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Vitor Belfort's lab results raise questions about UFC self-regulation

Vitor Belfort's lab results, which were accidentally emailed out 3 years ago, raise questions about the UFC's efforts at self-regulation at that time.

Three years ago in Toronto, Canada at UFC 152, Jon Jones defended his belt against Vitor Belfort. Belfort was moving up from middleweight in order to replace Dan Henderson as the new challenger for the light heavyweight title. An injury to Henderson and the refusal by Jon Jones to fight Chael Sonnen on short notice had forced the cancellation of the whole UFC 151 event. Now, with Belfort filling in, the match had been moved to the main event of UFC 152.

While many decried a middleweight contender getting a shot at the light heavyweight title, Belfort almost proved those detractors wrong when he locked in an armbar against the champ but failed to force a submission. Jones would go on to win and both would continue with their careers.

Vitor Belfort though, would soon gain the reputation as a cheater among other MMA fighters. Chris Weidman, Michael Bisping, Tim Kennedy, and Luke Rockhold have all openly called him a PED user and a cheater. Behind the scenes numerous other fighters have expressed similar sentiments.

If you wonder why Vitor Belfort is the subject of so many accusations by his fellow fighters, Josh Gross's piece on Deadspin should answer your question.

Gross reveals that on September 4th, 2012, less than three weeks before UFC 152, an email with Belfort's lab results was accidentally sent out by an employee of the UFC to a hodgepodge of fighters, managers, vendors, and others in the MMA world.

This email was soon followed by another from a paralegal working for the UFC informing the recipients that they had received the last email by mistake and asked them to delete it. This was followed by yet another email sent by UFC legal affairs manager Tracy Long, writing on behalf of Ike Lawrence Epstein, UFC's executive VP and general counsel that made it obvious how big of mistake the first email had been. Epstein warned that "if you have and/or intend to disclose and/or disseminate this information to anyone, Zuffa will have no choice but to seek all available judicial remedies against you in both your professional and personal capacities."

Gross explains what Belfort's lab results attached to that first email revealed:

Belfort's test—administered, according to these records, on Sept. 1, 2012 by Dr. Pierce—measured 1038 nanograms of testosterone per deciliter. A person in Belfort's age range is more likely to be in the 700s, so while this result was within the normal range, it was near the high end of it. His free testosterone levels, though, were clearly elevated.

Beneath "FLAG," to the right of the "RESULT" column on the LabCorp document, Belfort's free testosterone result is labeled in bold as "High."

The acceptable range listed on LabCorp metrics—standards vary between laboratories—is 8.7 to 25.1 picograms, or a trillionth of a gram, per milliliter.

Belfort's free testosterone, which encompasses .5- to 3-percent of the testosterone in the body and is crucial to enhancing recovery and performance, registered 47.7 pg/ml. That's two and a half times where a man his age should have been.

Fairly or unfairly, many in MMA, thanks in a large part to the email spread amongst the MMA community, hold the view that Belfort was allowed to abuse the therapeutic use exemptions for testosterone.

Belfort's lab results raise several questions, such as how did Belfort get a TUE for TRT? What were the UFC's guidelines for self-regulating TRT use? And should Belfort have even been allowed to fight based on his lab results?

According to Belfort, he chose to go on TRT shortly after his February 5, 2011 fight with then middleweight champion Anderson Silva at UFC 126 after being diagnosed for low testosterone when he reported feeling "tired and lethargic". Brett Okamoto reported for ESPN that, during a June 23, 2014 hearing of the Nevada State Athletic Commission, Belfort's lawyer, Michael G. Alonso, said that his client had received permission to use TRT from the commissions in Pennsylvania (for UFC 133), Ontario (UFC 152) and Brazil (where he fought on UFC 142, UFC on FX: Belfort vs Bisping, UFC on FX: Belfort vs. Rockhold, and UFC Fight Night: Belfort vs Henderson). While he may well have received permission, it might not be entirely accurate to say that he had received permission from those commissions.

When asked if Vitor Belfort had received a TUE from the state of Pennsylvania for his August 6, 2011 fight against Yoshihiro Akiyama at UFC 133, Greg Sirb, Executive Director of the Pennsylvania Athletic Commission, could not recall for us the details of an event held four years ago but did make it very clear to Bloody Elbow that the Pennsylvania Athletic Commission "have never issued a TUE."

