It’s been an historic week for the anti-doping world not only in boxing but for all of sports. WBA/IBF junior welterweight champion Lamont Peterson was caught using exogenous testosterone by the Voluntary Anti-Doping Association (VADA). What is historic is the way he was caught. As part of their screen test, VADA used the Carbon Isotope Ratio testing method (CIR) which is designed to detect exactly what it found in Peterson: exogenous (meaning from a source besides your own body) testosterone. It is a banner week for anti-doping in sports, not just boxing, that will have ramifications all the way up to the London Games this summer.
A couple days after the news broke, Victor Conte called me to say “I am preparing information for [World Anti-Doping Agency founding Chairman] Dick Pound to present at the WADA board of directors meeting on May 18 [in Montreal] regarding using the Carbon Isotope Ratio testing method as a screening tool for target testing.”
Mr. Conte has been met with derision since he entered boxing a few years back. But a closer examination of the message he has been sending for the past five years reveals that what Major League Baseball, MMA and boxing have experienced this year with Ryan Braun, Alistair Overeem and now Lamont Peterson testing positive for synthetic testosterone, reveals Conte has been presciently preaching the truth for several years.
“I brought this to Dick Pound’s attention and he gave me the assignment,” Conte told me. “If a guy like Dick Pound talks to me, I wonder if boxing should talk to me.”
Testosterone, not Human Growth Hormone, is likely the most popular performance enhancing drug (PED) available today for athletes. It is the building block from which all other steroids flow. How do we detect it? Two ways. We can hope the athlete is stupid enough to take enough testosterone that his T/E ratio spikes higher than 4:1 in jurisdictions following the WADA code. Another way is to cut out the middle man T/E ratio urine test that is easily beatable and use the same method that caught Lamont Peterson: using Carbon Isotope Ratio testing method as a screen test tool.
However, it is too large a story to be told in just one article. This installment will delve deeper into Mr. Peterson’s side of the story from the perspective of his trainer Barry Hunter and the doctor in question, Dr. John A. Thompson, DO
CIR has been around for close to 12 years but has been generally used only after a red flag, such as a high T/E ratio, was raised. In an interview released by ESPN, USADA claims they have been using it for years both as a screener and as an after a red flag tool. However, VADA is the only doping association to actually be transparent about their process and openly admit using it this way.
In essence, the standard urine T/E ratio test is looking for red flags. CIR is looking for a specific drug. Right out the gate, in that very first urine sample taken from Lamont Peterson, a moment of great significance has occurred. VADA’s theory was proven right. CIR as a screen test detected a drug that would have passed unnoticed under the scrutiny of any other agency other than VADA. Credit should be given to them for catching an athlete this way. It appears to be a precedent.
Why would the drug have gone undetected? Because Peterson’s T/E ratio was 3.77:1.
On average males have a T/E ratio of 1:1. It varies depending on factors such as race and age. Most males peak and then level out from 21 to 28 on average. After that, it’s a steady 1% decrease each year.
In the world of sports, every WADA-code following country observes the accepted standard of a 4:1 T/E ratio. New York and Nevada’s athletic commissions adhere to the outdated standard of 6:1. To Nevada’s credit, they nabbed UFC star Alistair Overeem on a random drug screening. However he was caught because he had a T/E of 14:1. Had he been smarter, he could have stayed under the limit of 6:1 and still cheated just as effectively.
Despite Nevada’s success, the drug war can’t rely on luck and the stupidity of greedy cheaters.
The point of significance is that Peterson had a T/E ratio that would not have triggered any red flags, no one would know he had exogenous testosterone in his system and you wouldn’t be reading this article.
When Ryan Braun was caught in MLB, he had a 20:1 T/E ratio. CIR was used after he was flagged and it determined he had exogenous testosterone in his system. He beat his 50-game suspension by having his lawyers attack the chain of sample collection custody as opposed to fighting his positive test results.
But in the case of Peterson as well as the Victor Ortiz-Andre Berto and the Shane Mosley vs. Canelo Alvarez fights, VADA uses CIR as a drug screening tool. While they use the normal urine T/E ratio test, combined with CIR, VADA tests are very hard to beat. As a result, the drug was detected and the rest of the anti-doping community as well as every person looking to use testosterone without a medical exemption has been put on notice: CIR testing is a must use screening tool in the current drug war landscape because it will catch you.
