Qualitative detection of desmopressin in plasma by liquid chromatography-tandem mass spectrometry.

This work describes a liquid chromatography-electrospray tandem mass spectrometry method for detection of desmopressin in human plasma in the low femtomolar range. Desmopressin is a synthetic analogue of the antidiuretic hormone arginine vasopressin and it might be used by athletes as a masking agent in the framework of blood passport controls. Therefore, it was recently added by the World Anti-Doping Agency to the list of prohibited substances in sport as a masking agent. Mass spectrometry characterization of desmopressin was performed with a high-resolution Orbitrap-based mass spectrometer. Detection of the peptide in the biological matrix was achieved using a triple-quadrupole instrument with an electrospray ionization interface after protein precipitation, weak cation solid-phase extraction and high performance liquid chromatography separation with an octadecyl reverse-phase column. Identification of desmopressin was performed using three product ions, m/z 328.0, m/z 120.0, and m/z 214.0, from the parent ion, m/z 535.5. The extraction efficiency of the method at the limit of detection was estimated as 40% (n = 10), the ion suppression as 5% (n = 10), and the limit of detection was 50 pg/ml (signal-to-noise ratio greater than 3). The selectivity of the method was verified against several endogenous and synthetic desmopressin-related peptides. The performance and the applicability of the method were tested by analysis of clinical samples after administration of desmopressin via intravenous, oral, and intranasal routes. Only after intravenous administration could desmopressin be successfully detected.

Quantitative detection of inhaled salmeterol in human urine and relevance to doping control analysis.

Salmeterol is a frequently prescribed ß2-agonist used for the treatment of asthma. Due to performance-enhancing effects of some ß2-agonists, salmeterol appears on the prohibited list published by the World Anti-Doping Agency and its therapeutic use is allowed but restricted to inhalation. Because the data on urinary concentrations originating from therapeutic use are limited, no discrimination can be made between use and abuse when a routine sample is found to contain salmeterol. Therefore, the urinary excretion of 100 µg of inhaled salmeterol was investigated. A liquid chromatography-tandem mass spectrometry method was developed and validated for the quantification of urine samples. Sample preparation consists of an enzymatic hydrolysis of the urine samples followed by a liquid-liquid extraction at pH 9.5 with diethyl ether/isopropanol (5/1). Analysis was performed using selected reaction monitoring after electrospray ionization. The method was linear in the range of 0.5-50 ng/mL. The limits of quantification were 500 pg/mL. The inaccuracy ranged between 10.4% and -3.7%. Results show that salmeterol could be detected for 48 hours. The maximum urinary concentration detected was 1.27 ng/mL. Cumulative data showed that only 0.27% of the administered dose is excreted as parent drug within the first 12 hours. Analysis of 47 routine doping samples, declared to contain salmeterol during routine analysis, did not exhibit concentrations that could be considered originating from supratherapeutic doses.

A fast, comprehensive screening method for doping agents in urine by gas chromatography-triple quadrupole mass spectrometry.

The use of performance enhancing drugs in sports is prohibited. For the detection of misuse of such substances gas chromatography or liquid chromatography coupled to mass spectrometry are the most frequently used detection techniques. In this work the development and validation of a fast gas chromatography tandem mass spectrometric method for the detection of a wide range of doping agents is described. The method can determine 13 endogenous steroids (the steroid profile), 19-norandrosterone, salbutamol and 11-nor-Δ9-tetrahydrocannabinol.9carboxylic acid in the applicable ranges and to detect qualitatively over 140 substances in accordance with the minimum required performance levels of the World Anti-Doping Agency in 1ml of urine. The classes of substances included in the method are anabolic steroids, ß2-agonists, stimulants, narcotics, hormone antagonists and modulators and beta-blockers. Moreover, using a short capillary column and hydrogen as a carrier gas the run time of the method is less than 8min.

Comparison between triple quadrupole, time of flight and hybrid quadrupole time of flight analysers coupled to liquid chromatography for the detection of anabolic steroids in doping control analysis.

