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26.07.2014, admin  
Category: Muscle Magazine

Vitor Belfort was 33 years old when an Ultimate Fighting Championship doctor in Las Vegas -- whose name has faded from his memory -- diagnosed low testosterone as the cause for his feeling "tired and lethargic." The fix for the two-time champion was a testosterone-replacement therapy regimen that continues to this day.
Now 36, as he basks in a career rebirth that has him set for a spring UFC title fight, Belfort has emerged as the poster child for a practice anti-doping experts portray as, at worst, outright cheating and, at best, an unfair exploitation of a performance-enhancing-drug testing loophole: athletes competing while treated with synthetic testosterone. Exemptions for testosterone use -- a substance banned in sports as a performance enhancer -- are being handed out at exceedingly high rates in the ever-popular combat sport of mixed martial arts, with state athletic commissions routinely granting allowances based solely on low lab values and diagnoses of hypogonadism, an "Outside the Lines" investigation has found. In the past five years, at least 15 mixed martial artists have been issued exemptions to use testosterone, the vast majority revealed or confirmed through public records requests filed by "Outside the Lines" with the major state commissions or athletic bodies overseeing the sport.
Along with exemptions, several MMA fighters and officials also described to "Outside the Lines" widespread use of performance-enhancing substances in the sport. A few state commissions where MMA fights occur less frequently acknowledged they don't test for PEDs or don't require fighters to reveal whether they are being treated with testosterone.
Drug testing in MMA is confined to postfight by the state athletic commissions that test for performance-enhancing substances, with Nevada believed to be the only commission attempting out-of-competition testing. The issue, said Catlin, is that synthetic testosterone remains one of the favorite drugs to enhance performance.
Belfort, dubbed "The Phenom" from the early days of his pro career, says life has never been better, inside or outside the octagon. When prodded, Belfort (24-10, winner of eight of his past 10 fights -- seven via KO or TKO) insists the synthetic testosterone regimen hasn't fueled his longevity or late-career revival, which he describes at one point as "devastating people" and "taking guys' heads off." He called the injections a legal, necessary treatment, not an enhancement -- much like insulin for a diabetic. Belfort, who tested positive for the anabolic steroid 4-Hydroxytestosterone in 2006, cast himself as the most transparent, drug-tested athlete in the sport. Yet Belfort, who is training for a late May title fight with middleweight championA  Chris WeidmanA at UFC 173 in Las Vegas, looms ominously over a sport maneuvering through the TRT conundrum. Belfort has been a lightning rod, even with his past five fights staged outside the country -- including four in his native Brazil, where he's been allowed to fight under TRT by a Brazilian commission loosely aligned with his UFC promoter. White's latest change of heart followed the Association of Ringside Physicians' call last month for the elimination of testosterone exemptions in combat sports -- a motion pushed by Las Vegas-based board member Dr. In the wake of the recommendation as well as in anticipation of Belfort's application, the Nevada commission plans to review its TRT policy in a regularly scheduled meeting Thursday, raising the possibility it could decide to eliminate testosterone exemptions. But, although the state athletic commissions and not the UFC ultimately grant exemptions, the MMA promotional giant has at times played a role in leading fighters down a path to TRT. Belfort revealed that he also has been under the care of Pierce, although Belfort said Pierce is not the "UFC doctor" who offered his initial diagnosis.
Asked when he began testosterone-replacement therapy, Belfort initially told "Outside the Lines" it was before a loss in early 2011 to then middleweight champion Anderson Silva, then corrected himself and said it was after the fight. Belfort struggled in an interview to describe the cause of his low testosterone, other than to offer that he had felt rundown and tired.
Belfort referred questions regarding a more detailed explanation to medical professionals, including Pierce, medical director of the Ageless Forever clinic -- which sits five miles west of the Las Vegas Strip.

