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Huge FAQ on Jon Jones USADA suspension

Jon Jones' USADA suspension can be hard to follow, and harder to parse. Iain Kidd lays out the facts and answers your frequently asked questions.

Interim UFC Light Heavyweight Champion Jon Jones Press Conference Photo by Ethan Miller/Getty Images

Since writing a detailed timeline of the Jones USADA saga, I’ve seen a number of questions and misconceptions pop up. I decided I’d write a Q&A style article on the most frequently asked questions, which ended up expanding into the definitive guide you see before you. Hopefully this answers all of the questions you may still have about the entire situation - and even some questions you may never have thought to ask.

For those of you who prefer to listen, I answered most of the same questions on a special episode of the Three Amigos Podcast recently.

What did Jon Jones test positive for?

Jones tested positive for metabolites of clomiphene and letrozole.

What does “metabolites of” mean? Did he take them or not?

When you take a drug it’s generally broken down - metabolized - in your body into different substances. These substances are usually - though not always - unique to a particular substance. The metabolites can stay in your system for a significant period of time, depending on the substance. Generally it’s in the weeks to month range.

Clomiphene and Letrozole both have distinct metabolites which aren’t shared with other substances to my knowledge. This means if clomiphene and letrozole metabolites show up on your WADA-accredited lab test, it’s because you ingested some clomiphene and letrozole

How long was he suspended for?

Jones has been suspended for a year, starting retroactively on the day USADA was informed of his test failure, which was July 6th 2016. His ban will be up on July 7th 2017 and the UFC will be free to book him in fights after that date.

Can USADA test him during his suspension?

This is an interesting one. Suspended fighters are still party to the UFC anti-doping program, and based on my reading of the anti-doping agreement, there’s no reason they couldn’t be tested during their suspension. That being said, It seems, based on the reports we have seen from USADA, that suspended fighters do not actually get tested during their suspension, though it’s possible USADA simply don’t report those tests.

Update: Thanks to data provided by @dimspace I've been able to verify that banned fighters can be tested, and have been in the past.

How long could it have been?

The UFC anti-doping policy allows for a maximum of a 4 year suspension for a doping offence, based on a few criteria, with one exception. The exception is, if you are found guilty of trafficking or administering PEDs to other athletes, you can face a lifetime suspension.

The suspension for taking a specified substance is one year, with up to two extra years added for aggravating circumstances.

The suspension for taking a non-specified substance is two years, with up to two extra years added for aggravating circumstances.

Jones was originally informed that clomiphene and letrozole counted as non-specified substances, and as a result he would be facing a 2 years suspension, with up to 2 extra years added on. On July 22nd USADA informed him that clomiphene and letrozole would be considered specified substances, and as a result the suspension would be one year, with up to two years added on for aggravating circumstances.

In short, Jones could have been suspended for up to three years had USADA felt there were aggravating circumstances to justify a longer suspension. In this case, they only sought the standard one year suspension.

An interesting sidenote is that the WADA code - which the UFC Anti-doping policy is based on - actually requires 2 year suspensions for specified substances, and 4 year suspensions for non-specified substances. The UFC/USADA suspension terms are half that of WADA.

What is a specified and non-specified substance?

Specified and non-specified substances are just categorizations by WADA of drugs which are more, or less, likely to have been taken by an athlete for purposes other than enhancing performance. The following types of drugs are considered non-specified substances and thus carry a longer penalty:

Class S1 substances - Anabolic agents, e.g. anabolic steroids and similar drugs

Class S2 substances - Peptide hormones, growth factors, related substances, and mimetics

Certain S4 class substances, specifically:

Class S4.4 substances - Myostatin affecting substances

Class S4.5 substances - Metabolic modulators, such as insulin, meldonium and others

Class S6.A substances - non-specified stimulants, such as modafinil and many others

All other drugs are considered specified substances, and thus carry a one year sentence under UFC’s anti-doping policy. Jon Jones took Letrozole - a class 4.1 substance, and clomiphene - a class 4.3 substance. Class 4.1 includes aromatase inhibitors, and class 4.3 includes other anti-estrogenic substances which WADA doesn’t class as aromatase inhibitors or selective estrogen receptor modulators. Class 4.1 and 4.3 substances are both considered specified substances.