But while the sports drug war just took a very interesting turn in boxing, there is potentially an ironic tragedy here. While CIR is designed to detect the existence of exogenous testosterone in your system, anti-doping tests are meant to catch drug cheats. In the case of Lamont Peterson, CIR appears to have caught a man who may have a legitimate medical condition that requires him to take exogenous testosterone in order to return to normal levels. And not only that, the VADA tests were ordered by the man they caught. However, it is important to note that each day that passes, new information is revealed to the public. This case won’t be solved in this article.
Late Tuesday night, Maxboxing.com was contacted by Peterson spokesperson Andre Johnson who along with Peterson’s trainer Barry Hunter and the doctor who gave him the testosterone pellet injection that caused the positive drug test, Dr. John A. Thompson, DO
In the midst of preparations for his first bout with Khan, Peterson was treated by Thompson for low testosterone. Peterson is 28 years, a male in the prime of life. Yet he felt fatigued, lightheaded and had trouble concentrating for long periods of time. Peterson had been treated for dehydration in the past by Dr. Thompson during either the preparation for Victor Ortiz in December 2010 or Victor Cayo July of 2011, according to Barry Hunter. In an interview with Lem Satterfield of Ringtv.com this week, Peterson said he began seeing Thompson around late 2009 before his fight with Tim Bradley. However, According to Peterson, Hunter, and Dr. Thompson, it wasn’t until last October 4, 2012 that Peterson was diagnosed and treated for hypergonadism.
From Zach Arnold’s excellent primer piece “A crash course on testosterone, hypogonadism, and doping http://www.boxinginsider.com/columns/a-crash-course-on-testosterone-hypgonadism-and-doping/:”
“Hypogonadism is when your endocrine system can’t produce normal levels of testosterone. The end result is less energy, a crippled sex drive, less physical power, and less mental focus. It should be promptly noted that, at most, around 2% of adult males naturally suffer from hypogonadism.”
According to Dr. Thompson, who practices neuromusculoskeletal medicine, hyperbaric medicine and undersea medicine at his Desert Oasis clinic in Las Vegas, NV, Peterson suffers from severely low testosterone. It should be noted that when determining hypogonadism, a long series of multiple tests conducted by a board certified endocrinologist, which Dr. Thompson is not, would be much more appropriate.
“[Peterson’s levels] were the levels of a 70-80 year old man,” Dr. Thompson told Maxboxing.com. “You measure testosterone in the blood in two fractions. The total testosterone and we also measure something called the free testosterone. This is the most important is the free not the total. The free is not bound and that’s the testosterone that is doing the work in the body. So the norm is 9.3-26.5 normal range and his came back at 7.5. The lab put an alert on there because he was lower than low. I’ve seen several patients over the years and I have never seen a 26-27 year old male with free testosterone that low.”
On November 12, 2011, roughly four weeks before he was scheduled to face Amir Khan in Washington, DC, Peterson went to Thompson’s Las Vegas, Nevada Desert Oasis clinic where he was injected into his left buttock with one soy-based testosterone pellet. The dose was 800 milligrams for a slow release of up to five months. According to Team Peterson, this was the first and last time he has had the procedure done despite major news outlets reporting otherwise. His trainer was aware of the treatment.
“I was aware of the doctors. The first time the doc really checked him, he checked him for parasites. And once he saw there were no parasites in his blood, he gave him a test to check his thyroid. Lamont had been getting lightheaded. And I thought maybe he had a thyroid problem which made him go get his blood checked. And after he got his blood back from the doctor, that is when they discovered the testosterone thing,” explained Barry Hunter.
There is a question and assumption about the competitive edge what Peterson took might have given him. The average male produces roughly 7 milligrams of testosterone per day, approximately 50 per week. Peterson’s 800 milligrams slow released over 150 days comes out to 36.8 milligrams a week. Less than what an average male normally generates. For a person as deficient as his doctor claims and his records seem to indicate Peterson was not consuming a drug to gain competitive advantage.
It is here that one begins to wonder if Lamont Peterson and Barry Hunter were led down the wrong path by a doctor not qualified to determine damage to Peterson’s endocrine system, what might have caused it and how to fix it. Too often in the new world of anti-aging clinics and quick fix results, testosterone replacement therapy or “anti-aging” or even more ambiguous “wellness centers” are becoming as easy to order at as a Starbucks. In many cases, it is a classic case misdiagnosis. Within the confines of combat sports, the need for testosterone use among the athletes is due to past anabolic steroid use that has blunted the bodies’ ability to make its own testosterone. Other ways to trigger hypogonadism are concussions, pain pill abuse, and cutting weight in a dangerous or unhealthy manner on a regular basis. Which is basically how fighter’s make weight.
