{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:49:11Z","timestamp":1791434951971,"version":"4.3.3"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["analyticalsciencejournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug Testing and Analysis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>In this study, intra\u2010individual variation of serum and urinary Athlete Biological Passport (ABP) steroids was investigated in relation to 3\u2009days of codeine intake in healthy men and women. Two study populations were included: (a) 14 participants evaluated for longitudinal variation over 6\u2009weeks, and (b) 11 participants evaluated for variation within 1\u2009week and following 24 and 72\u2009h of daily codeine intake. Urinary and serum steroid concentrations were analyzed using WADA\u2010accredited GC\u2013MS\/MS and LC\u2013MS\/MS methods, respectively. To study the longitudinal changes of the ABP hormones after codeine intake, individual thresholds were calculated as the mean\u2009\u00b1\u20093 SD of three baseline values. During the 6\u2010week observation period, the variability of serum markers ranged from 3% to 34%. Comparable variability was observed when serum markers were measured on three occasions within 1\u2009week prior to codeine administration. Codeine intake did not significantly affect the median urinary and serum steroid concentrations. Urinary T\/E was elevated in five subjects, whereas for two participants, the serum T decreased below the individual calculated thresholds. The changes were observed in both male and female participants. The atypical serum T profiles were accompanied by stable T\/A4. Marked inter\u2010individual variability was observed in urinary concentrations of codeine and its active metabolite morphine; nevertheless, all participants would have tested negative for morphine in an in\u2010competition setting. These results show that both the urinary and serum steroid profiles may be perturbed already after 1\u20133\u2009days of codeine use.<\/jats:p>","DOI":"10.1002\/dta.70167","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:52:04Z","timestamp":1791431524000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intra\u2010Individual Variability of Blood and Urinary Steroid Markers and the Response to Codeine Intake in Healthy Men and Women"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6498-2603","authenticated-orcid":false,"given":"Alexander","family":"Andersson","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet  Huddinge Sweden"},{"name":"Medical Unit Clinical Pharmacology Karolinska University Hospital  Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basam","family":"Yousif","sequence":"additional","affiliation":[{"name":"Medical Unit Clinical Pharmacology Karolinska University Hospital  Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Pohanka","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet  Huddinge Sweden"},{"name":"Medical Unit Clinical Pharmacology Karolinska University Hospital  Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annica","family":"B\u00f6rjesson","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society Karolinska Institutet  Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Lehtihet","sequence":"additional","affiliation":[{"name":"Department of Medicine Karolinska Institutet  Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1053-2345","authenticated-orcid":false,"given":"Lena","family":"Ekstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet  Huddinge Sweden"},{"name":"Medical Unit Clinical Pharmacology Karolinska University Hospital  Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"issue":"8","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1210\/clinem\/dgad085","article-title":"Longitudinal Profiling of Endogenous Steroids in Blood Using the Athlete Biological Passport Approach","volume":"108","author":"Equey T.","year":"2023","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"issue":"3","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1002\/dta.3412","article-title":"Variability of the Urinary and Blood Steroid Profiles in Healthy and Physically Active Women With and Without Oral Contraception","volume":"15","author":"Moreillon B.","year":"2023","journal-title":"Drug Testing and Analysis"},{"issue":"1","key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1002\/dta.3373","article-title":"Disposition of Serum Steroids in Response to Combined Oral Contraceptives and Menstrual Cycle Phases: A Double\u2010Blind, Randomized, Placebo\u2010Controlled