Still competing? Check anti-doping rules before you start any treatment

Anti-doping rules can apply to you

Many masters and age-group athletes assume testing is only for elites. In fact, if you compete in events sanctioned by a national governing body or another organization that has signed the World Anti-Doping Code, you can be subject to its rules. That includes many masters championships in track, cycling, swimming, rowing, weightlifting and triathlon.

USADA directs recreational, non-competitive and masters athletes in sanctioned events to use its TUE Pre-Check Form to find out whether a medication needs an exemption. Rules differ by organization, so check yours.

Treatments that commonly cause problems

Some other treatments, such as certain stimulants, beta blockers in specific sports, or glucocorticoids, have rules that depend on the sport, timing or route. Check every medication, including topical and compounded products.

• Testosterone in any form. The 2026 list explicitly names esters of prohibited anabolic agents, such as testosterone cypionate, according to USADA.
• DHEA, which is prohibited at all times as an anabolic agent even though it is sold over the counter as a supplement in the U.S.
• BPC-157, listed under non-approved substances (S0). USADA notes it is not approved for human use by any health authority and that a TUE is unlikely.
• Growth hormone–releasing factors, including GHRH analogues such as sermorelin, CJC-1295 and tesamorelin, and secretagogues such as ipamorelin. These fall under peptide hormones (S2), prohibited at all times.
• Other peptides and hormone modulators that are not on the list by name can still be prohibited if they are structurally or biologically similar to listed substances.

How a Therapeutic Use Exemption works

A TUE is permission to use a prohibited substance for a genuine medical need. USADA asks athletes to apply at least 30 days before planned use, include full medical documentation, and expect a decision from its TUE Committee usually within 21 calendar days. Competing while an application is pending is a risk: if it is denied, you may have committed a violation.

TUEs are judged against strict international criteria. For testosterone, that generally means a documented medical diagnosis of hypogonadism with a clear cause, not age-related decline or a wish to feel better. USADA says a TUE for BPC-157 is unlikely because permitted alternatives exist. For DHEA, USADA describes only narrow situations where an exemption might be considered.

Athletes outside the international and national levels may be eligible for a retroactive TUE in some circumstances, but you should not count on one. Ask before you start.

Compounded and supplement products carry extra risk

Compounded medications are not FDA-approved and are not tested by anti-doping bodies for contamination. Dietary supplements are a well-known source of positive tests; USADA says DHEA is the most common prohibited anabolic agent found in supplements, with more than 150 products on its high-risk list.

If you compete, use only what you need, keep records of everything you take, and use certified supplements when you use any at all.

What HealifyMD can and cannot do

HealifyMD cannot obtain a TUE for you, and we cannot advise on whether a specific competition is covered. A prescription from us does not exempt you from anti-doping rules. If you tell us you compete, your clinician will factor that in and may suggest options that are not prohibited, or recommend that you settle the TUE question first.

Our clinicians can help you understand your lab results and medical options, and give you copies of records you may need for an application. The decision to compete while on any treatment is yours, and the responsibility under the rules is yours as well.

Permitted options are worth asking about

Being a competitive athlete does not mean you must live with untreated symptoms. Many midlife health issues have treatments that are not prohibited, and lifestyle factors such as sleep, fueling, alcohol and training load often matter more than any prescription.

For example, many common medicines for blood pressure, cholesterol, thyroid replacement and weight management are permitted in most sports, though rules can vary by sport and change from year to year. Always check the current status of each product rather than relying on a general category.

Your first steps

• Look up each medication and supplement on Global DRO.
• Complete USADA's TUE Pre-Check Form, or your own sport's equivalent outside the U.S.
• If a TUE is needed, gather records and apply at least 30 days ahead.
• Contact USADA's Drug Reference Line if anything is unclear.
• Tell every clinician you see that you compete.