Triple quadrupole (QqQ), time of flight (TOF) and quadrupole-time of flight (QTOF) analysers have been compared for the detection of anabolic steroids in human urine. Ten anabolic steroids were selected as model compounds based on their ionization and the presence of endogenous interferences. Both qualitative and quantitative analyses were evaluated. QqQ allowed for the detection of all analytes at the minimum required performance limit (MRPL) established by the World Anti-Doping Agency (between 2 and 10 ng mL(-1) in urine). TOF and QTOF approaches were not sensitive enough to detect some of the analytes (3'-hydroxy-stanozolol or the metabolites of boldenone and formebolone) at the established MRPL. Although a suitable accuracy was obtained, the precision was unsatisfactory (RSD typically higher than 20%) for quantitative purposes irrespective of the analyser used. The methods were applied to 30 real samples declared positives either for the misuse of boldenone, stanozolol and/or methandienone. Most of the compounds were detected by every technique, however QqQ was necessary for the detection of some metabolites in a few samples. Finally, the possibility to detect non-target steroids has been explored by the use of TOF and QTOF. The use of this approach revealed that the presence of boldenone and its metabolite in one sample was due to the intake of androsta-1,4,6-triene-3,17-dione. Additionally, the intake of methandienone was confirmed by the post-target detection of a long-term metabolite.

Population based evaluation of a multi-parametric steroid profiling on administered endogenous steroids in single low dose.

Steroid profiling provides valuable information to detect doping with endogenous steroids. Apart from the traditionally monitored steroids, minor metabolites can play an important role to increase the specificity and efficiency of current detection methods. The applicability of several minor steroid metabolites was tested on administration studies with low doses of oral testosterone (T), T gel, dihydrotestosterone (DHT) gel and oral dehydroepiandrosterone (DHEA). The collected data for all monitored parameters were evaluated with the respective population based reference ranges. Besides the traditional markers T/E, T and DHT, minor metabolites 4-OH-Adion and 6α-OH-Adion were found as most sensitive metabolites to detect oral T administration. The most sensitive metabolites for the detection of DHEA were identified as 16α-OH-DHEA and 7ß-OH-DHEA but longest detection up to three days (after oral administration of 50 mg) was obtained with non-specific 5ß-steroids and its ratios. Steroids applied as a gel had longer effects on the metabolism but were generally not detectable with universal decision criteria. It can be concluded that population based reference ranges show limited overall performance in detecting misuse of small doses of natural androgens. Although some minor metabolites provide additional information for the oral testosterone and DHEA formulations, the topical administered steroids could not be detected for all volunteers using universal reference limits. Application of other population based threshold limits did not lead to longer detection times.

Reference ranges for urinary concentrations and ratios of endogenous steroids, which can be used as markers for steroid misuse, in a Caucasian population of athletes.

The detection of misuse with naturally occurring steroids is a great challenge for doping control laboratories. Intake of natural anabolic steroids alters the steroid profile. Thus, screening for exogenous use of these steroids can be established by monitoring a range of endogenous steroids, which constitute the steroid profile, and evaluate their concentrations and ratios against reference ranges. Elevated values of the steroid profile constitute an atypical finding after which a confirmatory IRMS procedure is needed to unequivocally establish the exogenous origin of a natural steroid. However, the large inter-individual differences in urinary steroid concentrations and the recent availability of a whole range of natural steroids (e.g. dehydroepiandrosterone and androstenedione) which each exert a different effect on the monitored parameters in doping control complicate the interpretation of the current steroid profile. The screening of an extended steroid profile can provide additional parameters to support the atypical findings and can give specific information upon the steroids which have been administered. The natural concentrations of 29 endogenous steroids and 11 ratios in a predominantly Caucasian population of athletes were determined. The upper reference values at 97.5%, 99% and 99.9% levels were assessed for male (n=2027) and female (n=1004) populations. Monitoring minor metabolites and evaluation of concentration ratios with respect to their natural abundances could improve the interpretation of the steroid profile in doping analysis.

beta-Adrenergic stimulation.

Two groups of substances which stimulate the adrenergic system are listed as prohibited by the World Anti-Doping Agency. Stimulants are prohibited in-competition only and beta(2)-agonists are prohibited in- and out-of-competition. While beta(2)-agonists act directly on the target receptors, sympathomimetic amines can exert their action directly and indirectly. Due to differences in pharmacology but mainly due to differences in administered dose, differences in detection methods between both groups of substances exist although preparation is similar and consists of an extraction at basic pH. Gas chromatography coupled to mass spectrometry has been the detection methodology of choice for several decades. However, the importance of liquid chromatography-mass spectrometry as a preferred detection methodology is rapidly increasing, especially for the detection of beta(2)-agonists and new additions to the list of prohibited stimulants, such as modafinil. Pharmacology, metabolism and detection of both groups of prohibited substances will be discussed.