I wrote a little more on what anti-estrogenic substances are here, and on clomiphene specifically here.

What reason did Jones give for his failure?

Jones said the failure was caused by a “dick pill” he had taken. Specifically, Jones said he believed he was taking tadalafil, also known as cialis, which is a prescription-only medication for erectile dysfunction.

Where did Jones get the pill that made him fail his test?

According to Jones, he received it from his teammate Eric Blasich. Blasich’s LinkedIn profile claims he is a Muay Thai champion, and he apparently competed in an amateur MMA bout in 2010.

Blasich ordered the pills, apparently labelled as “tadalafil”, from All American Peptide, but it’s important to note that he also ordered clomiphene at the same time. That only came out after USADA’s general counsel pointed out the invoice Blasich originally provided couldn’t possibly be the source of the pills Blasich gave to Jones due to timing inconsistencies, which forced Blasich to provide the correct invoice that also contained an order for clomiphene.

It should also be noted that both “tadalafil” and clomiphene are only available with a prescription in the US, but it doesn’t appear that Blasich had a prescription for either.

Blasich’s story also contained multiple inconsistencies, which the USADA lawyer pointed out at the hearing. Stephie Haynes wrote a great piece on Blasich’s role in this, as well as the inconsistencies in his story, which you should absolutely read, here.

Why didn’t Jones get a reduced 6 month suspension like Tim Means and Yoel Romero?

Jones’ lawyer actually brought this up at the arbitration hearing to try to get his suspension reduced. The panel said that Means and Romero both ordered supplements in good faith, and checked the label properly, but were caught out by substances not on the label. The panel also noted that because there was no judgement of what steps Means/Romero took that caused USADA to be lenient, that the panel couldn’t compare the steps Jones took to the steps Means and Romero took.

The panel did,however, point out that Jones was “verging on reckless” with how little he looked into the source of the pill he took. There are a number of things Jones didn’t do that led them to that conclusion:

Jones didn’t check the label for the ingredients of the pill. In fact, he apparently didn’t ask to see the packaging at all.

Jones didn’t even ask where Blasich obtained the pill. If he had, he would have seen the site the pill was ordered from also advertised and supplied banned substances.

Jones deliberately used a prescription-only medication without a prescription, against the advice of his agent.

Jones didn’t ask his agent - whom he had entrusted with giving him advice on complying with the anti-doping policy - whether the pill was safe to take before doing so.

Lastly, at no point did Jones use the anti-doping educational materials provided to him by Jeff Novitzky and the UFC, instead he relied on a summary from his agent Malki Kawa, who has no background or expertise in the subject.

What does clomiphene do?

I wrote a pretty detailed piece on this that you can read here, but i’ll go over the basics.

Clomiphene is usually given to women as a fertility drug. It modifies the way some parts of the body react to the female sex hormone estrogen, especially in the pituitary, which can help to induce ovulation in women who are unable to ovulate normally. Clomiphene can also be prescribed as a fertility treatment for men, as it can stimulate sperm production.

There are also studies which suggest it can increase testosterone production in men. By preventing estrogen’s action in the pituitary, clomiphene causes the body to produce more luteinizing hormone. In men, this is converted to testosterone by leydig cells in the testicles. Studies have shown this can double natural testosterone production in men, and clomiphene is occasionally prescribed off-label for men with low testosterone.

It is also popular as a “post-cycle therapy” drug for users of anabolic steroids. Use of anabolic steroids can cause the body to drastically reduce natural testosterone production. As a result, users of anabolic steroids have been known to use clomiphene after a cycle of steroids to encourage the body to produce testosterone again.

What does letrozole do?

