How athletes can legally use prohibited peptide substances for genuine medical conditions through the TUE process.
Filed under sports rules, written for athlete-coach, clinician, evidence level regulatory-update.
Not medically reviewed. Last updated 2026-03-05. Nothing here is medical advice.
Athletes who require prohibited peptide substances for legitimate medical conditions can apply for a Therapeutic Use Exemption (TUE). This guide explains the process, requirements, and common scenarios.
A TUE is a documented approval that allows an athlete to use a prohibited substance or method for a genuine medical condition. It is granted by the athlete's Anti-Doping Organization (ADO) or the relevant international federation.
All four criteria must be met:
1. The athlete would experience significant health impairment without the substance
2. The substance would not produce significant performance enhancement beyond returning to normal health
3. There is no reasonable permitted alternative treatment
4. The need is not a consequence of prior use of a prohibited substance
One of the most common TUE applications. Requires documented diagnosis, treatment records, and ongoing monitoring.
Requires stimulation testing confirming GH deficiency, endocrinologist documentation, and evidence that the condition predates athletic career where possible.
May be required for legitimate medical conditions. Requires specialist documentation.
1. Consult team physician and ensure documentation is complete
2. Submit TUE application to the relevant ADO (USADA, UKAD, etc.) or international federation
3. Application reviewed by a TUE Committee (minimum 3 physicians)
4. Decision communicated to athlete
5. Appeals possible through CAS (Court of Arbitration for Sport)
This guide provides anti-doping education only.
More guides: All guides, Safety centre, Peptide library.