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When American middle distance runner Shelby Houlihan learned late last year that she had tested positive for an anabolic steroid called nandrolone, she said she had to run a Google search on the substance to learn what it was.
"I had never even heard of nandrolone," Houlihan wrote on Instagram on Monday.
In the world of sports doping, however, the substance is both common and well-known.
Nandrolone has been a go-to anabolic steroid among athletes for more than 40 years, resulting in sanctions in a wide range of sports and leagues, from the NFL to Major League Baseball to boxing and running. FIFA, the international governing body for soccer, describes it in an undated fact sheet as "one of the most widely-used synthetic anabolic-androgenic steroids by athletes who need power and muscle strength."
Houlihan, a reigning national champion and American record-holder, has strongly denied ever taking performance-enhancing drugs, including nandrolone. She wrote on social media that she believes a burrito containing pork offal is to blame for the positive drug test, which has resulted in a four-year ban.
"I feel completely devastated, lost, broken, angry, confused and betrayed by the very sport that I’ve loved and poured myself into just to see how good I was," the 28-year-old wrote in an Instagram post.
What is nandrolone?
The National Institutes of Health characterize nandrolone as a synthetic, anabolic steroid, similar to testosterone. Like testosterone, it can lead to increased muscle mass or definition.
The Guardian described it in a 1999 article as "the body builder's favourite" because it "pumps up muscle bulk."
Created in the 1950s, nandrolone has been banned by the International Olympic Committee since 1974. It can be either taken orally or injected into the muscle, sometimes in the form of a drug called Deca-Durabolin. And it is easily detectable in urine samples, which has led to a decline in positive tests for the steroid over the past decade.
How common is nandrolone?
According to an annual report from the World Anti-Doping Agency, a derivative of nandrolone – the metabolite 19-norandrosterone – was one of the most common anabolic steroids detected in athletes in 2019.
WADA said its labs recorded 162 instances in which it identified 19-norandrosterone as an adverse analytical finding during a drug test, which ranks third among anabolic steroids behind stanozolol and drostanolone.
Which other athletes have tested positive for nandrolone?
The list of athletes who have been linked with nandrolone is long and diverse, including swimmers, tennis players, mixed martial artists, baseball players, sprinters and football players.
Manchester City manager Pep Guardiola, for example, tested positive for it during his playing days at Barcelona. Tyson Fury blamed his positive test on boar meat.
Roger Clemens is among the most prominent American athletes to be associated with nandrolone. As part of the Mitchell Report investigation, a former New York Yankees strength coach said he injected Clemens with steroids from "a bottle labeled either Sustanon 250 or Deca-Durabolin" during the 2000 season.
A lawyer for former NFL linebacker Shawne Merriman told reporters in 2006 that nandrolone from a tainted supplement was responsible for Merriman's four-game suspension. And the wife of Juan Dixon, a former Maryland basketball star, cited a similar reason when Dixon tested positive for nandrolone while playing overseas in 2010.
More recently, MLB suspended Starling Marte for 80 games after he tested positive for nandrolone in 2017.
Can nandrolone come from pork?
Athletes have cited a wide variety of tainted substances as the reason for their positive nandrolone results.
In 2000, a German runner named Dieter Baumann unsuccessfully attempted to blame his positive test on spiked toothpaste, which caused him to miss the Sydney Olympics. Many others have pointed to tainted supplements or meat.
Houlihan believes her positive test is the result of pork offal in a burrito that she purchased from a food truck about 10 hours before her drug test.
According to the Handbook of Experimental Pharmacology, there is some research to suggest that eating meat from certain animals can lead to the presence of nandrolone in urine samples. Authors Peter Hemmersbach and Joachim Große note that the steroid has been used in breeding and is produced naturally in some animal species, including boars, but they also write that "the likelihood of ingesting steroid-contaminated food must be considered slim."
Anti-doping organizations and the Court of Arbitration for Sport have generally declined to entertain arguments about contaminated meat unless the athlete can provide a sample of the meat for testing.
Earlier this year, for instance, an arbitrator ruled against Kenyan long-distance runner James Kibet, who claimed that he tested positive for nandrolone after ingesting pork fat. Kibet informed doping regulators that the meat in question came from a shop called "Glorious Pork Joint" and provided additional evidence to support his claim, but the arbitrator said Kibet did not provide a sample of pork fat from that location to be analyzed and therefore "failed to prove that the pork fat he allegedly consumed contained nandrolone."
Contributing: The Associated Press
Contact Tom Schad at email@example.com or on Twitter @Tom_Schad.
This article originally appeared on USA TODAY: Nandrolone, steroid in Shelby Houlihan case, is common in sports world