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Should Athletes Be Able To Compete Who Are On Hormone Therapy?

On October 18, 2012 IRONMAN announced a one-year suspension for Kevin Moats who at the time was 58-years old. He failed an out of competition drug test. It explained why he was nearly unbeatable in his age group.

Kevin Moats, now 63 years old just received his second positive drug test in the past 5 years.

Moats tested positive for testosterone that he had taken as part of “hormone therapy”. The test was done on January 20, 2012. It required a 2-year suspension that got reduced to one via some kind of special panel.

Just days ago Moats, now 63, announced to that he tested positive a second time for testosterone. It was from an out of competition test done on him just prior to the 2017 IRONMAN World Championship. IRONMAN has not as of this posting said a word about it.

Moats said he was receiving hormone therapy under a doctor’s supervision for hypothyroidism and andropause. In laymen’s terms that means a doctor was injecting or otherwise giving him things like testosterone to bring his hormone levels up to what is considered “normal”. Testosterone is a banned substance for competing athletes. Should he, or any athlete, be allowed to compete who is on hormone therapy? I say, “NO”. Here is why.

There are two main reasons why someone has low hormone levels for the types of hormones that you need to be competitive as an athlete.

The first is age. As we age our bodies slowly stop producing the high levels of hormones that make younger athletes just so much faster, stronger and more resilient than older athletes. It’s a natural process. A 70-year old is not going to have the same levels of testosterone, human growth hormone, DHEA and so on that a 25-year old has rolling around in their system.

This means that recovery will be slower. It means that laying down new muscle is going to be tougher compared to what the younger athlete can do. It also means that the older athlete will not be able to maintain the same speed or endurance of the younger athlete.

Some people look at this falloff as a “medical condition” that needs attention. Hormone therapy helps reverse some of this falloff. All of the hormones that naturally drop off with age are supplemented (most through injections) to bring those levels back up to “normal”. But here’s the catch. Bringing the performance enhancing hormones up to legal levels in an older person puts them at astronomically high levels compared to their fellow competitors who are not on hormone therapy.

That is why we have age groups! As we age our bodies change, naturally. Yes, you can go on hormone therapy and have ripped abs and the recovery rate of a 20-year old even though you are 60. But it’s just not right!

Anyone who wants to compete who is on hormone therapy should just enter the 30-35 age group regardless of what their age is because that’s about what the hormone levels are going to be that the doctors target.

But let’s get real. Older athletes should all be competing against others with the same age-related disadvantages. That’s was keeps competing fun. No one in their 60’s is thinking they can win the IRONMAN in Hawaii. But there are plenty who are hoping to win that age group! Yet if their fellow competitors are on hormone therapy, well the playing field is not level. So I don’t care what your justification as an older athlete is to use hormone therapy. You should not be allowed to compete against those fully embracing their age-appropriate realities.

The second reason hormone levels are low, even dangerously low, is because of how an athlete trains.

Even young athletes can have hormone levels that look like the un-supplemented 60-year old. That happens when an athlete competes too often, trains too fast too often and loads on huge volumes. Any one of those three things can result in a young athlete with severely suppressed hormone levels. Doing all three together is a guarantee that the young athlete will look like a 60-year old hormonally.

An overtrained young athletes can have dangerously low hormone levels just like an older competitor.

So what? Well, the young athlete has three choices. They can continue to drive themselves into the ground, in which case they will likely die young. They can get hormone therapy, which has a quirk where you can get away with it. It’s called a Therapeutic Use Exemption (TUE). That means that the medical profession acknowledges that you have a dangerous hormone situation. You then get a free pass on taking all the stuff that is illegal. But they are still taking  Performance Enhancing Drugs!

OR, you can actually change your training to be realistic and healthy so that your body bounces back and does what is should be capable of at your age.

If the younger athlete goes for the hormone therapy, then they have just doubled down on stupid.

The only reason they got in a situation where their hormone levels were not top notch is because they ignored the fact that their body is not invincible. They overtrained to the point of complete depletion of their body’s capability to recovery. Hormone levels followed and drop off the cliff. Then instead of correcting a flawed training philosophy they just embark on hormone therapy, get their TUE and continue on competing.

