October 21, 2012
Interview with Kevin Moats from https://bengreenfieldfitness.com/2012/10/age-group-drug-testing/
Ben: Hey folks, it’s Ben Greenfield. And on the call with me today is a top age-grouper triathlete. His name is Kevin Moats and he’s 58 years old, and the reason that he’s on this call today is Kevin was recently suspended from competition by the World Triathlon Corporation as a result of a positive test for testosterone. And today, we’re gonna talk to Kevin about what exactly happened here, and of course, this is coming at the same time as the controversial Lance Armstrong doping scandal and I also happen to know for a fact that many of the listeners of this podcast actually use bio-identical hormone replacement therapy, or therapeutic testosterone for medical reasons, and this is very relevant if you fall into that category of someone who is perhaps trying to manage it, a medical condition with hormones, or even with supplements or other materials and we’re gonna get into all this with Kevin. So Kevin, thank you for coming on the call today.
Kevin: Thank you. Thank you for inviting me.
Ben: So, let’s jump right in. What exactly happened here? Did somebody show up at your house to test you, or was it after a race that you got pulled aside, or how exactly do you get tested when you’re in an age-group, when you’re not a professional doing one of these events?
Kevin: Well, WTC, which is the owner of Ironman, is the only private organization that does drug testing for athletes. Typically, it’s part of a governing body USADA, USAT. But because there’s no formal test, no governing bodies test for Ironman because it’s not an Olympic event, WTC created its own sort of testing protocol, etc. So anyway, you’re basically eligible for testing between when you qualify for Kona, and when you actually race Kona…
Ben: It’s for people who like to qualify for Ironman World Championships in Kona, all of a sudden becomes eligible to get tested.
Kevin: Right. And when you qualify and sign the sheet that says you’re going to Kona, you agree to be part of a designated testing call. And my understanding that they now have the same rule for the 70.3. So for instance I qualified in November in Florida, so I was basically part of the testing call for 11 months. So anyway, I was tested just before Ironman 2010 and again, it was the first time I’m getting tested, so with a little bit of strange experience, somebody called at the gate and all of a sudden three people came in.
Ben: To your house.
Kevin: Yes, to my house. And there was a lead tester and a nurse, two nurses and they say they were here to test. You signed the sheet that said you’re subject to this testing and then you have to basically pee in a cup and I think… so anyway, they go in there, one person go into the bathroom with you to make sure that you’re peeing in the cup so that’s a little bit intimidating. And then they draw your blood, too, and they take 4 to 6 vials, which just before a race, you really don’t want that taken out of you. So I’m tested like in 2 days before the race and then last January I was tested again, that was in 2011. This time I think it was… they do out of competition testing, and Kona sort of a prime location in the winter. The pros have to tell… they have to notify WTC where they are at all times. And so you get, you know, like a case list training camp, so all of a sudden there may be 10 professional triathletes in Kona at one time and so they come out, spend full day testing a bunch of people. And at that point, I was one of the few age-groupers that’s already pre-qualified for Kona and living on the islandso I sort of get the test.
Ben: So you are over there in Hawaii when you got tested again.
Kevin: Right. I got tested then. Same procedure. And then I got tested again in January 2012. And that was in Texas end of January, I didn’t hear anything and then all of a sudden in first of April, I received an email notification that there had been an adverse analytic result, and basically…
Ben: They called you or they wrote you a letter?
Kevin: They just sent me an email.
Kevin: It was a letter via email.
Kevin: So I retained an attorney to help me through the process. Someone named Howard experienced in this whole doping…
Ben: He’s kind of a big name attorney. Hasn’t he worked with some pros on this?
Kevin: Yeah. You want somebody who understands, you can’t just ask your friend who’s an attorney and say, “Hey, represent me on this because it’s just… you know, I’ve spent the last six months getting an education. It is a very complex…
Ben: It’s not like getting a parking ticket or something like that.
