Today we're diving into a hot topic. It's stirring debates in the masters cycling community all over the world and that is testosterone replacement therapy T or T and its implications on fair competition. Is the use of testosterone replacement therapy in mast's racing is it a legitimate medical necessity or does it cross the line into unfair advantage?
Anthony, so TRT or testosterone replacement therapy has become a really hot topic and debated heavily especially across our socials in the last couple years. It's been hugely popular. Yeah, I think more athletes that are competing, athletes over the age of 35 really.
They're kind of seeking ways to maintain these high performance levels even though naturally you've got factors that are declining as we kind of go into those 35 plus age groups and TRT has emerged as a medical solution. So, but it's also a point of contention. Proponents of it have been arguing that, and we're getting to see a really balanced debate in the comments because it's nearly split 50/50.
And proponents of it argue that testosterone replacement therapy helps helps to address legitimate health concerns in people, allowing athletes to continue to participate in a sport that they clearly love. They emphasize that with proper medical supervision, testosterone, it can be safe and it can be fair and it's a means to level the playing field. Yeah.
But like anything, we know that these things can be abused and there's huge question marks around whether TRT gives you a very unfair advantage. And that blurs the lines between needing this therapy for your health reasons or using it as a performance enhancement. Yeah, it's for me I Okay, so cards on the table where I fall on this debate.
I don't think there's room for nuance in the debate. We have a set of rules that govern conduct of athletes. Assuming you are a racer, assuming you have a racing license.
If you have a racing license, we're in Ireland. I have a racing license. You might be listening in the UK or the US.
It's all the same. Those racing licenses are issued by your national federation from the UCI. And as a as a clause in the contract, when you sign for that racing license, you agree to be bound by the world anti-doping code.
The world anti-doping code, it outlaws the use of testosterone. We can go through it in a second. I have I've pulled out the section which I'll go through now.
So according to the world anti-doping agency, it's the most recent version of it back in 2024. Testosterone and its analogies are classified as section S1 anabolic agents. This section states the world antid-dopen code agency anabolic agents are prohibited at all times in competition and out of competition.
This category includes both exogenous testosterone that's administered outside your body and other anabolic agents that might enhance growth hormone or athletic performance. However, while it does recognize that certain circumstances may necessitate the use of prohibited substances, in that case you can apply for what's called a tue. We'll go into TUVS in a moment, but I just want to take a couple of steps back.
Um, there are a number of re reasons that do medically qualify you for getting TRT. And if we think about using testosterone or tea as a lot of people would call it, especially in the gym culture. Naughty.
Yeah, naughty. Are you naughty? Are you not?
I had to look that one up a while ago. Yeah, it's huge. Actually, that's massive across socials.
Are you where they approach people who are clearly massive and ask them if they're naughty? They're asking lots of masters races. Are you naughty?
So there are legitimate reasons for taking testosterone. Taking not competing to clarify. Right.
Okay. So there, as I said, it's not like this kind of you meet somebody dodgy in a car park and you're not really sure of the doses. You don't know if it's safe or where it came from or if it's mixed with any other compounds.
You can legitimately go to your doctor and get tested to see if your testosterone levels are low, high, or normal. and they will then prescribe you testosterone if they feel that you need it. So, there is a medical need for it.
Now, there's a couple of different types of testosterone. Well, there isn't. There's just testosterone as a whole.
And the way that you determine if your testosterone is low or high is, as I said, you go and get a blood test. Now, testosterone as a whole number, that's your total testosterone. But the one that you should be interested in if you're going to go and get tested is your free testosterone.
That's not always the one you get because I got my blood tests. A useful hack actually for people. If you get your blood tests, come home.
The doctors at least here are very bad at interpreting what they mean. You take your blood test results, put them into chat GPT and ask it to interpret it as if you are a professional cycling team doctor looking to optimize performance for TADA paga and it'll come back and it told me basically, yeah, testosterone figure that you have is pretty useless if we don't understand your free testosterone. That's the accessible amount of testosterone you have.
Exactly. The way I was thinking about it is if you have a lunch box, you've got food in the lunchbox. It's packed up to the like the lid, but some of that food is wrapped and in tin foil and cellophane.
