recognizes as items that are more likely to be inadvertent use of, so they gave her a warning as there appeared to be no intent. As for Levi, I assume you're talking about the original case, not his stuff involving Lance? rules were different then, and if USAC had results management as i believe they did, USADA cant do much about it. if youre talking about the USPS related case, it's another point people disagree on, but they use the same type of sentencing our legal system does for those who give evidence, and to me thats a good thing. I've learned most of what I know about anti-doping from ex-dopers, so if reduced sentences are what it takes to get people to talk, more power to them.

Finally, I think taking anything that makes your life good and is healthy for your body is a good thing. However I dont think you should be allowed to compete, even if you and your doctor feel it is just making you "normal" if it a product like testosterone. Very simply put, it's impossible to know that maybe 1/2 the "standard range" is normal for you, and you can compete just fine like that, and effectively doubling your ng/ml would then clearly be doping. Since they have no way of knowign that, all they can do is set a hard line and follow it.

I respect your point. But I disagree. I've found on this forum that it's impossible to actually change people's minds on this topic so I'll not continue further in an attempt to do so. It would be mutually disrespectful to attempt to do so.

understood, and I certainly can see where you're coming from. I just hope if you're currently in treatment that even though you disagree with the rules that you're following them.

...and I hope you never draft. :D

I can honestly say I never have. I know I might come across as holier than thou on here, but it's a sincere attitude. I saw WAY TOO MUCH in junior high and high school athletics as a kid that made me realize that a lot of people just don't think rules apply to them in sports. And while I don't claim to be perfect, I'm very careful to follow the rules when I train and compete.

I haven't been posting here long enough to know what you come of as. So far, you seem reasonable to me, and I wanted to bust out some pink text.

LOL. fair enough.

Well, I'm a female in menopause so 0 T is, while, abnormal, not unheard of. IMO, since the docs are saying you get no benefit at 200, then yeah, you should be able to treat up to 200 just like any Joe can use an inhaler.

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I agree with your line of thought, but I think you are giving way too much credit to Testosterone itself. Yes, LA used it, but you can be sure that the majority of his drug enhanced performance was from the other drugs/methods (EPO, blood doping, HGH).
If you're at Ironman and some guy on TRT beats you by a few minutes, you were gonna get beat anyway, IMHO. Hell, most folks would probably see more race day performance benefit from popping an ephedrine tab or some caffeine pills, than taking daily testosterone.
It's not a miracle drug, and it has a lot of side affects, some unseen, that can make it rather undesirable. Throws off other hormone levels (estrogen, DHT, etc.) shuts down testes, raises BP, water retention, harder to keep weight in check, etc etc

Then why take it if it does "nothing" up to 200?

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I don't give a shit what it says in the exisiting rules..Guys like you are so fucking anal about this that no matter what anyone says you will keep throwing "the rules" our way.It is sad that you can't see the difference.

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And many of these same folks (not necessarily pick6...) think nothing of catching a draft during a 5 hour bike leg...

Im not talking about getting beaten by TRT; Im talking about people getting beaten by folks who claim to be on TRT, but are dosing well above that. I recognize fully that EPO, HGH, blood doping are the strongest ways to get benefits during racing, but Armstrong and others use testosterone as a recovery agent primarily. If your T is low due to sustained consistent training, the performance benefit you're getting from it is not being exhausted the next day. That makes a big difference.

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Exactly..There are blatant draft cheats getting far more benefit from wheel sucking but that doesn't rile people nearly as much for some reason..

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to increase libido, decrease fatigue, keep your heart healthy, stop insomnia and other reasons I don't personally know of.

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https://www.caringbridge.org/visit/katasmit

I know a guy who was essentially the definition of roid rage UNTIL he started taking TRT.

here's the point you don't seem to get. There are dirty doctors out there, lots of them. They'll doctor test results to give people plausible excuses to take meds. Look at all the anti-aging clinics, look at whats going on in baseball. it's not "the rules" it's the fact that how do you stop it if you let any doctor with a diagnosis get an athlete a valid TUE? So it's either let them all do it, or make it really hard to get. I assume you aren't advocating the "let them all do it" approach?