Kevin: Right. So they tell me they’re gonna test the B samples so I went ahead and tested the B samples. One thing, too, that I didn’t realize… and explained why I tested positive. About six, seven years ago, when I turned into my early 50’s, I was really suffering from chronic fatigue and depression and just my whole system just seemed to be shutting down. So I went to see an endocrinologist, coz I thought, “Is this AIDS, or is it the fact that Ironman is a hobby for me, but I’ve been doing this marathon, etc. all my life, and was I perhaps suffering from a depressed endocrine system?” I mean, it’s common among the top pros in training in incredible levels after three, four years they fried, so I was a little concerned that maybe I had really done my adrenal system and… so I went to this endocrinologist and he looked at all the values, the cortisol levels, thyroid and testosterone and whatever, and he came back to me and he said, you definitely have a low thyroid. You definitely have dangerously low testosterone levels and also you have…
Ben: Which affects the thyroid, as well, right?
Kevin: Right. What causes what. And then also that I actually have elevated estrogen. That’s the function, as you get older your estrogen levels go up. That’s why we get man boobs and stuff like that. But anyway, so he said, I’m going to… what he meant by dangerously low, again I’m not a medical expert, but my understanding is a healthy person in 20’s and 30’s, their testosterone levels are maybe in 500 to a thousand level or 800 to a thousand or whatever. My levels were somewhere around 75 to a hundred. What my doctors explained to me was it really, to be healthy, you need to be around 400. So anyway he put me on hormone replacement therapy regimen. He gave me thyroid which I take once a day. He gave me… initially I started feeling, it was like an injectable testosterone, but I didn’t feel comfortable, so I suggested gel. And I would put a modest amount of gel on my arm, a testosterone crème on a daily basis. And then…
Ben: You gotta be careful with that stuff, right? I read the book Doper Next Door by Andrew Tilin where he goes to tell how he got to keep that gel and lotion away from his kids.
Kevin: Yeah. The other thing is just probably the injectable would be more scientific because the gel, it’s hard to get the gels exactly right and how much gets absorbed, so I would… about every six months I would see my doctor and look at the levels. Sometimes I’d be low, sometimes I’d be a little high. Our target was around 400 and then results would be, there’s two T’s, like total testosterone and free testosterone. My doctor that free testosterone was the more important value because that’s what’s able to help body health.
Ben: You just didn’t go to your doctor one time and walked out.
Kevin: No. I’ve been under his care throughout the whole time. This is not I got on the internet and got into testosterone. And the other aspect that he zeroed in and I hadn’t really, we also are not gonna live forever, but my grandfather died and he was 35 and my uncle died at 55, and my brother dies in 2007 at 55. So there was a history of heart disease and that’s why he was sort of saying that I had dangerously low levels, because he thinks that actually, testosterone supplementation is very important for healthy heart. It keeps inflammation down, it does all sorts of things, if there’s a propensity for heart disease it’s even more important.
Ben: Back in 2010 and 2011, there was a bunch of news about that, about how low testosterone can raise heart disease or low testosterone is linked to heart disease. It’s interesting. Sorry to interrupt.
Kevin: So anyway, the whole thing, when they started the whole link, when WTC started the whole testing thing, yes, testosterone is a banned substance, but I was thinking, in my mind, I’m taking levels to get me to sort of a healthy level. I’m not using an anabolic steroid, which is solely for the purpose of performance enhancement. It’s not like… whatever the sprinters use, I wasn’t using EPO, I wasn’t using a performance enhancement product, though testosterone, is sort of… what’s the right level. To me it was not for performance enhancement. It was just to get to normal values.
Ben: When you started on all this stuff, did you start feeling better?
Kevin: Yeah. I felt like I had more energy, etc. So is that performance enhancement, because I feel better and I can train better? It’s sort of an interesting aside was after I got the letter in April, I totally, I said, well, let’s let this thing sort itself out so I went off all hormonal therapy. I still took the thyroid, but I did a race in early August. The same race that I’ve done the previous year and so I had not been on any synthetic testosterone for 4, 5 months. And it’s interesting enough, my time was exactly the same. Having more energy, etc., it’s not like you take testosterone and you’re gonna suddenly run 2 minutes, 4 minutes faster. It’s the quality of life, the health issue, it’s not this.
Ben: So you’re saying it was more about like being able to get out of the bed every morning and feel the way that you used to rather than being able to turn out 20 extra watts when trying for something like that.
Kevin: Yes, exactly.
Ben: When they tested you, it’s my understanding that they don’t actually test your testosterone level as much as a ratio, right?