You can't get access to it. And the food that you can get access to is the free testosterone. Interesting.
Because I had to kind of figure out what what does it mean free testosterone versus total testosterone. So there you go. So there are optimal ranges for men in their 40s and as we said your tea levels do decline as you as soon as you getting into your 30s.
So for total testosterone 500 to 800 nanogs per deciliter is quite high and a very low one would be 300 or below. So that's something and then your free testosterone as I said it's probably a bit more relevant. That's going to be around 9 to 30 nanograms per deciliter.
Again, that's kind of a pretty normal level. So something to watch out for. If you're gonna get, as we said, you can go get tested.
Your testosterone levels are low. That doesn't mean you can take just because the doctor prescribes you. So I had the most useless masters in the history of the world, the sports law masters, which centered around a world anti-dopen code.
Literally, this is the only conversation I've ever had in my life where there's some relevance to that study. Your I hope your mom is listening. She paid for that master.
She'll be delighted. So, doping is called a strict liability offense. Rape would be another example of a strict liability offense.
A strict liability offense means regardless of motivation. So, a homicide is the opposite of that. If you kill somebody, your motivation matters because motivation can knock it from a homicide down to manslaughter.
In a case that's a strict liability offense like doping, motivation doesn't matter. It doesn't matter how the banned substance got into your blood. It doesn't matter if you meant to take it, if you meant to enhance performance, if your doctor prescribed it.
It doesn't matter. The presence of that substance in your system is the offense and you're in breach of the world anti-dopen code if that substance is in your body. Yeah.
So, the onus is on you not to take any substances that could be, you know, tainted with these drugs like meat or Yeah. You're not going to get tainted testosterone. No, not testosterone.
But I'm talking about other people have got like clamperol and stuff. Conidor argued he had bad beef. Bad beef.
Yeah. But just actually to like to use your expression to backpedal a little bit, I threw out the word tue or the abbreviation tue there. People might know what that is.
That's therapeutic use exemption. So, a therapeutic use exemption is you apply to the UCI and you say to them, look, here's my medical records and there's a criteria for getting this TUE. It's not just, you know, you happen to get a TU because you think you'll go better.
TUEEs are granted in very very very limited circumstances. And the criteria is the athlete must have a primary or secondary hypogondism. Don't even know what that is.
You know what that is? No idea. Due to legitimate medical issue, eg pituitary dysfunction.
Must show unequivocal lab results showing consistently low testosterone typically for typically 6 to 8 N O per liter depending on lab reference. The treating physician must show that no viable band substance alternative exists. A panel of independent doctors often appointed by W must agree the TUE is justified.
Yeah. How often you said they're they're hard to get. I mean, how often are we seeing these TU?
They're like hence TE. They don't get granted. The that last data I could find was from 2020.
And for all TUEs, not just testosterone, all TUEs granted by the UCI in all countries. Now bear in mind Cycling Ireland I think has 20,000 cycling Ireland license holders. UK, US have multiples of this across all license holders worldwide in 2020 there was 20 tou granted total.
So I don't know total numbers but you'd have to say as a percentage that's like 0.001%. So people in the comments down below going I might qualify for a TUE.
You won't. You won't. It's like I might win the lotto.
You won't. I mean, taking testosterone does have a lot of benefits. This this doesn't mean that it's not going to affect you.
It's been proven that people who take TRT um have improved motivation, confidence, emotional stability, better cognitive performance, and I guess importantly for sports, um testosterone plays a really vital role in muscle protein synthesis and improves muscle tone. um you've got more energy, you've got less fatigue, it restores your energy levels, you get an enhanced libido and sexual function and better body composition. So, it definitely does help you in so far as how you perform in your sporting endeavor.
But how much of this do you think is actually going on? Well, I think before I answer that question, the counterpoint to that argument is it's just restoring you to your normal levels. you've had a decline in testosterone.
So, you're not taking testosterone to supplement normal ranges. This is somebody who they they will argue, this is not my viewpoint on it. People who are proponents of taking testosterone and think they should be allowed to compete with it will argue that it's just restoring them to their natural testosterone range and they're not getting any of these benefits you listed.
