Welcome to DOPING.nl, the Anti-Doping Knowledge Center

This site has been established to host information about doping in the broadest sense of the word, and about doping prevention.


The Anti-Doping Authority Netherlands (the Dutch Doping Authority for short) established this site and maintains it. The Doping Authority was founded in 1989 and it is one of the oldest NADOs in the world. Doping.nl was developed with financial support from the Dutch Ministry for Health, Welfare and Sport.


This website was established because of the importance that the Doping Authority and the Ministry attach to the dissemination of information relevant to doping prevention. Disclosing and supplying relevant information is one of the cornerstones in the fight against doping in sport. However, in practice, a significant amount of information is still not available, or only available to a limited group of users. We therefore decided to bring together all the relevant information in a single site: Doping.nl.


The Doping Authority aims to supply as much information through this website as possible on an ongoing basis. The information will be varied but will focus primarily on: WADA documents like the World Anti-Doping Code, the International Standards like the Prohibited List, Doping Regulations, scientific articles and abstracts, decisions by disciplinary bodies (mainly CAS decisions).As well as making documents available, the Doping Authority aims to supply searchable documents when possible, and to add relevant keywords to ensure easy access.
In the future, Doping.nl will also become a digital archive containing older information that is no longer available elsewhere.

Target readers

This site has been designed for use by anti-doping professionals such as National Anti-Doping Organisations and International Federations but also for students, journalists and other people interested in the subject.

More information explaining how to use this website can be found under "help".

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Counterfeiting in performance- and image-enhancing drugs

9 Jun 2009

Counterfeiting in performance- and image-enhancing drugs / Michael R. Graham, Paul Ryan, Julien S. Baker, Bruce Davies, Non-Eleri Thomas, Stephen-Mark Cooper, Peter Evans, Sue Easmon, Christopher J. Walker, David Cowan, Andrew T. Kicman. - (Drug Testing and Analysis 1 (2009) 3 (March); p. 135-142)

  • PMID: 20355187
  • DOI: 10.1002/dta.30


The current drastic escalation in obesity may be contributing to the exponential rise in drugs used for image enhancement. Drugs such as anabolic-androgenic steroids (AAS) are perceived as a viable method of achieving a perfect physique. They are also the most widely abused drugs in sport. The Internet has encouraged the abuse of expensive drugs, particularly human growth hormone (hGH), resulting in increased importation for personal use. The substantial increase in this market has opened up avenues for counterfeiting, estimated as a multi-million pound business. The acute adverse effects from contaminated vials may result in a variety of pathologies including communicable diseases. In 2007, in the UK, a series of intramuscular abscesses, requiring surgical treatment, led us to study samples obtained from the underground market.

The analysis of 38 parenteral samples and 19 oral samples of tablets was performed by a World Anti-Doping Agency (WADA) accredited laboratory, in an attempt to establish the extent of available counterfeit products. Fifty-three per cent (20) of the injectable AAS esters and 21% (4) of the oral tablets were counterfeit. Culture and sensitivity revealed the presence of skin commensal organisms, which may have contributed to the development of the abscesses. Users of AAS and hGH for sport, including bodybuilding, are currently risking their health because of counterfeit and poorly controlled products.

Human in vivo metabolism study of LGD-4033

25 Sep 2018

Human in vivo metabolism study of LGD-4033 / Argyro G. Fragkaki, Panagiotis Sakellariou, Polyxeni Kiousi, Nassia Kioukia-Fougia, Maria Tsivou, Michael Petrou, Yiannis Angelis. - (Drug Testing and Analysis 10 (2018) 11-12 (November-December); p. 1635-1645)

  • PMID: 30255601
  • DOI: 10.1002/dta.2512

Erratum in:

Human in vivo metabolism study of LGD-4033 / Argyro G. Fragkaki, Panagiotis Sakellariou, Polyxeni Kiousi, Nassia Kioukia-Fougia, Maria Tsivou, Michael Petrou, Yiannis Angelis. - (Drug Testing and Analysis 12 (2020) 1 (January); p. 164)

