Floyd Landis & Testosterone-Doping?

The Science of Drug Testing:

Unanswered Questions
in a Mystery Story

by Craig Rusbult, Ph.D.

Updates and I.O.U.
    Almost all of this page was written in August 2006, with very little revising or supplementing since then, mainly a few updates in 2007.   Obviously, it needs a major update based on events between then and now:  especially Floyd's confessions in 2010 (about plenty of doping including 2006, but maybe [I'm not sure about this] not testosterone for his super-ride in 2006) {ESPN - Landis admits to doping};  plus his testimony about Lance Armstrong's use of EPO & blood doping, which has been reinforced by statements from other riders, including Tyler Hamilton (60 Minutes in May 2011, and in August 2012 a book, The Secret Race: Inside the Hidden World of the Tour de France).
    Eventually I'll add an introductory section about these new developments.  The new section will supplement my original thoughts with new thoughts, and will provide external links to web-sources with up-to-date information about the testosterone mystery and the news-events since August 2006.
    But I will leave the page below unchanged.  As an honesty-check on this, you can see an archived copy of this page (it opens in a new window so you can compare it with the current version) from the Wayback Machine, captured by them on March 14, 2007.   { a personal note: That's exactly 10 years after I officially submitted my PhD dissertation to the U of Wisconsin-Madison on 3-14-97. }
    Below is “what the page was” in its early days.

As a scientist, athlete, and a fan of the Tour de France since 1985, I'm confused.  Why?  Because in some ways "it doesn't add up," according to an expert on drug testing.

        Avoiding Oversimplification
Those who don't understand the physiology of pushing-the-limit athletics ask “how could Landis be so weak during Stage 16 and so strong the next day, if he wasn't using drugs?”  This question might make sense if we ignore the fact that Landis was consistently strong throughout the tour (pages with details are cited below)* and that external testosterone is typically abused for long-term improvement in muscle strength, not as a "one-day wonder drug" for a quick increase in energy, strength, and performance.
        During three weeks on the Tour, Landis was riding as fast (or faster) than almost all of the other top-10 riders in almost every stage.  But in Stage 16 something strange happened to him physiologically;  probably his body didn't have enough water (he got dehydrated), enough energy (he ran low on glycogen, the "sugar fuel" used by muscles), and/or he got overheated.  When the body's physiology gets messed up, it's difficult to operate at the high levels demanded in mountain climbing, and he fell far behind his world-class competitors.  The next day, in Stage 17, several times the TV commentators pointed out how he was drinking lots of water, eating lots of food, and pouring water over himself (to cool off), doing all of this to insure that whatever happened in his "bad physiology day" would not happen again in Stage 17.
        This variation in performance is not unusual, and other riders sometimes have one bad day and naturally recover the next day.*  This could also happen to Landis, so there is no need to say "it was drugs" to explain his dramatic one-day improvement between Stages 16 and 17.   (* an example: Oscar Pereiro, who finished second and may now be awarded first, lost 26 minutes in Stage 11 but regained 30 minutes in Stage 13, and rode strongly the other 19 days despite his one very bad day.)
        * Here is information (in pages I've linked to) about Stages 16 & 17.  Also, there is a detailed table about the "roller coaster" race (check the third paragraph with "comments" in green print) showing that Floyd Landis was the most consistently strong rider throughout the Tour, followed closely by Andreas Kloden.

        A Mystery Story
When I began writing this page (on August 3, 2006) there were mysteries, with uncertainties leading to many questions —
        • 1. Was Floyd "artificially supercharged" during his amazing win in Stage 17?  and also in other parts of the Tour?
        • 2. If YES, why were all of his other eight tests normal?
        • 3. If NO, then
        • 3A. was this test positive due to physiological strangeness (unique to Landis and the context of Stage 17) that naturally raised his testosterone level and/or lowered his epitestosterone level?   { But what about the "isotope test" that indicated artificial testosterone? }
        • 3B. Or was he "framed" by someone who had access to his urine samples, and added drugs to them, or who falsified the lab-analysis results?
        • 4. If YES to 1 or 3B, then WHO? — Was there intentional cheating (and when did it begin) that Landis knew about and approved?  or, without his knowledge, did his team (Phonak) try to "help" him?  or did some member of his team, such as a masseur, rub testosterone cream onto Landis without the knowledge of Landis or Phonak?  Or was Landis "framed" by an enemy — someone on another team, a team supplier, a spectator along the route,... — by secretly adding drugs into (or onto) his body?
        [ here is an extra comment, added in late-May 2011 — If you compare 1-and-4 with 3B, you'll see two different questions:  Was the lab test accurate because there really was extra non-natural testosterone in his urine?  Was his performance during the race improved by a body that was supercharged with non-natural testosterone? ]

        The following wish was written August 5, after the B-sample also tested positive, because (unless it's 3A above, with everyone being totally honest) at least one person, and maybe more — maybe it's Landis, and maybe not — knows what happened, who was involved and why.  Whoever this is, I wish they would share the truth with us.   But in the absence of honesty by this person(s) and because there is no theory to explain 3A, I still consider the questions above to be part of an unsolved mystery story.