Brazil did not yet have a commission when Vitor Belfort defeated Anthony Johnson on January 14, 2012 at UFC 142. The Brazilian MMA Athletic Commission (CABMMA) would not oversee their first event until January of 2013, UFC on FX: Belfort vs. Bisping. The five UFC events held in Brazil before that were all self-regulated by the UFC. There's no evidence Belfort received permission to use TRT for UFC 142 from any commission. It's not clear who Belfort's lawyer is saying granted permission, although one can infer UFC is a possible candidate.

When we asked the Ontario Athletic's Commission if they had issued a TRT TUE to Vitor Belfort, had performed any drug tests before his fight with Jon Jones, or had been informed by the UFC of the results of any drug test, lab results, or TUE approval by the UFC before UFC 152, we were given the following statement by Andreas Kyprianou of the Ontario Ministry of Government and Consumer Services:

"Under the Athletics Control Act, all professional boxing, kick-boxing and mixed martial arts (MMA) events and participants are licensed by the Athletics Commissioner. Promoters and fighters must meet the requirements set out in the legislation and its regulation in order to be licensed or issued a permit. [Note: Fighters from outside Ontario will be issued a permit to fight in a particular event; Ontario fighters are licensed for a year.]

"The Athletics Control Act does not require testing for illegal drugs and/or performance enhancing substances. If a promoter includes a requirement for drug/substance testing in its contract with the fighters, they can request that the Commissioner administer those tests.  However, it would be up to the promoter to determine what would satisfy that contractual requirement or if an exemption should be made for certain treatments. The Commission has no role to play in such decisions. Questions about test results for drugs or performance enhancing substances for fighters in a particular event should therefore be directed to the promoter."

We have asked the UFC if Vitor Belfort was granted a therapeutic use exemption for his matches with Yoshihiro Akiyama at UFC 133, Anthony Johnson at UFC 142, or Jon Jones at UFC 152 by either the local regulatory body or the UFC itself, but as of yet they have not responded to our query.

Several people who work in the sport have expressed dismay that Belfort may have been granted a TUE by the UFC without first receiving one from Nevada, the state commission that the UFC has repeatedly said they follow with regards to the regulation of their events.

According to the NAC, Belfort never applied for or received a TUE for TRT with their commission. Statements at the time by then NAC executive director, Keith Kizer, make it clear that it would have been very unlikely that he would have been granted a TUE from Nevada, due to his previously failed drug test. In 2006, at Pride 32 in Las Vegas, Belfort had tested positive for 4-hydroxytestosterone, an anabolic steroid. Nevada's guidelines excluded past PED offenders from receiving TUEs.

To receive a TRT TUE in Nevada, a fighter had to meet certain conditions, some of which can be seen on the Nevada State Athletic Commission's TRT TUE request form.

Among the requirements, a certified endocrinologist, urologist, family practitioner, or internal medicine practitioner needed to provide a diagnosis that requires TRT. The low T level must be proven through an exact replication of a test described on the application. Medical history and relevant notations would also have to be provided to the commission. The dosage and injection schedules would also have to be given to the commission.

After a fighter was granted a TUE for TRT by the NAC, the commissions guidelines called for the fighter to be subject to random tests of his Testosterone levels.

A yearly lab result proving testosterone insufficiency was also required to retain the TUE.

In a 2013 interview with Bloody Elbow the UFC vice president of government and self regulatory affairs, Marc Ratner, said that the UFC would now be following Nevada's guidelines.

"There are a few guys that are on this [testosterone replacement] therapy, and now we're following the state of Nevada guidelines, where they have to go to an endocrinologist and get a complete history before they start doing anything. I think you'll see less guys on it, because it's going to be harder to get that exemption."

It is unclear if Vitor Belfort had been required to meet the NAC's conditions to acquire his therapeutic use exemption or, if not, what guidelines the UFC used in granting it to him.

According to Dr. Don Catlin, an anti-doping scientist and one of the founders of modern drug-testing in sport, Belfort should not have been granted a therapeutic use exemption no matter what guidelines were followed. "No elite athlete should need testosterone replacement therapy. There should be no reason to grant it."

