Changes in blood parameters after intramuscular testosterone ester injections – Implications for anti‐doping

Solheim, Sara Amalie; Mørkeberg, Jakob; Dehnes, Yvette; Hullstein, Ingunn; Juul, Anders; Upners, Emmie N; Nordsborg, Nikolai Baastrup

doi:10.1002/dta.2803

Cited by 13 publications

(15 citation statements)

References 32 publications

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“…The initial increase in Ret% did not result in a measurable increase in hemoglobin. This is consistent with the results observed by Solheim et al, 30 where the increase in reticulocytes was not accompanied by an increase in hemoglobin after intramuscular T injection. It should be noted that the increase in reticulocytes was small and when considered in a longitudinal monitoring scenario would likely be eclipsed by the intra‐individual variability of this parameter.…”

Section: Resultssupporting

confidence: 93%

Evaluation of blood parameters by linear discriminant models for the detection of testosterone administration

Nair

Sharpe

Husk³

et al. 2021

Drug Testing and Analysis

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The steroidal module of the Athlete Biological Passport (ABP) has been used since 2014 for the longitudinal monitoring of urinary testosterone and its metabolites to identify samples suspicious for the use of synthetic forms of Endogenous Anabolic Androgenic Steroids (EAAS). Multiple recent studies have suggested that monitoring of blood parameters may provide enhanced detectability of exogenous testosterone administration. Transdermal and intramuscular testosterone administration studies were carried out in 15 subjects, and the effect on blood steroidal levels, hematological parameters, and gonadotropins was evaluated. Serum testosterone and dihydrotestosterone levels increased while gonadotropin levels were suppressed after administration. A modest increase in reticulocytes was also observed. The blood parameters that were responsive to the administrations were combined into several linear discriminant models targeting both administration (on) and washout (off) phases. The models were effective in detecting the large dose intramuscular administration but were less successful in the detection of the lower dose transdermal application. The blood profiling models may provide complementary value but do not appear to be substantially more advantageous than longitudinal urinary profiling.

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Section: Resultssupporting

confidence: 93%

Evaluation of blood parameters by linear discriminant models for the detection of testosterone administration

Nair

Sharpe

Husk³

et al. 2021

Drug Testing and Analysis

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“…Using a more limited set of reticulocyte parameters (% reticulocytes, immature reticulocyte fraction) than in the present study, the effects of injectable T were much more prominent than those of transdermal administration 82 . Following injections of 250‐mg mixed T esters, the urine steroid module markers (T/E ratio 5α‐diol/E ratio) were positive in 9/12 men, whereas the key hematological parameters (% reticulocytes, OFF score and ABPS) were positive in fewer (three to six) participants 81 . A discriminant analysis of transdermal T gel administration to 15 healthy men reported that reticulocyte parameters that exceeded cutoff thresholds in only 7/32 treatment sequences 82 .…”

Section: Discussioncontrasting

confidence: 62%

“…82 Following injections of 250-mg mixed T esters, the urine steroid module markers (T/E ratio 5α-diol/E ratio) were positive in 9/12 men, whereas the key hematological parameters (% reticulocytes, OFF score and ABPS) were positive in fewer (three to six) participants. 81 A discriminant analysis of transdermal T gel administration to 15 healthy men reported that reticulocyte parameters that exceeded cutoff thresholds in only 7/32 treatment sequences. 82 The present study extending these findings to healthy females treated daily for 7 days with transdermal T gel reveals better differentiation of exogenous T exposure using more sensitive reticulocyte parameters alone as well as when combined with steroidal module parameters.…”

