The Association of Ringside Physicians' recently TRT/" style="line-height: 1.6em;" target="_blank">called for the elimination of testosterone replacement therapy in mixed martial arts. Further, UFC President Dana White said he was "thrilled" by the ABC call, and noted that government athletic commissions should close the TRT loophole permanently. And ZUFFA CEO Lorenzo Fertitta recently announced UFC financial support of thorough drug testing.
In short, Therapeutic Use Exemptions (TUEs) for Testosterone Replacement Therapy (TRT) are on their way out of mixed martial arts.
That change may be hastened by an investigation by ESPN.com's Mike Fish, revealing that TUEs are being granted by State Athletic Commissions at a far higher rate than they are by other international regulating bodies.
In the past five years, at least 15 mixed martial artists have been issued exemptions to use testosterone, the vast majority revealed or confirmed through public records requests filed by "Outside the Lines" with the major state commissions or athletic bodies overseeing the sport. The sport itself has had more than 20,000 pro fighters over the past five years, according to record keeper mixedmartialarts.com, although fewer than 1,800 MMA combatants are under contract to the sport's dominant promoters -- Zuffa (UFC) and Bellator, which account for 11 of the fighters on TRT. Although only a small fraction, the number of exemptions still dwarfs what can be found in other sports:
• The International Olympic Committee did not issue a single testosterone exemption for the 2012 London Olympics, which featured 5,892 male athletes.
• The U.S. Anti-Doping Agency issued one testosterone exemption last year among the thousands of elite-level athletes under its jurisdiction.
• Major League Baseball has issued six exemptions to athletes over the past six seasons -- an average of 1,200 players populate its rosters each season.
• National Football League officials say testosterone exemptions are "very rare" and only a "handful" have been issued since 1990. Nearly 2,000 players circulate through rosters each season.
• No pro boxer is known to have had an exemption issued through a state athletic commission, and Nevada officials said they have never even received an application.
"It's a huge number," said Dr. Don Catlin, the country's leading anti-doping expert, of the MMA testosterone exemptions. "I am on the IOC committee that reviews [therapeutic-use exemptions for testosterone] requests. We essentially grant none. But in boxing and MMA there is no central control. There is no set of rules that everybody has to follow.
"There is a set of rules for each [state athletic commission], but they are kind of Mickey Mouse rules. So the route to being able to take testosterone is wide open. ... You go in and say 'I have these symptoms.' The doc says, 'Oh yeah, you got low testosterone.' You get a TUE."
U.S. and international anti-doping agencies insist therapeutic-use exemptions for testosterone should be rare and permitted only in dire medical cases such as testicular cancer and Hodgkin's disease, as is the norm in most major sports. The international standard for an exemption specifically states that "low-normal" levels of a hormone isn't justification for granting approval, also noting the same of isolated symptoms such as fatigue, slow recovery from exercise and decreased libido.
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However, the piece has some bad math. Leading endocrinologist and University of Michigan professor of internal medicine, Dr. Richard Auchus, is quoted as saying the incidence of low testosterone (or hypogonadism) in healthy 30-year-olds is well less than 0.1%. However, with 20,000 fighters having been registered, a .1% would translate to 20 fighters. And the actual number of TUEs issued to date? 15, a number well under 20.