With Nate Diaz cleared by both the New York State Athletic Commission (NYSAC) and the United States Anti Doping Agency (USADA) to compete this weekend at UFC 244 at Madison Square Garden, The Body Lock takes an extensive look at the many questions that abound following Diaz’s atypical test finding and the resulting controversy that arose from it.
Did Nate Diaz test positive for a banned substance?
Yes, and no.
In the strictest sense of the word, Nate Diaz provided a sample that contained detectable levels of a prohibited substance, a positive test. However, under the World Anti-Doping Agency (WADA) Code, a comprehensive document detailing many of the provisions and guidelines that govern global anti-doping efforts, lab findings are reported in two distinct ways: adverse findings and atypical findings.
“An Adverse Analytical Finding (AAF) is used to record a Lab Result which has been found to contain a prohibited substance. It is created automatically by the system when a lab creates an analysis record that indicates an AAF.
An atypical finding (ATF) is reported by a laboratory through a lab result to indicate that, while there may not be an adverse analytical finding, there may be some suspicion according to the results and that further analysis or investigation should be conducted,” – WADA
An atypical finding may result when a substance is detected below a certain threshold, or “decision limit,” or where variance in an athlete’s biological markers (eg. his or her testosterone/epitestosterone ratio) indicates that further investigation is needed despite the absence of a “positive test.” That investigation may or may not lead to it being changed to an adverse analytical finding.
Is atypical not just another way of saying a positive test?
No, and not all atypical findings go on to be adverse findings (nor, in turn, anti-doping rule violations).
One recent case would be that of now ex-UFC light heavyweight Ivan Shtyrkov. The newly-minted RIZIN fighter provided two “atypical” samples in late March and early April 2019. These samples were not positive tests but did require further investigation and/or additional testing. Because the ATF’s came just a few days before he was due to compete against Devin Clark at UFC St. Petersburg, he was pulled from the card “out of an abundance of caution” under what was announced as an illness.
Further testing was conducted; in this case, USADA utilized gas chromatography/isotope ratio testing (more commonly referred to as CIR), which detected the use of exogenous steroids. His ATF became an AAF, and the Russian was charged with an anti-doping rule violation (ADRV).
Another case would be that of Cortney Casey-Sanchez. In 2017 she returned a sample that showed an elevated testosterone to epitestosterone limit. Under the WADA code, this is considered atypical and requires further investigation (although at the time, the Texas commission wrongly charged her with an anti-doping violation). Further investigation by USADA determined that no prohibited substance or method was involved and Casey-Sanchez was cleared and not charged with an anti-doping violation.
In the case of Nate Diaz, the levels in his sample were present below newly established thresholds or “decision limits” and as such could be considered “atypical.”
What is a “threshold substance?”
Threshold substances are substances that under the WADA code are not considered AAF’s (or positive tests) under a particular “decision limit.”. Generally, this is applied to substances that are not prohibited out of competition but where residual presence could cause a positive in-competition test.
Up to now, decision limits have not been put in place on substances associated with contamination but, for example, many have pushed for clenbuterol – widely associated with meat contamination in parts of South America and Asia – to be made a threshold substance.
So ligandrol (LGD 4033) is a threshold substance?
Under the WADA code, no. But in principle, the UFC and USADA have agreed decision limits for a number of substances that are being used in practice and will be written into the anti-doping policy. Ligandrol is one of these substances.
When did this happen?
The plan to implement decision limits for certain substances including ostarine and other SARMs was reported as early as December 2018 by the UFC’s President of Health and Performance, Jeff Novitzky on the Joe Rogan MMA Show.
“The World Anti Doping Agency, or WADA, their next code review is written in 2021, and they regularly put out ‘hey, what are the issues going forward that we want to address?’ and one of the main issues is potentially establishing thresholds for these low level substances that keep appearing.
DHCMT being one of them, Ostarine being one of them. The idea that WADA is looking at and has a working group of worldwide experts is “if something gets reported back under 50pg (per ml) and all the evidence is showing that more likely than not this is a very low level contaminant issue, we’ve never seen an issue of micro-dosing or intentional use that’s reached that level why are the labs even reporting that at quantities lower than 50 picograms or 100 picograms.
I think very soon they are going to come out with a recommendation. We are going to adopt that before 2021. Once that working group, we are in communication with them, comes up with recommendations you will see it first in the UFC program.”
The thresholds have been agreed in principle and put into practice in the UFC since August 2019.
Will WADA make Ligandrol and other SARMs threshold substances?
WADA is currently considering the implementation of decision limits for substances associated with contamination. The executive committee is due to vote on changes in November 2019 with any approved changes being introduced in the 2021 code [Ref: Section 16].
One advantage of the UFC program is that USADA is able to implement changes or trial methods in advance of WADA. In 2018, USADA implemented DBS (Dried Blood Spot testing) in the UFC and in 2020 will trial saliva testing. WADA, in contrast, is only now beginning trials on DBS.
Why only in principle, why not officially as part of the anti-doping policy?
It is likely that USADA is awaiting the upcoming decision by WADA as to whether to establish decision limits for ligandrol for the 2021 code.
The anti-doping policy is a physical document in multiple languages given to athletes and it may be there are other changes to be finalized prior to publication. For example, the prohibited list for 2020 was only finalized by WADA in September and there are multiple other regulatory modifications being considered by WADA for the 2021 anti-doping code. Among these changes if approved include a reduction in the suspensions handed out for street drugs such as cocaine to just three months.
Other changes proposed include rules over second violations and redistribution of prize money forfeited by those convicted of doping violations. It is very possible that some of the measures approved for the 2021 code will find their way into the UFC Anti Doping Program much sooner and any delay in the publication of an updated policy could be due to further modifications being made.
Will USADA or WADA make public the “thresholds”?
USADA is unlikely to make public the thresholds although a report by ESPN claims the decision limit for ligandrol has been set at 100pg/mL.
Should WADA choose to implement decision limits for ligandrol and other SARMs they will be published in a technical document for laboratories.
Was Diaz the first fighter to be cleared with the introduction of the new thresholds?
No. Neil Magny was originally charged with a potential violation back in May 2019 after being withdrawn from his bout against Vicente Luque. He was cleared in late August after the new decision limits were in principle approved.
Have any other fighters been cleared?
We don’t know, but it is possible. In fact, statistically, it is likely.
Neither USADA or the athlete involved are obliged to make atypical findings public if no violation is deemed to have taken place.
USADA isn’t required to make ATF’s public?
An atypical finding is not a violation and no violation is deemed to have been committed. Additionally, neither the UFC or USADA make public potential violations until after a full investigation has been completed and, if a violation is determined to have been committed, sanction handed down.
The only reason we know about the Neil Magny case is because he chose to make his potential violation public.
It is entirely possible that other fighters have received potential violations for ligandrol or other SARMs over the course of 2019, and that with the introduction of the new decision limits in August were cleared and not charged with a violation.
In 2018, now fewer than six athletes had adverse samples in relation to SARMs. This year we only know publicly about three, with only one, Thibault Gouti serving a suspension. It is unlikely that these three (including Diaz and Magny) are the only three athletes to provide atypical or adverse findings in 2019.
So if neither Nate Diaz or USADA were obliged to report this, why did Diaz choose to speak out?
“I think it was all just a big old bunch of bullsh*t,” Nate Diaz said during the recent UFC 244 conference call.
“I just wanted to not be a part of the big old f*cking secret. I think the thing about people on steroids— people on steroids don’t talk about steroids out loud.
“It was just a big secret and it was shady and it sounded like some sh*t people on steroids are involved in. I didn’t feel comfortable with that. So I’m like let’s just put it on the table then.”
Will the name of the supplement be made public?
The supplement should in time be added to the USADA high-risk list at supplement411.org
Is this the end of the story?
Hopefully, but it may not be.
In the UFC 244 conference call, Diaz stated that he had “doubled down on his supplement use” and when asked by TSN’s Aaron Bronsteter if USADA had pinpointed what the supplement was and told him which one to stop using he responded “yeah, but I don’t believe them anyway – it’s a conspiracy.”
Continued use of a supplement known to contain, albeit trace, levels of a prohibited substance would almost certainly be considered an anti-doping rule violation.
The justification for a decision limit on ligandrol and other SARMs is that the levels are consistent with non-intentional use of a contamination supplement. Continued use of a supplement known to contain prohibited substances is unlikely to be viewed in a positive sense by USADA.