Section: Discussionmentioning

confidence: 99%

Detection of testosterone microdosing in healthy females

Savkovic

Desai

et al. 2022

Drug Testing and Analysis

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The ready detectability of synthetic androgens by mass spectrometry (MS)-based antidoping tests has reoriented androgen doping to using testosterone (T), which must be distinguished from its endogenous counterpart making detection of exogenous T harder. We investigated urine and serum steroid and hematological profiling individually and combined to determine the optimal detection model for T administration in women. Twelve healthy females provided six paired blood and urine samples over 2 weeks prior to treatment consisting of 12.5-mg T in a topical transdermal gel applied daily for 7 days. Paired blood and urine samples were then obtained at the end of treatment and Days 1, 2, 4, 7, and 14 days later. Compliance with treatment and sampling was high, and no adverse effects were reported. T treatment significantly increased serum and urine T, serum dihydrotestosterone (DHT), urine 5α-androstane-3α,17β-diol (5α-diol) epitestosterone (E), and urine T/E ratio with a brief window of detection (2-4 days) as well as total and immature (medium and high fluorescence) reticulocytes that remained elevated over the full 14 posttreatment days. Carbon isotope ratio MS and the OFF score and Abnormal Blood Profile score (ABPS) were not discriminatory. The optimal multivariate model to identify T exposure combined serum T, urine T/E ratio with three hematological variables (% high fluorescence reticulocytes, mean corpuscular hemoglobin, and volume) with the five variables providing 93% correct classification (4% false positive, 10% false negatives). Hence, combining select serum and urine steroid MS variables with reticulocyte measures can achieve a high but imperfect detection of T administration to healthy females.

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“…The study was a randomized double-blind placebo-controlled trial and was part of a larger anti-doping research project that aimed to further develop analytical methods to detect doping with TEs (Solheim et al, 2020). For ethical reasons, we are highly focused on providing as much information as possible from the obtained data.…”

Section: Methodsmentioning

confidence: 99%

An Intramuscular Injection of Mixed Testosterone Esters Does Not Acutely Enhance Strength and Power in Recreationally Active Young Men

Solheim

Mørkeberg²,

Juul

et al. 2020

Front. Physiol.

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Purpose: Limited data are available on the acute performance-enhancing effects of single-dose administration of testosterone in healthy humans. Studies of testosterone administrations to healthy humans are rare due to the difficult nature and necessity of close clinical monitoring. However, our unique physiological experimental facilities combined with close endocrinological collaboration have allowed us to safely complete such a study. We tested the hypothesis that an intramuscular injection of 250 mg mixed testosterone esters (TEs) enhances physical performance in strength and power exercises acutely, measured 24 h after injection. Additionally, we investigated whether the basal serum testosterone concentration influences the performance in countermovement jump (CMJ), 30-s all out cycle sprint, and one-arm isometric elbow flexion. Methods: In a randomized, double-blind, placebo-controlled design, 19 eugonadal men received either a TE (n = 9, 23 ± 1 years, 183 ± 7 cm, 83 ± 10 kg) or a PLA (n = 10, 25 ± 2 years, 186 ± 6 cm, 82 ± 14 kg) injection. Hormonal levels and the performance in CMJ, 30-s all out cycle sprint, and one-arm isometric elbow flexion were measured before and 24 h after injection. Results: Firstly, an intramuscular injection of 250 mg mixed TEs did not enhance the vertical jump height in a CMJ test, peak power, mean power, and fatigue index in a 30-s all-out cycle sprint or rate of force development and maximal voluntary contraction in a one-arm isometric elbow flexion 24 h post-injection. Secondly, baseline testosterone levels appeared not to influence performance in strength and power exercises to a large extent in healthy, recreationally active young men. Conclusion: A single intramuscular injection of 250 mg mixed TEs has no acute ergogenic effects on strength and power performance in recreationally active, young men. This novel information has implication for basic physiological understanding. Whether the same applies to an elite athlete population remains to be determined. If so, this would have implications for anti-doping efforts aiming to determine the most cost-efficient testing programs.

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Changes in blood parameters after intramuscular testosterone ester injections – Implications for anti‐doping

Cited by 13 publications

References 32 publications

Evaluation of blood parameters by linear discriminant models for the detection of testosterone administration

Evaluation of blood parameters by linear discriminant models for the detection of testosterone administration

Detection of testosterone microdosing in healthy females

An Intramuscular Injection of Mixed Testosterone Esters Does Not Acutely Enhance Strength and Power in Recreationally Active Young Men

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