The uPA(+/+)-SCID mouse with humanized liver as a model for in vivo metabolism of 4-androstene-3,17-dione.

The metabolism in primary human hepatocyte cultures often deviates from that in clinical studies, which in turn are hampered by ethical constraints. Here the use of urokinase-type plasminogen activator-severe combined immunodeficiency [uPA(+/+)-SCID] mice transplanted with human hepatocytes was investigated as a model for in vivo metabolic studies. The urinary excretion profile after oral administration of 4-androstene-3,17-dione (AD) in chimeric mice was investigated by using gas chromatography-mass spectrometry detection and was compared with previously reported metabolites of AD in humans and cell cultures. Chimeric mice exhibited an AD metabolic profile similar to that of humans, showing androsterone and etiocholanolone as major metabolites. Several hydroxylated steroids were detected as minor metabolites in the chimeric mice compared with hepatocyte cultures. A significant correlation between the extent of liver replacement and the relative abundances of human-type metabolites was established. The results for AD showed that humanized liver uPA-SCID mice can serve as an alternative model for in vivo metabolism studies in humans. In the future, this model could possibly be used for other steroids or pharmaceutical compounds.

Detection and characterization of a new metabolite of 17alpha-methyltestosterone.

The misuse of the anabolic steroid methyltestosterone is currently routinely monitored in doping control laboratories by gas chromatography-mass spectrometry (GC-MS) of two of its metabolites: 17alpha-methyl-5beta-androstane-3alpha,17beta-diol and 17alpha-methyl-5alpha-androstane-3alpha,17beta-diol. Because of the absence of any easy ionizable moiety, these metabolites are poorly detectable using liquid chromatography-tandem mass spectrometry (LC-MS/MS) with electrospray ionization (ESI). In this study, the metabolism of methyltestosterone has been reinvestigated by the use of a precursor ion scan method in LC-ESI-MS/MS. Two metabolites have been detected using this method. Both compounds have been confirmed in postadministration urine samples of an urokinase plasminogen activator-severe combined immunodeficiency (uPA-SCID) mouse with humanized liver and were characterized by LC-MS/MS and GC-MS using both quadrupole and time of flight analyzers. From the detailed study of the fragmentation, these metabolites were proposed to be epimethyltestosterone and a dehydrogenated compound. Epimethyltestosterone has previously been described as a minor metabolite, whereas the occurrence of the oxidized metabolite has not been reported. Comparison with the synthesized reference revealed that the structure of the dehydrogenated metabolite is 6-ene-epimethyltestosterone. A selected reaction monitoring method including three transitions for each metabolite has been developed and applied to samples from an excretion study and to samples declared positive after GC-MS analysis. 6-Ene-epimethyltestosterone was found in all samples, showing its applicability in the detection of methyltestosterone misuse.

uPA+/+-SCID mouse with humanized liver as a model for in vivo metabolism of exogenous steroids: methandienone as a case study.

BACKGROUND: Adequate detection of designer steroids in the urine of athletes is still a challenge in doping control analysis and requires knowledge of steroid metabolism. In this study we investigated whether uPA(+/+)-SCID mice carrying functional primary human hepatocytes in their liver would provide a suitable alternative small animal model for the investigation of human steroid metabolism in vivo. METHODS: A quantitative method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed and validated for the urinary detection of 7 known methandienone metabolites. Application of this method to urine samples from humanized mice after methandienone administration allowed for comparison with data from in vivo human samples and with reported methandienone data from in vitro hepatocyte cultures. RESULTS: The LC-MS/MS method validation in mouse and human urine indicated good linearity, precision, and recovery. Using this method we quantified 6 of 7 known human methandienone metabolites in the urine of chimeric mice, whereas in control nonchimeric mice we detected only 2 metabolites. These results correlated very well with methandienone metabolism in humans. In addition, we detected 4 isomers of methandienone metabolites in both human and chimeric mouse urine. One of these isomers has never been reported before. CONCLUSIONS: The results of this proof-of-concept study indicate that the human liver-uPA(+/+)-SCID mouse appears to be a suitable small animal model for the investigation of human-type metabolism of anabolic steroids and possibly also for other types of drugs and medications.

