Presently there is perhaps no greater controversy in professional combat sports than Therapeutic Use Exemptions for anabolic steroids. A bright spotlight will shine on this issue again with many asking whether Vitor Belfort will receive a Therapeutic Use Exemption for TRT by the Nevada State Athletic Commission for his upcoming middleweight title fight which is rumoured to take place in Las Vegas. Below is the test Belfort needs to pass for clearance.
NAC 467.850 adopts the WADA criteria for granting a TUE. The four criteria that must be fulfilled before a TUE is granted are set forth in the International Standard for TUEs which are as follows:
1. “The Athlete would experience a significant impairment to health if
the Prohibited Substance or Prohibited Method were to be withheld in
the course of treating an acute or chronic medical condition.” (Article
4.1 a. of the International Standard for TUEs.)
2. “The Therapeutic Use of the Prohibited Substance or Prohibited
Method would produce no additional enhancement of performance
other than that which might be anticipated by a return to a state of
normal health following the treatment of a legitimate medical
3. “There is no reasonable Therapeutic alternative to the Use of the
otherwise Prohibited Substance or Prohibited Method.” (Article 4.1
c of the International Standard for TUEs.)
4. “The necessity for the Use of the otherwise Prohibited Substance or
Prohibited Method cannot be a consequence, wholly or in part, of
prior non-Therapeutic Use of any Substance from the Prohibited
List.” (Article 4.1 d. of the International Standard for TUEs.)
Given that TUE’s for TRT have been handed out in the past we can safely assume the NSAC can be persuaded with respect to the first three criteria. The fourth will be the focus of controversy. In 2006 Belfort tested positive for anabolic steroids, specifically for 4-hydroxytestosterone which is a WADA prohibited substance.
Belfort’s excuse for using this anabolic steroid (ingesting a supplement which, unknown to him, contained it) is irrelevant in the TUE analysis. All that matters is that it was ingested for “a non-therapeutic use” which it was by his own admission. From there evidence must focus on why Belfort has the need for TRT in the first place.
To follow the letter of the law the NSAC must be presented with evidence that the cause of Belfort’s TRT needs is not even “in part” related to his previous anabolic steroid use. Given that a known consequence of anabolic steroid use includes decreased testosterone production it will be an uphill battle for the NSAC to justify a TUE in Belfort’s circumstances. Unless a doctor can provide persuasive medical evidence explaining the cause of Belfort’s low testosterone production and further ruling out the previous 4-hydroxytestosterone use a TUE cannot be granted under WADA standards.
I reached out to Dr. Benjamin about whether medical evidence can meet this test to which he provided the following candid reply: