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.
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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.