Letrozole is an aromatase inhibitor that is typically prescribed to people with estrogen receptor positive breast cancer. Aromatase inhibitors prevent estrogen being created by inhibiting the action of an enzyme called aromatase. This enzyme usually converts other hormones, especially testosterone, into estrogen.

In estrogen receptor positive breast cancer, the tumor cells can be activated by estrogen. Around 70% of breast cancer is estrogen receptor positive. Letrozole reduces the amount of estrogen in the body, and as a result can prevent these tumors from growing.

Letrozole is also sometimes prescribed off-label as a fertility treatment, similar to clomiphene.

Letrozole is occasionally used as a “post-cycle therapy”drug by users of anabolic steroids. Anabolic steroids tend to increase the amount of testosterone in the body, and excess testosterone is converted to estrogen by aromatase. Generally speaking, men don’t want to produce more estrogen, as it can have feminising effects, such as breast tissue growth. Letrozole helps to prevent testosterone being converted to estrogen, and as a result is sometimes taken alongside and immediately after a course of steroids.

Would clomiphene or letrozole give a significant advantage to an athlete?

Clomiphene, taken at therapeutic doses, could significantly increase the amount of testosterone an athlete produces. Testosterone is probably the single most important factor in muscle development and is positively correlated with athletic performance. It should be noted, however, that the doses in the pills Jones took were far below therapeutic. A therapeutic dose of clomiphene is 50 milligrams, or 50,000 micrograms. The pills Jones ingested only contained a few hundred micrograms of clomiphene.

There is less evidence that letrozole significantly impacts testosterone production, though it’s possible that it has some effect. The amount of letrozole in the pills Jones took were again in the hundreds of microgram range, thought letrozole’s therapeutic dosage is lower than clomiphene’s. When prescribed, letrozole is usually taken in doses of 2.5 milligrams, or 2,500 micrograms.

Did USADA test the pills Jones took? What did the tests show?

USADA performed several tests related to the pills Jones took. They ordered a batch from the source Blasich provided, the WADA-accredited testing lab in Utah also ordered a batch, and Jones sent two batches to the lab as well - one which was damaged in transit, and a follow up batch which wasn’t. All of the below amounts are in micrograms (mcg).

Sample #1, purchased by SMRTL contained:

Clomiphene - 10 mcg, Letrozole - 170 mcg, Tamoxifen - 360 mcg

Sample #2, purchased by USADA, contained:

Clomiphene - 130 mcg, Letrozole - 80 mcg, Tamoxifen - 120 mcg

Sample #3, provided by Jones and damaged in transit, contained:

Clomiphene - 320 mcg, Letrozole - 37 mcg, Tamoxifen - 230 mcg

Sample #4, provided by Jones, contained

Clomiphene - 430 mcg, Letrozole - 45 mcg, Tamoxifen - 320 mcg

What is tamoxifen, and did Jones test positive for it, since it was in those pills?

Tamoxifen didn’t show up in Jones’ drug test, but it did show up in the tested “tadalafil” pills. This discrepancy was explained by the arbitration panel as being plausible because of the evidently poor quality control on the pills.

The four samples varied widely in their contents. Clomiphene varied from 10mcg to 430mcg - a difference of 4,300%. Letrozole varied from 37mcg to 170mcg - a difference of over 400%, and tamoxifen varied from 120mcg to 360mcg - a difference of over 300%. As a result the panel concluded it made sense for Jones to have taken an individual pill with too little tamoxifen to be detected by the drug test.

Tamoxifen, also known as nolvadex, is usually prescribed to patients with estrogen receptor positive breast cancer, much like letrozole. Tamoxifen works by binding to the receptors estrogen would usually bind to, preventing the estrogen from doing so. As a result, it prevents estrogen from activating those cells.

Tamoxifen is also often taken by users of anabolic steroids in order to prevent the side effects of the increased estrogen that anabolic steroid use can cause. In particular, tamoxifen is very effective at preventing the growth of breast tissue, or gynecomastia.