If youre suggesting some ammendment to the rules that allows people to race while on testosterone, I'd be interested to hear how you'd plan to police that.

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First thing you do is remove them from "competition" by having all those AG'ers on TUEs for testosterone (or other similarly helpful substances) start in a separate wave or if that is not possible have their numbers marked so that officals and racers know that they are ineligable for awards.That will keep the true and harmless participants involed in the sport and take away some of the reason for the cheaters to cheat.Those who truly want to stay in the sport for their health and for fun will stay and those who are blatantly cheating for advantage will no longer have any advantage.Pro's who are on TUE's would be allowed to compete but under very strict doping controls.

I am not saying TUE folks or those on lifelong meds for illnesses should get a free pass but I am saying that we could be less militant about it.

There are rules in place for sure but sometimes rules can be bent or amended for special reason or individuals who simply can't participate for one reason or another.This needs to be recognised and some guidlines for rule "breaches" laid down.I remember having a conversation with the 2IC of NAS after IMCdA about drafting among the slowpoke recreational triathletes at the back of the pack and he was so sad that the draft busters were being totally anal about busting non-competative folks who were clearly struggling just to get through the day while the athletes "working together" up the front were left alone.Some "rules" need to be applied differently in different situations.

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Honestly, this is the first idea I could get onboard with for T or similar drugs you can get a TUE for. They are in their own wave, and there's no podium for that wave. So go rip out that new PR, but if you're on T, all you're getting to show for it is the same medal as everyone else. No one in those waves could qualify for any championship. Further, No USAT ranking for that wave either. That means folks in that wave are truly completing not competing, and if you're on T for a valid reason, you're in that wave.

Of course if you're not on T for a valid reason you're telling USAT youre not on T anymore, you enter the normal wave, and there we hope they get increased drug testing going and catch those assholes.

As for drafting, if they're in that "completion wave" they can draft. Otherwise, no soft touch for drafting. Remember, there are clyde/athena/newbie waves in a lot of races, and those guys & gals are often at the back, so if 2 guys who know each other are drafting at the back (which I've seen on more than 1 occasion) that puts me at a disadvantage. I'll never say (at least as long as I am as slow and fat as I am) that doping affects me personally, but other peoples drafting and my unwillingness to cheat has absolutely affected my position in my age group.

I think that VO2 max has been bandied about way too much as an absolute indicator of physical abilities. I've known a couple of cyclists who were quite successful at the elite level with horrible VO2 max scores. On the other hand I was tested at 80 in my prime and though I did okay I never had the kind of results that you'd expect if that was an absolute indicator. I certainly never any results that would put me ~2.5% from Lance Armstrong when he was an amateur. I don't remember making any Olympic teams or winning the Elite National RR, etc.

Taking a VO2 max test is slightly different than a 6 hour mountain stage in the Tour or a Classic or even something like the Nevada CIty Classic. Yeah, people with high VO2 max scores tend to do better, but it's not 1 to 1.

As for testosterone, I am of the opinion that guys with low T that are supplementing are cheating and should get a two year ban if they get caught. End of story unless you get a TUE from USADA.

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Kevin

http://kevinmetcalfe.dreamhosters.com
My Strava

I agree with you on pretty much your entire post; my point about VO2 max was simply a mention of how lemond reminded lance about clean racing that if youre starting from a truly elite position like with a 95 vo2, it's something physiologically someone with an 82 simply doesnt have that capacity.

As for the your VO2 in comparison to lances, frankly, we don't know that anything he's done in professional cycling was ever clean. Rumor has it from some pretty well places sources is that he's going to admit to doping going back to 1987. That would make him what, 16?

And as for the rule change, I was merely hypothesizing with someone who is unhappy with a current rule. Cheating is all about taking away from someone else. The rule change he suggests merely means new cheaters wouldnt bother with the TUE and risk getting caught, because theyre not doping to cheat, theyre doping to win. People with TUEs could still complete the race and get the value of finishing, which I think is where the real value coems from anyways.