  • DOI: 10.1002/dta.2700. Epub 2019 Nov 17.
  • PMID: 31984662


Selective androgen receptor modulators (SARMs) are an emerging class of therapeutics targeted to cachexia, sarcopenia, and hypogonadism treatment. LGD-4033 is a SARM which has been included on the Prohibited List annually released by the World Anti-Doping Agency (WADA). The aim of the present work was the investigation of the metabolism of LGD-4033 in a human excretion study after administration of an LGD-4033 supplement, the determination of the metabolites' excretion profiles with special interest in the determination of its long-term metabolites, and the comparison of the excretion time of the phase I and phase II metabolites. The results were also compared to those derived from previous LGD-4033 studies concerning both in vitro and in vivo experiments. Supplement containing LGD-4033 was administered to one human male volunteer and urine samples were collected up to almost 21 days. Analysis of the hydrolyzed (with β-glucuronidase) as well as of the non-hydrolyzed samples was performed using liquid chromatography-high resolution mass spectrometry (LC-HRMS) in negative ionization mode and revealed that, in both cases, the two isomers of the dihydroxylated metabolite (M5) were preferred target metabolites. The gluco-conjugated parent LGD-4033 and its gluco-conjugated metabolites M1 and M2 can be also considered as useful target analytes in non-hydrolyzed samples. The study also presents two trihydroxylated metabolites (M6) identified for the first time in human urine; one of them was recently reported in an LGD-4033 metabolism study in horse urine and plasma.

Discontinuation of estrogen replacement therapy in GH-treated hypopituitary women alters androgen status and IGF-I

1 May 2005

Discontinuation of estrogen replacement therapy in GH-treated hypopituitary women alters androgen status and IGF-I / Jens Juel Christiansen, Sanne Fisker, Claus Højbjerg Gravholt, Paul Bennett, Birgit Svenstrup, Marianne Andersen, Ulla Feldt-Rasmussen, Jens Sandahl Christiansen, Jens Otto Lunde Jørgensen. - (European Journal of Endocrinology 152 (2005) 5 (May); p. 719-726)

  • PMID: 15879357
  • DOI: 10.1530/eje.1.01898


Objective and design: Compared with their male counterparts, healthy females secrete more growth hormone (GH) and those with GH-deficiency have lower insulin-like growth factor I (IGF-I) levels and are less responsive to GH substitution. To test whether this gender difference is related to sex hormones we measured androgen status and IGF-I related parameters in 38 hypopituitary women (mean (range) age 41.5 (20–58) years) during continued GH substitution as compared with a control group of 38 healthy women matched for age and menopausal status. Twenty six patients were studied twice: with estrogen replacement and after 28 days of estrogen discontinuation in a randomised design.

