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Thread: Association of Ringside Physicians calls for phasing out of TRT

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    Default Association of Ringside Physicians calls for phasing out of TRT

    Association of Ringside Physicians calls for phasing out of TRT
    Association of Ringside Physicians has releases a consensus statement on Therapeutic Use Exemptions for Testosterone Replacement Therapy.

    The Association of Ringside Physicians (ARP), an international, non-profit organization dedicated to the health and safety of the boxer and mixed martial arts athlete, has released a consensus statement on therapeutic use exemptions for testosterone replace therapy in professional combat sport athletes, as follows:

    The incidence of hypogonadism requiring the use of testoster one replacement therapy (TRT) in professional athletes is extraordinarily rare. Accordingly, the use of an anabolic steroid such as testosterone in a professional boxer or mixed martial artist is rarely justified. Steroid use of any type, including unmerited testosterone, significantly increases the safety and health risk to combat sports athletes and their opponents. TRT in a combat sports athlete may also create an unfair advantage contradictory to the integrity of sport. Consequently, the Association of Ringside Physicians supports the general elimination of therapeutic use exemptions (TUE) for testosterone replacement therapy.

    Dr. Ray Monsell
    Chairman, ARP
    However, several factors are casting this narrative in doubt.

    First, TUE in MMA is rare. as determined by a survey of the leading Athetic Commissions in the US.

    "We've given out three in 12 years," says Nevada's Keith Kizer in 2102 (they were to Dan Henderson, Todd Duffee, and Shane Roller). New Jersey's Nick Lembo put the number at "less than five." The busiest commissioner in the world, Ohio's Bernie Profato has given only two, to Henderson and Strikeforce fighter Bristol Marundo.

    So out of 15,000 regulated fighters, only a handful of TUEs have ever been granted. That is not an epidemic.

    "Itís very rare, but there are some legitimate needs," Lembo explains. "My biggest concern is that most commissions donít even test for these things in the first place so weíre over-penalizing the people that are coming forward and saying, ĎHey, do whatever you want to me. Test me before and after the fight. Test me randomly. I need this, Iím on it and Iím going to be within normal limits.í There are a lot of commissions who donít believe in TUEs for any reason, but why be hard on the ones coming forward?"

    A second factor - one that until now was largely unknown - is that head trauma can lead to low levels of testosterone. In a truly important piece, Mike Chiappetta explains.

    In 2007, a paper published in the Journal of Athletic Training reported the first known connection between mild concussions and hypopituitarism, a deficiency that can lead to low testosterone.

    That research, along with how traumatic brain injuries impact the pituitary gland, is being continued by Dr. Daniel F. Kelly, the director of the Brain Center and Pituitary Disorders Program in Santa Monica, California.

    Kelly is currently in the midst of a study of 75 former NFL players. In an interview with MMA Fighting, Kelly said that preliminary data from the study suggests that pituitary damage is occurring in a subset of the retirees.

    That study seems to corroborate a 2006 finding in Turkey that found that head injuries incurred by pro kickboxers have resulted in damage to the pituitary gland.

    Dr. Fahrettin Kelestimur, a professor of endocrinology at Erciyes University in Turkey who authored the 2006 study, told MMA Fighting that the most common damage has caused growth hormone deficiency and hypogonadism, respectively.

    Only a handful of state commissions require an MRI in order to grant a fighterís license, but MRIs donít always show the problem. A blood draw is more likely to determine if an issue exists, according to Kelly. Tests for luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, growth hormone (GH) and IGF-1 (insulin-like growth factor 1) could serve as an effective screening tool to determine any pituitary damage.

    Dr. Kelly, who has been working on issues pertaining to the pituitary gland for nearly 20 years, in 2008 co-authored a study that concluded chronic hypopituitarism occurred in approximately 20 percent of patients who had suffered mild, moderate or traumatic brain injury.

    "(MMA) fighters are getting repeated insults to the head, sometimes more than concussive events," Kelly said. "And if you did a careful analysis of those people, I'm sure you'd see a significant rate of pituitary gland dysfunction. That's my prediction."

    "I guess whatís really amazing, if you look at it another way, is how infrequently it occurs, and how sturdy the system is, how much damage it can take. The pituitary gland is this tiny little thing thatís less than a centimeter cubed. Itís sitting in a little, bony depression in the skull base and itís getting banged around, and the connection is getting banged around repeatedly, yet it keeps it on ticking in most people. Itís a pretty resilient system, but only up to a point."

    A third consideration is that TRT is not a magic bullet.

    The number of fighters on TRT is not known with complete precision, nor is it known precisely how long they have been doing so. However, last year Bloody Elbow did an admirable survery of fighters known to be on TRT, and how the did. The fighters went a combined 15-17:
    Chael Sonnen (5-4)
    Vitor Belfort (2-0)
    Dan Henderson (4-4)
    Quinton Jackson (0-2)
    Forrest Griffin (1-0)
    Frank Mir (0-2)
    Todd Duffee (1-1)
    Nate Marquardt (2-1)
    Shane Roller (0-3)

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    speaking of Todd Duffee. Where the hell has he been? Didn't fight at all in 2013. Is he injured?
    Sorry Fedor, but Dan Henderson is the G.O.A.T.