Pierce said the most reasonable cause of low testosterone in a combat athlete, as well as a football player, is repetitive head injury resulting in damage to the hypothalamus or pituitary in the brain, which affects the release of natural testosterone. To Pierce's point, researchers have documented pituitary dysfunction as result of head trauma in battered children, as well as victims of severe car accident and soldiers injured in war, but medical experts caution that in most cases individuals suffered an extreme injury, often accompanied by cerebral hemorrhage. As for MMA fighters, medical experts question the logic of allowing someone diagnosed as suffering head trauma to step back in an MMA octagon. Some experts further challenge the notion of head trauma triggering the shutdown or reduction of testosterone production in MMA fighters, noting that multiple hormones likely would be affected by damage to the hypothalamus or pituitary -- not just the production of testosterone. Four endocrinologists and neuropathologists interviewed by "Outside the Lines" also said they were unaware of any controlled studies in which it had been shown head trauma in an athlete had shut down hormone production. Michael "The Count" Bisping probably knows best what a shot of testosterone can do, although by all accounts he hasn't dabbled in the stuff himself.
The British middleweight (24-5) has suffered the misfortune of having been in the octagon against three fighters benefiting from testosterone exemptions: Dan Henderson, Sonnen and Belfort, accomplished veterans in their mid to late 30s at the time. Indeed, the safety issue is dicey in a combat sport in which the endgame is inflicting enough bodily harm to send an opponent into submission -- occasionally via a blow to the head. But whether naive or merely oblivious to the rumor mill, 34-year-old Bisping claims he was ignorant of his past opponents' testosterone exemptions when he stepped in the octagon. Only a month after the fight, amid a firestorm of rumors, the UFC issued a statement revealing Belfort had been on a medically approved TRT regimen under the supervision of a Nevada physician. Despite his current hardened stance, Bisping said he likely would not have balked at challenging Belfort even had he known of his testosterone supplementation. Nor is the fiery Brit the lone voice of suspicion in a sport in which doping has evolved through the years -- as in many others -- from hard-core steroids to growth hormone and designer drugs.
Anti-Doping Agency issued one testosterone exemption last year among the thousands of elite-level athletes under its jurisdiction.
Nor, apparently, does any state -- including Nevada, arguably the most influential commission and a model for other regulators -- require notice in a bout agreement of an individual having an exemption to use testosterone, so an opponent is left to learn through the rumor mill, if at all. The UFC also does some of its own testing, although officials declined comment and little is known about the program. The majority enjoyed exemptions from multiple states, and, in some instances, fighters were found to have simply informed a commission they were on TRT rather than filing a formal application to compete while being treated with testosterone.
Richard Auchus, a leading endocrinologist and University of Michigan professor of internal medicine, described the incidence of low testosterone or what is known as hypogonadism in healthy 30-year-olds as "vanishingly small" -- or well less than 0.1 percent. Anti-doping leaders thus fear testosterone exemptions might be used by athletes to dope under the disguise of legitimate medical need.
A sweaty, tightly muscled figure, he chugged from a Muscle Milk bottle and playfully fussed over his two young daughters -- Victoria, 6; and Kyara, 4 -- after a recent grueling gym workout with his Blackzilian fight team in Boca Raton, Fla. Belfort is expected to appeal to the Nevada State Athletic Commission for an exemption to stay on testosterone therapy for the Weidman fight, which is complicated by the fact that the same commission suspended him in 2006 after a positive steroid test.

Tannure and UFC officials refused multiple interview requests for this story, even after asking for and receiving written questions.
UFC co-owner Lorenzo Fertitta responded, saying the promoter would continue to defer to the judgment of athletic commissions with regard to TRT. Belfort volunteered that it was a "UFC doctor" who started his testosterone regimen in 2011 -- similar to a 2012 claim by Quinton "Rampage" Jackson, who said a UFC doctor referred him to an age-management specialist.
John Pierce wrote in 2012 advising Davidson and Greg Hendrick, then director of event operations for UFC, that fighterA  Frank MirA had been diagnosed with hypogonadism and had already started on a regimen of Testosterone Cypionate. Records also identify Pierce as the doctor who referred and evaluated the lab work for Nelson in 2010. But "Outside the Lines" found no boxers having been granted a testosterone exemption -- in fact, Nevada officials said they had never received a request. The only definitive way to make such an observation is to autopsy brains after death, and an expert in the study of chronic traumatic encephalopathy in athletes indicated research to date had recorded no such hormone deficiencies.
He said, though, that friends told him after the fight of having feared for his well-being because of the "sheer size" of Belfort. By comparison, major pro leagues such as the NFL and MLB -- in part as a result of urging from Congress -- engage in far more rigorous programs that include testing at the start of camp or spring training as well as year-round, random testing.
The international standard for an exemption specifically states that "low-normal" levels of a hormone isn't justification for granting approval, also noting the same of isolated symptoms such as fatigue, slow recovery from exercise and decreased libido.
When the fighters were receiving testosterone exemptions, 11 of 15 were promoted by Zuffa LLC, which encompasses UFC and Strikeforce. Sources also told "Outside the Lines" that the UFC encouraged heavyweight Roy "Big Country" Nelson to see a doctor about TRT, although he eventually opted not to after having lab work done in 2010. Mark Czarnecki apologized for the handwritten letter, noting "apparently Dana needs the information ASAP." "Dana" is presumed to be UFC president White, and the letter details Sonnen's use of testosterone since a 2008 diagnosis of hypogonadism.
At the very least, a full CAT scan should be done to rule out permanent damage or anything catastrophic, they said.
According to Belfort, the Brazilian doctor also has a role in an unrelated DNA study the fighter is participating in. UFC President Dana White has been inconsistent in interviews about the exemptions, saying most recently that they should be banned. You also have to understand that, as your body gets older, certain parts slow down a little.

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