Detection and structural investigation of metabolites of stanozolol in human urine by liquid chromatography tandem mass spectrometry.

The applicability of LC-MS/MS in precursor ion scan mode for the detection of urinary stanozolol metabolites has been studied. The product ion at m/z 81 has been selected as specific for stanozolol metabolites without a modification in A- or N-rings and the product ions at m/z 97 and 145 for the metabolites hydroxylated in the N-ring and 4-hydroxy-stanozolol metabolites, respectively. Under these conditions, the parent drug and up to 15 metabolites were found in a positive doping test sample. The study of a sample from a chimeric uPA-SCID mouse collected after the administration of stanozolol revealed the presence of 4 additional metabolites. The information obtained from the product ion spectra was used to develop a SRM method for the detection of 19 compounds. This SRM method was applied to several doping positive samples. All the metabolites were detected in both the uPA-SCID mouse sample and positive human samples and were not detected in none of the blank samples tested; confirming the metabolic nature of all the detected compounds. In addition, the application of the SRM method to a single human excretion study revealed that one of the metabolites (4xi,16xi-dihydroxy-stanozolol) could be detected in negative ionization mode for a longer period than those commonly used in the screening for stanozolol misuse (3'-hydroxy-stanozolol, 16beta-hydroxy-stanozolol and 4beta-hydroxy-stanozolol) in doping analysis. The application of the developed approach to several positive doping samples confirmed the usefulness of this metabolite for the screening of stanozolol misuse. Finally, a tentative structure for each detected metabolite has been proposed based on the product ion spectra measured with accurate masses using UPLC-QTOF MS.

Quantification of testosterone undecanoate in human hair by liquid chromatography-tandem mass spectrometry.

Testosterone undecanoate (T-C11) can be used by athletes in order to improve performance. After oral intake, T-C11 is rapidly metabolized, hampering discrimination between exogenous and endogenous testosterone. A possible alternative is to detect the intact ester in hair. A method based on liquid chromatography-tandem mass spectrometry was developed for the determination of T-C11 in hair. The sample procedure consisted of digestion of 200 mg of pulverized hair with tris(2-carboxyethyl)phosphine hydrochloride and liquid-liquid extraction with n-pentane. Several parameters such as the mobile phase, the ionization source and the washing step were optimized. The method was validated at different spiked levels obtaining satisfactory values for accuracy (between 92 and 102%) with relative standard deviations lower than 7% and a limit of detection of 0.2 ng/g. The applicability of the method was checked by the analysis of three samples from patients using T-C11. A peak for the analyte was detected in all samples with concentrations between 0.4 and 8.4 ng/g.

Evaluation of different scan methods for the urinary detection of corticosteroid metabolites by liquid chromatography tandem mass spectrometry.

Different approaches for the non-target detection of corticosteroids in urine have been evaluated. As a result of previous studies about the ionization (positive/negative) and fragmentation of corticosteroids, several methods based on both precursor ion (PI) and neutral loss (NL) scans are proposed. The applicability of these methods was checked by the injection of a standard solution containing 19 model compounds. Five of the studied methods (NL of 76 Da; PI of 77, 91 and 105; PI of 237; PI of 121, 147 and 171; and NL of 38 Da) exhibited satisfactory results at the concentration level checked (corresponding to 20 ng/ml in sample). Some other methods in negative ionization mode such as the NL of 104 Da were found to lack sufficient sensitivity. Some of the applied methods were found to be specific for a concrete structure (NL of 38 Da for fluorine containing corticosteroids) while others showed a wide range applicability (PI of 77, 91 and 105 showed response in all model compounds). Interference by endogenous compounds was also tested by the analysis of negative urines and urines spiked with different corticosteroids. The suitability of these methods for the detection of corticosteroid metabolites was checked by the analysis of urine samples collected after the administration of methylprednisolone and triamcinolone. A combination of the reported methods seems to be the approach of choice in order to have a global overview about the excreted corticosteroid metabolites.

Steroid metabolism in chimeric mice with humanized liver.

