Iain Morrison: Scots star caught in no-man's land

MacLeod must wait and see if it is possible to prove a negative after abnormal levels of testosterone are revealed

LAST WEEK was a good one for those that bewail the declining influence of Scottish rugby on the world game. One Scottish player grabbed headlines across the globe, from New Zealand and Australia, through Africa, the Americas and all over Europe. "Scots Lock in Drug Scandal", or words to that effect, screamed out from newspapers wherever an oval ball is kicked in anger, and if the man at the centre of the storm, Scott MacLeod, owns a cat, it was probably kicked in anger too.

The timing of MacLeod's second drug scandal proved poignant, with his club, the Scarlets, playing their final game at Stradey Park last Friday night after 129 years of unbroken service on the famous old turf. If proven guilty of a doping offence, this latest episode could prove the final chapter of MacLeod's professional rugby career, although that, like almost everything else in the sorry tale, is far from clear.

When MacLeod first faced the press back in February he looked like a man contemplating the gallows but he had little idea then that the brouhaha surrounding his asthma inhaler was only an aperitif to something very much bigger. The reprimand he received for that error may return to haunt him – if he is found to have made a second inadvertent mistake he could yet be banned for two years.

Last week the press concentrated almost all their attention on the Scottish international despite the fact that a South African lock by the name of Martin Engelbrecht was caught using the banned steroid Stanozolol while playing for Gran Parma in Italy. This news broke last Tuesday but Engelbrecht could have been sipping a can of Tizer for all the attention he received as the papers instead focused on the player who has yet to fail a test. Admittedly MacLeod didn't pass the test either. Instead it was deemed "not negative"; the doping equivalent of a no-score draw, with a re-match between MacLeod's urine and the doping controllers scheduled for the middle of next week.

While MacLeod may be in a horribly uncomfortable position, at least the big lock knows he is not the first player to go under the microscope. The UK Sport website lists all the drug incidents since they started to collate them in 2003 and it shows that rugby union has produced five players over that six-year period who have returned unnaturally high levels of testosterone in their urine. Three of those five players are Scots, which in itself looks significant until a spokesman for UK Sport explains that they do more annual tests in Scotland (450) than in England (350-400) or Wales (200). After due investigation, the three Scots involved were found with; "no case to answer".

MacLeod, too, would have had the protective cloak of anonymity like his three colleagues but for the spotlight of the Heineken Cup and a late withdrawal from the Scarlets team to play Paris.

Still, there is one crucial difference between the three innocent Scots and MacLeod. The trio were never named because they were awaiting the results of what is called a "longitudinal study". That is a series of tests (the World Anti Doping Agency (WADA) recommends three across three months) to establish whether the high hormone reading that they produced was outside the normal range for that particular player. In MacLeod's case, the longitudinal study has already taken place. He had one test in January, another in April and one at some point in between those two dates.

Whatever emerged from the three tests indicated that further investigation was deemed necessary. In other words, matters have progressed beyond that part of the process when most charges are thrown out, but MacLeod still has no resolution.

Russell Langley is a spokesman for UK Sport, the body that does the testing on behalf of the SRU, and, while he was unable to comment on MacLeod's particular case, he was able to talk about testosterone testing in more general terms.

"It's a very complex subject," he said last week, "because the body can create the substance naturally. It's not a black and white issue and levels of testosterone can vary with time, with what you eat and even after exercise or medication. A host of other things can impact the level of testosterone."

Indeed, Tour de France "winner" Floyd Landis claimed that his elevated levels of testosterone were caused in part by drinking huge amounts of whisky and beer the night before he took eight minutes out of the maillot jeune in the mountains. Even if this was true, and ethanol can have a profound effect on hormone levels, it would not explain how traces of exogenous (synthetic) testosterone came to be found in his body thanks to what is called the Isotope Ratio Mass Spectrum (IRMS) test.

Reliable sources have suggested that MacLeod's IRMS tests have found nothing synthetic in his body but, while that is welcome news for the Scarlet Scot, it does not unconditionally clear him of any wrongdoing. There remains the possibility that he could have taken something to boost the body's own production of testosterone. MacLeod's difficulty is the age-old problem of proving a negative. "What testers need to do is create a profile of the athlete and then look for unexplained changes," says Langley, expanding his explanation of longitudinal studies. "If you get an even reading, even if it's high, then that is good news for the athlete. It's when you get unexplained peaks and troughs that can point to a problem."

But there is another element to testosterone testing, according to a recent study done by Dr Jenny Schulze at the Karolinska University Hospital in Stockholm. This study took 55 Swedes and injected all of them with a dose of 360 mg of testosterone for scientific purposes.

Drug testers view the ratio of testosterone glucuronide with epitestosterone glucuronide (commonly called the TE ratio). We understand that MacLeod's TE ratio was above the permitted 4:1 but well below the 11:1 reading that Floyd Landis gave.

The Stockholm study proves that the TE ratio is highly dependant upon an enzyme that breaks down testosterone and which, in turn, is controlled by a gene (UGT2B17). The general population can be divided three different ways; some people have two functioning genes (one from each parent), others have one functioning and one faulty gene and the remainder have two faulty genes.

The Stockholm study produced two alarming results. Firstly 40% of the people with no functioning gene did not test positive for testosterone after they had been given the hormone injection. Dr Schulze also found that 14% of those people with two functioning genes tested positive before they were given the injection. The study concluded that 9% of any normal cross section of (Swedish) society would give a false-positive test for testosterone abuse.