“At the time, I had to make a decision to treat him,” explained Dr. Thompson of the decision to treat Peterson so close to a fight. “I made a medical decision to treat him with something called testosterone pellets. These pellets are made from soy. They are not synthetic. And the treatment has been around in this country since the 1930’s. Nothing new. The pellets have a slow release. You only have 800 milligrams. My concern was ‘Ok. I am going to give him some treatment but this close to the fight, is it even going to do anything? Because the pellets are slow release, it just releases it as the body kind of needs it over 24 hours. A physiological dose of testosterone not a pharmacological does of testosterone.
“Let me explain the difference,” continued Dr. Thompson. “A physiological dose of testosterone is the amount of testosterone that would be emulating what the testes would be releasing on a 24 hour basis. A pharmacological is dose of fake testosterone that is above and beyond what the body normally produces. So there are two different things here. Most males I give the testosterone to, within four weeks, which is the time frame between from when he got this pellet and when the fight took place, most men will tell me in four weeks ‘Doc I don’t feel anything yet.’ The vast majority of them tell me that. There is not a sudden spike in testosterone. These pellets release slowly. And he only got 800 milligrams. On average these pellets can last up to five or six months for males. But the pellets don’t really come on until about three and half months.”
In Washington, DC, on December 10, 2011, Peterson beat Amir Khan in a close, controversial decision while that pellet slow released in his system. Under any commission much less under the rules of WADA and it’s code, Peterson was operating illegally that night. Synthetic testosterone is a banned substance. While there are medial exemptions for it, one must be obtained before the fact. Though Khan was the champion and marquee fighter, DC is Peterson’s hometown. Accusations of chicanery flew hard from the Golden Boy and Amir Khan side. Nothing ever proved much less indicated that the judges had been tampered with and the decision, despite one sanctioning body demanding a rematch, stood. What is more, Peterson passed both the pre and post-fight urine test.
A rematch was set for May 19 at Staples Center in Los Angeles. Only this time, Peterson asked for VADA testing on top of California’s commission testing. Khan’s team complied.
Peterson’s very first sample, taken March at the final press conference to announce the rematch, was the one that tested positive for synthetic testosterone. That day, as related to me by Andre Johnson, Peterson arrived early. When the VADA inspectors came to collect his samples, he was too dehydrated to give blood or urine having worked out that morning. But rather than have the testers come back, Peterson, who like Khan knew about this first test beforehand, asked if he could eat and drink water before the press conference and try again afterwards.
“I want to comply,” Peterson said.
It should be noted that while Peterson tested positive on his A and B sample from his very first VADA test, subsequent tests throughout training camp came up negative. Dr. Thompson had a theory as to why that is.
“The reason it showed [3.77] at that particular time and they don’t really peak until the third month or so. That’s probably what happened right there,” said Dr. Thompson. “Again, I have never had a guy in the first four weeks say ‘Doc I feel great. I feel like Superman. I feel like I can do anything.’ Most of the guys who get test. pellets call after 4 weeks and say nothing is happening. It takes time to find out if it works for them. And even then, you are not going to get a surge of energy. You’re not going to feel like Superman. You’ll probably sleep better You’re mood is better. You feel more balanced. That’s what’s happening. But these pellets are not designed for . . . you can’t get these and four weeks later enhance athletic performance. They are not designed for that. It just doesn’t work like that.”
Again, that claim remains to be proven true. It is simply Dr. Thompson’s, who is not an expert in the field of endocrinology, theory.
Following his notification of a positive test on April 13, 2012, Peterson’s team had him independently tested twice. This whole process, of passed drug tests in December, one positive in April and then subsequent passed tests, has Hunter baffled.
“When you think about it, and doc turned around and he gave Lamont this particular procedure and his testosterone was low and he had it flagged and I saw it personally, it had been flagged at 7.5,” explained Hunter. “Now we go to a month after the fight. Every test was good. Every test we ever had we tested negative. We tested before the fight and we tested negative after the fight. Once we got to the range where we started dealing with VADA directly, if you think about it, the first test we took, which was in L.A., was the test we knew we were taking and the test we were looking forward to taking. Urine came back positive. The blood negative.”