Results: The patients were androgen deficient compared with controls (median, range), dehydroepiandrosterone sulphate (DHEAS): 185 (99–7800) nmol/l vs 4400 (820–13 000) nmol/l, P = < 0.001; androstenedione: 0.5 (0.1–7.1) nmol/l vs 4.3 (1.6–8.8) nmol/l, P = < 0.001; dihydrotestosterone (DHT): 0.13 (0.09–0.54) nmol/l vs 0.55 (0.09–0.89) nmol/l, P = < 0.001; testosterone: 0.28 (0.09–1.56) nmol/l vs 1.1 (0.71–2.24) nmol/l, (P = < 0.001); free testosterone: 0.004 (0.001–0.030) nmol/l vs 0.016 (0.001–0.030) nmol/l, P = < 0.001. The circulating levels of IGF-I, IGF-II, IGF-binding protein 1 (IGFBP-1), and IGFBP-3 did not differ between patients and controls. The subgroup of patients receiving hydrocortisone (HC) replacement (n = 24) had significantly lower levels of androgens (suppressed by 80–100%) as well as IGF-I and IGFBP-3 as compared with the patients not receiving HC. IGF-I was correlated to free testosterone in patients (r = 0.57, P = 0.0005) as well as controls (r = 0.43, P = 0.008), and free testosterone was a significant positive predictor of IGF-I. Estrogen discontinuation induced an increase in IGF-I (167 ± 15 vs 206 ± 14 μg/l, P = 0.005 and IGFBP-3 (3887 ± 139 vs 4309 ± 138 μg/l, P = 0.0005). Estrogen discontinuation was associated with a significant increase in median (range) free testosterone (0.004 (0–0.02) vs 0.0065 (0–0.03) nmol/l, P = 0.001) and a significant decrease in median (range) sex-hormone binding globulin (SHBG; 93 (11–278) vs 55.5 (20–142) nmol/l, P = 0.001). ΔIGF-I correlated with ΔSHBG (r = −0.45 P = 0.033) and ΔIGFBP-3 (r = 0.67 P = < 0.001). In a regression model ΔE2, Δtestosterone, ΔSHBG and ΔIGFBP-3 explained 93% of the variation in ΔIGF-I.

Conclusions: Androgen levels are low in hypopituitary women and free testosterone correlates with IGF-I. Discontinuation of estrogen replacement in these patients induces elevations in IGF-I as well as free testosterone, and ΔIGF-I correlated positively with Δfree testosterone. These effects may contribute to the gender differences observed in the GH–IGF axis in healthy adults as well as in the responsiveness of hypopituitary patients to GH substitution.

Effects of dehydroepiandrostenedione, superimposed on growth hormone substitution, on quality of life and insulin-like growth factor I in patients with secondary adrenal insufficiency

1 Jun 2005

Effects of dehydroepiandrostenedione, superimposed on growth hormone substitution, on quality of life and insulin-like growth factor I in patients with secondary adrenal insufficiency: a randomized, placebo-controlled, cross-over trial / Sjoerd W. van Thiel, Johannes A. Romijn, Alberto M. Pereira, Nienke R. Biermasz, Ferdinand Roelfsema, Albert van Hemert, Bart Ballieux, Johannes W.A. Smit. - (Journal of Clinical Endocrinology & Metabolism 90 (2005) 6 (1 June); p. 3295–3303)

  • PMID: 15797966
  • DOI: 10.1210/jc.2004-1802


To assess whether dehydroepiandrostenedione (DHEA) substitution, superimposed on GH substitution, improves quality of life of patients with secondary adrenal failure, we studied the effects of DHEA (50 mg/d, 16 wk) vs. placebo (16 wk) in GH- and ACTH-deficient men (n = 15; age, 52 +/- 3 yr), and postmenopausal women (n = 16; age, 61 +/- 2 yr) in a double-blind, placebo-controlled, crossover study. All patients were receiving stable hormone replacement therapy, including a fixed dose of human recombinant GH during the study. The men received testosterone substitution. The female patients did not receive estrogen substitution. At baseline, multiple parameters of quality of life were impaired compared with age- and sex-matched controls, especially in female patients. These parameters were not improved by DHEA treatment. DHEA only slightly improved the depression score (women) and health perception (women and men), although these parameters were not abnormal at baseline. DHEA increased serum IGF-I concentrations in female patients (by approximately 18%; P < 0.001), but not in male patients. In neither group did DHEA affect IGF-binding protein-3 levels. We conclude that DHEA, superimposed on GH substitution, does not substantially improve quality of life in patients with secondary adrenal insufficiency regardless of gender. In addition, DHEA increases IGF-I levels only in estrogen-depleted females, but not in testosterone-treated males, with secondary adrenal insufficiency.

Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study

2 Jul 2014

Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study / Andreas Kimergård, Jim McVeigh. - (Harm Reduction Journal 11 (2014) 19 (2 July); p. 1-13)

  • PMID: 24986546
  • PMCID: PMC4098923
  • DOI: 10.1186/1477-7517-11-19


Background: The UK continues to experience a rise in the number of anabolic steroid-using clients attending harm reduction services such as needle and syringe programmes.