I agree with everything you wrote. As long as there isn't a scarlet letter for those who require legitimate medication I think it's a great idea. I'm an age grouper. I'm under no delusion that the few times I've won an "age group podium" at a local race that it was a fictional creation to give some people an added incentive. If they did away with age group medals all together I wouldn't stop training or racing. I race myself. I have a friendly competition with my brother and people I train with. The only other person I don't compete with is that guy or girl who is within my sight 400 to 800m from the finish line.

As someone who is on T-supplementation for life due to a genetic disorder (mid 20's male) I have to disagree with your stance upon a separate TUE wave. I know that I would love to qualify for a championship race someday (maybe only in my dreams). And why would I and others with legitimate TUEs wish to be excluded from rankings and normal award ceremonies? I'm normally MOP and I think if I could give up delicious beer and pizza I think I could start to get to FOP. I know the people with legitimate TUEs don't wish to be excluded nor do we want to be singled out and marked for being medically "handicapped" if you wish to say. Plus, I don't think everyone would like to be publicly labeled for a medical exemption no matter how minor or major it is. I think the TUE system is okay the way it is except for the ridiculous cost for supplementary tests for proof related to the TUE paperwork.

i don't think anyone is talking about legitimate TUEs. The system being discussed, as I understand it, would be for those who have a legitimate need for TRT but cannot receive a TUE because they don't qualify, can't afford it, etc... Your specific problem is covered under a TUE. Some people, for whatever reason, get a low testosterone count very early. For example, if you need TRT to get to an "average" level of 500-700ng/mL, some here would say you're "average" is just lower than everyone else. Many physicians deal with that and prescribe it. Sure, that guy could probably get a TUE if he went to see every specialist under the sun and spent more on tests and doctors than a Cervelo P5-six with Di2 and Zipps would cost just to get to a sprint tri as an age grouper. Seems ridiculous to many people. Seems perfectly legit to many people. There's no right answer on this issue.

umm......yes it does, check after IM Florida or mayne even search IMflorida on here and you will see many do care about drafting on here. check cheting in general and see that many on here care about it. if you dont play by the rules you are cheating. it is black and white no grey area in there at all. go ahead cheat and then follow what happens on slowtwutch after if you get caught. I wont do it but I can guarentee someone else will. These guys here will eat you alive.

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I agree that the system is fine the way it is. I was merely hypothesizing with someone who isn't ok with it. If you got your TUE approved by USAT, than I have faith it's for a condition that warrants it. The problem some others here seem to have is that USAT is too strenuous in their policing, and it's my opinion they need to be.

All these benetfits you're listing - this is your view of "Nothing" ?

The nothing that was quoted from my post was in reference to the superhuman ability that many here seem to attribute to a T level of 200.

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The point is that you are making the case that even taking a small amount of T reduces fatigue, helps you sleep, strengthens your heart... these are all beneficial to triathlon performance. So it clearly does "something". A drug does not have to turn you into superman to qualify as cheating - if such a drug even exists.

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Ed O'Malley
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If you read Tyler Hamilton's book, the first time he doped was with testosterone and he definitely felt it made a significant difference to his performance, even before he started up with the EPO.

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Ed O'Malley
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Then using that logic, I should not be allowed to use glucoasmine and chrondroitin for my knees or albuterol for my lungs. I don't believe T actually strengthens your heart but instead a LACK of T predisposes your heart to disease, so bumping your T up to the minimum of normal would simply put you back in the same category of everyone else WRT heart disease. Again, using that logic I also should not be allowed to use soy to decrease insomnia and hot flashes and the deep brain fog and inability to recover as opposed to my non-hormone depleted state (dunno what my T was before but it is 0 now).

We already have an example of a drug that is allowed at low concentrations (albuterol inhaled) but not high concentrations (albuterol nebulized). I don't see the problem, considering the health issues associated with seriously low T (make a number just like the pulmonologists have done with asthma), of bringing someone's T up to the bare minimum of normal (which seems to be accepted to be 200 ng/mL). Just like asthma, you can have a clearly delineated line for excess and minimum standards for treatment.

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how do you propose to enforce that those using it that way will not abuse it until just prior to the event where they might get tested? not everyone has a good moral compass and those that do not will be giving themselves........................

They already have that. There is a clearly defined process for getting a TUE for testosterone.