Kevin: Right. Because my levels were at a normal level that I was gonna be fine. Obviously I was mistaken because they don’t look at your levels, at all ever. What they do do, they have an initial screening, which is they work up your testosterone level, and looks at your epi-testosterone and my understanding that basically it should be a 1:1 ratio that for every molecule of testosterone is one molecule of epi. So if you’re doing a synthetic testosterone, what ends up happening is you get elevated testosterone but your epi stays the same. So they’re looking at the ratio. If you’re out of whack, forensics learned this, the initial test… what he had, an epi and then we’ve got a TE ratio of 11:1. The threshold is 4:1. And there used to be 8:1 and then they dropped to 4:1. My test came at 12.2:1, so I was barely over, but I was over. And what happens is, being over is not in itself a doping offense. All that does is say okay we’re gonna go to the next level, which is a much more expensive test, which is called carbon isotope testing for testosterone, and the way that works, my understanding is all of the bio-identical testosterone is not exactly bio-identical. The difference is like 1 atom. And synthetic testosterone is all plant-based. A natural testosterone is ami-based, or whatever they are. And so there’s one atom off, and this isotope testing can determine that. Exogenous testosterone, big red flag, doping effects. It doesn’t matter, you can have one molecule of extra exogenous testosterone and that’s a doping effect. So that’s my case, they said you got exogenous testosterone, blah, blah, blah. And basically, we’re suspending you for two years. End of discussion. So that’s where… I mean, look at your own rules.
Ben: That’s the one I’d ask you about because… someone I know got this thing called the Therapeutic Use Exemption or the TUE. It’s basically your doctor signs some form that says, yeah, this guy’s on testosterone for a medical condition that I diagnosed. So I know based off what I’ve read on what proceeded, that you didn’t have one of those, and I was basically curious about what went on there between you and your doctor and WTC when it came to that…
Kevin: First of all, again, I was a little naïve, because it was like, okay, it’s a medical condition, it’s been prescribed by a doctor. My first thought was that should be it. I can show that it was, you know. But then as you get in the various specific of the WTC, and you go back to the form that I signed with Ironman Florida and getting to working at the whole thing, again, a little bit of background. So you had professionals, they’re gonna start testing. They have all these rules laid up to professionals. You know, you’re talking about 100, 200 athletes. They’ve got a report they were about to be available one time of day for testing. There’s very strict requirements, if you’re using a banned stuff, you gotta have a TUE or your’e out of here. It’s very straightforward. And then they said that we’re gonna cover something together for age-groupers. That’s different. If you think there’s 1500 athletes going to Kona, so that’s a pool of 1500 and then you add 70.3 on top of that, you got 3000 people going to that world championship, all of a sudden you got 4500 people. So maybe the requirement for pros should not be, I mean, age group requirement should be a little bit different. So they made some changes specifically for age groupers. So anyway we get back to this TUE, Therapeutic User Exemption. Okay, do I need to get one or not? So you go to… you look at the document, the main body. It says TUE required. The WTC says when you sign that form, you go to their website and there’s like the main body of sort of anti-doping. They do talk about Therapeutic Use Exemption, you have to obtain one, blah, blah, blah. But the thing about it is, it tells you you need to get one and that references you to another site where it tells you the whole procedure about how to get one. You go to that page and it says know your categories, and there it specifically says, age groupers no TUE required. And then it goes further on and it says, for an age group athlete that has been tested positive for banned substance, shall not be deemed to be a doping effect if you could show the following: medical condition, non-performance enhancing, make yourself available for an additional testing at WTC may want to do.