Methods: The present study uses interviews conducted with harm reduction service providers as well as illicit users of anabolic steroids from different areas of England and Wales to explore harm reduction for this group of drug users, focussing on needle distribution policies and harm reduction interventions developed specifically for this population of drug users.

Results: The article addresses the complexity of harm reduction service delivery, highlighting different models of needle distribution, such as peer-led distribution networks, as well as interventions available in steroid clinics, including liver function testing of anabolic steroid users. Aside from providing insights into the function of interventions available to steroid users, along with principles adopted by service providers, the study found significant tensions and dilemmas in policy implementation due to differing perspectives between service providers and service users relating to practices, risks and effective interventions.

Conclusion: The overarching finding of the study was the tremendous variability across harm reduction delivery sites in terms of available measures and mode of operation. Further research into the effectiveness of different policies directed towards people who use anabolic steroids is critical to the development of harm reduction.

Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK

4 Jun 2014

Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK / Andreas Kimergård, Jim McVeigh. - (BMJ Open 4 (2014) 6 (4 June); p. 1-8)

  • PMID: 24898090
  • PMCID: PMC4054627
  • DOI: 10.1136/bmjopen-2014-005275


Objectives: The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how 'risk environments' produce harm.

Methods: Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK.

Results: Body satisfaction was an important factor when deciding to start the use of anabolic steroids. Many users were unaware of the potential dangers of using drugs from the illicit market, whereas some had adopted a range of strategies to negotiate the hazards relating to the use of adulterated products, including self-experimentation to gauge the perceived efficacy and unwanted effects of these drugs. Viewpoints, first-hand anecdotes, norms and practices among groups of steroid users created boundaries of 'sensible' drug use, but also promoted practices that may increase the chance of harms occurring. Established users encouraged young users to go to harm reduction services but, at the same time, promoted risky injecting practices in the belief that this would enhance the efficacy of anabolic steroids.

Conclusions: Current steroid-related viewpoints and practices contribute to the risk environment surrounding the use of these drugs and may undermine the goal of current public health strategies including harm reduction interventions. The level of harms among anabolic steroid users are determined by multiple and intertwining factors, in addition to the harms caused by the pharmacological action or injury and illness associated with incorrect injecting techniques.

Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs

12 Sep 2013

Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs: a cross-sectional study / Vivian D. Hope, Jim McVeigh, Andrea Marongiu, Michael Evans-Brown, Josie Smith, Andreas Kimergård, Sara Croxford, Caryl M. Beynon, John V. Parry, Mark A. Bellis, Fortune Ncube. - (BMJ Open 3 (2013) 9 (12 September); p. 1-11)

  • PMID: 24030866
  • PMCID: PMC3773656
  • DOI: 10.1136/bmjopen-2013-003207


Objective: To describe drug use, sexual risks and the prevalence of blood-borne viral infections among men who inject image and performance enhancing drugs (IPEDs).

Design: A voluntary unlinked-anonymous cross-sectional biobehavioural survey.

Setting: 19 needle and syringe programmes across England and Wales.

Participants: 395 men who had injected IPEDs.

Results: Of the participants (median age 28 years), 36% had used IPEDs for <5 years. Anabolic steroids (86%), growth hormone (32%) and human chorionic gonadotropin (16%) were most frequently injected, with 88% injecting intramuscularly and 39% subcutaneously. Two-thirds also used IPEDs orally. Recent psychoactive drug use was common (46% cocaine, 12% amphetamine), 5% had ever injected a psychoactive drug and 9% had shared injecting equipment. 'Viagra/Cialis' was used by 7%, with 89% reporting anal/vaginal sex in the preceding year (20% had 5+ female-partners, 3% male-partners) and 13% always using condoms. Overall, 1.5% had HIV, 9% had antibodies to the hepatitis B core antigen (anti-HBc) and 5% to hepatitis C (anti-HCV). In multivariate analysis, having HIV was associated with: seeking advice from a sexual health clinic; having had an injection site abscess/wound; and having male partners. After excluding those reporting male partners or injecting psychoactive drugs, 0.8% had HIV, 8% anti-HBc and 5% anti-HCV. Only 23% reported uptake of the hepatitis B vaccine, and diagnostic testing uptake was poor (31% for HIV, 22% for hepatitis C).

