Over the last 2 years, one of the most controversial issues in the top level of MMA has been an increasing trend of top-level fighters being prescribed Testosterone Replacement Therapy (TRT). With this treatment, a fighter who's medically proven to have a testosterone deficiency may be granted a Therapeutic Use Exemption (TUE) in order to take supplemental testosterone. The therapy has been widely ridiculed as a legal loophole around the anti-PED rules for competition.
On Saturday, Fight Medicine published an interview with Nevada State Athletic Commission directory Kieth Kizer. Kizer explained his view on many of the issues involved with PED control. One of the biggest revelations of the interview was that the NSAC's consulting physician regarding granting TUE's has no background in endocrinology:
We have a consulting physician who does all of our medical information. Timothy Trainor’s his name. So he does all that stuff, and he’s the consulting physician for the Commission. What he does is he’ll go out and review the information. He’ll talk to experts in the field if it’s something beyond his basic level of practice or knowledge. And so he’ll have his consultants and specialists he’ll talk to, in this case endocrinologists or something along those lines, that helps him in these issues.
There’s also a broader policy type issue. We have a medical advisory board or medical advisory panel, which we have doctors with various different specialties that come onboard and, again, if it’s something that doesn’t fall within one of their specialties, we’ll invite other experts in the field – specialists in the field – to come and testify before the panel.
Dr. Timothy Trainor is actually an orthopedic doctor, who's specialty focuses on bones and tissue. Although he has access to contacts in other fields, it's questionable if having an orthopedist as the leading adviser concerning a serious hormone treatment is the optimal scenario.
The TRT issue has been at the forefront of discussion in MMA this year following a veritable flood of high profile fighters being granted exemptions. In 2012 alone, we have seen two UFC title contenders and two co-main event fighters granted exemptions for the first time in their competitive careers. Both Heavyweight Frank Mir and Middleweight Chael Sonnen were using TRT leading up to their championship fights and former Light Heavyweight champs Quinton Jackson and Forrest Griffin were also granted exemptions.
With so many high profile additions to the TUE list, the question has to be asked if all of these athletes do suffer from a serious medical condition or if they've found a way to game the system.