Baume, N., Avois, L., Schweizer, C., Cardis., C, Dvorak, J., Cauderay, M., Mangin, P., Saugy, M. (2004). [13C]Nandrolone excretion in trained athletes: interindividual variability in metabolism. Clinical Chemistry, 50(2), 355-364.

"BACKGROUND: Nandrolone is one of the most abused anabolic steroids, and its use in doping is increasing, as revealed by numerous positive cases during recent years in various sports. Different authors have reported the possible natural production of nandrolone metabolites in humans, and some of these authors argued that exhaustive exercise could increase nandrolone production in the body or induce dehydration and consequently lead to an increase of nandrolone metabolites in urine. METHODS: Volunteers (n = 22) ingested two 25-mg doses of [(13)C]nandrolone at 24-h intervals and collected urine specimens for 5 days. The labeled nandrolone metabolites 19-norandrosterone and 19-noretiocholanolone were identified and quantified by gas chromatography-mass spectrometry. RESULTS: Interindividual variability was observed in nandrolone excretion patterns and kinetics, as well as for the noretiocholanolone:norandrosterone ratio. The amounts of nandrolone metabolites measured at the excretion peak varied between 1180 and 38 661 microg/L for norandrosterone and 576 and 12 328 microg/L for noretiocholanolone. At the end of the excretion period, the noretiocholanolone:norandrosterone ratio was sometimes >1. The analysis of numerous spot-urine samples allowed the determination of an acceptable correlation between urinary creatinine and specific gravity for placebo- and steroid-treated individuals: y = 0.0052ln(x) + 1.0178 (r(2) = 0.8142) and y = 0.0068ln(x) + 1.0172 (r(2) = 0.7730), respectively. CONCLUSIONS: The excretion kinetics and patterns of labeled nandrolone show interindividual variability. More investigations are currently underway to estimate the influence of exhaustive exercises on excretion of labeled nandrolone metabolites in urine".

Implication. To ascribe one level of nandrolone/nandrolone-metabolites as the cut-off point for declaring a positive drug test is unfair to those individuals whose natural concentrations are on the extreme right of the normal distribution of these substances. This study shows that it should be expected that individuals will test positive through no fault other than natural causes. In that light, the current testing for Nandrolone should be deemed unfair.

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