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Many athletic groups, including the IOC, or International Olympics Commission, use a variety of methods to test for anabolic steroids in athletes’ bodies. The most common method used for steroid testing is urinalysis, although some companies and organizations may also look for the presence of steroids via hair follicle tests.
One of the best ways to describe the ways in which steroid testing works involves using MLB, or Major League Baseball, as an example. Each MLB team has 40 players on its roster, and every one of those players receives testing twice per year. Every player submits to urinalysis in the spring, prior to the start of the season. Then, the MLB conducts 1,400 more samples from players randomly throughout the season. On top of this, if anyone has “reasonable cause” to believe that an MLB player is doping, that player must test within 48 hours. All of those samples go to the WADA (World Anti-Doping Association) laboratory in Montreal.
Upon receipt of a sample, the WADA lab uses two separate urine tests to detect anabolic steroids. The body produces not only testosterone, but also another hormone called epitestosterone, in the same quantities, so the ratio of one to the other in the body is usually about 1:1. Anabolic steroids are all derivatives of testosterone – not epitestosterone. Because of this, and as you might imagine, WADA checks athletes for both testosterone and epitestosterone in the first test. When the ratio is greater than 1:1 and more testosterone than average is present, WADA performs another test to confirm the presence of performance enhancing chemicals.
Each sample with a ratio greater than 1:1 in the first test is subject to a “confirmation” urinalysis, or an isotope radio test. Now, to keep things simple, keep in mind that the carbon that makes up the testosterone in the body is a consistent ratio of carbon-13 and carbon-12. Carbon-13 makes up only a very small amount (less than 1%) of all of the carbon on earth, and living things seem to prefer the carbon-12 isotope because it is lighter and thereby easier to utilize. It is safe to say that living things (natural testosterone) contain much more carbon-12 than non-living things (synthetic testosterone), which naturally have higher levels of the heavier carbon-13 isotope.
Not all athletes who fail to pass the original test are guilty of doping. In fact, these tests return more than 100 false positives each year. Because of this, WADA utilizes the second isotope radio test to check for elevated numbers of the carbon-13 isotope. If this test reveals that there are more than three carbon-13 atoms per thousand or more, then the player fails the test because it indicates the presence of synthetic testosterone, the hallmark of anabolic steroids.
However, not all companies utilize the same testing methods. Isotope radio tests are quite expensive, and for this reason, many organizations simply test for abnormally high levels of testosterone; others test for individual steroids by separating urine into its chemical components and looking for the chemical “fingerprints” of those steroids.