John

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http://xkcd.com/1173/

This joke is so incredibly short sighted and disingenuous. Young cyclists are dead because they couldn't avoid the slippery slope this puts athletes on. Even those working with physicians with years of doping experience have died or nearly died. Hamilton's book details his own misadventure with bad or wrong typed blood. And there's no way to know how many more have had trouble because they can't talk about it for fear of reprisal. Cycling needs some truth and reconciliation for no other reason than to get the name of doping doctors out into the light.

Intellectually, I understand this argument. Food is chemicals. Testosterone is a chemical. EPO is a chemical. What's the difference. I can say that the difference is what is "natural" rather than "engineered" and the counter-argument is that many things that are food today and perfectly legal are engineered. Our bikes are engineered. Why can't our bodies be engineered?

All I can really say is that sport is about humans competing with other humans with their natural talents. There is a line to be drawn at what you can do to your body that is detected by the "smell" test. Generally, if you are trying to alter your body's chemistry in ways that cannot be done with regular food, beyond what is allowed by the current TUE process which makes sense to me, then that is cheating. Engineering food to be smaller or in a form easier to carry with you rather than as apples rice or chicken is fine. You are not altering your body chemistry differently than you would with regular food. But when you start supplementing hormones, it is different than food.

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Ed O'Malley
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The idea that sports are about competing based on one's natural talents is not true as either as a description of what the rules actually are nor as a description of what the rules ought to be. The rules give tons of leeway for all sorts of procedures and strategies that are not "natural." That's true from the trivial -- such as shaving -- to the middle of the road -- such as altitude tents -- to major stuff like surgery. The rules ought to focus on things which have one of two features. First, the rules ought to focus on things which are inherently unequally available. For example, if something gave a large advantage but is affordable to only a tiny percentage of the field, there is a good equity argument for not allowing it. Wealth will always be an advantage in sports, but it should not be a decisive advantage. Second, the rules ought to prevent things that are dangerous. We require cyclists to wear helmets because we don't want people to trade a few seconds for a risk to their health. Requiring everyone to wear a helmet avoids the temptation to make the tradeoff. Some drugs fall into that category.

Well, it is a joke. However, the theory behind it holds true. Alcohol is a chemical that kills many more young people than PEDs. I'm speaking from a strictly philosophic point of view here. Again, it's my opinion there's no "right answer" to this debate. I just think that the joke, while obviously generalized and meant for humor, does posess a particular insight that can be gleaned from it without swallowing the whole thing at face value.

So people taking testosterone supplements for a legitimate medical condition (i.e., pituitary adenoma, Kallman syndrome) shouldn't get to compete? What's the point of a TUE, if not to distinguish between those who genuinely need medical exemption, versus those simply trying to gain an edge?

Holy crap, I just did a little google research myself and I feel dirty just by looking at these forums and websites... TONS of people are out there openly discussing how to use T and EPO for cycling and triathlon, as well as a ton of shit I have never heard of.

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Ed O'Malley
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You ned to realize that you, me, most of us are out for a day of hard work. It has noting to do with sport or winning. We are just out to see what we can do. The results others put up are of no importance.

If you are competing for a lot of money, then you might want to take drug asage in consideration when you place your bets.

If you need to measure your performace against anyone, measure against the pros. (I expect they tend to take drugs - some sort of risk/benefit tradeoff.)

The first year plus i spent talking to the ex-dopers in cycling about all this I thought I was through the looking glass. I've done quick searches by topic before when I needed better understanding of something Vaughters or Floyd or a hematologist I talk to was telling me, but I stayed away from those places other than if a very specific post came up on the topic I was focused on at the time. But when we started talking about "what % in tri are using" I started looking. What startled me was not the sheer volume of people involved, that i was pretty sure about already; it was how far back it goes. 6 and 7 years ago, triathletes and cyclists, not just asking about EPO, but EPO microdosing. Frankly, it's scary, and I come away from those sites every time feeling dirty. There are 2 that i've been told that have been very popular with endurance athlete dopers, but both require registration to read posts, and I've decided at least for the time being it's too creepy even having a user name at those places.

x2. The iceberg that you can see is only about 10% of the real thing.