Speaking from Stockholm yesterday, Dr Shulze admitted. "Our genetic tests are more relevant when the TE ratio of an athlete is low rather than when the TE ratio is high," as it is in the case of Scott MacLeod. "When the ratio is high the longitudinal method of testing is very sound," the doctor concluded.

UK Sport agree. They argue that this genetic influence is exactly why the testers use profiling and those longitudinal studies to ascertain what is within the "normal" range for each individual. Moreover, WADA issued this statement when presented with Dr Schulze's results: "WADA is well aware of this phenomenon and has been working with its accredited laboratories to ensure that any suspicious profile leads to a carbon isotope (IRMS] test that is not affected by genetic factors and that allows for a clear distinction between the endogenous (naturally occurring] production of testosterone and the prohibited exogenous (externally sourced] intake of that substance." But we have already seen that, while an IRMS test can convict an athlete, it cannot acquit them.

The world doping body goes on to talk about "athlete passports", which would include the biometric parameters of each individual athlete and so make it easier to notice any discrepancy outside of that norm. But athlete passports are a thing of the future and MacLeod's need is immediate.

"We certainly wouldn't be looking to prosecute an athlete for no reason," said a spokesman for UK Sport. "We are very conscious of the consequences of any positive finding. It's essential to be aware of all the information."

The authorities should have all the relevant information this week but, even as the men in white coats are mulling over the data, MacLeod has several more restless nights ahead of him before he is told what his immediate future holds.

HORMONE'S TRACK RECORD OF SHAME

IN ITS natural form, testosterone is a sex hormone, and is vital for human health and reproduction.

It has been the steroid of choice for many athletes over the years, ever since artificial testosterone was first manufactured in the 1930s.

Natural testosterone is a product of the male sex organs, though the female ovaries also produce the hormone as do the adrenal glands. It is made from cholesterol, and over a lifetime, a man will produce around 50 times more than a woman.

In the 1950s, anabolic steroids were synthesised from testosterone, and were found to have three to five times the muscle-building effects of testosterone. They are used medically to treat a range of hormonal problems such as bone disease. There are many of these testosterone derivatives, of which the best known is nandrolone.

Sport cheats use testosterone and other anabolic steroids to increase muscle mass and promote quicker recovery after exercise and injury. Side effects can include liver damage, high blood pressure, women growing facial hair and men growing breasts.

After public concern grew about doping in general, the International Olympic Committee put anabolic steroids derived from testosterone on its first list of banned drugs in 1967. At the time there was much more concern about stimulant drugs such as the amphetamine which killed British cyclist Tommy Simpson during the Tour de France that year.

Testing for the abuse of natural testosterone by athletes was first conducted at the 1982 Commonwealth Games in Brisbane. The following year the IOC's medical experts introduced the Testosterone/Epitesterone (T/E) test. Epitestosterone is a compound made by the body at the same time as testosterone is produced, and is excreted in the urine at approximately twice the concentration of testosterone. It followed that a urine sample showing the presence of much greater amounts of testosterone was a clear indication of testosterone abuse. To be sure that "rogue" samples did not occur, the IOC set the permitted T/E ratio at 1:6, i.e. six times more epitestosterone than testosterone, which is three times the naturally occurring level.

Effectively, the abuse of both natural and artificial testosterone was banned from then on. However, East German and Russian scientists in particular found many methods of hoodwinking drug testers and testosterone has remained a much-used steroid.

Athletes who have failed tests or admitted using testosterone and its derivatives include:

Ben Johnson: In 1988, Johnson, right, broke the world record in the 100m final at the Olympic Games in Seoul, but was later disqualified and banned after testing positive for nandrolone. Johnson could never be described as the sharpest spike on a running shoe, and after serving his two year ban he made a comeback and in 1993 was caught again, this time failing for testosterone. He was banned for life, but was reinstated in 1999, only to fail a third drugs test.

Justin Gatlin: Another "fastest man" who got caught. Having earlier failed a drug test and been reinstated – he claimed amphetamines were necessary to treat attention disorder – the former world 100m and 200m sprint champion tested positive for "testosterone or its precusors" in April 2006 and later banned for four years.

Diane Modahl: At the 1994 Commonwealth Games, the British Olympic athlete, left, was declared to have tested positive for testosterone. Her career in ruins, and banned from competition for four years, Modahl launched a long campaign to clear her name. The IAAF reinstated her in 1996 after it was found that her sample, which showed testosterone levels 42 times greater than normal, could have been contaminated in a Portuguese laboratory.

Mary Decker-Slaney: The American athlete fell foul of the T/E test in 1996, when her test at the US Olympic trials showed she had a ratio greater than was allowed. Decker-Slaney fought the case for years, arguing that her birth control pills had caused the failed test. She was eventually banned by an IAAF arbitration panel and stripped of the 1,500m silver medal she won at the world indoor championships in 1997.

Floyd Landis: The American, right, was stripped of his 2006 Tour de France title after he tested positive for an enhanced level of testosterone during a T/E test. It was later discovered that the testosterone was synthetic. Landis contested the findings but the Court of Arbitration in Sport upheld the cycling authorities' decisions. His two-year ban will expire in time for him to race next year.

Dennis Mitchell: In 1998, a T/E test caught out the former world record holder at 100m. Mitchell's famous defence was that his raised testosterone levels were natural as he had guzzled "five bottles of beer". He also said he had sex with his wife at least four times... "it was her birthday, the lady deserved a treat." The authorities did not believe him and he was banned for two years.