Jan 29, 2015
Bulletin Board

A Better Doping Test

University of Utah scientists have developed a new test to identify athletes who have taken testosterone to enhance performance. By using mass spectrometry to measure levels of both testosterone and the closely related epitestosterone in a urine sample, researchers were able to detect doping more quickly and accurately than with other existing methods.

Testosterone and epitestosterone levels vary widely among individuals, but the two hormones are normally present in the body at nearly equal levels. If an athlete takes additional testosterone or drugs that boost testosterone production, the test will detect an artificial imbalance in the testosterone-epitestosterone ratio. The World Anti-Doping Agency considers a ratio of 4:1 or higher to indicate doping.

Testosterone-epitestosterone tests are already used in some settings–in one famous example, Floyd Landis was stripped of his 2006 Tour de France title after his ratio was measured at 11:1. But the tests have been difficult to perform and required specialized procedures.

This new mass spectrometry test can be performed using standard lab equipment and is more sensitive than other methods, because it increases the number of usable “diagnostic qualifier ions,” which are markers that indicate doping. As a result, it may make testing for testosterone doping more widely available. “Our system means that we can determine the testosterone-epitestosterone ratio in a sample with greater confidence, and therefore be in a better position to spot doping violations without falsely accusing innocent athletes,” Jonathan Danaceau, MD, Preventive Medicine Specialist at the University of Utah Hospital, said in a press release.

“Quantitative confirmation of testosterone and epitestosterone in human urine by LC/Q-ToF mass spectrometry for doping control” was published in the July 2008 issue of the Journal of Mass Spectrometry. The journal can be found online at: www.uclibs.org/PID/839.

Flip-Flops & Athletes: A Bad Combination

It’s not hard to imagine why flip-flops can be bad for your feet, since they offer very little cushioning and virtually no arch support. But now, research from Auburn University’s Department of Kinesiology provides specific data about how flip-flops can affect athletes who wear them.

“There’s plenty of anecdotal information out there that says flip-flops can cause problems,” says graduate student Justin Shroyer, MA, CSCS, who co-wrote Auburn’s flip-flop study with Professor Wendi Weimar, PhD. “We wanted to look at them scientifically to see what effects they have.”

In the study, researchers analyzed the way 39 college-age men and women walked while wearing flip-flops, then compared it to the way they walked in athletic shoes. With flip-flops, subjects took shorter strides, hit the ground with less vertical force, and increased the “attack angle” of their ankles during the leg’s swing phase. When participants switched to sneakers, some of the gait changes remained, causing discomfort.

The study raises questions that Shroyer and Weimar would like to answer with further research: How do muscle recruitment patterns differ when wearing flip-flops versus athletic shoes? Does the shortened stride put athletes at risk for injury? How much energy do foot muscles have to use to grip the flip-flop? Does the flip-flop step cause muscles to work harder?

Shroyer stops short of drawing too many conclusions from the initial study, and hasn’t yet tossed his own flip-flops. But he does caution athletes against wearing them all day long. “Flip-flops were made for the beach, the pool, and the shower, and that’s where they should be worn,” he says. “There are some great things about flip-flops: They’re easy to take off and put on, and they help keep feet cool. But they’re not the best choice for everyday footwear.

“If athletic trainers are trying to provide an optimal environment for their athletes, they’ll want to eliminate anything counterproductive,” adds Shroyer. “If athletes want to keep wearing flip-flops, they should look for ones with more arch support and a thicker cushion. And they should replace them every three or four months. If they have to break out the duct tape, they’ve gone way too far.”

Injury Reporting Revised in the ACC

This season, the Atlantic Coast Conference (ACC) is adopting the NFL model for reporting football injuries. The new guidelines state that head medical personnel for each team, rather than coaches, will report every Monday during the season which players are scheduled for surgery or are out for the season. On Thursday, within 90 minutes of the end of practice, teams will release a list classifying each player as definite, probable, questionable, doubtful, or out. Teams won’t release any injury information on Tuesday or Wednesday.

ACC schools used to release a full injury report on Monday, as is standard practice in most other conferences. The new policy was adopted to give teams more time to evaluate the status of players, and to keep coaches from having to answer media questions about medical issues.

“We’re not doctors, athletic trainers, or medical personnel,” says North Carolina State University Head Football Coach Tom O’Brien. “This policy gets us out of the business of answering questions about injuries. Trying to get an injury report out on Monday after a Saturday game is almost impossible, because you can’t really tell at that point if someone will be able to make it or not.”

O’Brien says he’ll work with athletic trainers and team physicians in much the same way he did before, but now, they will be able to provide more accurate information to the media and the public. This reporting process will also keep coaches from having to worry about violating the Health Insurance Portability and Accountability Act (HIPAA), which protects the privacy of personal health information.

The new injury reporting system is voluntary, with no penalties for deviating from the agreed upon protocols. No other conferences are currently planning to follow the ACC’s lead, though Head Football Coach Mack Brown of the University of Texas (a Big 12 Conference member), has expressed interest in adopting the system.

Study Finds Hormonal Link to Amenorrhea

A study from Harvard University has found a possible predictor for amenorrhea (the absence of menstruation in females of reproductive age) among teenage female athletes. The hormone ghrelin, which normally stimulates appetite, was found to be at elevated levels in amenorrheic athletes.

Madhusmitra Misra, MD, a pediatric endocrinologist at Harvard-affiliated Massachusetts General Hospital, studied 21 teenage athletes with amenorrhea alongside 19 normally menstruating teenage athletes and 18 menstruating teenage non-athletes. The non-menstruating athletes had significantly higher average levels of ghrelin and lower levels of a corresponding hormone called leptin than the other two groups. The amenorrheic athletes also had lower bone density and lower levels of estrogen, which is essential for bone growth.

Misra’s study says amenorrhea affects as much as 25 percent of the high school female athlete population, compared with two to five percent of teenage females overall. The higher rate is usually linked to energy deficits caused by high-intensity exercise and low caloric intake.

This most recent research helps clarify the role hormones play, and may be a step toward identifying who is at greatest risk for amenorrhea and the female athlete triad in general. “These findings suggest that hormonal disorders may explain why amenorrhea occurs in some but not all adolescent athletes,” Misra said during a presentation at the Endocrine Society’s June 2008 meeting. “In addition, ghrelin may be an important link between an energy deficit state and the hormones that regulate menstrual function.”

An abstract of Misra’s presentation, “Reproductive and Bone Health in the Female Athlete,” can be found on the Endocrine Society’s Web site at: www.abstracts2view.com/endo.


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