title: Trace contamination of over-the-counter androstenedione and positive urine test results for a nandrolone metabolite.
abstract: BACKGROUND
  Several anabolic steroids are sold over-the-counter (OTC) in the United States, and their production is not regulated by the US Food and Drug Administration. Reports have suggested that use of these supplements can cause positive urine test results for metabolites of the prohibited steroid nandrolone.
  
  
  OBJECTIVE
  To assess the content and purity of OTC androstenedione and to determine if androstenedione and 19-norandrostenedione administration causes positive urine test results for 19-norandrosterone, a nandrolone metabolite.
  
  
  METHODS
  Randomized controlled trial of androstenedione, open-label trial of 19-norandrostenedione, and mass spectrometry of androstenedione preparations, conducted between October 1998 and April 2000.
  
  
  METHODS
  Outpatient facility of a university hospital.
  
  
  METHODS
  A total of 41 healthy men aged 20 to 44 years.
  
  
  METHODS
  Participants were randomly assigned to receive oral androstenedione, 100 mg/d (n = 13) or 300 mg/d (n = 11) for 7 days, or no androstenedione (n = 13); in addition, 4 patients received 10 microg of 19-norandrostenedione.
  
  
  METHODS
  Content of OTC androstenedione preparations; level of 19-norandrosterone in urine samples, determined by mass spectrometry, compared among the 3 randomized groups at day 1 and day 7, and among the participants who received 19-norandrostenedione from October 1998 to April 2000.
  
  
  RESULTS
  All urine samples from participants treated with androstenedione contained 19-norandrosterone, while no samples from the no-androstenedione group did. Urinary concentrations were averaged for day 1 vs day 7 measurements; mean (SD) 19-norandrosterone concentrations in the 100-mg/d and 300-mg/d groups were 3.8 (2.5) ng/mL and 10.2 (6.9) ng/mL, respectively (P =. 006). The 19-norandrosterone content exceeded the cutoff for reporting positive cases (>2.0 ng/mL) in 20 of 24. The androstenedione preparation used was pure at a sensitivity of 0.1%, but at 0.001% 19-norandrostenedione was found. For the 4 participants to whom 10 microg of 19-norandrostenedione was administered, 19-norandrosterone was found in all urine samples. Of 7 brands of androstenedione analyzed at the 1% level, 1 contained no androstenedione, 1 contained 10 mg of testosterone, and 4 more contained 90% or less of the amount stated on the label.
  
  
  CONCLUSIONS
  Our study suggests that trace contamination of androstenedione with 19-norandrostenedione is sufficient to cause urine test results positive for 19-norandrosterone, the standard marker for nandrolone use. Oral steroid doses as small as 10 microg are absorbed and excreted in urine. Some brands of androstenedione are grossly mislabeled. Careful analysis of androstenedione preparations is recommended in all studies of its biological effects. JAMA. 2000;284:2618-2621.
authors.affiliation: UCLA Olympic Analytical Laboratory, 2122 Granville Ave, Los Angeles, CA 90025, USA. dcatlin@ucla.edu
authors.forename: D H
authors.initials: DH
authors.lastname: Catlin
authors.forename: B Z
authors.initials: BZ
authors.lastname: Leder
authors.forename: B
authors.initials: B
authors.lastname: Ahrens
authors.forename: B
authors.initials: B
authors.lastname: Starcevic
authors.forename: C K
authors.initials: CK
authors.lastname: Hatton
authors.forename: G A
authors.initials: GA
authors.lastname: Green
authors.forename: J S
authors.initials: JS
authors.lastname: Finkelstein
mesh_terms: D000328:Adult; D045930:Anabolic Agents / Q000378:metabolism*; D000735:Androstenedione / Q000031:analogs & derivatives* / Q000737:chemistry / Q000378:metabolism* / Q000494:pharmacology; D019587:Dietary Supplements; D004340:Drug Contamination; D004962:Estranes / Q000652:urine*; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D009277:Nandrolone / Q000378:metabolism*; D004366:Nonprescription Drugs; D015813:Substance Abuse Detection; D014481:United States; D016482:Urinalysis
chemical_list: D045930:Anabolic Agents; D004962:Estranes; D004366:Nonprescription Drugs; D000735:Androstenedione; C036015:19-norandrosterone; D009277:Nandrolone; C002828:19-norandrostenedione