Manny Ramirez is the latest Major League baseball player to be suspended under the joint drug agreement between MLB and the players’ association. Ramirez reportedly tested positive during a drug test in late March during spring training with an elevated level of testosterone. Ramirez apparently initially claimed that the elevated testosterone levels were due to a “personal health issue” and further investigation by MLB of Ramirez’s medical records found that he had been prescribed HCG (human chorionic gonadotropin), a drug usually used for fertility treatment in women, low sperm count in men, or treating delayed puberty in children.

Unfortunately for Manny Ramirez, HCG was added to Major League Baseball’s banned substance list in May 2008 and Ramirez received a 50 game suspension as a first-time offender of MLB drug-testing program. Further reporting by Sports Illustrated and the Los Angeles Times now suggest that Ramirez’s urine sample tested positive for synthetic forms of testosterone and no presence of HCG was found. This latest finding of  synthetic testosterone would be suggestive of someone that was taking or recently taking anabolic steroids, which are also on MLB banned substance list.

What is HCG and why take a fertility drug?

The obvious question most people are asking is why would Ramirez take a fertility drug and what benefit would he gain?

When anabolic steroids are used to increase muscle mass, the pituitary gland often shuts down production of luteinizing hormone (LH) which controls testosterone production by the testis. When an anabolic steroid user comes off a cycle of steroid use, there is a need to quickly restart the body’s natural testosterone production. Since there can be a significant delay in the pituitary gland’s response to restarting luteinizing hormone (LH) release and therefore, testosterone production by the testes, often times HCG is used instead to increase natural testosterone production.

The benefit to an athlete would be an increase in testosterone production which would increase muscle mass,  drop healing time from muscle damage and decrease body fat.

Did he test positive for steroids?

Current reports on the case only mention Ramirez testing positive for an elevated level or ratio of testosterone to epitestosterone in his urine. The typical male will have aprroximately a 1:1 ratio, with Major League Baseball using a cut-off of a 4:1 ratio of testosterone to epistesterone as an abnormal test. Ramirez’s urine sample from March allegedly tested higher than the 4:1 ratio and repeat testing reportedly has found the presense of synthetic testosterone, which would indicate Manny Ramirez was taking some type of performance-enhancing drug that is banned by MLB.

Additionally, since no HCG was found in the urine sample, Ramirez’ original arguement that the elevated levels of testosterone where due to his use of HCG for a medical condition is moot. No HCG present in the urine would suggest that the elevated testosterone levels were not due to his HCG prescription.

Furthermore, even if Manny Ramirez’ elevated testosterone levels were due to his HCG prescription, he and his doctor did not file a therapuetic exemption form with Major League Baseball outlining his need to take a substance on the MLB’s banned substance list for a medical condition currently under treatment by a physician.

The next question that arises is if Manny Ramirez is guilty of using testosterone or other performance enhancing drugs – then for how long? Should there be an asterix next to the 2004 and 2007 World Series Championships by the Boston Red Sox that Ramirez was an integral part of?

Looking at Ramirez’s career batting statistics from his stints with the Cleveland Indians (from 1993 to 2000), the Boston Red Sox (2001-2008) and the Los Angeles Dodgers (2008-present), there has been a significant uptick in Ramirez’s batting average (.312 with Boston and .13 with Cleveland to an amazing .380 in 80 games with the Dodgers.) and slugging percentage (a superhuman .710 with the Dodgers compared to simply an All-Star level of .592 with Cleveland and .588 with Boston).

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