Friday, July 28, 2006

The WADA and IRMS: a positive is always positive, but a negative can be positive too

According to the WADA's guide on T/E testing, if you test positive using the IRMS test, you're definitely guilty. But if the IRMS test clears your sample, then you can still be held as guilty of cheating.

That's right folks. If the definitive test finds you guilty, you're definitely guilty, but if the definitive test clears you, the WADA can still say you're guilty anyway.

According to the WADA guidelines, the labs administering the T/E tests don't have to use the IRMS test.

The IRMS test, to refresh your memory, in effect distinguishes between naturally occurring testosterone levels and artifically-induced levels. They can count the differing types of two types of carbon isotopes. If the one's high and the other is low, you're clearly doping, but if the one is low and the other is high, your own body is producing those high levels appearing in the T/E test. The test is expensive, unlike the T/E test, but conclusive, unlike the T/E test.

Apparently, in the case of Floyd Landis, there are four decision points involved in choosing whether to use IRMS: (1) the WADA lab can choose to do the IRMS as part of the T/E test protocol, which they rarely do because it is relatively expensive; (2) the WADA lab, in its report to the UCI, can choose whether to recommend that an IRMS be performed on sample B; (3) regardless of the WADA recommendation coming from the LNDD, UCI can order the LNDD to perform the IRMS on sample B; and finally (4) I've heard that Landis can demand it. This latter point is not in the report, but apparently the UCI allows the riders the opportunity to be involved in the requirements setting.

If Landis doesn't request an IRMS, then he's either guilty or poorly informed, and if he does request an IRMS, he is at the very least maintaining an appearance of innocence.

Also indicated in the WADA guidelines is an estimation of the timeline and procedure should Landis' B sample be tested using the IRMS and come out negative. If he comes out positive using the IRMS, the UCI ruling should come swiftly. But if he comes out negative, there are a number of steps involved that can prolong this process as many as four to five months. The length of time will depend on the subjective evaluation of a previous testing history. If there's not much of a history, then they will surprise him with random tests over the course of 1 to 3 months to establish that history.

It is likely that the UCI already has a history of tests with Landis. What isn't clear from the WADA guidelines, however, is whether the history of tests must include a history of IRMS results, or, alternately, whether the follow-up tests if he has no history must also be IRMS tests.

The implication of this is that if Landis is truly suffering from a serious thyroid ailment needing immediate treatment and the UCI is deficient in testing historyon Landis, then Landis will either have to forego treatment of the thyroid problem and continue to suffer from it or get that treatment and doom himself to a de facto positive result.



10 Comments:

Blogger DBrower said...

Full NPR interview with Floyd at http://download.npr.org/anon.npr-mp3/atc/20060728_atc_landisext.mp3

There are things here that are not caught in the headlines and stories - in particular, he isn't claiming elevated levels, because he doesn't know, but that they are a ratio and he doesn't know what the actual values are.

4:54 PM  
Blogger Unknown said...

I'm not sure what you're saying in the last paragraph about Floyd's thyroid. I've read and heard several other places that his thyroid condition and medication would have absolutely no effect on T:E levels. Are you disagreeing with that notion, and if so, what is your reference?

5:50 PM  
Blogger Patrick said...

I'm saying that the treatment for thyroid dysfunction I've heard Landis needs would mess with his T levels. If he needs further tests to establish a history the last thing he would need is a treatment that would jeopardize a negative result. I wasn't saying anything about his medication. That shoudln't cause elevated levels to my understanding.

8:25 PM  
Blogger Julie said...

Just an FYI, Hypothyroidism isn't a serious ailment, and there wouldn't be any suffering involved in skipping the pills for a while. Over time, you feel more tired, and may have dry patches of skin, dry hair, weight gain, feeling cold, that sort of thing. I mean, you don't want to let it go untreated, but I'm just saying, it's not an immediate suffering kind of thing. Yes, this is from personal experience. The thyroid pill is just a natural replacement for the stuff one's body has stopped producing.

11:42 PM  
Blogger Patrick said...

jmatt8 - I'm not a doc but I do their research for them on a regular basis. I can tell you even at a quick glance floyd ain't suffering from hypothyroidism. it's hyperthyroidism, which is consistent with the radioactive iodine treatment wo which floyd. Further, I don't think either of us is in any position to make an assessment of the gravity of Floyd Landis' hyperthyroidism. What's worse, the seriousness of thyroid dysfunctions range widely but does travel into the lethal end of the spectrum. Maybe his case is like yours, mild and manageable, but we don't know that.

10:15 AM  
Blogger Julie said...

I like what you're doing, so not to nitpick, but no, it's Hypothyroidism. If you insist, I can go find all the links to where he's mentioned it, but if you go ahead and do that, you'll find it's Hypo. He specifically mentioned Hashimoto's, which is a cause of Hypothyroidism. He also mentioned his elevated TSH tests. TSH levels are high when the body is not producing enough thyroid hormones (TSH being thyroid-stimulating hormones, high because the body sees that there isn't enough thyroid hormone and it's trying to get the body to make more). So, his high TSH levels indicated Hypothyroidism, and he now dakes a daily thyroid hormone replacement pill, which he has also mentioned, and his TSH has leveled out, which his doctor has mentioned. I applaud this website, and don't doubt your knowledge in other areas, but you're just mistaken on this one minor point. And absolutely, left untreated indefinitely, Hypothyroidism can become serious.

10:59 AM  
Blogger Patrick said...

Yes you're right jmatt8 I stand corrected.

11:16 AM  
Blogger Patrick said...

And I can see why I'm confused...the treatment commonly given to people with Hashimoto's can induce hyperthyroidism.

11:17 AM  
Blogger jpkaye said...

One thing that puzzles me: don't the cyclists get their own samples of the A and B at the same time the lab samples are taken, so that they can have independent tests taken if necessary? I think they do in athletics. Given the skuldugerry that there seems to be in cycling, this would seem to be an elementary precaution.

7:48 AM  
Blogger dude.abides said...

cyclingnews.com is reporting that Landis' test was a IRMS test that confirmed exogenous testosterone. Not quite the next headline that I was expecting.

12:46 PM  

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