Even more problematic for Dr. Catlin is the idea that the UFC would be the one granting a therapeutic use exemption.

"That it seems to be the promoter granting the use exemption is very troubling. There's a conflict there."

Marc Ratner would apparently agree, telling Ben Fowlkes in 2012 interview at MMA Fighting that, "You don't want a promoter self-regulating. For us, what we've been doing is trying to grow the sport. But when I'm in charge, I still work for the promoter, so there's an inherent conflict and we're the first to admit that. But you can't grow the sport unless you do that to start with."

Many individuals who were aware of Belfort's lab results expressed dismay at him being allowed to still compete at UFC 152. Many of them expressed the opinion to us that looked as if Belfort had failed his test and the results had been brushed under the carpet. While apparently failing to meet the NAC's guidelines, we do not know as yet if those were the same guidelines being used here.

Belfort's serum testosterone level from the September 1, 2012 LabCorp test was 1038 ng/dl. The normal range for the NAC was 250 -1150 ng/dl. The testosterone levels for those receiving a TRT TUE in Nevada were expected to stay around midway of the normal range with a level above 700 ng/dl could be considered a "test failure". As the NAC executive director at the time, Keith Kizer, told Bloody Elbow's Iain Kidd "We expect, with treatment, at best you should be somewhere in the 600's." (The NJSACB had very similar guidelines.)

We have asked the UFC to clarify if they were following the NAC's guidelines for this show and what the protocol was for test results that showed above normal testosterone levels for athletes with TUEs, but they have not as yet responded to our queries. Therefore It is unclear what guidelines the UFC was flowing for UFC 152.

We spoke to Kizer (this was before the posting of the Deadspin's article and did not include any questions regarding Vitor Belfort's lab results) and he confirmed that the details of Nevada's TRT and TUE policy he shared with Iain Kidd were correct. We also contacted Dr. Timothy Trainor, the Nevada Athletic Commissions Research & Consulting Physician who emailed us some additionally details,

According to the NAC's guidelines, a serum testosterone level above 700 ng/dl did not mean that fighter was immediately suspended even if it could be viewed as a "test failure" by the NAC. Instead, for levels slightly above the normal range the results would be flagged and the fighter would be informed he needed to have his physician lower his current dose and retest. The fighter would not be allowed to compete until the level was back in the mid-range of normal in a timely fashion.

If the fighter had a bout scheduled and tested slightly above normal range he was expected to return to below 700 ng/dl as soon as possible and with enough time before his contest that the NAC wouldn't feel he was entering the match with an advantage.

A score in the 800s or even 900s was generally viewed as slightly above normal. Above 1000 was thought to be getting closer to the far end of the normal range and Nevada would have considered how soon the fighter was scheduled to fight when determining if he should be allowed to still participate. In other words, the sooner he or she had a fight the less lenient they were to scores above the the midway of normal range.

When we asked Keith Kizer -- this was an earlier conversation regarding the policies of the NAC while he was executive director and not Belfort's specific situation -- if a hypothetical fighter on TRT would have been allowed to fight in Nevada if his serum testosterone levels were above 1000 three weeks before his scheduled card Kizer expressed doubt, 'I think he would be told he couldn't fight."

It is not known what the guidelines were for Belfort before UFC 152.

Vitor Belfort was eventually scheduled to fight in Nevada against Chris Weidman at UFC 175 on July 9, 2014. A surprise drug test conducted while Belfort attended the World MMA Awards ceremony in Las Vegas on February 7 earlier that year revealed a serum testosterone level of 1,472 ng/dL  well beyond the range considered normal by LabCorp, a facility that frequently performs drug tests for the NSAC. The range for men Belfort's age is between 348 ng/dL and 1,197 ng/dL, according to LabCorp.

Shortly thereafter, starting on February 27, 2014, Nevada no longer permitted therapeutic use exemptions for testosterone replacement therapy.

UFC enlisted the services of USADA to served as the independent administrator to oversee the promotion's new drug testing policy that went into effect on July 1 of this year.

The era of TRT and self-regulation appears to have come to a close for the UFC.

Special thanks to Iain Kidd and Jacob Miller for assistance with the research for this story.