Steroids and Other Appearance and Performance Enhancing Drugs (APEDs) Research Report
How are anabolic steroids tested in athletes?

Although non-athlete weightlifters account for the bulk of anabolic steroid misuse, occasional steroid use by professional and Olympic athletes to improve performance or cheat in competition ("doping") has done the most to raise awareness of steroid misuse. The World Anti-Doping Agency (WADA) was founded in 1999 to consistently apply anti-doping policies across sports organizations and governments around the world. Non-compliant organizations can face sanctions such as event cancellation, loss of WADA funding, or ineligibility to host events.114

This pie chart shows which sports had the greatest number of anti-doping rules violations in 2015. The categories, "other," "bodybuilding," "athletics," and "weightlifting" were at the top of the list.
Source: WADA. 2015 Anti-Doping Rule Violations (ADRVs) Report. 2017.
Sports with the greatest numbers of anti-doping rules violations in 2015.

Refinements in drug testing have improved the ability to detect anti-doping violations, resulting in increased numbers of reported violations over recent years. For example, the discovery of long-term steroid metabolites has lengthened the drug detection window, making it more difficult for athletes to pass drug tests by simply discontinuing steroid use just prior to an event. In addition, more sensitive technologies have allowed detection of lower metabolite thresholds.115

Although testing procedures are now in place to deter steroid use among professional and Olympic athletes, new designer drugs constantly become available that can escape detection and put athletes willing to cheat one step ahead of testing efforts.116–118 To detect early use of designer steroids and provide more accurate baseline standards for each athlete, testing laboratories store data from each drug testing sample. These samples are then used as reference points for future testing, thereby eliminating the possibility that a person tests positive simply because he or she has naturally elevated levels of testosterone when compared to the general population.119 Long-term use of designer steroids suppresses levels endogenous steroids in urine samples, which could be the first indication that an athlete is taking a designer steroid.117

Drug Testing and Nutritional Supplements

Athletes taking over-the-counter nutritional supplements may believe that such products are safe. However, nutritional supplements are not subjected to the same pre-approval requirements and quality tests as FDA-approved medications.120 For example, some supplements advertised to promote weight loss have been found to contain banned stimulants such as ephedrine121 or clenbuterol.122 Other research shows that supplements sometimes contain prohormones or anabolic steroids.123 In a study looking at 634 nutritional supplements from 13 different countries, 15 percent included some type of prohormone not listed on the label.115 Another study showed that some non-labeled prohibited substances could be detected by drug tests up to 144 hours later.124

Nutritional supplements sometimes contain banned substances that are not indicated in their labels.115,124 The FDA notes that consumers should be wary if a product meets any of these criteria:

  • products claiming to be alternatives to FDA-approved drugs or to have effects similar to prescription drugs
  • products claiming to be a legal alternative to anabolic steroids
  • products that are marketed primarily in a foreign language or those that are marketed through mass e-mails
  • sexual enhancement products promising rapid effects such as working in minutes to hours, or long-lasting effects such as 24 hours to 72 hours
  • products that provide warnings about testing positive in performance enhancement drug tests125

According to WADA’s codes, athletes are responsible for any prohibited substance found in their samples, regardless of whether ingestion was intentional or unintentional. However, sanctions may be reduced or avoided if the athlete can demonstrate that the substance was ingested through no significant fault or negligence on his/her part, or in some circumstances where the athlete did not intend to enhance performance.126