But you're competing against people who aren't artificially restoring their tea levels. So therefore you do have a little bit of an advantage because you're racing in mast's category for instance you're amongst peers everyone is around the same age and their testosterone levels are declining and you're artificially keeping yours afloat. So I don't really go for that argument but how much of this do you think is happening in the amateur level at the moment?
We had some amazing comments on our YouTube video from last week basically and people were commenting in their hundreds. One person said, "I'd argue this is a far greater problem than at elite level. I wonder just how much TRT is going on at grassroots level, not just in cycling, but in triathlon and swimming.
It's a much bigger problem at age group or mast's level for a couple of reasons. In competition and out of competition testing are your two means for testing an athlete for breaches of a world anti-deop. So, for people not familiar, incompetition testing is you go to the race and you're randomly pulled at the finish line to give blood and or urine samples at the end.
Out of competition is what I had in the run-up to Tokyo where somebody would just call to the house randomly, unannounced at any time of day, the vampires, and they come and they take your blood and they take your urine. Incompetition testing is it's not really a drug test. It's an IQ test because anyone that's taken something knows at elite level how long that's going to stay in their system for.
So they're not going to show up at a race with something in their system where they could potentially get tested for it. Elite athletes are especially world tour athletes if we're talking if we're calling them elite and we're kind of drawing the line after pro as non- elite. World Tour athletes just won't risk taking TRT because it's on the band list.
their contract is at stake, their reputation is at stake. If they're going to take it, it's going to be super sneaky and it's going to be in that category of we're actually doping. Why it's more prevalent, I think, at age group level is the people taking it don't consider as doping.
It it is doping, but they don't consider it as doping. And I guess the reason for that is you got to look at what you're optimizing for. If you're optimizing for health, it most likely makes sense to take testosterone.
You're going to be a healthier version of yourself if you take testosterone. The problem with that is sport is about fairness and fairness means following the rules. If you're not following the rules, you're not competing on a level playing field with your peers.
Like the entire point of mast's racing, why we have a mast's category is it's a recognition that masters when they get older, they don't sleep as well, they don't recover as well, they don't get adaptations to training in the same degree as you do when you're an elite athlete. Everything is slower. So you make a category where people that are experiencing all these challenges in life can compete against each other in an even footing.
So for one person to mask the effects of aging to and compete against somebody who is dealing with the effects of aging and using alternate strategies to deal with that. They could be meditating, taking extra time off work, all of these things to optimize. Nailing your diet makes such a difference with testosterone levels, stress levels, sleep, managing the stress in relationships.
All of this goes to optimizing testosterone in a natural way if you want to compete. So, it's totally skewing and given an uneven playing field for athletes. It's more of like a morality type of question rather than you're going to get popped for TRT, right?
Because how could they poss if you're just bringing your TRT levels up into a zone, the numbers that I kind of quoted earlier that are, you know, high or normal, no one is going to test for that and say, oh, you're not, you know, you're being stripped of your No, no, you can't test for that. Yeah, you can test for that. the tests are getting it's for artificial TRT is it?
Yeah. And the tests are sophisticated now where they're not just testing for because you know initially that would have been true back in the day but to sidestep stuff like that your traditional dopers would have started infusing their own blood back into them with the rationale of well how can they test for my own blood? So the tests it's this game of cat and mouse with testers and cheers getting increasingly more sophisticated.
So you can chat, you can test for bodies like plasticytes and precursors that are in needles that are transmitted through the use. So yeah, the testing is quite sophisticated. So you will get popped if you get tested for taking testosterone.
Okay, interesting. That I didn't know. So another comment that I really want to touch on because I found it really interesting and not funny but um and not in cycling, this is triathlon, but a commenter said, "The same thing happened to me at the South African Iron Man.
I came sixth in my age and the Hawaii Hawai Hawaii slot went down to number 13 as no one was at prize giving because there was a the first EPO test that year. That's just go to show you that people went over the line as soon as they heard that there was testers. They didn't show up for the podium.