Ben: So what you’re saying is that basically it seemed to indicate that you didn’t need the Therapeutic Use Exemption as long as you could show retroactively…
Kevin: Then after that first event, so to speak, if you then wanna continue to use the “banned substance” you would then need to get TUE, but in the first instance that you could show it was for medical condition, and it’s not performance-enhancing, you do not need one. And it would deem not to be a doping effect. Very specific language, it’s there. That’s basically where I hang my hat off. And then the other aspect why I guess it makes perfect sense is what I think they did, they took the language they used for the NCAA. I mean they already have thousands and thousands of college athletes and if they basically said all you guys, you gotta get TUE regardless, it would just swamp the system. If you use an inhaler, you got to get a TUE. If you have plantar fasciitis your doctor inject cortisone into you, you got to get a TUE. If I had surgery and the doctor did some TRP therapy on me, I would have to get a TUE. It just, if there’s no mechanism for that sort of thing, let’s look at this and see whether you need to get a TUE or not. That’s fine if you’re pro. When you’re making a living, you should know better. But if you’re an age grouper which is a hobby, just like age groupers don’t have to say where they are everyday. They can have their plans changed, send an email to somebody saying, okay, I’m gonna be in Charlotte today, instead of… could you imagine 4500 athletes having to inform WTC as to their whereabouts the whole time? It’s unworkable. Just like requiring 4500 athletes to all get TUEs every time they inject a banned substance.
Ben: So what happened in the trial? Obviously, somebody interpreted this differently than you.
Kevin: Let me explain what happened. So we went, Howard went to WTC and said, this is ridiculous. You want to ban him for two years, he followed your direction. You have here the leeway. First offense it won’t be deemed to be a doping offense. If you can prove that it’s a medical condition and not performance enhancing. We have this letter from the doctor that says he’s been under his care for 5, 6 years. The regular labs showing the reason for, we’ve got prescription history showing that we’re basically this testosterone came from organic part of the therapy. But WTC didn’t want to hear from us. In fact what they did, even though the documents which I thought pretty clear, they started saying, oh you’re a member of USAT. And by virtue of being a member of USAT regardless of our rules says, you need to comply with the USAT rules, and they made this sort of…
Ben: USAT, for people who are listening and don’t know what that is, it’s USA Triathlon.
Kevin: USA Triathlon, yeah. As being a member of USA Triathlon they have different… they don’t have this all language about… you don’t know TUE requirement. And their document… they said they have this sort of advisory, it says, regardless of what our requirements are, you may want to check with your governing body to see if there are more stringent requirements. They didn’t say you’re subject to the most stringent requirements, which really meant to say, just in case you don’t need a TUE to compete in Ironman, if you compete in the National Olympic distance for USA Triathlon or Xterra, they may have different requirements, and say you need to comply with their requirements. But it didn’t say specifically those requirements apply here. But they just try to say that you are a USA Triathlon member and therefore you need to get a TUE regardless of what our rules say. And that’s not what’s in there. So anyway, we say okay. The only recourse that you have is arbitration. You can argue with WTC but it’s their right, it’s their rule. They elect to interpret their rules. That’s their right. In August, we had an all day hearing. The panel is very good. I actually had no issues. There were three very confident, experienced attorneys/arbitrators. They were very savvy in sports aspects, in sports arena. And it’s amazing how Howard argued very simply. Howard just basically said, this is really a simple case. No TUE required, that’s what the document said. End of story. And they threw everything at us. They said, yeah, it says that. But over here it says TUE required and then you’re a member of USA Triathlon, you should have gotten one there, blah, blah, blah. And I kept saying, wait a minute. There’s no question that in your document in numerous places, it says TUE required, but then it also says the specifics of the actual TUE application, go to this location, you go that location, and it specifically says you don’t need one if it’s a medical condition and is prescribed, blah, blah, blah. If you look at where the panel finally came down, they specifically said, it’s my interpretation was reasonable and persuasive. So in that letter there was no significant fault and I didn’t… now I understand the nuances. There’s no fault, and there’s no significant fault. The reason I found some level of fault with me or negligence. And this is where the WTC turned to hammer me. You have this contradictory position, why didn’t you just call WTC and asked them if the TUE is required? And I said, to me it was not contradictory. It made perfect sense. You have TUE and you went to specifics and you have a subset and it says if you’re in age group it’s not required. End of story. That’s it. And they said, well, you should have tried to get clarification either from USA Triathlon. You know how they’re turning, they’re just throwing whatever that came out there. And a little of it sucks, so to speak. So the panel basically said, they sanctioned me but they tried to water it down. It says they could because WTC non-negotiable two-year ban. So what they did was they cut it in half and said, by the way the test was way back in January, here we are in September, we’re basically gonna give you a one-year suspension but it’s gonna be starting from the test date, not from the notice date, not from the hearing date, but from the test date. So basically, it’s a three-month suspension.
