Opinion 15th June 2021

Have you heard of Nandrolone?

Is it conceivable that a top athletics Coach and experienced athlete have never heard of nandrolone? Shelby Houlihan, 28, the US record holder at 1,500m and 5,000m and her Coach, Jerry Schumacher, claimed never to have heard of it in statements (here and here) confirming a four year ban for an anti-doping rule violation (ADRV) involving the anabolic steroid.

Anabolic Steroids made up 44% of AAFs reported to WADA in 2019…

Anabolic steroids such as nandrolone make up almost half of the ‘positive tests’ (adverse analytical findings – AAFs) reported to the World Anti-Doping Agency (WADA – see right) per year. Based on 2019 figures, nandrolone (also known as 19-nortestosterone and by its metabolite, 19-Norandrosterone) made up 11% of the AAFs reported to WADA that involved anabolic steroids.

So in the anti-doping world, nandrolone is a fairly common substance. It also has a dubious history in athletics, having been used by Linford Christie, Merlene Ottey, and Dieter Baumann. On the face of it, a claim by an experienced athlete and her coach never to have heard of nandrolone does appear inconceivable.

But for many athletes, anti-doping just doesn’t exist until it happens to them. Most athletes support life bans until they discover that you can ‘test positive’ due contaminated food, water, or even for kissing another person.

Perhaps Houlihan and Schumacher focussed on competition and remained ignorant of the whole anti-doping system. Perhaps the many doping scandals of the last ten years just passed them by and didn’t pique their interest in who was taking what and why.

Perhaps they received bad advice. “Say you’ve never heard of it”, one can imagine friends, family, or even an inexperienced lawyer might advise. “It’ll make your story more plausible”. 

But in the world of anti-doping jurisprudence, where an athlete is considered guilty unless they can prove innocence, such a claim is likely to have the opposite effect. As can be seen on Twitter, this is exactly what has played out.

No published Decision

Both parties must agree for a CAS Decision to be published…

The Athletics Integrity Unit (AIU) of World Athletics and the Court of Arbitration for Sport (CAS) have yet to publish any Decision regarding Houlihan’s case. Under Rule R43 of the Code of Sports Related Arbitration, Decisions are not made public unless all parties agree (see right). This makes verification of claims made in the statements issued by Houlihan and Schumacher difficult.

A WADA Technical Document recognises that nandrolone contamination in meat is an issue…

Both are very critical of the anti-doping jurisprudence process. Houlihan argues that a burrito purchased 10 hours before the 15 December 2020 test was to blame. She correctly argues that WADA recognises that consuming pig offal can cause a nandrolone AAF.

She also argues that WADA recognises such AAFs as a ‘false positive’. This is debatable.

WADA specifies that consumption of pig offal can cause a positive test (AAF). Its Technical Document relating to nandrolone (TD2021NA) specifies that consumption of pig offal can result in the excretion of sufficient quantities of nandrolone of exogenous origin (i.e. not produced internally) to produce an AAF. 

‘Following consumption of the edible parts of non-castrated male pigs, concentrations of excreted 19-NA in urine are usually in the low ng/mL range (< 10 ng/mL), although higher concentrations have been exceptionally reported’, reads TD2021NA. ‘The origin of the urinary 19-NA may not be established by GC/C/IRMS analysis, since the varying die13C values which may range between -15 ‰ and -25 ‰. Therefore, if the consumption of edible parts of intact pigs is invoked by an Athlete as the unlikely origin of a 19-NA finding, this may be established based on the pharmacokinetics of 19-NA excretion. Profiles of 19-NA and 19-NE excretion following oral ingestion will have a different time course than following an injection of 19-norsteroids.’

You see. Anti-doping really is simple. If it’s on the Prohibited List, don’t take it. Joking aside, what the above jargon appears to mean is that nandrolone of porcine origin can be identified by a Laboratory, as its excretion will have a different time course to injectable nandrolone. If Houlihan is correct in her claim that this crucial analysis wasn’t carried out in her case, she would appear to have a valid point.

Houlihan argues that the levels of nandrolone in her sample were consistent with studies conducted on people who had consumed pig offal and were tested ten hours afterwards. There is scientific literature to support this argument. In a Study performed in 2000, three male volunteers reported nandrolone concentrations in urine between 3.1µg/L and 7.5µg/L ten hours after being fed 310g of pig offal. A standard burrito recipe contains 500g of meat.

Houlihan also points out that she passed a polygraph (‘lie detector’) test; her hair was sampled; and there was no build up of the substance in her body. Yet despite all of this she was sanctioned with a four year ban. Why? As nobody has seen the Decision other than the parties involved, commentators can only guess.