Weren't the substances in the pills kind of expensive? Why would someone spike a supplement or fake drug with expensive, prescription only ingredients?

While clomiphene and letrozole are relatively expensive in the United States, people producing supplements or medications typically don’t pay retail prices for drugs. Even so, it’s important to note that in this case, the amount of clomiphene and letrozole in each pill was very small.

The average amount of letrozole in each pill was around 80 micrograms. A single prescription-strength pill of letrozole contains 2,500 micrograms. One letrozole pill would be enough for more than thirty of these “tadalafil” pills.

The average amount of clomiphene in each pill was around 220 micrograms. A single prescription-strength pill of clomiphene contains 50,000 micrograms. One clomiphene pill would be enough for more than 200 of these “tadalafil” pills.

It’s a similar story with tamoxifen. Tamoxifen is usually prescribed in 10,000 or 20,000 microgram pills. On 10mg tamoxifen pill would be enough for more than 40 of these “tadalafil” pills

Is that something that seems effective for a dick pill?

My answer to this is, unfortunately, a strong maybe. Clomiphene in particular can be used as a fertility treatment for men, and can boost testosterone production, so I can see how it would theoretically help. How it would help in practice, at the minute doses in the pills, is another matter entirely.

Letrozole is an aromatase inhibitor and will stop produced testosterone being converted to estrogen, again, in theory you can see how that could potentially improve libido, but in practice it just seems extremely unlikely at the doses given - especially since a certain amount of estrogen is required for a healthy libido in men.

I’m not even sure tamoxifen has a clear mechanism by which it could improve libido, it simply suppresses the action of estrogen, but preventing the action of estrogen has as much chance of harming libido as helping it, and again, the amount of tamoxifen in the pills is not large.

Basically, I don’t personally see how the ingredients could have any noticeable effect at the doses in question, but i’m not able to find any research definitively showing the effect doses at this range would have on male libido.

Does his story add up?

In terms of his failed test being caused by the pill he claimed? I think that it does. Some people are extremely skeptical, and that’s understandable. Jones returned to the UFC with a significantly larger and more muscular physique than he had before, and the substances he failed for are commonly used by people who have been using anabolic steroids, which is enough to make some people suspicious.

What tipped the balance for me is the basic chemistry involved. Jones’ tests must have come back within a narrow range - if his test had come back showing more clomiphene or letrozole metabolites in his body than could possible by produced by a single “tadalafil” pill, USADA would have definitely brought this evidence up at his hearing. The fact they didn’t tells me that his tests came back with extremely low amounts of both metabolites.

Jones claimed he took the pill two days before his test, which gives us an idea of what the test results must have showed for USADA not to contest that claim - numbers consistent with taking a small amount of the substances in the last two days.

This is important, because both drugs stay in your system for very different amounts of time. Clomiphene has an elimination half-life of 5-7 days, which means it takes that long for half of the substance to be out of your system. If Jones was taking a therapeutic dose of clomiphene - that is 50 milligrams - it would take around six weeks for his test result to be low enough to match taking under 500 micrograms 2 days beforehand.

Letrozole has a different elimination half-life entirely, of only two days. If Jones was taking the therapeutic dose of letrozole, he must have taken a 2.5mg pill around a week ago to get a test matching the dose in the “tadalafil” pill.

Notice that the two time periods are very different - six weeks versus six days. If Jones had been taking clomiphene and letrozole as PEDs, he would have had to cease taking them at exactly those two times for his test to make sense - his random test, which he had no idea was coming. The chances of that being true are miniscule in my opinion, and the explanation that he took this pill makes much more sense, even taking into account that the specific pill he took must have had extremely low concentrations of tamoxifen.

Why did it take so long for this to get resolved?

Jones’ case was the first UFC/USADA case to be taken to arbitration, which takes time as a process. On top of this, Jones’ management had sent samples of his supplements to an independent laboratory for testing prior to initiating the arbitration proceedings. You can find a full timeline of everything, from when Jones took the pill to when the hearing was concluded, in another article I wrote here.