Bok prop facing four-year ban on second doping charge relating to prescribed medication

Asenathi Ntlabakanye’s career is at a crossroads with the 26-year-old Springbok facing a possible four-year ban for what appears to be a case of medical mismanagement.

On 9 September, the South African Institute for Drug Free Sport (Saids) formally charged Ntlabakanye for taking the non-specified (performance-enhancing) drug Dehydroepiandrosterone (DHEA), which he declared on a medical form, sources have confirmed.

This is a separate charge to the one mentioned in a South African Rugby Union (Saru) press release last month.

Saru sent out a statement on 24 August 2025 confirming the adverse finding for a specified (non-performance enhancing) substance found during a routine doping test while Ntlabakanye was on Springbok duty in July.

However, the player also declared another prescribed drug, used to treat a medical condition, to testers on a form, which contains a non-specified (performance-enhancing) ingredient, DHEA. This appears to be after he specifically checked it with two medical professionals (whose names are known to Daily Maverick) and was cleared to take it.

Ntlabakanye, following protocol, listed the drugs he was on at a routine testing, after clearing the prescription with both the endocrinologist he had seen to address his weight issues, and another sports doctor.

The original substance that was red-flagged through a blood test by Saids, is specified (meaning non-performance-enhancing).

The non-specified (performance-enhancing) drug did not show up in the blood test results, probably because it was out of his system. But by declaring it on a form, Ntlabakanye incriminated himself, under the “strict liability” rule. 

It’s important to emphasise that, according to several sources, both these drugs were prescribed and cleared by two medical professionals. Even though Ntlabakanye could face a lengthy ban, he is not currently suspended, and could even feature on the Springboks’ November tour as it stands.

Saru’s original statement was unusually direct in pointing the finger at the doctors involved in the case.

“The non-performance-enhancing substance for which he (Ntlabakanye) tested positive was prescribed by a specialist physician early in 2025 for medical reasons,” Saru’s 24 August statement reads.

“It was taken with the approval and the supervision of a medical doctor specifically appointed to manage the medical affairs of professional rugby players.

Transparent in his declarations

“Ntlabakanye was transparent in his declarations, acted in good faith and, at all times, followed the medical due process as prescribed by the industry.

“He relied on the relevant professional medical advice and at no time did he seek to obtain an unfair advantage, nor did he take any medical substance without prior medical authorisation.”

Saru’s statement deliberately did not mention the non-specified drug because at the time they sent it, Saids had yet to charge Ntlabakanye for the second offence.

Massive weight loss

In June, Springbok coach Rassie Erasmus revealed that Ntlabakanye had shed close to 20kg, dropping from 160kg to 141kg.

At the time, the big prop’s weight loss was ascribed to his tough training regime on Bok scrum coach Daan Human’s farm. It has now emerged that there was slightly more to it, as the player sought medical assistance to shed kilos. 

Although Ntalabkanye tested positive for a non-performance enhancing substance, which is on the World Anti-Doping Agency (Wada) banned list, it is a “specified” substance. It can still carry a two-year ban. But often sentences are reduced.

Under Wada’s regulations, a specified substance is unlikely to have given any performance-enhancing benefits. Lenient sentences are therefore applied.

Non-specified drug

However, when the testing officers arrived, Ntlabakanye, seemingly in good faith, listed the full set of ingredients and medication he was taking on a form.

A second medication he listed contains a substance called Dehydroepiandrosterone (DHEA), which is a “non-specified” drug. It comes with much heavier sanctions.

According to the United States Anti-Doping Agency (Usada), DHEA can lead to an increase in the body’s levels of androgens, such as testosterone. Androgens are known to have anabolic (muscle-building) effects, and therefore DHEA is considered to have the potential to enhance athletic performance.

It is therefore a non-specified drug and falls into the category of being “performance-enhancing”. That comes with a maximum four-year suspension for first-time offenders.

Why was it prescribed?

It does beg the question – why was a drug containing this substance even prescribed by a medical professional and cleared by a second doctor? Ntlabakanye’s defence probably hinges on proving negligence by the doctors.

Usada’s website is clear about DHEA.

“Although DHEA is included in some dietary supplements, the efficacy and safety of those products have not been established for diagnosing, curing, mitigating, treating or preventing any disease,” the website states.

“Despite this, DHEA is advertised for the treatment of all kinds of conditions, including anorexia, ‘diminished ovarian reserve’, adrenal fatigue, exercise-induced muscle damage, major depressive disorder, metabolic syndrome, hormone replacement therapies, fatigue, weight loss and many other conditions.

“There is insufficient evidence that DHEA is a safe or effective treatment for any of these conditions.

“Athletes should not use DHEA supplements because DHEA is prohibited at all times, even if it is consumed through a dietary supplement.

“There are more than 150 supplements on the Supplement Connect High Risk List that contain, or claim to contain, one or more forms of DHEA.”

This information was easily found on the Usada and Wada websites, further underlining the apparent medical systems failures in this case.

Athletes can apply for Therapeutic Use Exemption (TUE) for certain drugs for specific medical conditions. But the doctors in this case did not apply for TUE on Ntlabakanye’s behalf.

Technically, Ntlabakanye was eligible to tour New Zealand with the Boks, as he was not provisionally suspended.

But the Springbok management took the decision to remove Ntlabakanye from the squad, expecting the charge for a non-specified drug to come while they were away, which it has. Such a charge would cause unnecessary disruptions and negative press on tour in New Zealand.

Strict liability

Wada and anti-doping codes in general operate on the principle of “strict liability”. Quite simply, athletes are fully responsible for what goes into their bodies regardless of medical advice.

Ntlabakanye appears to be a victim in this case, but that does not necessarily exonerate him from responsibility for what went into his system. 

Unlike courts of law in almost every country, where innocence is presumed and guilt must be proven, strict liability comes from the opposite direction. 

After returning an adverse finding (a positive doping test), athletes are immediately assumed to be guilty, and must prove their innocence if they want to avoid suspension. They can do this through various tribunals, right up to the Court of Arbitration for Sport in Switzerland. 

The anti-doping code places a heavy burden on athletes to prove their innocence, and there are very few cases where positive dope tests are overturned.

Ntlabakanye may well be innocent, and during his hearing he will attempt to show that he followed medical advice.

Even if he can prove that he was acting under supervision and in good faith, relying on expert knowledge and advice, the best he can realistically hope for is a reduced sentence of two years. DM