MDs weigh in on TRT use and abuse in MMA
Panelists Mark Pavelich and Matt Mitrione are joined by Dr. Nickolas Tomasic, Urologist and expert in the field of testosterone…
Panelists Mark Pavelich and Matt Mitrione are joined by Dr. Nickolas Tomasic, Urologist and expert in the field of testosterone therapy, as Inside MMA tackles PED abuse in MMA.
Kenny Rice: Let’s get right to the expert here. Why would a guy who’s in his 30s, who is in his athletic prime, and who has two children with one on the way, have a problem with any kind of testosterone, in your expert opinion (and I know you don’t treat him or any other fighter)?
Dr. Nickolas Tomasi: In my opinion, the incidence of a low testosterone level, hypogonadism condition in a world-class athlete in his early 30s would be quite low. There could be other factors involved, previous exposure to radiation, chemotherapy, testicular injuries, those things would be quite, quite rare, but also possible previous anabolic steroid use could be a factor as well.
Bas Rutten: That’s what I was going at, the nandrolone he was using five years ago when he got caught for it. Does that have something to do with it, you think?
Dr. Nickolas Tomasic: Well, there’s no question that repeated, excessive use of anabolic steroids can lead to testicular atrophy and, I can’t say in his case at all, but that is a factor that could be involved.
Kenny Rice: Doctor, as far as it would seem with when we talk about steroids, when we talk about any kind of testosterone that you would be taking out there to increase your level, as far as giving an edge to an athlete which is always the presumption, is that true?
Dr. Nickolas Tomasic: Yes, I do believe that excessive testosterone levels could give a world-class athlete a competitive edge. Muscle-building, conditioning, even the conditioning process prior to a fight, that could be a real competitive edge.
Kenny Rice: Do you have a lot of young guys come in that need testosterone to boost it, that are in their 30s?
Dr. Nickolas Tomasic: It’s rather, rather uncommon.
After this comment, Matt Mitrione played the role of Meathead to perfection by asking whether or not getting repeated hits to the balls during training would cause low testosterone.
Dr. Nickolas Tomasic:: I’d say it would take a rather severe testicular injury, actually rupturing the testicle, something more dramatic than just common bruising that might occur.
For anyone seeking a straightforward presentation on Testosterone Replacement Theray, check out Jim Genia’s excellent TRT for Dummies Q&A with the New Jersey State Athletic Control Board’s resident TRT ace, Dr. Sherry Wulkan:
Jim Genia: What is testosterone replacement therapy?
Dr. Sherry Wulkan: Testosterone replacement therapy is the use of hormone replacement for men incapable of producing sufficient amounts of this hormone themselves. This is a medical condition, and the medicine used to treat this ailment is testosterone and similar androgenic compounds. Levels are monitored to maintain patients in the mid-range used by the reference laboratory available to their physician. Injectable formulations are available as are gel forms. Oral androgen replacement is rarely used, since there has been a strong association of its use with liver cancer.
Testosterone replacement therapy is not synonymous with the use of this hormone for performance enhancement; that is a form of abuse, not necessity. Males in their twenties and thirties rarely experience this disorder. End stage liver disease, end stage kidney disease and alcoholism can cause low testosterone.
JG: To what would you attribute the increase in requests for testosterone replacement therapy as comapred to even five years ago
SW: There are several reasons for the increase in requests for testosterone replacement therapy. Easier access to performance enhancing drugs by internet, and products advertised on television networks, have likely increased the number of athletes using these medicines. Perhaps of greater importance, more and more athletes are openly admitting prior use of performance enhancing drugs (steroids), and a greater number of these men are requesting assistance with the health issues caused by chronic prior use. We are beginning to see a secondary wave of consequences of long term use of these drugs, that is, permanent or partial suppression of a young male athlete’s ability to make his own hormone(s).
JG: What precipitates the need for TRT/What would cause the need for it?
SW: The most common reason to require TRT in a young male is prior use of high doses of performance enhancing androgens (ie steroids). They are used to make levels of the hormone supra-normal, so that muscles become larger, strength increases, aggressiveness increases; post work-out recovery is also anecdotally reported as faster. However, there are consequences to using too much of a good thing; you can destroy your own ability to make testosterone. When that happens, levels fall below normal range, and supplementation is required to alleviate the symptoms caused by inadequate hormone production.
JG: Is it possible for someone to abuse TRT during training by exceeding the prescribed dosage, gain an advantage in better training recovery, and ease back on the TRT to get their testosterone down to acceptable levels by fight time?
SW: That is the theory.
There is a cost-benefit ratio that needs to be looked at. A competitor’s cardiac abilities (cardio) may actually be hindered by using performance enhancing androgens, because the skeletal muscle mass (biceps, quadriceps etc) becomes so great that it requires more of the blood pumped by the heart.. This puts a strain on the heart and other vital organs, since excess androgens do not cause specialized tissues to enlarge proportionate to skeletal muscle growth. High blood pressure is also a complication of steroid abuse, and can contribute to diminished cardio. In addition, there is also an increased risk of tendon tears.