Conclusions: Previous prevalence studies had not found HIV among IPED injectors. HIV prevalence in this, the largest study of blood-borne viruses among IPED injectors, was similar to that among injectors of psychoactive drugs. Findings indicate a need for targeted interventions.

WADA - A summary of WADA investigations into the International Weightlifting Federation and the sport of weightlifting

22 Oct 2020

A summary of WADA investigations into the International Weightlifting Federation and the sport of weightlifting / Intelligence and Investigations Department. - Montreal : World Anti-Doping Agency (WADA), 2020

  • WADA published provisional outcomes of its ongoing investigation into weightlifting
  • Inquiry into practice of real-time urine substitution by athletes and the use of ‘doppelgängers’ has uncovered suspected cases involving 18 weightlifters from six countries
  • Call for additional powers for WADA’s independent Intelligence and Investigations Department

The World Anti-Doping Agency (WADA) has developed a new method of detecting the prohibited practice of urine substitution at the point of collection and the use of sample surrogates or ‘doppelgängers’, following a ground-breaking investigation into the sport of weightlifting.

After more than three years examining the activities of the International Weightlifting Federation (IWF) and the sport as a whole, WADA’s independent Intelligence and Investigations (I&I) Department today publishes the provisional findings of what is still an ongoing investigation.

Launched in August 2017, WADA I&I’s investigation into weightlifting has four pillars, namely:

  1. Operation Outreach, looking into claims that a high-ranking member of the IWF was paid to promote Russian interests and to protect Russian athletes from detection;
  2. Operation Heir, investigating allegations of an organized doping and protection scheme operating within Romanian weightlifting;
  3. Operation Extra, dealing with the complex process of collection, collation and assessment of all weightlifting intelligence received by WADA I&I; and
  4. Operation Arrow, a covert investigation into the practice of urine substitution at the point of collection.

This investigation has focused not just on athletes but also on others who might have been involved in facilitating this deception, including doping control officers, coaches, other athlete support personnel and officials. In 2019, WADA I&I successfully sought the support of multiple law enforcement agencies to investigate some of the allegations mentioned in the report. These law enforcement agencies approved today’s publication of this provisional report.

As it relates to Operation Arrow, the new methodology to refine the identification of potential substitute urine was developed by WADA I&I with assistance in part from confidential sources and analysis experts. This methodology has so far allowed investigators to identify, through DNA profile analysis, cases of suspected urine substitution involving 18 weightlifters from six countries. These cases will be presented to the International Testing Agency (ITA), to which the IWF has now delegated the conduct of its anti-doping program, for results management. WADA I&I found evidence of ‘doppelgängers’ being used to impersonate athletes during the sample collection process, ensuring clean urine was fraudulently provided.


  1. The Investigations
  2. Whistleblowing Program
  3. Confidential Information Unit
  4. Operation Outreach
  5. Operation Heir
  6. Operation Extra
  7. Operation Arrow
  8. Conclusion

WADA - Policy for the Acceptance of New World Anti-Doping Code Signatories

23 Oct 2020

Policy for the Acceptance of New World Anti-Doping Code Signatories (Signatory Policy) : Article 23.1.3 of the Code / World Anti-Doping Agency (WADA). - Montreal : WADA, 2020

The World Anti-Doping Agency (WADA) has published its revised Policy for the Acceptance of New World Anti-Doping Code Signatories (Signatory Policy), which was approved by the Agency’s Executive Committee (ExCo) during its meeting of 14-15 September 2020.

