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An investigation of Robbie Lawler’s ‘very suspicious’ test results

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After Rory MacDonald claimed to have seen 'very suspicious' test results from Robbie Lawler, Iain Kidd investigated. Here are the results, and an explainer of what they mean.

MMA: UFC 189-Lawler vs MacDonald Joe Camporeale-USA TODAY Sports

Rory MacDonald recently claimed on the MMA Hour that Robbie Lawler tested 'four times higher than the limit,' and had some ‘very suspicious’ results. I believe Rory is referring to the Nevada athletic commission tests which were performed at the WADA-accredited SMRTL lab In June 2015—prior to their UFC 189 bout—the results of which were first brought to my attention by @dimspace on twitter.

The results of these tests do have an abnormal result: in a test on sample taken on June 5th, Lawler’s Luteinizing Hormone (LH) results came back at 64.2 mlU/mL. WADA guidelines label any result over 20.0 mlU/mL a presumptive adverse analytical finding which requires further testing. There is a caveat regarding the specific gravity of the urine involved, but it’s not applicable to Lawler’s results.

The guidelines state that a follow up no-notice test should be conducted to look for evidence of PEDs which can potentially cause an elevated LH finding - selective estrogen receptor modulators (SERMs), aromatase inhibitors (AIs) and Gonadotropin-releasing hormone (GnRH) or its synthetic analogues.

It looks like the NAC performed a follow up test on a sample collected on June 17th, during which Lawler’s luteinizing hormone levels came back at 12.9mlU/mL, which is well within the normal range. The test also looked for SERMs, AIs and GnRH abnormalities, and didn't find any. WADA guidelines also recommend an expert panel examine the results—as well as previous LH results—but it’s not clear if the Nevada athletic commission took this step.

When the follow up test comes back negative, the initial test should be regarded as an atypical result. An atypical result is an abnormal result that is not evidence of performance enhancing drug use, and as a result is not considered a test “failure.” That’s what seems to have happened in this case.

Outside of that single test, all of Lawler’s other pre-fight and fight night tests came back with LH levels within the normal range.

While measuring absolute testosterone levels in urine is unreliable at best, Lawler’s results came back in the normal range. His testosterone:epitestosterone (T:E) ratio came back between 1.7:1 and 3:1. As an adverse finding is a T:E ratio higher than 4:1, his testosterone levels and ratios were in the normal range.

All of his other results seem normal, though some have raised concern over his reticulocyte percentage and numbers as being abnormal. In some tests, Lawler’s reticulocyte percentage could be considered slightly elevated. Medlineplus.gov considers 0.5%-1.5% to be normal, while Lawler tested at 1.63%, 1.84% and 1.02%.

Lawler’s hematocrit/hemoglobin numbers are on the low end of normal. Normally as those numbers decrease, the reticulocyte number/percentages will increase. This is because low hematocrit/hemoglobin numbers can suggest recent blood loss, after which reticulocyte production will increase. It seems likely this is the case here. Other potential causes of those results could be things like a vitamin deficiency.

Hematocrit measures the ratio of red blood cells to the total amount of blood. Red blood cells carry oxygen around the body, and typically, an athlete would look to have an increased number of red blood cells. One of the advantages for people training at altitude, is an increase in hematocrit, which increases aerobic exercise capacity.

Hemoglobin is the specific protein in red blood cells which is responsible for carrying oxygen to the muscles and returning carbon dioxide to the lungs. An increase in hemoglobin is beneficial, and is another benefit to altitude training.

Blood doping is typically concerned with increasing these numbers, often by increasing the reticulocyte number/percentage. Reticulocytes are produced by the bone marrow and are essentially "immature" red blood cells. A high number of reticulocytes suggests a person’s hematocrit percentage will rise in the near future as they mature.

Sometimes athletes will remove blood from their body, allow their body to replenish its red blood cells naturally, and then transfuse the existing blood back into their bodies prior to competition. This increases the red blood cell availability during competition.

Lawler's post-fight tests show absolutely no signs of increased blood volume or any other abnormal blood work.

Rory’s concern is understandable, since luteinizing hormone is involved in testosterone production and is often raised by PEDs; Clomiphene, the drug Lesnar & Jones tested positive for, increases testosterone by improving luteinizing hormone production for instance. Odd hematological results can also be indicators of blood doping, as noted above.

The truth is, none of Lawler's results should have stopped the fight from taking place. While an elevated luteinizing hormone result is odd, it’s not unheard of, and the WADA-accredited lab found no evidence of any performance enhancing drugs in Lawler’s system in any of the tests. The pre-fight hematological test results meanwhile were slightly high, but the results do not appear indicative of blood doping or PED use, and his fight night results were all completely normal.

You can view the results of every test conducted by the Nevada athletic commission for UFC 189 here.