The main disadvantage of urine is that the drug can be excreted either as free or conjugated metabolites, and the parent drug may be present in relatively low concentrations (IOC Medical Commission).
The purpose of the International Standards for Testing is to plan for effective testing and to maintain the integrity and identity of samples throughout the testing process, from notifying the athlete to transport of the samples for analysis. The purpose of the International Standard for Laboratories (ISL) is to ensure production of valid test results and evidentiary data, and to achieve uniform and harmonized results and reporting from all accredited laboratories. When looking at the statistics of 2004, anabolic steroids are still the most often reported doping agents, as it has been the case every year since the beginning of the 1990s. The large number of testosterone cases should be taken with caution because the differentiation between a naturally elevated concentration of the endogenous hormone and abuse of testosterone esters cannot always be done (Mottram and George, 2000, 55-69).
Anabolic steroids are synthetic derivatives of testosterone modified to enhance the anabolic rather than the androgenic actions of the hormone. Testosterone is hormone-synthesized in the human body from cholesterol. It serves distinct functions at different stages of life. During embryonic life, androgen action is central to the development of the male phenotype. At puberty, the hormone is responsible for the secondary sexual characteristics that transform boys into men. Testosterone intervenes in many physiological processes in the adult male including muscle protein metabolism, sexual and cognitive functions,...
The implications are serious. This indicates additional criteria for testosterone doping detections are needed. Decreased urinary luteinizing hormone excretion or increased urinary T/LH ratio has been suggested to be another alternative for detection of anabolic steroid doping. Another strategy could be to measure the T: E ratio in urine samples collected at various intervals after the collection of the first sample with an increased ratio. The basis of this concept is that if testosterone has been administered, the T: E ratio is expected to change over time. Exogenously administered testosterone is converted to estrogen to some extent. An idea has been advanced in this context that urinary estrogen can be a marker of testosterone doping. Supplementary analysis of a serum sample can provide additional supportive and useful information. These methods can be useful to diagnose doping in the volleyball player, and before advancing recommendations, it is very important for the medical officer to take a cautious decision. For anti-doping work, it is important that the analytic procedure be as maximally accurate as possible. It is also important for the analytic process to eliminate all possible risks for false positive results. In all suspected cases of testosterone doping, some researchers have come up with suggestions of supplementary immunological analysis of 17OH progesterone, Testosterone, and LH. To this end, a highly sensitive immunoassay of 17OHP, preferably including an extraction step to improve specificity could be used.