The crazy thing about this scenario is that if we could all do gigantic volumes and weeks on end of high intensity speedwork and actually recover from it, we would all post superhuman results at the races. But with hormone therapy you can get away with this faulty training paradigm. The athlete is actually able to continue crazy training and come back from it. That’s a HUGE advantage. So again I just say NO to hormone therapy for younger people as well.

Stay tuned for two more parts to this important theme. The next will be how an aging athlete can maintain their performance even without drugs or hormone therapy. And then the final blog will be on my journey through low hormone levels.

Learn how to train at the highest levels naturally:


  1. Third option is a medical condition. I’m 35, was racing (high mid pack). Diagnosed with a brain tumor that was near my pituitary gland and completely damaged it. My T naturally was measuring under 100 ng/dl. I’ve been on replacement T for 3 years. Haven’t raced since. I hover around 200 ng/dl now, still massively low for a 35 year old. Should I be allowed to race and compete in my AG?

    1. This is a classic reason to allow someone to race who is on Hormone Therapy. People who have real hormonal problems will never get back to “normal”. But the others who have abused their bodies by training too hard too long and suffered the results can supplement in a way that brings that back to well above the normal range. It’s an advantage that is given to those who have trained stupid!

  2. Yes, for sure there are true medical conditions that requisite hormone therapy. I did not address those in the article because I wanted people to really hear how non-biological influences can lower hormone levels. Those are things like training too hard, too fast, being stressed and racing too much. Those are situations that we all have to learn to manage to stay healthy. And if an athlete chooses to ignore the limits of their body, then they should pay the price, not be remedied through hormone therapy. It’s taking Performance Enhancing drugs to pull yourself out of a state that you should never have gotten into in the first place.

    A situation like a pituitary issue, or testicular cancer or a hysterectomy are true medical reasons for hormone therapy to every have a chance of getting back to normal. Those for sure should get a TUE. All others though? I don’t think so.

    1. Mark,
      Unfortunately, even then it is nearly impossible to receive USADA’s blessing in the form of a TUE. I am a testicular cancer survivor, and post chemo I started growing breasts, hot flashes, gained 20 pounds, etc. Diagnosed with low T, started replacement therapy. Applied for TUE, which required going off of T replacement for a couple of months (symptoms all came back, not fun) and getting weekly bloodwork. Every test came back with below-threshold T values, except ONCE of just above threshold. Yay! My one nut was actually sporadically putting out a little T!
      But, that was enough for USADA to deny my TUE. So, no more racing* for me.
      *Not that I want to any more, my T levels are still low-normal even on T replacement- I’m only on enough to avoid the craptastic symptoms of low T, but it’s not enough to get me any where near able to train at the level needed to race.
      PS-By the way, Mark, you are responsible for my best memory of my multisport career. You “hosted” the Two Harbors off road tri in Catalina years ago. You were in the lead jeep with Jack Carress, and I was on the front going up the steepest climb on Jack’s MTB he loaned me for the race. When it wouldn’t drop into the small ring, I jumped off and ran the bike up the hill…when you heckled me for not riding up the hill! I couldn’t believe that I was being razzed by The Grip!
      Good times!
      I hope retirement from tri is treating you well- it was forced for me by cancer, and I’m finding it to be a tough pill to swallow. I still have the itch, but am unable and incapable of scratching it. Perhaps I should read ST’s book “Racing the Sunset”…

      1. The overall system has it’s flaws unfortunately @John Brazelton. Indeed there are conditions that warrant supplementation. And as you are seeing in those the levels do not come close to Mother Nature. But we all know there are those abusing this, even though their low hormone levels were caused by overtraining and not from a physical condition like you experienced.

  3. Great article. I agree with Mark’s assessment. Perhaps exceptions can be made for people undergoing hormone therapy for exceptional circumstances, e.g. after cancer treatment. I agree that no exception should be made for the more commonly prescribed hormone therapies to restore hormone levels of a younger age.

  4. Mark you are just spot on
    We sadly can’t be young forever and hormonal dip is a given. Being smart and adapting our training may just be the right thing to do
    These past 6 years i’ve been to Kona and it wouldn’t take much to have more guy tested just by looking at their body on the pier. I personally heard girls in their late 50’s talking T cream. Were they racing i dont know (was a week out) but hell that was pretty obvious they were not on bread and water

    1. Love it @tri@tritolive:disqus . If we adapt to our current life then we can immerse ourselves in the incredible experience of endurance sports for life!

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