The day Peterson gave his blood and urine sample to VADA, he was particularly dehydrated, according to Andre Johnson. I remember walking into the Grammy Museum and there was Peterson, drinking from a bottle of water and eating some snacks Golden Boy had provided. When he had arrived, according to Johnson, Peterson was too dehydrated to give a sample to the VADA collectors. Rather than miss a test, he asked if he could go drink water and try again later. VADA complied and he went inside to eat and rehydrate.
Is this the behavior of a “drug cheat” looking to get one over on the system? One would think Peterson would be happy to miss the test. And now his request has come back to haunt him.
One question that was raised was if Peterson was going through the therapy currently. Thompson replied “Well, first of all, we were looking at where he was at for that fight. That’s why we did a test first and did a follow-up after. But I never talked to Barry about anything else after that. We never discussed it.”
Once Peterson tested positive, his team sought out Dr. Albert K Lee, MD, LLC Internal Medicine at Johns Hopkins to examine the fighter.
Upon his examination, Dr. Lee determined that the therapy Peterson had received did not appear to work and in fact, Peterson’s levels were dropping. When Dr. Thompson had examined Peterson, his free testosterone was 7.5. Now after treatment and in the midst of another training camp, his measurement had dropped to a level of 5.0. Dr. Lee also detected a possible hyperthyroid condition. Seeking another opinion, Dr. Lee enlisted the aid of James F. Mackin, M.D. Board Certified in Endocrinology and Metabolism.
“Ultrasound of the testes confirm normal gonads not compatible with anabolic-androgenic abuse. Ultrasound of the abdomen shows that his liver is normal. Again, not compatible with anabolic-androgenic abuse,” explained Dr. Macklin about his findings after examining Peterson. “Testing has showed no evidence of illicit drugs use. Testosterone has been found of exogenous origin, but we know that he has testosterone pellets in his buttock placed by Dr. Thompson for replacement therapy. His testosterone levels are in the normal range and the free levels available to him are low. This has never given an unfair advantage in competition.
I feel that his documented history fits the laboratory data and confirms that he has not used androgens for anabolic effect,” Dr. Macklin concluded. “He has received only appropriate androgen replacement.”
The strangest and most surprising part of the interview with Hunter and Dr. Thompson was that Hunter said “We still don’t know what he tested positive for that showed up in the urine. Not the blood.”
When I explained why and how Peterson was caught, it felt as if it was the first time someone was explaining the CIR process to Hunter and the Dr. No one on the phone knew what the T/E ratio in DC was.
“What I don’t understand with almost no testosterone he tests hot and number two, that conflicts with what doc said with what he said he gave [Peterson] a soy-based type of deal and it wasn’t synthetic,” wondered Hunter.
What Hunter was not told by Dr. Thompson is that synthetic testosterone is made from either yams or soy. It’s not as if what Dr. Thompson gave Lamont was the equivalent of Soy milk at Starbucks. It isn’t organic food you buy at the market. It’s a banned substance that a fighter can be medically cleared to use should be able to prove he has a problem with low T. Peterson’s problem is that his proof is coming too late.
The oddest thing about this entire situation is of course the fact that Peterson himself pushed for the extra VADA drug testing. Had he chosen to not join the anti-doping wave sweeping boxing, this article would not be written. But he did and it leaves all of us wondering why.
“Excellent question. I am still trying to figure it out,” said a genuinely baffled Hunter of the positive result. “We all are trying to figure it out. Lamont pushed extremely hard for the tests. And we didn’t accuse Amir of being on steroids. Me, personally, I like to thank Floyd for bringing it out. I think on that level, everybody should be tested because you never know. In case somebody taking some kind of sports drink or medicine or in our case, maybe a pellet. We don’t even know if that was what it was. So why would he go into a drug test knowing we would be testing positive? Knowing we had stuff in our system. And then go and fail? Number one. Number two, the two tests that we passed was random drug tests. Then the third was a private test that included blood. And that came back negative. And the testosterone level after that last test was lower than after when doc gave him in the procedure.”