The revised Signatory Policy, which will come into force on 1 January 2021, has been reviewed to ensure that it aligns with the 2021 World Anti-Doping Code (Code). It is intended to enable organizations that are committed to protecting clean athletes to become Code Signatories. The Policy relates specifically to Code Article 23.1, which outlines the entities that may become Signatories to the Code.

It was determined that the current Signatory Policy – which has been in effect since November 2017 – needed to be reviewed and updated. Therefore, in May 2019, it was agreed that a working group, composed of WADA stakeholder representatives of the Sports Movement and Public Authorities, be established to consider the matter and develop proposed revisions to the Policy. The revisions that were included within the revised Policy reflect the consensus reached by the group. They aim at finding the right balance between protecting the pyramidal model of sport and allowing WADA to accept, as Code Signatories, organizations that are of sufficient relevance in the world of sport; and, are committed to protecting clean athletes, regardless of their status within the Sports Movement.

In summary, the revised Signatory Policy establishes a process whereby an applicant will be assessed in a collaborative manner between WADA Management and a newly created “Signatory Expert Group”, convened as required. As outlined in the Terms of Reference, such a Group would be comprised of one representative from the Sports Movement and one from the Public Authorities; as well as an independent Chair proposed by WADA Management to be approved by the WADA ExCo.

Once WADA Management and the Signatory Expert Group (or, in case of disagreement, the WADA ExCo) determine that the criteria of assessment are met, WADA Management will review the anti-doping program of the applicant through a Code Compliance Questionnaire and review its anti-doping rules. If the applicant’s anti-doping program has no critical non-conformities with the Code and the International Standards or all of its critical non-conformities are corrected within the relevant deadline(s), the applicant shall be accepted as a Signatory by WADA Management.

World Athletics 2020 WA vs Salwa Eid Naser

14 Oct 2020

In June 2020 the Athletics Integrity Unit (AIU) of World Athletics has reported two anti-doping rule violations against the Nigerian Athlete Salw Eid Naser, member of the Bahrain Athletics Association, for her Whereabouts Filing Failures and Missed Tests within a 12 month period.

After notification a provisional suspension was ordered. The Athlete filed a statement in her defence and she was heard for the World Athletics Disciplinary Tribunal. The AIU later withdrew the charges against the Athlete regarding 3 Whereabouts Filing Failures within a 12 month period. 

The Athlete explained that she has never been able to submit het own Whereabouts information into ADAMS, nor could she log in. The BAA assigned her Technical Manager to submit her Whereabouts information into ADAMS. This created a risk of problems due to miscommunications, misunderstandings and errors. The Athlete was not entirely happy with the assistance of the Technical Manager and had requested the BAA to appoint someone different.

Further the Athlete argued that the AIU failed to timely bring charges against the Athlete since the Adminstrative Review of the April 2019 test was completed in 2019 and the charges against the Athlete were reported in June 2020. 

Considering the circumstances the Panel establishes that there was a Missed Test committed on 24 January 2020 but concludes that the Missed Test on 12 April 2019 could not be attributed to the Athlete. As a result the anti-doping rule violation has not been established for 3 Missed Tests to the comfortable satisfaction of the Panel. The January 2020 Missed Test still stands against the Athlete. 

Nevertheless the Panel deems that the Athlete needs to take great care to ensure that she complies with the requirements and makes it as easy as possible for DCOs to make contact. An agent putting the Athlete’s up-to-date and accurate Whereabouts information on ADAMS for her is bound to lead to problems.

The Panel very strongly recommends the Athlete to seek advice regarding her personal use of ADAMS so that in the future she is able to enter and update her whereabouts into ADAMS without the need for an agent to assist her. 

Therefore the World Athletics Disciplinary Tribunal decides on 14 October 2020 to dismiss the charges against the Athlete.

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