• Most of this page was developed in early-August 2006, and I stopped working on it by mid-August, but... here is a minor update in July 2007, about a book published in late June 2007, Positively False: The Real Story of How I Won the Tour de France, by Floyd Landis with Loren Mooney;  description & excerpt (Chapter 1) from the publisher, Simon & Schuster;  and floydlandis.com has a series of interesting entries, including those for April 30 & 23.   Recent legal news, from September & October 2007, are described in Sports Illustrated & TDF-blog & L.A.Times & FloydLandis.com.

Now, back to a year earlier, in late July and early August of 2006:

A Variety of Views
I'm not the only one who (in early August 2006) is confused and is asking questions, as you can see in these pages:

Doping expert thinks Landis result ‘doesn't add up’ (July 27, re: Gary Wadler)
Sports doping expert explains cycling's drug-testing process (from Dr. Don Catlin, director of the Olympic Analytical Laboratory in U.S.)
In Landis affair, more questions than answers (July 29)
testosterone is effective for quick recovery (in second half of page)

a good introductory overview for the science of testosterone & testing (+ blog discussion thru July 31) (July 27)

On July 27, ESPN analyst John Eustice said the amount of testosterone in Sample A was normal, so perhaps the testosterone/epitestosterone ratio was high due to an unusually low level of epitestosterone. USA Today (Eustice-info plus links & blog)

But the suspicions are based on more than just a high T/E ratio:
Isotopes help pin down Artificial Testosterone (from Nature)
Test for Synthetic Testosterone is Accurate (August 1)
UCI source says some Landis testosterone exogenous (Aug 1)
IRMS Test is Positive but Low, Says Landis' Doc (on "Free Floyd Landis" blog)

August 5:  Landis' 'B' test results come out positive   Landis's second sample confirms original finding"Landis... was tested eight other times during the three-week tour [six times before July 20 when he tested positive, and two after this on July 22 & 23] and all the results came back negative."   /   I have a biological question:  If Landis knowingly took (or was given without his knowledge) enough testosterone before Stage 17 to produce a very high T/E ratio of 11-to-1, would it quickly decrease so it wouldn't show up in his next test two days later, on July 22 when he was automatically tested after regaining the yellow jersey?
        Here is information (but it's incomplete) from my initial searches:
        In a forum Terri says, "According to the results of my Google search on "half life of testosterone", it depends on how testosterone is administered (oral, dermal, intramuscular, etc. as to how efficient the absorption by the body) AND with what the testosterone has been compounded.  It appears the half life of "testosterone" can be anywhere from 1 hour to 12 days.  This is a pretty complex topic.  Any pharmacists/chemists/physicians want to weigh in on this one?"
Dr. Pam Hinton (on fitness panel of Cycling News) says — in Testosterone, epitestosterone and the doping tests"The form of the hormone that is available for exogenous administration is chemically identical to what is produced naturally in the body.  Only a small fraction (about one percent) of the testosterone produced every day is excreted in the urine.  Blood and urine levels increase after taking testosterone.  But because the half-life of testosterone is very short, about one hour, blood and urine levels return to normal very quickly.  Thus, measuring testosterone levels in urine is not an effective means of detecting steroid abuse." (July 31)
        In the SuperTopo Climber's Forum Kate says, "... [first half of paragraph, also interesting, is skipped]  Natural T in the body has a half life that can be as short as 10 minutes.  Methyltestosterone, available orally, has a half life of about 4.5 hours. [editor's comment: sources vary, some say 4 hours & others say 4 days, maybe there is a difference between 4-hour elimination & 4-day breakdown?]  Some are available for longer.  Various synthetic orally-available testosterones have been engineered with the objective of increasing half-life to reduce dosing frequency and dosing volume, which could reduce harm to the liver.  One could pick and choose the synthetic testosterone molecule with the desired half-life."
I have a question:  Terri says the half-life (inside the body, not in a sample) could be "anywhere from 1 hour to 12 days."  What form of testosterone was found in his samples?  (Or would all of the forms be converted into regular testosterone in his body and thus in the samples?)  Is there any T-form that would be durable enough to last throughout the race (5 hours & 23 minutes)* but would disappear in two days, before the next time he was tested?
        * Maybe if Landis was guilty, during the tough race his physiology would be so unusual — producing lots of natural-T and also breaking it down (along with the extra-T he injected),... while pedaling up and down mountains at peak capacity — that the half-life math just wouldn't work.  And he has unusual medical conditions, with Hashimoto's disease (affects thyroid metabolism), plus taking cortisone for his hip,...  It's all very complicated and confusing.