“After that time,” said Andre Johnson who handles PR for Team Peterson, “there were two random drug tests which both came back negative. After we got the positive result, we were told to look for maybe a cream that had steroids in it. So we scrambled. We looked at everything. Shampoos. Toothbrushes. Everything. We looked at the baby’s stuff to make sure she didn’t have anything on her. In fact, we had a form of arthritis medicine, like a Ben-Gay type. That turned out not to be it. We checked sports drinks. It didn’t have the stuff in it. So we gave him a private drug test. And the drug test was all negative and his testosterone levels from 7.5 (free testosterone) after the dosage to 5. I am trying to figure this out. I don’t understand. Maybe you can shed some light for me.”
Peterson’s team procured LabCorp, an independent laboratory to handle his private drug tests. The results of which only have served to confuse the team more as they came back negative for testosterone. However, as of press time, it was undermined if those private tests used CIR.
“If you think about it, if you have crazy levels like that, which they said he had in his urine, how is it that four days later after we get this information, that was on the 15, so the 19 and the 20. The 19th we had his blood tested. Everything came back negative,” asked Hunter. “The 20th we had his urine tested and he came back negative. Now keep in mind, whatever was found was supposed to be found in his urine and was supposed to have these crazy numbers. How can you get high testosterone numbers from virtually no testosterone at all?”
One answer could be that what the doctor injected in Peterson perhaps is not exactly as advertised nor as effective.
To clear up one claim or question: when tests are run in the lab, they are done in batches. HGH tests are done together. EPO tests are done together. And finally CIR tests are done. The results are sent out as they are arrived at. So it while it would appear that early tests come back negative, it does mean a subject is clean and then suddenly dirty. It just means not all the tests had been conducted.
For now the men wait to proceed with clearing Peterson’s name. While tensions are still high between Amir Khan’s camp, who’ve been less than forgiving in the press, Hunter knows the top priorities.
“We definitely want to get in the ring with Amir Khan. I think the fans want to see it. And I know I want to see it but I am concerned with Lamont’s health number one and his reputation number two. Because he did everything right and it’s totally unfair to have a witch hunt like this,” said Hunter.
“We’re really sticking to that word “evidence,” said Dr. Thompson.
The problem with Dr. Thompson’s statement about evidence is that his client’s trainer has been repeating misinformation. Who gave him that information remains to be seen. In an interview with USA Today’s Bob Velin, Hunter is credited with the following information:
“Hunter said the natural soy-based testosterone pellets Peterson had injected into his hip in November are not steroidal — they are not on the World Anti-doping Agency’s list of banned substances — but are a slow-release natural hormone designed to work with the body, not to enhance performance.”
Two things: 1) Synthetic testosterone is on WADA’s banned substance list. There is no question of that. I’m not sure what Mr. Velin means by the terms “not steroidal” but synthetic testosterone is certainly used for performance enhancement. Was it in this case? That remains to be seen. Tests taken from that first Khan fight have to be examined.
Before we parted, Dr. Thompson gave me a bit of information and warned me about a problem he believes is real in the sport.
“There are other fighters in the professional ranks with low testosterone,” claimed Dr. Thompson. “If they started testing a lot of these young guys, you’ll see a lot of abnormally low levels. And boxing really hasn’t had a crisis with a guy cheating with testosterone. But what about the guy putting himself in there that is putting himself at risk because his testosterone is too low? If you have lower testosterone you don’t have as much strength, stamina and energy to maybe move out of position for something after ten rounds or greater,. This is something we have to look at. This is no aberration. We believe strongly, I know this for a fact because of my medical practice, that there are several young guys out there that have extremely low testosterone. This creates a risk. And if we care about the safety of the boxers, we need to look at this more closely.”
One report out of Australia estimates 1 out of 200 Australian men suffer from low testosterone. That’s 1 of 1 half percent of men that have it in Australia. No one I spoke to seems to agree with Dr. Thompson that low testosterone or hypogonadism in younger men, much less men in general is the epidemic he would have you believe. Time will tell if what he claims is truly a problem or simply a commercial for the Desert Oasis Clinic.
Over two years ago, boxing took a major step forward when Floyd Mayweather, Jr began implementing USADA-performed testing to his fights. Now, with VADA and Golden Boy Promotions’ victory under their belts, whatever the truth may be about Lamont Peterson and his condition, shots have been fired from the Anti-Doping community and a message sent loud and clear: a more effective method of testing has been tried and found to be working very well. Those looking to get over on the system or more importantly, on the men and women they compete against: look out.
As for Peterson himself, he has yet to fully present his case in the proper forum. Once he does, the time for judgement of any kind will be then.