Anabolic androgenic steroids are considered to be doping agents and are prohibited in sports. Their metabolism needs to be elucidated to allow for urinary detection by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-tandem mass spectrometry (LC-MS/MS). Steroid metabolism was assessed using uPA(+/+) SCID mice with humanized livers (chimeric mice). This study presents the results of 19-norandrost-4-ene-3,17-dione (19-norAD) administration to these in vivo mice. As in humans, 19-norandrosterone and 19-noretiocholanolone are the major detectable metabolites of 19-norAD in the urine of chimeric mice.A summary is given of the metabolic pathways found in chimeric mice after administration of three model steroid compounds (methandienone, androst-4-ene-3,17-dione and 19-norandrost-4-ene-3,17-dione). From these studies we can conclude that all major metabolic pathways for anabolic steroids in humans are present in the chimeric mouse. It is hoped that, in future, this promising chimeric mouse model might assist the discovery of new and possible longer detectable metabolites of (designer) steroids.

Combination of liquid-chromatography tandem mass spectrometry in different scan modes with human and chimeric mouse urine for the study of steroid metabolism.

Anabolic steroids are among the most frequently detected compounds in doping analysis. They are extensively metabolized and therefore an in-depth knowledge about steroid metabolism is needed. In this study, a liquid chromatography tandem mass spectometry (LC-MS/MS) method based on a precursor ion scan with a uPA-SCID mouse with humanized liver (a chimeric mouse) was explored for the detection of steroid metabolism. Methandienone was used as a model compound. The application of the precursor ion scan method in positive human samples and chimeric mice samples after methandienone administration allowed the detection of most steroid metabolites without any structural restriction. Three hitherto unreported metabolites were found using this approach. These metabolites were characterized using LC-MS/MS and feasible structures were proposed. The structure of one of them, 6-ene-epimethandienone, was confirmed by the synthesis of the reference compound. A selected reaction monitoring (SRM) method for the specific detection of all these metabolites has been developed. The application of this method to several human and chimeric mouse samples confirmed that more than 80% of the steroid metabolites were found in both samples. Only metabolites that are poorly detectable by LC-MS/MS were not detected in some urine samples. The metabolic nature of the unreported metabolites was also confirmed. A global strategy for the detection of steroid metabolites combining both human and chimeric mouse urine is proposed.

Collision-induced dissociation of 3-keto anabolic steroids and related compounds after electrospray ionization. Considerations for structural elucidation.

The collision-induced dissociation of forty-one 3-keto anabolic steroids and related compounds has been studied using both triple quadrupole (QqQ) and hybrid quadrupole-time of flight (QTOF) instruments. Due to the complexity of the product ion spectra of these analytes, which generate a large number of ions, only two specific regions were studied in depth: the product ions near the precursor ion (m/z > or =M-100) and the most abundant product ions at a collision energy of 30 eV. Accurate mass measurements were used in order to obtain an unequivocal assignment of the empirical formula and the origin of each selected product ion. Analytes have been divided into eight groups according to the number and position of double bonds and the presence of functional groups such as hydroxyl- or nitrogen-containing rings. A correlation between the steroid structure and the product ions obtained has been postulated. The application of these correlations can be useful in the elucidation of feasible structures for unknown steroids and/or their metabolites.

Declared use of medication in sports.

OBJECTIVE: To assess and compare the prevalence of declared medication, such as corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), beta2-agonists, narcotic analgesics, anaesthetics, and antidepressant drugs, in time and between different sports among athletes tested for doping control in a 4-year period. DESIGN: Survey study. SETTING: Belgium. PARTICIPANTS: This paper reviews the data obtained from 18,645 doping control forms gathered between 2002 and 2005 from national doping organisations in Belgium and The Netherlands, the International Cycling Union (UCI), and the Belgian Cycling Federation. INTERVENTION: All athletes were asked by doping control officers to declare the medication taken in the last 3 days before competition after which the doping control forms were double blinded and handed over to the laboratory. MAIN OUTCOME MEASUREMENTS: Classification of declared medication according to the active ingredient. RESULTS: The overall declared use of medication belonging to one of the monitored categories increased from 19.8% in 2002 to 24.67% in 2005. Differences in use of medication were observed between sports with a higher prevalence of use of NSAIDs in ball sports compared to other sports and a higher use of beta-agonists and corticosteroids in cycling with percentages of declared corticosteroid use in samples from the UCI exceeding 36% in 2005. CONCLUSION: These results indicate that the current granting of therapeutic use exemption for corticosteroids and beta-agonists needs to be revised and that threshold levels for beta-agonists should be implemented.

