title: 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.
authors.affiliation: Aegis Sciences Corporation, Nashville, Tennessee 37228, USA.
authors.forename: Melinda K
authors.initials: MK
authors.lastname: Shelby
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Crouch
authors.forename: David L
authors.initials: DL
authors.lastname: Black
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Robert
authors.forename: Rebecca
authors.initials: R
authors.lastname: Heltsley
mesh_terms: D000735:Androstenedione / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D003687:Dehydroepiandrosterone / Q000652:urine*; D013196:Dihydrotestosterone / Q000652:urine*; D004300:Doping in Sports / Q000517:prevention & control*; D006801:Humans; D057230:Limit of Detection; D058573:Performance-Enhancing Substances / Q000652:urine*; D012015:Reference Standards; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D015415:Biomarkers; D058573:Performance-Enhancing Substances; D013196:Dihydrotestosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone