Abuse of performance enhancing drugs in athletes differs from drug abuse in the general public in that:
(1) it is not done to become intoxicated
(2) it is done to be faster or quicker than a competitor
(3) it can be achieved with normal physiologic compounds at supraphysiologic levels
(4) the athlete may be supported by a network of scientists and coaches with sophisticated resources
(5) overt attempts at adulteration are less likely
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Masking Agent
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Purpose
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diuretic
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dilute compound in the urine
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probenecid
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reduce excretion of an anabolic steroid into the urine so it does not appear elevated
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infusion of a plasma expander (albumin, dextran, hydroxyethyl starch, plasma)
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acutely lower the hemoglobin and hematocrit elevation secondary to erythropoietin
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epitestosterone
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mask use of anabolic steroids by lowering the urinary testosterone to epitestosterone ratio
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alpha reductase inhibitors (finasteride, dutasteride)
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inhibits conversion of testosterone to dihydrotestosterone
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Overhydration can be used to reduce the concentration of a compound in the urine. However, many young female athletes may normally produce a dilute urine.
Although not listed in the official table, administration of LH could be used to mask anabolic steroid use by lowering the urinary testosterone to LH ratio (see above).
In addition to masking, an athlete may use a designer compound with anabolic steroid effects but which cannot be detected in tests for testosterone.
