Published: Journal of Analytical Toxicology, Volume 24, Number 2, March, pp.102-115

Evaluation of Testosterone/Epitestosterone Ratio Influential Factors as Determined in Doping Analysis
D.H. van de Kerkhof¹, D. de Boer^1,2, J.H.H. Thijssen^1,3, and R.A.A. Maes^1
1Utrecht Institute of Pharmaceutical Sciences (UIPS), Department of Human Toxicology, University of Utrecht, Sorbonnelaan 16, 3584 CA Utrecht, The Netherlands; ²Instituto Nacional do Desporto, Laboratório de Análises de Dopagem e Bioquímica, Av. Prof. Egas Moniz (Estádio Universitário), 1600 Lisboa, Portugal; and 3Department of Endocrinology, Academisch Ziekenhuis Utrecht, Heidelberglaan 100, P.O. Box 8550, 3508 GA Utrecht, The Netherlands

The ratio of the concentration of testosterone glucuronide to the concentration of epitestosterone glucuronide (T/E ratio) as determined in urine is the most frequently used method to prove testosterone abuse by athletes. A T/E ratio higher than 6 has been considered as proof of abuse in the past; however, cases of naturally occurring higher T/E ratios have been described. Since the introduction of the T/E ratio in doping analysis, the parameters that may or may not influence the T/E ratio, possibly leading to false-positive results, have been debated. To achieve more insight on the influencing circumstances, an overview is given to obtain an objective view on the merits of the urinary T/E ratio. Relevant analytical aspects of the T/E ratio, potential parameters of endogenous and exogenous origins, as well as some alternative methods to determine testosterone abuse, such as the urinary testosterone/luteinizing hormone ratio, gas chromatography– combustion–isotope-ratio mass spectrometry, hair analysis, and high-performance liquid chromatography–mass spectrometry, are discussed.

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