Ben: So what did the arbitration panel think about what you and Howard were saying, what kind of discrepancy is on the WTC’s website text?
Kevin: They agreed. They basically said, there were two aspects they agreed with. In the finding, they said, WTC you got to clean up your language. Because the other thing, when they kept trying to sort of say while I was subject to USA Triathlon, they kept saying why didn’t you say regardless of the WTC requirement you’re subject to your own governing body, you don’t say that. You’re just given advisory check with your governing body. That’s why they try to reduce the “sentence” as much as possible. And again, if you read through the decision, you’ll see it’s highly critical of WTC. But my feeling is, I don’t think there’s anything wrong with the way the documents were drafted. I think it works in the sense that if you have a positive test for a banned substance and you can show it’s a medical condition and it’s not performance enchancing, you basically should have another shot. Not everybody should have to go and have a TUE because of using a banned substance. It’s just a bureaucratic nightmare. Based on this page, WTC has changed their language. They’ve taken away
Ben: Because of kind of what seems like some messiness in your case, things have changed.
Kevin: Yes, it has. And I think to the detriment of age groupers. And also to the detriment of USAT because the earlier language was somewhat unclear at where you’re supposed to get the TUE from, not they clearly shifted that over to USA Triathlon and USADA. So it basically says, you got to get TUE from your governing body and it sort of covers them now in the future. They can say you didn’t get a TUE and they’re able to change their language saying that basically a violation of the governing body shall be deemed a violation of WTC rules. So they closely linked the two and they shifted the entire burden of reviewing any TUE, of issuing any TUE. Before that was on WTC side. Now they shifted totally to, if you’re a USA Triathlete, you got to go through, deal with USADA and USA Triathlon, and if you don’t, you’re banned for two years.
Ben: So if somebody is listening in and their doctor has given them testosterone lotion or injections or something like that, they need to go through USA Triathlon and file a Therapeutic Use Exemption with USA Triathlon, if they’re a triathlete.
Kevin: The other aspect, again, I did not know the strictness of the TUE process, you can go to the USADA site and you can download the doctor’s form to file for a TUE and with respect to testosterone, and again I, you could say there was some negligence on my part coz I had not done this til we go into the whole trial and everything, but it’s impossible to meet basically for age… it doesn’t say levels of below x, you basically have to produce no testosterone. With USAT it helps being healthy at 400 to 500 and my levels are a hundred, I should be entitled. But it says for a 58-year old man, a hundred’s really not so bad, so yes, it’s not healthy in the general population, but vis-à-vis a 58-year old man, we’re not gonna give it to you.
Ben: What about the USA Triathlon Therapeutic Exemption form? Same thing, or…
Kevin: Well, it’s now… USADA has now become the focal point. Obtaining a TUE now falls totally with USADA.
Ben: I see.
Kevin: And you might want to download that, because if you look at it…
Ben: I’ll put a link to the shownotes for people who want it for themselves.
Kevin: It’s a very difficult test to me. My thought would be if it says your levels are below x, your doctor has to test you like two times a week apart to get sort of a base level. If they had something like it’s below a certain level, basically you’re eligible, but now it specifically excludes supplemental testosterone for anti-aging purposes.
Ben: So what are you gonna do? Are you gonna keep using the testosterone that your endocrinologist gave you, or do you kind of have to make a decision now between… you got to choose between getting into triathlon at this point?
Kevin: You’re right. I can train all day and I can continue to use the testosterone, but if I’m not ready, you can’t. At my age, it’s gonna be a detriment, but I think the huge issue is when you’re in your 60’s, or 70’s, or your 80’s, and being forced to make that decision if I want to continue in Ironman races. I can’t use any supplemental testosterone. You’re putting it as health versus competition.
Ben: For you it’s an important consideration. You’re an impressive looking guy.
Kevin: I assure you that’s not because I’m using testosterone. It’s funny be cause everybody thinks when you’re skinny or you’re lean, you must be on something. I’ve been that way all my life. I don’t take that much credit for it. I tell people it’s your parents, not you. I just have a little comment about Kona itself, the thing about Kona is it’s really not the competition, it’s the course. It’s you against the course. If you focus on your competition, you really get beaten everytime. You just have to go out there and race the course. I had a sanction against me, but I’m glad I wasn’t in Kona this year. It was brutal.