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    Quote Originally Posted by The8thPlague View Post
    speaking of Todd Duffee. Where the hell has he been? Didn't fight at all in 2013. Is he injured?
    Yes he had some injury before/during the DeFries fight that kept him out for several months then he returned to training and ended up being diagnosed with some rare issue that caused issues with his arm/shoulder and probably is out til mid 2014 at best

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    All TRT should remain on a case by case basis and should not become public information due to the privacy of the individuals involved. Dropping it altogether at this point would be an admission that the AC's are a bunch of dumbasses (Which may be true).
    And the piano, it sounds like a carnival
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    Ugh, this debate will just go on forever I think

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    They went 15-17, so basically TRT doesnt really matter or give you a big advantage.

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    Quote Originally Posted by the_dark_angel_4ever View Post
    They went 15-17, so basically TRT doesnt really matter or give you a big advantage.
    Maybe without trt they wouldve gone 6-26.. So basically you drawing a conclusion that trt does nothing and gives you no advantage because of these results is absolutely retarded.

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    Quote Originally Posted by SimpleJack View Post
    All TRT should remain on a case by case basis and should not become public information due to the privacy of the individuals involved. Dropping it altogether at this point would be an admission that the AC's are a bunch of dumbasses (Which may be true).
    Of course they are a bunch of dumbasses.. Thats one of the biggest problems in everything today, nobody can ever admit to being wrong. So we continue down these paths of idiocy because some rich dude doesnt want to admit he fucked up.

    Please Vitor win the belt so you can be thrown under the bus and crucified by the mainstream media.

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    There is an association of ringside physicians yet still no fighters union?

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    Quote Originally Posted by IceCold48 View Post
    There is an association of ringside physicians yet still no fighters union?
    Very different organizations.




    I am not sure if the UFC allows it because it can make their fighters more exciting or because it is a whole can of worms in itself:

    A second factor - one that until now was largely unknown - is that head trauma can lead to low levels of testosterone. In a truly important piece, Mike Chiappetta explains.

    In 2007, a paper published in the Journal of Athletic Training reported the first known connection between mild concussions and hypopituitarism, a deficiency that can lead to low testosterone.

    That research, along with how traumatic brain injuries impact the pituitary gland, is being continued by Dr. Daniel F. Kelly, the director of the Brain Center and Pituitary Disorders Program in Santa Monica, California.

    Kelly is currently in the midst of a study of 75 former NFL players. In an interview with MMA Fighting, Kelly said that preliminary data from the study suggests that pituitary damage is occurring in a subset of the retirees.

    That study seems to corroborate a 2006 finding in Turkey that found that head injuries incurred by pro kickboxers have resulted in damage to the pituitary gland.

    Dr. Fahrettin Kelestimur, a professor of endocrinology at Erciyes University in Turkey who authored the 2006 study, told MMA Fighting that the most common damage has caused growth hormone deficiency and hypogonadism, respectively.

    Only a handful of state commissions require an MRI in order to grant a fighter’s license, but MRIs don’t always show the problem. A blood draw is more likely to determine if an issue exists, according to Kelly. Tests for luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, growth hormone (GH) and IGF-1 (insulin-like growth factor 1) could serve as an effective screening tool to determine any pituitary damage.

    Dr. Kelly, who has been working on issues pertaining to the pituitary gland for nearly 20 years, in 2008 co-authored a study that concluded chronic hypopituitarism occurred in approximately 20 percent of patients who had suffered mild, moderate or traumatic brain injury.

    "(MMA) fighters are getting repeated insults to the head, sometimes more than concussive events," Kelly said. "And if you did a careful analysis of those people, I'm sure you'd see a significant rate of pituitary gland dysfunction. That's my prediction."

    "I guess what’s really amazing, if you look at it another way, is how infrequently it occurs, and how sturdy the system is, how much damage it can take. The pituitary gland is this tiny little thing that’s less than a centimeter cubed. It’s sitting in a little, bony depression in the skull base and it’s getting banged around, and the connection is getting banged around repeatedly, yet it keeps it on ticking in most people. It’s a pretty resilient system, but only up to a point."
    MMA and boxing luminaries combine efforts to help Cleveland Clinic brain health study
    http://www.mmafighting.com/2014/1/27...d-clinic-brain

    White backs physician call for TRT ban

    "The doctors came out and said they want to ban it? Well, that's the answer," White told The AP on Monday. "It's legal in the sport. The commissions let you do it. You get an exemption, and you have to be monitored and all the stuff that's going on, but if they're going to do away with it? There you go. It's a problem solved."

    "He drives me crazy, and me and Vitor were not on good terms a few months ago," White said. "Just because this whole TRT thing, I think, is unfair, and I said we're going to test the living s--- out of him [during training]. And we have, and he has complied, and he has been within the limits he's supposed to have."

    Although the UFC tests its fighters when they sign contracts and adds additional in-house testing before certain fights, White said he's wary of completely stepping in front of government regulators on the issue.

    "We couldn't be more proactive," White said. "Drugs hurt us. Hurts our sport. Let alone our perception in the media and everything — it destroys great athletes. Drugs destroy great athletes, because once you start on them, you can never get off them. You're on them for the rest of your career."
    Last edited by Cat--Smasher; 01-28-2014 at 06:48 PM.

  11. 01-27-2014, 07:32 PM


  12. 01-28-2014, 09:54 AM


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