John

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Sorry, I missed most of this thread while being away all weekend coaching and competing, but I'm floored by this. Thanks for sharing. I wonder what I am up against racing in M45-49, and I like to give my competition the benefit of the doubt, but I'm really jaded by all of this.

But here is the deal. A guy like Ken Glah who races in my age group goes 1.5 hours slower than he used to at Ironman and 40 min slower than he used to in half Ironman. Sure Ken is training less, but time catches up with all of us. So when guys pop up that we have not heard of and give Ken a run....well questions will arise. I use a guy like Ken as an example because he has pro level genetics and has consistent spectrum of results over time that reflect "graceful aging". There are a host of other national level age groupers who have been the "fast guys" for 20 years over time that I can also use as my benchmarks...

Dev

Sure, but at the same time, you can't just eyeball a doper based on time. The "smartest" dopers, as we're seeing in cycling, are now doping to fit in with the level above them, rather than trying to dominate it. there is too much technology, money, and coaching at some people's fingertips that there are people coming to the sport late in life that some of them are clean and putting up decent times. there's simply no way around the fact that we need to test more people and test more thoroughly.

EDIT: Further, im not accusing anyone specifically at all, but its hard to say for sure the guys in the 45-49 at the world class level havent been doping for past 20 years.

There were definitely younger people in there as well. One guy identified himself as a 22yo cyclist. He was pumping himself full of testosterone and people were telling him he should be doing EPO. At least several people were smart enough to tell him that he was probably screwing himself up for life with the testosterone and he should quit it immediately.

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Ed O'Malley
www.VeloVetta.com
Founder of VeloVetta Cycling Shoes
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I am always slightly amazed at the responses to this topic. While there are obviously some who will find "legitimate" reasons to avail themselves of any number of PED's, I think that before you decide to drop all the users of testosterone into the ocean you might want to do a little research. As mentioned before, hypogonadism is a serious issue (I can't get past thinking it means "little balls"). My unsupplemented testosterone levels are in the high female range. While it is difficult to maintain a stable level, my physician does a pretty good job of keeping mine in the "normal" range for a 58 year old. Sometimes a little lower, sometimes a little higher. This makes a significant difference in my quality of life and , I assure you, not a single member of my AG needs worry about my suddenly improving a PR by half. Should I seek a TUE I imagine it will be at least be seriously considered. There are a number of side effects associated with long term use, not the least of which would be adding fuel to the fire for a latent prostate cancer but this can be monitored. Yes there are many folks out there who will seek the use of testosterone and physicians who will prescribe based on "I feel like crap and I don't have a "blue steel, cat can't scratch it" erection. I rather imagine that more than not are in my situation, not seeking any great advantage but availing themselves of a proven treatment for a proven condition.

No one here is saying that someone with a legit medical condition that requires treatment with testosterone should be thrown in the Ocean. There are many people and complicit doctors using it in races, without a TUE, and it is giving them an advantage without a medical condition that justifies their use of of testosterone while racing. If you are in fact racing, I would encourage you not to race until you have been granted a TUE. Otherwise you are competing outside the rules.

The post you responded to was referring to people using drugs solely for the purpose of gaining an unfair advantage.

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Ed O'Malley
www.VeloVetta.com
Founder of VeloVetta Cycling Shoes
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High female range would put you somewhere around 200 ng/dl lower than the bottom of the male range. Obviously you need the supplementation, and if you have the history of it, you *should* be able to get a TUE. I have no problem with you racing, competing, whatever. A lot of the "low T" people that we are discussing in the older age groups are the ones that are still within the normal range (300+), but are on T for the "wanna feel young again" sensation. Those are the ones that I don't think should be competing. If they want to take T, great, just don't compete.

John

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Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |

[quote Devlin


x2. The iceberg that you can see is only about 10% of the real thing.

John[/quote]

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So here is something interesting,look what arrived on my Facebook page today.It seems that testosterone use for triathletes is not only accepted by some but actively advertised by one or two race production companies.Looks like the horse has well and truly bolted

A screenshot for all you ST detecives out there.


I think the USAT is going to have to start some real dialogue and begin to define what is and what isn't considered acceptable before this all goes to hell!

www.innovativemen.com

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