Yeah, that maybe he's like conflating like terms because you know in E there's not specifically an EPO tester. That's just an anti-doping tester because if there was a case that we were having fifth down to 13th on EPO, EPO is a different less nuanced debate because EPO bar some very extreme health complications isn't something you would take to optimize health just to optimize performance. But it just goes to show that there is a significant number within these type of events that are prepared to take something and are not prepared to be tested.
And then another comment I but even to jump on that one as well I can rationalize it as well even if you're not taking anything because if you're not an elite athlete when I was an elite athlete in competition and out of competition testing you're acutely aware of every single thing that goes into your body. If you have a drink, this kind of monster, you're looking at the ingredients, you're scanning it onto your Institute of Sport app, you're making sure it's batch tested, you're making sure it's approved, and you're making sure you're not going to get crosscontaminated from somewhere. So, you're looking at supplements, you're looking at your creatine, your multivitamins.
That was the number one app that we used when you were in, you know, whereabouts and being tested. We never bought anything different to like consulting that first. So, so when you're not an elite athlete and you're not doing this, like if you've come 11th in an iron man and the testers are there and you're like, "Oh, was that preworkout I had the other day?
Did that have a band ingredient in it? Did it not?" Because no one's going to read past the headline of Sarah an Egan popped in Iron Man.
Your reputation everything is just completely gone at that stage. Okay, that is a really really good point. road man.
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Another comment, and I'm not going to read the whole thing. We'll pop it up on screen. basically is that um this person stopped racing because he knew that everybody else within the mast's group was going to be was taking TRT or some kind of peds essentially.
I mean that is the thing isn't it? It's if you're seeing these kind of big leaps in performance of people, if you're seeing people that you know have had this very sudden kind of uh you know resurgence of their fitness and their health, their stamina, their endurance, and you're kind of thinking, oh, look, everyone around me is uh is doing this. It's quite heartbreaking, I said, and it's it really does push people out of the sport, unfortunately.
Yeah. You know, I've never personally thought about it. Like when we're sitting here and we're discussing it abstract, it's terrible to read that comment that someone has chosen not to compete anymore.
That his joy is getting sucked out of cycling because he doesn't feel like he's competing on a level playing surface. But then for me personally, it's not something I ever consider. I just kind of go, you know what, if I can win, I can win.
If I can't, I can't. Probably my variable is just could I train a little bit more? could I order a few less curries?
like that's my variable and I tried to control what I can control because you know I came up racing with a team in France and one of my teammates there had been popped the previous year for EPO use and at any stage in your cycle and career or at least for me you had opportunity to be skeptical of people around you and you get to either opt into that or opt out of and I just always opted to focus on my performance so I can't put myself into his shoes and really sympathize too with that on one level, but on the other level, like he's living his reality. If that's his reality, it's sad that he walked away from the sport. Another point that was kind of reoccurring in the comments of our last video was this argument that you reach a certain age and you want to keep racing, but you do need to supplement with TRT to be competitive and well, why not?
Kind of. People are saying it's just local level racing. Who am I hurting?
And I hate that argument. Yeah, that argument winds me up so much because right Pagotaa winning the sort of France is the most important goal for him this season. Joe winning the local Tuesday night criterium at 45 to 55 might be the most important goal for him.
Absolutely. like he doesn't care if Bagotaa wins the tour and the sacrifices that he makes every day are maybe in some cases more real than the sacrifices a world tour writer is making. You're looking at, you know, and this is not uh fictional.
This is like friends that will choose to not take a promotion in work because it'll mean extra hours and it'll cut into their training hours. friends that will choose not to take at other career advancement because they don't want to locate to a place that's not as friendly for training, hours spent away from family, hours spent away from, you know, other partners, hours spent away from caring for elderly parents, the opportunity cost for masters, racers, and people in the real world of staying fit and staying at this level is huge. So then for someone to come along and say, "Oh, it doesn't really matter.
" Like it's very trit. I don't like it at all. Let me read out this comment.
So, uh, this is from Michael. I'm not sure about this one. Although I've never used testosterone.
I have a thyroid issue and as I age, I might end up needing it just to get up in the morning. I don't want to give up racing. I dig the community and I'm not winning with or without it.
