Seems like there is still A LOT of confusion surrounding TRT and TRT Exemptions. I hope we can get some clarification...
It seems that if a fighter has a test/epitest ratio of more than 6:1 then they are violating NSAC rules. Also, there seems to be no radio isotope test done to see if levels below 6:1 have the presence of synthetic test.
Meanwhile, there seems to be more and more fighters getting or looking to get TRT Exemptions.
- What exactly is the nature of this exemption?
- Can a fighter with an exemption have a higher than 6:1 ratio and still fight?
- If yes, what are the circumstances where they can (i.e. they have an exemption and then a doctor's note saying they got a shot close to their fight)?
- If they cannot fight with a higher than 6:1 ratio will their suspension be reduced because they have the exemption?
- If not, what is the point of the exemption?
If a fighter is not allowed to have a ratio higher than 6:1 regardless of an exemption than I do not understand what the benefit of having a TUE is. If a fighter takes TRT and has a 4:1 ratio than the Commission does no further testing (i.e. radio isotope for synthetic test). And if the fighter has a 10:1 ratio but will not be allowed to fight and will be suspended regardless of the TUE, then why have the exemption? What EXACTLY are they exempt from?
It is all very confusing.
Thank you, in advance, for your clarification.
I think you're confusing the chemistry.
First, the TUE is an exemption to use a banned substance - no more, no less. In this case, it's Testosterone, but it could be anything listed in http://www.leg.state.nv.us/NAC/NAC-467.html#NAC467Sec850
A test/epitest ratio of 6:1 or greater does not in and of itself provide evidence that an athlete is using a banned substance. The TE ratio test is simply a screening tool, to allow testers to process a large number of samples over a short period of time.
You need to remember that testing takes time, and for some events (i.e. the Olympic Games) there may be hundreds, if not thousands, of samples to be chemically processed for testing. The ratio test is selected to be sensitive - that is, it will catch the vast majority of cheats - while also selective - there won't be an inordinate number of false positives. A ratio test is good for a quick initial screen because it has it's own internal control; a more quantitative assay would require much more effort.
Again, the TE ratio test is only a screening (or presumptive) test. The confirmatory test would be the carbon isotope test (not a radioisotope test - this test discriminates between C12 and C13). However, this test requires more care and skill, and I presume is more expensive, therefore not suitable for screening.
But note, the CI test only determines the chemical origin of testosterone (short answer, synthetic hydrocarbons won't have the same C12/13 ratio as plant or animal derived hydrocarbons). A cheater could use animal-derived testosterone and pass the CI test.
A fighter with a TUE would, I presume, still be screened (because screening involves blinding - the chemists can't know the origin of the samples), but any result pertaining to testosterone would be ignored by the commission. They might instead choose to require additional blood testing to determine testosterone levels. In this case, the CI test would not be needed - the source of testosterone covered by TUE wouldn't matter, just circulating levels.