Ben: Yeah, I was out there. There were definitely slower times in a lot of categories. Just a number of quick questions for you. What about using things that aren’t testosterone that aren’t injections, that are creams, that are kind of like herbal formulas like tribulus for testosterone or D Aspartic Acid, or a lot of these supplements that aren’t necessarily synthetic testosterone? Is that something that you test for, or something that is illegal, or have you looked into that?
Kevin: I have not looked into…
Ben: The reason I asked you coz I know there’s a lot of people out there who’s using a lot of other things under the sun…
Kevin: Let’s look at it this way… if there’s scientific evidence that it actually boost testosterone levels, there’s no question that you’re using synthetic testosterone, your values are a hundred and over a 2 to 3-week period your value will rise to 3 or 4 hundred. Using them are there real significant specifically significant increase. Certainly, I would consider that. It is unfortunate there is no threshold or some leeway with respect to testosterone, but I also understand the argument that once you open that door, it’s subject to abuse. And people can hyperdose that stuff.
Ben: The other question that I want to ask you was Lance Armstrong obviously banned due to use of steroids and the blood booster and blood transfusion. For you as an age grouper, when they come in and they test your blood in your yard, where they just looking for testosterone or do they have this full panel where they’re looking at a lot of stuff, for example, that have been implicated in the Lance Armstrong doping scandal?
Kevin: I am sure they are looking for… actually when I got the results back, it said basically I tested positive for exogenous testosterone and it said negative for EPO. So definitely they were looking for EPO.
Ben: And probably steroids and blood transfusion as well.
Kevin: Yeah. But you know, I get the feeling that at least for the age groupers there is sort of like preliminary screening. I think they’re using the urine for an EPO and the T ratio, coz that’s fairly inexpensive, I understand. And then if they find something, then they start looking at the blood. And again, one thing Howard and I should have argued early on before we went to arbitration was that you got my blood, look at my testosterone levels and you’ll see that they’re consistent, not on the performance-enhancing level. I don’t know how expensive the initial screening is but I’m sure if they get a positive, but in my case they never looked at the blood. Six vials of my blood, they never looked at that. They were totally focused on the urine. I would think EPO is the big thing they’re looking for. It’s clearly for endurance event. And then the blood transfusion. My understanding is that they’re now doing a level of sophistication. And even if they don’t… supposedly the guys were injecting EPOs directly into their veins and all that. But now what they do is analyze somebody’s blood to see the percentage of fresh blood cells, and even if they don’t find EPO, and your percentage of new blood versus old is x% and that’s basically a marker for EPO. I don’t know if that also matters for transfusion. But yes, they certainly gather enough and it’s sort of sub contracted out. I forget who the tech there, it’s like the results go to some lab in Salt Lake City.
Ben: I’m sure that we have some listeners who are also somewhat knowledgeable on these issues. If you’re listening in and you got questions, you got comments, you got feedback, if you want to share your thoughts about age group testing, about doping in triathlon or other sports, or about Kevin Moats’ story in particular, go to the shownotes of this episode. They’ll be up over at BenGreenfieldFitness.com. I’ll make sure that I’ll put a link to the Therapeutic Use Exemption form from USADA. And also a couple of other interesting resources in the same category. There’s a very interesting interview with Victor Conte on the Joe Rogan Show that some of you may want to listen in to. Last year, my friend Roma Mica over at EveryManTri interviewed the author of Doper Next Door, Andrew Tilin. I’ll also put a link in there to a lot of things that people use these days for natural testosterone enhancement and some of the idea behind those things as well. Kevin, you’ve been very generous with your time today and I want to thank you for coming on the call.
Kevin: I appreciate your being able to hear my side of the story. People just see a doping offense. They don’t actually read the decision to see that basically that panel found a significant guilt on my part, fault on my part. They don’t see that there’s confusion in the rules and all of that, and also that the panel reduced my sanction. So I appreciate you allowing me to speak out. Thank you, Ben.
Ben: Thanks for coming on, Kevin. And until next time, folks. This is Kevin and Ben from BenGreenfieldFitness.com, signing out.