Study","volume":"15","author":"Knutsson J. E.","year":"2023","journal-title":"Drug Testing and Analysis"},{"issue":"7","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1002\/dta.3479","article-title":"Intra\u2010Individual Stability of Longitudinal Urinary Steroid Profiles in Swedish Athletes","volume":"15","author":"Ekstrom L.","year":"2023","journal-title":"Drug Testing and Analysis"},{"issue":"6","key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1046\/j.1365-2265.2003.01772.x","article-title":"Diurnal Rhythms of Serum Total, Free and Bioavailable Testosterone and of SHBG in Middle\u2010Aged Men Compared With Those in Young Men","volume":"58","author":"Diver M. J.","year":"2003","journal-title":"Clinical Endocrinology"},{"issue":"9","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1515\/cclm-2016-0805","article-title":"Parallel Diurnal Fluctuation of Testosterone, Androstenedione, Dehydroepiandrosterone and 17OHprogesterone as Assessed in Serum and Saliva: Validation of a Novel Liquid Chromatography\u2010Tandem Mass Spectrometry Method for Salivary Steroid Profiling","volume":"55","author":"Mezzullo M.","year":"2017","journal-title":"Clinical Chemistry and Laboratory Medicine"},{"issue":"16","key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1136\/bjsports-2011-090806","article-title":"Abuse of Medication During International Football Competition in 2010\u2014Lesson Not Learned","volume":"46","author":"Tscholl P. M.","year":"2012","journal-title":"British Journal of Sports Medicine"},{"issue":"8","key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1177\/1012690220973552","article-title":"Walking the Line? An Investigation into Elite Athletes' Sport\u2010Related Use of Painkiller and Their Willingness to Use Analgesics to Train or Compete When Injured","volume":"56","author":"Overbye M.","year":"2021","journal-title":"International Review for the Sociology of Sport"},{"key":"e_1_2_8_10_1","unstructured":"WADA \u201cWORLD ANTI\u2010DOPING CODE\u2014INTERNATIONAL STANDARD PROHIBITED LIST 2026 \u201d (2026) https:\/\/www.wada\u2010ama.org\/sites\/default\/files\/2025\u201009\/2026list_en_final_clean_september_2025.pdf."},{"issue":"4","key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1002\/dta.2301","article-title":"Codeine Influences the Serum and Urinary Profile of Endogenous Androgens but Does Not Interact With the Excretion Rate of Administered Testosterone","volume":"10","author":"Lehtihet M.","year":"2018","journal-title":"Drug Testing and Analysis"},{"key":"e_1_2_8_12_1","unstructured":"WADA \u201cWADA Technical Document\u2014TD2022DL \u201d (2022) https:\/\/www.wada\u2010ama.org\/sites\/default\/files\/2022\u201001\/td2022dl_v1.0_final_eng_0.pdf."},{"issue":"8","key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1002\/j.1552-4604.1990.tb03641.x","article-title":"Plasma Codeine and Morphine Concentrations After a Single Oral Dose of Codeine Phosphate","volume":"30","author":"Shah J. C.","year":"1990","journal-title":"Journal of Clinical Pharmacology"},{"issue":"4","key":"e_1_2_8_14_1","doi-asserted-by":"crossref","DOI":"10.5812\/asjsm.28798","article-title":"Morphine\/Codeine Ratio, a Key in Investigating a Case of Doping","volume":"6","author":"Seif\u2010Barghi T.","year":"2015","journal-title":"Asian Journal of Sports Medicine"},{"issue":"11","key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"2220","DOI":"10.1002\/dta.3932","article-title":"Detection of a Single Microdose of Testosterone and Recombinant EPO in Healthy Volunteers","volume":"17","author":"Heiland C.","year":"2025","journal-title":"Drug Testing and Analysis"},{"issue":"8","key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1002\/dta.3600","article-title":"Detection of Anabolic Agents Including Selective Androgen Receptor Modulators in Samples Outside of Sport","volume":"16","author":"Bohlin K. P.","year":"2024","journal-title":"Drug Testing and Analysis"},{"issue":"7","key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1002\/dta.2121","article-title":"Urinary Steroid Profile in Females\u2014The Impact of Menstrual Cycle and Emergency Contraceptives","volume":"9","author":"Mullen J. E.","year":"2017","journal-title":"Drug Testing and Analysis"},{"issue":"11","key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1002\/dta.3925","article-title":"Avoid Falsely Accusing Female Athletes Who Use Levonorgestrel of Doping","volume":"17","author":"Andersson A.","year":"2025","journal-title":"Drug Testing and Analysis"},{"key":"e_1_2_8_19_1","unstructured":"\u201cA Language and Environment for Statistical Computing (v4.3.1) \u201d R Core Team (2023)."