Schumacher’s statement outlines that it’s not OK for anti-doping jurisprudence to be right ‘nine times out of ten’ if this involves convicting innocent athletes of doping. I would respectfully argue that nine times out of ten is an overestimation. 

USADA assisted Jimmy Wallhead in discovering the source of his AAF…

Schumacher’s statement outlines that the US Anti-Doping Agency (USADA) is aware of contamination issues, and helps athletes discover the possible source of an AAF. A good example is the differing treatment afforded to Jimmy Wallhead and Sonny Webster, both of whom reported AAFs for ostarine, a substance commonly reported as a contaminant in supplements.

Wallhead received an 18 month ban, whilst Webster spent his life savings and received a four year ban. Arguably, neither athlete intentionally doped, but Wallhead received USADA’s assistance in proving this, whereas UK Anti-Doping (UKAD) didn’t help Webster. Under the World Anti-Doping Code, it doesn’t have to.

Wild boar was central to the Furys case…

Pork contamination has been offered as an explanation in two other high profile cases. James Kibet was sanctioned with a four year ban after claiming that his AAF was caused by contaminated pork fat. Tyson and Hughie Fury infamously ‘settled’ with UKAD after claiming that their AAFs were caused by consuming wild boar. Whether you believe their stories or not, it is significant that the athletes in all three cases independently came to the same conclusion that their AAFs for nandrolone were caused by contaminated pork.

But WADA is also aware of contamination issues. Late last month, it updated two Technical Letters. One of these explicitly recognised that six diuretics repeatedly turn up in contaminated medication. It advised that levels at or below 20ng/mL shouldn’t be treated as an AAF since such low amounts wouldn’t mask the presence of other prohibited substances in the sample, which is the main reason diuretics are abused.

Why would meat contamination be any different? It isn’t, but it is more complicated. Steroids can be used to directly cheat as opposed to diuretics, which are commonly used to mask cheating.

WADA has always maintained that any amount of a steroid shown to be of exogenous origin indicates an AAF. The logic for this is sound. It allows WADA to pick up trace amounts of steroids in the samples of athletes, which may indicate that they are coming off a doping cycle. 

Unfortunately for athletes, unscrupulous farmers also use steroids on cattle. This means that any meat has the potential to produce an AAF. 

Another recent Technical Letter published by WADA recognises this. It advises that in cases where four substances are detected in a sample at a concentration below 5ng/mL, the anti-doping organisation involved should investigate if meat contamination is the likely source. 

Despite the cases outlined above and perhaps surprisingly, nandrolone was not one of these four substances, despite WADA recognising its presence in meat, as explained above. Is that why the CAS Decision in Houlihan’s case hasn’t been published? Because it exposes double standards? Or because it exposes Houlihan and Schumacher’s arguments as false? Without seeing the Decision, it is impossible to know.

The truth will out

The whole episode exposes a serious issue with anti-doping jurisprudence. Athletes accused of a doping offence must explain how a substance ended up in their system. If they are sanctioned, they can only appeal to the CAS. The athlete and the prosecuting sport must both agree on publishing the Decision.

Houlihan’s case draws into question whether this is the right approach. Without the CAS Decision, all we have is the word of an athlete who has been convicted of an ADRV and the word of her Coach. We only have one side of the story.

Protection of privacy is – of course – understandable. Past Decisions have involved pregnancy and allegations of infidelity, so it is understandable that the CAS may want to give athletes a say in whether a Decision reaches the public. But redacted Decisions are often published by other sporting bodies, and have also been published by the CAS.

Houlihan and Schumacher have gone public with their arguments. Why not go public with the CAS Decision? Knowing which party is opposing publication of the Decision would be most illuminating.

Sport doesn’t suffer from ‘personal information’ being compromised in CAS Decisions. The CAS rules allow sport to withhold Decisions that expose bad science or rules. It also allows sport to monopolise control over anti-doping jurisprudence, by allowing it to only agree to publish Decisions that paint its anti-doping policies in a good light. As parties to a case are always provided with the Decision and lawyers representing sport tend to know each other, this provides sport with a powerful legal arsenal, which an athlete accused of a doping offence cannot match.

This is why sport doesn’t like it when athletes such as Kristen Worley, Claudia Pechstein, or Alex Schwazer take cases outside of sport’s closed system. It exposes their failures to outside scrutiny, undermining the ‘strict liability’ principle that underpins sports jurisprudence. It suits sport that the athlete is always considered guilty.

The highlighting of this problem with the sporting jurisprudence system is one aspect of Houlihan and Schumacher’s statements that is correct. This needs to change. The speculation about whether they are telling the truth or not only underlines this argument.

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