Floyd Landis positive: Was it the beer?

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The analysis of Landis' A sample from stage 17 of the Tour de France returned an abnormal ratio for the amounts of testosterone to epitestosterone. Testosterone is a naturally occurring hormone which stimulates muscle growth. Epitestosterone is also produced by the body, and while its role is less clear, it is normally present in urine in a ratio of between 1:1 and 3:1 testosterone:epitestosterone (T:E).

Over the years, athletes accused of doping after failing a T:E test have attempted to demonstrate, often successfully, that the elevated ratio had a natural cause[2]. In 1999, for example, Santiago Botero was exonerated of using testosterone because his doctor was able to convince authorities that he had a naturally high T:E ratio after he had returned levels well over 6:1. (Unfortunately for Botero, that doctor was Eufemiano Fuentes, the former Kelme team doctor at the centre of the Operacion Puerto blood doping investigation in Spain; Botero's Phonak team benched him in early June when his links with Fuentes were revealed).

The first, and probably weakest, explanation that springs to mind is "Nobody would be dumb enough to dope and then win a stage of the Tour de France by six minutes." Techniques for evading detection are sufficiently well-known that it's not unreasonable to accuse the current anti-doping regime of being an intelligence test. Landis and his staff would know that if he won the stage he would be tested. It's hard to believe that he would take the risk at all; harder still to think that if he did dope, he would do so at a detectable level.

Recovery during training has been the traditional use for steroids in sport, but Moosburger implies that it could be used during competition as well. However, one Cyclingnews reader who uses testosterone for legitimate medical reasons points out that the technique does have drawbacks. "Androderm patches are useless they fill your body with water and make the legs heavy," he writes. "They will however cause a big stiff painful erection and it lasts for hours. (Me missus loves it)."

Two other factors have been shown to elevate T:E levels: alcohol and intense effort. A 1988 study [3] found that ingestion of alcohol could increase the T:E ratio, though the effect is relatively small even for a large amount of alcohol. The subjects ingested between 110-160 g of ethanol (2 g/kg bodyweight), and researchers found that it "increased the ratio between testosterone and epitestosterone in urine from 1.14 +/- 0.07 to 1.52 +/- 0.09 in four healthy male volunteers. The increase ranged from 30% to 90% in the different subjects studied (mean 41%)."

Certain types of intense effort have also been shown to increase the T:E ratio[4]. It's hard to imagine a more intense effort than Landis' extraordinary escape in stage 17, but the studies that found high T:E after intense effort refer to the kinds of workout undertaken by bodybuilders. It's not clear whether these findings translate to hours-long aerobic efforts, where strength plays a small part in performance.

It's important to note that the above explanations have not been put forward by the Landis camp, but mostly by fans who desperately want to believe that Landis' stage 17 ride and his subsequent Tour de France victory was "real". Landis probably knows that if his B sample is positive, then he'll need something stronger than the above to convince the US Anti-Doping Association that he did not take exogenous testosterone to help him recover after stage 16.

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