If you're racing masters and taking it all that taking it all that seriously, lighten up. It's like saying it's unfair when the cat one former pro racer crushes your local masters. That's just the way it is.
And there will always be someone faster. You're over 40, you don't make money doing this, so stop taking yourself so seriously. Such a bizarre argument, isn't it?
And it's absolutely nothing like when the cat one former pro comes and races because you're competing on an entirely even playing surface. Maybe he's won the genetic lottery slightly different than you have. But that's what sport is.
We get to compete on our genetics sets our ceiling and our training sets how close to that ceiling we get. Yeah. No, I agree with you.
I think that look this the the line that's that sticks out to me is I'm not winning with or without it. So people kind of who are never going to win a race who are down in the middle or the back of the pack might just feel like well I'm not actually hurting anybody. You're impacting the race.
If you know anything about this is a comment from someone that knows absolutely nothing about cycling that's never been in a bike race. You can come 70th in a bike race and impact the outcome of that race. You can close a gap at a vital time.
You can lead someone out. You can hold position for somebody into the base of a climb or you can the opposite. You can impact it negatively.
You can split the bunch. You can crash and get a good better rider cop behind you. If you're in the bike race, it's just black and white.
If you're in a bike race with a license, you're in some cases, if you're taking money as well, you're committing fraud. It's not just breach of contract, it's fraud. I so again I want you to comment on this um comment because with the comments across our socials it's very we were very surprised at the fact that it was very almost 50/50 but 50% absolutely no way it's cheating and almost 50% saying yeah of course there's a place for it and this commenter says are you saying that a 47year-old male with a total testosterone level of 174 which is well below the clinical reference range of 300 to 1,000 for adult males is cheating if he considers TRT even if it's medically prescribed monitored and simply restores him to baseline.
I think we kind of covered that earlier because as I said everyone else is declining and nobody else and you're not. Yeah. And if he considers it no it's not a there's no taught crime like you have to actually do it.
We we're not in 1984. It's not like uh Minority Report. We spotted a future crime.
Okay. So, how do we stop it? And some of the funnier uh comments that we did get over the last week were, you know, people having come some some pretty interesting solutions as to how we can nip this in the bud.
What do you think? My favorite one was, "If you're in a break with a group of masters as you're coming to the finish line, just whisper that you seen the testers at the finish line and watch them drop out with one lap to go." Hey everybody, let's take a quick break to talk about the bike I'll be riding this season, Reap.
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Yeah, somebody said the race organizer should race raise the entry fee to cover doping testing costs and have it included as part of the starting package. I I just don't think that that will will wash with people because I I also think it would push the price up a lot for people to enter these racing already. Participation would definitely go down.
People will go to races that um that don't have this kind of you know this clause put it put in. We also have another comment here. Doctor with an S works here, so I fit your profile, but I and I loved your video.
I wished I could rent a white van, put USADA stickers on the side, and pay a stranger to park it at races. It's a good one. Yeah, I I actually think it's, you know, they're tongue-in-cheek comments, but I think there's a huge onus on us as the cycling community to call it out in our group rides with our peers.
For me, looking at the comments and knowing some of the people that commented, there seemed to be a huge split between people that thought it was all right that aren't racers or have raced at a super low level and people that have raced at a higher level are still active racers saying, "No, this is not cool under any circumstances." So, for me, one quote that sums it up, it's the former Cycling Ireland doctor, he was the doctor under Ross for years. He's a he's a great man, Dr.
Conor McGrain. He summed it up quite succinctly for me in one of the posts. He said TRT or testosterone is banned in competition and is cheating.
There is no gray area. There is no nuance. If you take it, no issues at all, but don't race.
While you probably won't get caught and you will get away with it, if you are caught, you will be labeled a doper for life and that will stick with you. I think that's just about where we'll leave it. I think that's the bottom line.
Ro men, thank you for tuning in. If you haven't watched our wider discussion on doping of all sorts within master cycling, that is definitely worth checking out. We're going to pop the video up there.
And please let us know in the comments down below. Is taking testosterone replacement therapy crossing the line? Do the Wada or USADA guidelines need to be adjusted for aging men so they can balance competing and optimizing their health?