Screening Indicators of Dehydroepiandosterone, Androstenedione, and Dihydrotestosterone Use: A Literature Review

Abstract

Because of their perceived and reported effects on self-image, muscle development, performance, and similar factors, anabolic-androgenic steroids (AAS) and their precursors are among the most abused substances by professional, amateur, and recreational athletes. However, AAS abuse is not limited to athletes, but is also prevalent in the workplace, especially those professions in which image, strength, and endurance are coveted attributes. The detection of many steroids in biological specimens is analogous to the detection of an abused drug such as cocaine. Identification of the parent drug or its characteristic metabolite(s) in a donor's sample with a drug screening technique and confirmation of the drug/metabolite with a suitable alternative technology provides evidence of use. These analyses and subsequent interpretive scenarios become far more complex when the ingested AAS is an endogenous compound such as dehydroepiandrosterone (DHEA), androstenedione (Adione), or dihydrotestosterone (DHT). These compounds and their metabolites are present in specimens such as urine as a course of our natural endocrine function. Therefore, it becomes much more challenging for the laboratory to establish testing and interpretative paradigms that can distinguish "normal" urinary profiles of these steroids and their metabolites from profiles indicative of exogenous use. Distinguishing "normal" from "abnormal" urine profiles is particularly challenging during screening when literally tens of steroids and their metabolites may be tested simultaneously in a single chromatographic analysis. The purpose of this paper is to review the relevant literature about DHEA, Adione, and DHT administration, detection, and interpretation specifically as it relates to changes in the urinary AAS profile that may be identified during the routine laboratory screening of donor urine specimens.

Epiandrosterone sulfate prolongs the detectability of testosterone, 4‐androstenedione, and dihydrotestosterone misuse by means of carbon isotope ratio mass spectrometry

“…One interesting point in the context of sports drug testing may be the fact that ADION is not only converted to T but also to E and therefore administrations result in less elevated T/E ratios . Therefore, ETIO and A concentrations were considered as promising candidates to detect ADION administrations together with different 6‐hydroxylated metabolites . Regarding CIR, formestane and ETIO or A have been suggested as possible markers .…”

“…Steroid profile parameters enabling the detection of DHT administrations were investigated in the 1990s and besides elevated urinary concentrations of DHT itself the inversion of the 5a/5b ratio was found to be diagnostic for administrations together with DHT/E or 5a/E . These findings have been substantiated in all follow‐up studies . Regarding CIR after DHT administrations, Shackleton et.…”

A statistical analysis of the effects of urease pre-treatment on the measurement of the urinary metabolome by gas chromatography–mass spectrometry

“…Thus, metabolites present in blood due to cell damage/death or excretion stand an excellent chance of appearing in the urine as biomarkers. Urinary metabolite biomarkers of interest include those used to assess drug (Wilkins, 1997) and anabolic steroid abuse (Shelby et al, 2011), identify individuals with cancer (Ganti and Weiss, 2011) and other diseases (Kussmann et al, 2006), diagnose inborn errors of metabolism (Kuhara, 2007), determine exposure to carcinogens (Hecht, 2002), pesticides (Egeghy et al, 2011), and endocrine disruptors (Meeker et al, 2009), and monitor levels of oxidative stress (Roberts and Morrow, 2000). …”

Metabolic and isotopic signature of short‐term DHEA administration in women: Comparison with findings in men

“…Only one subject (M7) presented this characteristic with an E concentration ranging from 28 ng/mL to 66 ng/mL after short- According to Shelby et al, 12 no study has been able to show significant increases in T or E concentration or in T/E. The analyzed female samples were those where E concentration was adequate for GC-C-IRMS analysis (ie, higher than 10 ng/mL): that is, for subjects F4, F6, F10, and F11.…”

“…1 This naturally occurring steroid is a prohormone of testosterone (T) and could be misused by athletes to improve performances, even though DHEA's ergogenic effect is still not unambiguously proven. [6][7][8][9][10][11] Shelby et al 12 5α-androstane-3α,17β-diol (5αAdiol), and 5β-androstane-3α,17β-diol (5βAdiol). [6][7][8][9][10][11] Shelby et al 12 5α-androstane-3α,17β-diol (5αAdiol), and 5β-androstane-3α,17β-diol (5βAdiol).…”