Direct quantification of steroid glucuronides in human urine by liquid chromatography-electrospray tandem mass spectrometry.

A method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) for the direct quantification of glucuronides of testosterone (TG), epitestosterone (EPG), androsterone (AG) and etiocholanolone (ETG) has been developed. The method allowed for the direct determination of these analytes avoiding hydrolysis and derivatization, which are usual steps in commonly used methods based on gas chromatography-mass spectrometry (GC-MS). The electrospray ionization and the product ion spectra of the glucuronides have been studied in order to obtain the most specific transitions. The use of the selected transitions is necessary for the determination of the analytes at low ng/ml concentration levels. Two different approaches have been tested for sample preparation: direct injection after filtration and acidic liquid-liquid extraction (LLE) with ethyl acetate. Both approaches have been validated obtaining satisfactory values for accuracy and precision with limits of detection lower than 1 ng/ml for TG and EPG. Ion suppression was more pronounced after LLE probably due to the concentration of interferences from acidic urine. The applicability of the method has been checked by the analysis of 40 urine samples. The results were compared with those obtained with the common GC-MS method. Results have shown a good correlation between both methods with correlation coefficients higher than 0.97. A slope close to 1 was obtained for all analytes except for AG possibly due to losses during the extraction process prior to GC-MS.

Efficient approach for the comprehensive detection of unknown anabolic steroids and metabolites in human urine by liquid chromatography-electrospray-tandem mass spectrometry.

The detection of new anabolic steroid metabolites and new designer steroids in urine is a challenge in doping analysis. An approach based on precursor ion scanning for the detection of unknown anabolic steroids and metabolites is proposed. The study of the MS/MS spectra of selected anabolic steroids revealed different fragmentation pathways at low and medium collision energy depending on the steroid structure. However, after analysis at high collision energy three common ions at m/z 105, m/z 91, and m/z 77 were found for all studied anabolic steroids. These ions can be explained by the fragmentation of the steroid structure and corresponded to the methyl tropylium, tropylium, and phenyl ions, respectively. Because of the theoretical low specificity of these ions, the simultaneous presence of all of them was used as a starting point to consider a substance as a possible anabolic steroid. Hence, the developed approach is based on the simultaneous acquisition of the precursor ion scan of m/z 105, 91, and 77. The specificity of this approach has been checked by the injection of several doping agents including beta-agonists, corticosteroids, beta-blockers, and diuretics. In general, only compounds with a steroidal structure showed a signal at all three selected m/z values although some exceptions have been found. The applicability of the method was tested for three different scenarios: the detection of steroid metabolites, the detection of unknown steroids, and the analysis of prohormones. In metabolic studies, several recently reported fluoxymesterone metabolites were also found using this method. For detection of unknown steroids, some negative urine samples were spiked with the designer steroid THG and 33 other anabolic steroids and treated as blind samples. Finally, the applicability of the developed approach for the analysis of dietary supplements was checked by the analysis of a prohormone where several impurities and/or degradation products were found.

Elucidation of urinary metabolites of fluoxymesterone by liquid chromatography-tandem mass spectrometry and gas chromatography-mass spectrometry.

The suitability of liquid chromatography tandem mass spectrometry (LC-MS/MS) and gas chromatography mass spectrometry (GC-MS) for the elucidation of fluoxymesterone metabolism has been evaluated. Electrospray ionization (ESI) and collision induced dissociation (CID) fragmentation in LC-MS/MS and electron impact spectra (EI) in GC-MS have been studied for fluoxymesterone and two commercially available metabolites. MS(n) experiments and accurate mass measurements performed by an ion-trap analyser and a QTOF instrument respectively have been used for the elucidation of the fragmentation pathway. The neutral loss scan of 20 Da (loss of HF) in LC-MS/MS has been applied for the selective detection of fluoxymesterone metabolites. In a positive fluoxymesterone doping control sample, 9 different analytes have been detected including the parent compound. Seven of these metabolites were also confirmed by GC-MS including 5 previously unreported metabolites. On the basis of the ionization, the CID fragmentation, the accurate mass of the product ions and the EI spectra of these analytes, a tentative elucidation as well as a proposal for the metabolic pathway of fluoxymesterone has been suggested. The presence of these compounds has also been confirmed by the analysis of five other positive fluoxymesterone urine samples.