Just a few days ago, we learned that Frank Mir has become the latest fighter to have been granted a therapeutic usage exemption for testosterone replacement therapy. The growing list now includes Dan Henderson, Chael Sonnen, Quinton "Rampage" Jackson, Dennis Hallman, Shane Roller and Nate Marquardt on the current Zuffa roster, although notably, Marquardt and Roller have both recently said they have stopped their treatment regimens.
Regardless, that's seven active athletes out of the roughly 350 fighters contracted to the UFC and Strikeforce that have been on TRT at one time. Compare that to the NFL, where spokesperson Greg Aiello recently told MMA Fighting that only about a half-dozen TRT TUEs have been granted in the history of the program, which dates back to 1990, and you'd be hard-pressed to deny that something is amiss.
The question then, is what? Is there something inherent in fighting that causes these physical specimens to suffer severe testosterone deficiency, are too many people trying to game the system, or is there some other as-yet unknown cause?
The answer might ultimately prove to be some combination of the three.
The case of Mir is particularly baffling. Just over two years ago, putting on size and muscle was so easy for him, he joked that he could do it simply by "looking at" weights. While in July 2009, he weighed 245 pounds for his fight with Brock Lesnar, he publicly voiced a goal of adding size to his frame, and just six months later at an appearance in January 2010, noted he had woken up that morning at 284.
A 39-pound weight gain is massive for any professional athlete, let alone one active during the time of the gain. In December, just a month before saying he weighed 284, Mir beat Cheick Kongo at 264.5, and noted he had to cut a few pounds to make the divisional weight limit. And it wasn't just fat he was gaining, as photos from the weigh-ins at the time shows.
There are many symptoms that relate to low testosterone level, but decreased muscle is among the best known. Yet two years before he was suffering from low T, Mir was piling on muscle. It's amateur sleuth work to suggest those facts don't correlate, yet given the available evidence, it's hard not to be skeptical. In a short time, Mir went from easy muscle gainer to dangerously low testosterone, yet showed no outward signs of a problem. On the other hand, that's what happens with health issues. One day you're perfectly fine, the next an issue arises with little to no warning.
The other head-scratching cases are those of Marquardt and Roller, who both say they are no longer on TRT. Why? In separate interviews, both men noted the "hassle" involved with extra drug testing and paper work, while Roller added that he didn't feel much of a difference from the treatment.
Far be it for me to tell anyone how to address their health issues, but this is a puzzling development. Last June, Marquardt sat in The MMA Hour studio with Ariel Helwani and, while crying on two occasions, explained that TRT had saved his marriage while addressing problems with sluggishness, memory loss and irritability. That seems a lot to give up on just because of a "hassle" with commissions.
While it might seem unfair to be skeptical about fighters coming off TRT, I guess that's the situation they put themselves in. If you really needed it, wouldn't you need it for life, as medical literature suggests? Aren't they putting themselves in danger by not using it? Once started, it's damned if you do, damned if you don't. The same holds true for the state athletic commissions that must attempt to balance a person's right to legitimate medical attention against the possibility of users gaining an unfair advantage in competition. These commissions were put in place to regulate sports, and suffice it to say that this fairly recent turn into the rapidly changing world of science has come as an unexpected burden. Whether you agree or disagree with the way they do the job, a fair look shows it's not an easy one.
As a result, alterations are coming. California recently changed its protocols for TUEs to more closely resemble those of the World Anti-Doping Agency, and added an endocrinologist to its team to review all cases. Every other state should do the same. Unfortunately, many states don't even require TUEs, as they only test for elevated testosterone-to-epistestosterone ratio, and any normal result is an automatic pass.
To say the whole thing is a confusing, jumbled mess is an understatement. The commissions have limited resources with which to do their job, but it's a job that needs to be done for the legitimacy of the sport. While there may be a handful of genuine testosterone problems, too many athletes have a willingness to cheat, even if it's under the guise of legitimate medicine. TRT when properly monitored should offer no advantage, but even in Sonnen's recent hearing for an exemption in Nevada, the state's doctor noted that he'd missed dosing, a problem that could lead to elevated levels when a new dose is administered. That goes to show that nothing is routine about TRT, and that there is much work to be done by all parties before the situation is under control, if it ever is.
Until then, at least we can take solace in the fact that TRT is no miracle. Those seven approved fighters have a combined record of 12-10 while on the treatment.