ABSTRACT:Prohormones such as 19-norandrostenediol (estr-4-ene-3,17-diol) have been added to the list of prohibited substances of the World Anti-Doping Agency because they are metabolized to the common nandrolone metabolites norandrosterone and noretiocholanolone. So far, no studies on the metabolism and in vivo conversion of 19-norandrostenediol after oral or sublingual administration have been reported nor have had quantified data on resulting plasma nandrolone levels. In the present study, an openlabel crossover trial with eight healthy male volunteers was conducted. After application of capsules or sublingual tablets of 19-norandrostenediol plasma concentrations of 19-norandrostenediol, nandrolone as well as major metabolites (19-norandrosterone and 19-noretiocholanolone) were determined using a validated assay based on gas chromatography/mass spectrometry. The administration of 100-mg capsules of 19-norandrostenediol yielded maximum plasma total concentrations (i.e., conjugated plus unconjugated compounds) of 1.1 ng/ml (؎0.7) for 19-norandrostenediol, 4.0 ng/ml (؎2.6) for nandrolone, 154.8 ng/ml (؎130.8) for 19-norandrosterone, and 37.7 ng/ml (؎6.9) for 19-noretiocholanolone. The use of 25-mg sublingual tablets resulted in 3.3 ng/ml (؎1.0) for 19-norandrostenediol, 11.0 ng/ml (؎6.4) for nandrolone, 106.3 ng/ml (؎40.1) for 19-norandrosterone, and 28.5 ng/ml (؎20.8) for 19-noretiocholanolone. Most interestingly, the pharmacologically active unconjugated nandrolone was determined after administration of sublingual tablets (up to 5.7 ng/ml) in contrast to capsule applications. These results demonstrate the importance of prohibiting prohormones such as 19-norandrostenediol, in particular, since plasma concentrations of nandrolone between 0.3 to 1.2 ng/ml have been reported to influence endocrinological parameters.Nandrolone (NL; Fig. 1A) is an anabolic steroid usually administered as the decanoate ester in the form of oily intramuscular injections. Nandrolone has been used as an anabolic agent after debilitating illness and for the treatment of postmenopausal osteoporosis, postmenopausal metastatic breast carcinoma, anemia as a result of chronic renal failure, and aplastic anemia. In addition to these therapeutic applications, NL gained public recognition because of its abuse by athletes for the purpose of increasing muscle mass and muscular strength (Yesalis and Bahrke, 1995). As a result, NL, among others, was banned in 1974 by the International Olympic Committee. To provide evidence of NL doping, the main urinary metabolites 19-norandrosterone (NA; Fig. 1B) and 19-noretiocholanolone (NE; Fig. 1C) have been used as target analytes (Schänzer and