Landis reaction from around the web (on TDFblog.com, July 27-28)
Landis suddenly a simple man entangled in a complex problem
another personal tragedy: stepfather-in-law (and friend) of Landis dead in San Diego (August 16)
Landis speaks out strongly in his defense (August 7)

an I.O.U. — Later, there will be a discussion of science-and-ethics, which will connect with other parts of our website including Ethics and Worldviews using papers from the ASA journal and more.

Here is a prediction — I think someone will write a book about this fascinating story, about the history of Landis and the scientific mysteries described (very roughly and incompletely) in this page, in the context of "doping in bike racing" more generally.

Below are interesting quotes, and then (following these) a few more links.

        from Scott Osler, San Francisco Chronicle, July 28:
        Another mystery: If a rider knows he's going to be tested, why would he juice up and risk almost-certain disgrace?  If Landis is guilty, he is either stupid, naive, careless or desperate — or all of the above.

        from CNN, July 29:
        Landis was tested eight other times during the race — six times before the abnormal test result and twice afterward — and he has not been told that any of those tests had unusual outcomes, he said.
        Regardless, Landis' physician, Dr. Brent Kay, said that testosterone would have done nothing to help Landis win the race.  "Testosterone is a body-building steroid that that builds mass over long-term use of weeks, months or even years," Kay said.  "It's crazy to think that a Tour de France professional cyclist would be using testosterone, particularly in the middle of a race.  It's a joke."

        from The News Tribune (Tacoma, WA), July 30, Expert thinks testosterone jolt possible:
        A forensic toxicologist in Nashville, Tenn., the author of the book “Drug Testing in Sports,” questioned the assertion by some experts that it would not make sense for suspended Tour de France winner Floyd Landis to have taken testosterone for a quick boost of energy and strength before his Stage 17 breakaway. ...  He said an injection of testosterone would have a “profound” short-term effect on an athlete.
        “I have injected myself with testosterone in doing research, and I can tell you from personal experience that within hours, you feel a profound psychological change, a sense of well-being, aggression and energy,” Black said.  “You feel strong and powerful.  And your endurance is definitely improved.  So, it’s not peculiar to me that a cyclist would take testosterone after a bad day.  What does seem peculiar is that an athlete of that caliber would put himself at such great risk, knowing that they test for testosterone.”

        Dr. Gary Wadler, a member of the World Anti-Doping Agency's prohibited list and methods committee, spoke Thursday [July 27, 2006] with ESPN.com about Floyd Landis, testosterone and testing.  /  The following Q-and-A is from about halfway through the brief interview:
        Q:  For a cyclist, what's the benefit of elevated levels of testosterone?  Why would a cyclist use it?
        A:  It's certainly not one of the first-line drugs one thinks of for racing.  Steroids can increase strength and improve recovery time and prevent the breakdown of muscle, maybe make him more assertive and aggressive.  All of those could have some positive attribute.  But most steroids are given in cycles [6-12 weeks] and in context of working out in a gym with weights.  It makes no sense to me why an athlete would take testosterone the day of a race when it doesn't work that way.  It doesn't make sense in terms of the pharmacology of the drug, and it really doesn't have the attributes that would be attractive to a cyclist — particularly one running the risk of violating anti-doping regulations.
        Everybody knew the spotlight was on cycling.  For eight years, the world has been watching cycling particularly closely.  It would be the ultimate form of denial, or the ultimate sense of invincibility, to think you're going to evade that.  And when the pharmacology of the drug doesn't really, in my judgment, seem like a drug of particular note to a cyclist, it doesn't really compute.

EXTRA NEWS (optional leftovers that may be cut soon)

Pereiro sees little gain if Landis loses Tour title (July 27)
Phonak: Landis had positive test after Stage 17 (July 28)
Landis calls his testosterone imbalance natural (July 30)

Inferences about Testosterone Abuse among Athletes (and false positives) (2004, J of American Statistical Association)

Testosterone 101 (7-28, AP) http://www.velonews.com/news/fea/10600.0.html

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