An ongoing dialogue on HIV/AIDS, infectious diseases,
January 4th, 2012
How Does Herpes Treatment Trigger a Positive Test for Performance-Enhancing Drugs?
- Acyclovir and related drugs are used to treat herpes: nearly 100%
- Ryan Braun, superstar left fielder for the Milwaukee Brewers, is facing a 50 game suspension for testing positive for elevated levels of a “banned substance”, most likely testosterone: 10%
- Braun has disputed the results, stating that it’s a false-positive caused by treatment he’s receiving for a “private medical issue”: 1%
- That medical issue is widely rumored to be herpes: 0.01%
Now I should mention that I am a huge Ryan Braun fan, not only because of his stellar play, and his nickname (“The Hebrew Hammer”, one Braun shares with Hammerin’ Hank Greenberg), but also because he bears an uncanny resemblance to my nephew.
But it’s that last bullet point I can’t quite figure out — treatment of herpes is incredibly safe. How in the world would it lead to an elevated level of testosterone?
Turns out, it doesn’t.
But a quick search of “acyclovir” and “testosterone”, plus a perusal of an actual book — the irreplacable The Use of Antibiotics — finds that there are some obscure animal studies suggesting that anti-herpes drugs could do the reverse, i.e., lower testosterone levels.
From the book:
Dose-related testicular atrophy and abnormalities of spermatogenesis were noted in mice, rats and dogs treated on repeated occasions with either famciclovir or penciclovir …
All of which leads me to the very speculative conclusion that some doctors could be providing testosterone supplementation to their patients receiving anti-herpes therapy.
Which is, frankly, a completely bogus indication, way more “out there” as a practice than the typical off-label use of approved medications.
But that’s the only way I can connect the dots here.
In other words, something’s not right — the test result, the diagnosis, the prescribing practice — we just don’t know what that is yet.