Sanctioned testosterone use already an epidemic in MMA world

UFC light heavyweight Forrest Griffin and I are only about three months apart in age, so you can understand why I was concerned recently when I heard that the 33-year-old fighter had been granted a therapeutic-use exemption (TUE) for testosterone prior to his UFC 148 bout in Nevada earlier this month. We all know testosterone levels decline naturally as we get older, but I didn't think guys our age had to worry about it yet. I mean, I feel fine. Maybe the workouts (and, okay, the hangovers) are a little tougher to recover from than they were 10 years ago, but come on, Forrest. We're still young men, are we not?

And you would think so, but no, apparently we aren't. Apparently we are in a state of hormonal decline. Griffin seems to be suffering from such chronically low testosterone levels that the Nevada State Athletic Commission deemed it appropriate for the former UFC 205-pound champ to use synthetic testosterone. You know, to level the playing field. Because it's simply not fair to send a poor, testosterone-deficient waif like Griffin into the cage with nothing more than his natural hormone levels to help him out. Why, he'd be absolutely helpless against men with the normal amount of testosterone coursing through their bodies.

Tough break for 37-year-old Tito Ortiz, who lost a unanimous decision to Griffin at UFC 148. He recently appeared on Inside MMA and said he hopes this trend of sanctioned testosterone use doesn't become "an epidemic" in our sport. I've got bad news for Ortiz: it already has. Just look around the MMA ranks and you'll see it. You don't even have to look very hard.

For instance, right after Griffin exited the cage at UFC 148, Chael Sonnen -- another fighter with a therapeutic-use exemption in Nevada -- stepped in for the main event. Two months before that, the main event of UFC 146 featured 33-year-old heavyweight Frank Mir, who also has permission from Nevada to use testosterone. Although, in fairness, Mir was only in the main event because former Strikeforce heavyweight Alistair Overeem had been scratched from the event for, well, using testosterone (without prior written permission). This September, when Las Vegas plays host to a light heavyweight title fight at UFC 151, we'll see the return of veteran fighter Dan Henderson, who, at 41, is one of the pioneers of testosterone-replacement therapy (TRT) in MMA. Of course, Henderson will face an uphill battle against dominant UFC champ Jon Jones, who, just shy of his 25th birthday, probably still has at least a couple good years of natural testosterone production left in him.

Then again, maybe that's an overly optimistic outlook for Jones. If fighters like Griffin, Mir and Sonnen are to be believed, there's something about this sport that absolutely wrecks a man's endocrine system. Because it's either that or they're lying to us all, gaming a system that's shot through with loopholes, and taking advantage of a tantalizing opportunity to get away with sanctioned use of one of the best performance-enhancing substances money can buy.

It has to be one or the other. When you see how many apparently fit, capable professional fighters in their early to mid-30s are claiming low testosterone -- and not just low end of normal, mind you, but chronically, abnormally low -- you have to conclude that either fighters suffer from hypogonadism at rates that are significantly higher than athletes in other sports, or else they aren't, but they know a sucker when they see one. I'm more inclined to believe the latter, but neither option is a good one. Whether it's the first explanation or the second, shouldn't we be concerned about what this means for the future of MMA?

Shouldn't we be doing something about it?

Start with door number one. Say a career in MMA really does destroy your body's ability to produce testosterone (but oddly, all other hormone production remains normal). Then the question is why? Is it a consequence of weight-cutting? If so, Olympic wrestlers should be prime candidates for TRT, though it turns out that therapeutic-use exemptions are actually exceedingly rare when one has to petition the IOC rather than a state athletic commission for one. ("It's simply not done," according to Dr. Don Catlin, who sits on the IOC's review board for therapeutic-use exemptions, and who describes testosterone as the "preferred" performance-enhancing drug for elite athletes these days.)

Is it the rigor of training? Are fighters working themselves to the point of total testosterone depletion? If so, you'd think the fatigue and muscle-wasting that goes along with textbook hypogonadism would be enough to force them to take it easy. Or, another possibility, is it past steroid abuse that has rendered their bodies unable to churn out normal amounts of this powerful hormone? If so, should state athletic commissions really be playing the role of methadone dealer to athletes seeking a shortcut around the consequences of their own illegal and unethical decisions?

But all these explanations assume that the scourge of low testosterone in MMA is a real one. It ignores the possibility that, with the help of friendly doctors and commissions that are either ignorant or complicit, fighters are faking a condition just to get the treatment. And don't kid yourself, it isn't so hard to fake.

Endocrinologists will tell you that there are any number of ways to manipulate your testosterone levels to make them seem low on a scheduled test. As we saw when Sonnen applied for his TUE in Nevada, the doctor employed by the commission to review such applications is not himself an endocrinologist, so it's possible that he might not be the toughest customer to fool on issues like this.

Since commissions like the NSAC don't do the type of testing necessary to detect synthetic testosterone use, and instead content themselves with merely checking testosterone-to-epitestosterone ratios (and Nevada allows for fighters to be up to six times higher than the normal 1:1 ratio before the test is considered positive), they're already doing very little to crack down on unsanctioned testosterone use. Add in the willingness to hand out permission slips for performance-enhancing drugs to every thirty-something with a doctor's note, and you have a real problem in the making. You have the epidemic Ortiz is worried about, and you have it already in full swing.

Does it matter? Some people would say no. Some would say we should be firing up the chemistry sets to create the best fighters we can. Others would say that because testosterone is a naturally occurring hormone, it's somehow justified to allow athletes to jack up their levels of it with artificial means. Neither makes much sense to me, especially in the context of a combat sport like MMA.

This isn't baseball, where home run inflation is the worst thing that happens as a result of performance-enhancing drug use. This is a sport where people try to knock each other unconscious, to hurt one another to the point of incapacitation. And we want to give them synthetic hormones with the power to make them stronger and faster? We want to inject them with chemicals that will allow them to give and take that punishment longer, far past the point where the deterioration of their aging bodies might have forced them to stop? Are we insane?

For MMA fans, this already feels like a tired debate. I'm sure many people are sick of hearing about it and wish it would just go away. The fighters who are rushing to be the next in line to claim that they've somehow succeeded as a professional fighter in spite of their abnormally low testosterone levels probably also wish that we'd all lose interest in the topic.

I can't. Especially not after talking to clean fighters who want to stay clean fighters, but who fear what will happen to them if they miss the testosterone train. Every sport struggles with performance-enhancing drugs of some stripe, but no other major professional sport offers its athletes this type of opportunity to use them right out in the open.

Maybe it's a cultural problem. In an age where we have a drug for everything from thinning hair to thin eyelashes, maybe we've come to assume that we have a right to these things, that no natural deficiency -- real or imagined -- need be tolerated. That might be fine for regular people who want to boost their bench press or attain better erections through science, but in the business of professional pugilism, where bodies and brains can get wrecked even without synthetic help, it's a dangerous mode of thinking.

It cheats the fighters who are competing naturally and it enables those who aren't. It's a loophole that begs to be exploited, and I can't (or maybe just don't want to) believe that it will even be allowed much longer. I also can't believe that, once the loophole is finally closed, we won't look back on this era of the sport and wonder what we were actually seeing during MMA's TRT phase, and what in the hell we were thinking to have tolerated it for so long.