},{"key":"e_1_2_8_20_1","unstructured":"H.Wickham \u201cggplot2: Elegant Graphics for Data Analysis (v3.5.1) \u201d (2016)."},{"issue":"1","key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1111\/pme.12926","article-title":"Opioid Related Endocrinopathy","volume":"16","author":"Gudin J. A.","year":"2015","journal-title":"Pain Medicine"},{"issue":"4","key":"e_1_2_8_22_1","first-page":"275","article-title":"Differential Effects of Opiate Peptides and Alkaloids on Anterior Pituitary Hormone Secretion","volume":"37","author":"Delitala G.","year":"1983","journal-title":"Neuroendocrinology"},{"issue":"4","key":"e_1_2_8_23_1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1093\/pm\/pnw182","article-title":"Association Between Commonly Prescribed Opioids and Androgen Deficiency in Men: A Retrospective Cohort Analysis","volume":"18","author":"Rubinstein A. L.","year":"2017","journal-title":"Pain Medicine"},{"issue":"3","key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1002\/dta.2960","article-title":"Urinary Steroid Profile in Relation to the Menstrual Cycle","volume":"13","author":"Schulze J.","year":"2021","journal-title":"Drug Testing and Analysis"},{"issue":"1","key":"e_1_2_8_25_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.steroids.2010.10.010","article-title":"Reexamination of Testosterone, Dihydrotestosterone, Estradiol and Estrone Levels Across the Menstrual Cycle and in Postmenopausal Women Measured by Liquid Chromatography\u2010Tandem Mass Spectrometry","volume":"76","author":"Rothman M. S.","year":"2011","journal-title":"Steroids"},{"issue":"5","key":"e_1_2_8_26_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1054\/jpai.2002.126790","article-title":"Hypogonadism in Men Consuming Sustained\u2010Action Oral Opioids","volume":"3","author":"Daniell H. W.","year":"2002","journal-title":"Journal of Pain"},{"issue":"3","key":"e_1_2_8_27_1","first-page":"86","article-title":"Opioids and Methadone Equivalents for Clinicians","volume":"7","author":"Vieweg W. V.","year":"2005","journal-title":"Primary Care Companion to the Journal of Clinical Psychiatry"},{"issue":"1","key":"e_1_2_8_28_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/0960-0760(92)90229-C","article-title":"A Conspicuous Down\u2010Regulating Effect of Morphine on Essential Steroid Hydroxylation Reactions and Certain Drug N\u2010Demethylations","volume":"41","author":"Rane A.","year":"1992","journal-title":"Journal of Steroid Biochemistry and Molecular Biology"},{"issue":"1","key":"e_1_2_8_29_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/S0026-895X(25)08524-4","article-title":"Divergent Regulation of Cytochrome P450 Enzymes by Morphine and Pethidine: A Neuroendocrine Mechanism?","volume":"47","author":"Rane A.","year":"1995","journal-title":"Molecular Pharmacology"},{"key":"e_1_2_8_30_1","unstructured":"Agency WA\u2010D \u201cTD2022DL \u201d Decision Limits for the Confirmatory Quantification of Exogenous Threshold Substances by Chromatography\u2010Based Analytical Methods: World Anti\u2010Doping Agency (WADA) (2022)."},{"key":"e_1_2_8_31_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.steroids.2023.109331","article-title":"Influence of Ethanol Consumption and Food Intake on Serum Concentrations of Endogenous Steroids","volume":"201","author":"Thieme D.","year":"2024","journal-title":"Steroids"}],"container-title":["Drug Testing and Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/analyticalsciencejournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dta.70167","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/analyticalsciencejournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dta.70167","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/analyticalsciencejournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dta.70167","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:52:11Z","timestamp":1791431531000},"score":1,"resource":{"primary":{"URL":"https:\/\/analyticalsciencejournals.onlinelibrary.wiley.com\/doi\/10.1002\/dta.70167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":30,"alternative-id":["10.1002\/dta.70167"],"URL":"https:\/\/doi.org\/10.1002\/dta.70167","archive":["Portico"],"relation":{},"ISSN":["1942-7603","1942-7611"],"issn-type":[{"value":"1942-7603","type":"print"},{"value":"1942-7611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"2026-07-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"dta.70167"}}