Doping

Thanks

No, Aussie doc probably covering for him so they don't waste all the money they paid for him. Cheating Brits should've never been allowed to sully the name of such a great team. Back to 0 tolerance Sky with all the cheats... :P

I was diagnosed with sports induced asthma when I was 14, I played football to a decent standard through my teens and 20s and rarely had to use my inhaler. Only on very cold days/nights when I hadn't had time to warm up properly (coming off the bench for example).

Having got seriously into cycling in my early 30s my symptoms got far worse (coughing and wheezing after long/hard sessions). I now have four puffs of the blue one before every hard training session and every race, if I'm out for a long time or it's particularly cold I may need to use it again.

Given certain scenarios; significant drop in temperature and thinning air on a mountain stage along with a sudden hard effort I'm surprised more pros don't need to use an inhaler at that point, I reckon I would.

Also respiratory illnesses are a bugger when your asthma is playing up. I've had three chest infections of various degrees this winter (mainly due to a toddler in nursery, rarely had them before). Start with a cold and go straight to your chest. Two bouts of asthma steroids this winter just to keep me breathing properly. If I were a pro I can imagine I would have had to smash through the TUEs just to keep training properly, let alone race.

I occasionally get excercise induced asthma - normally it's to do with pollen and pollution

That sounds more like allergic asthma which you only notice if you're placing extra demands on your pulmonary system by exercising. True exercise induced asthma doesn't need anything else in the atmosphere to trigger it, just the exercise. IANAD, but allergic asthma probably responds better to a preventer (e.g. beclomethasone, brown inhaler) rather than a reliever (e.g. salbutamol, blue inhaler). With the steroidal preventer medication, it takes a period of routine administration (up to a week) to get the full benefit and it needs experimentation to dial in the dosing to suit the individual, there's at least a 10:1 range of dosing between individuals for the minimal dose which provides optimal benefit.

I now have four puffs of the blue one before every hard training session and every race

You need to be careful about that if you're tested, some pharmacokinetic studies have shown that double-dosing (which is what you're doing) can lead to an adverse analytical finding if the test is just timed 'wrong', even though your daily dose is well below the permitted amount if you only have that one double dose per day.

Also, if you want to use your full permitted daily dose for maximum benefit, you're better off taking little-and-often rather than chugging it all at once, for the same pharmacokinetic reasons.

http://www.cyclingweekly.co.uk/news/racing/simon-yates-not-suspended-positive-test-terbutaline-confirms-uci-223094

allergic asthma probably responds better to a preventer (e.g. beclomethasone, brown inhaler) rather than a reliever (e.g. salbutamol, blue inhaler)

In addition to your antihistamine of choice.

That's interesting, I'm following doctor's orders on that dosing too. They've also put me back on the brown (inhaler) which I've stopped previously as it actually made me wheezy (and still is). Following my last appointment, the doctor said that in emergencies I could use the blue one 10 times which will apparently act in a similar way to a nebuliser. My peak flow is about 30% down on what it should be for my height and weight so it needs sorting one way or another.

Oh that's interesting. I don't get it quite so much these days anyway - think I maintain a pretty high level of fitness throughout the year now compared to when I was properly suffering - I guess if you're coming from shit all fitness and then asking your lungs to work really hard just when the trees are starting to flower, then you're going to feel it that much more.
Only had it once this year so far, and that was a few weeks ago in Mallorca where I guess there was that much more flowering than over here.

Yeah, I take ceterizine and use a nasal spray too.

...I'm surprised more pros don't need to use an inhaler at that point, I reckon I would.

Yeah, but you're actually asthmatic, they're just cheating.

I think just shows that everyone is still taking every Liberty they can with the rules. Which is fair enough. But sad.
Still, if you can't get your shit right then tough.

Though I bet a retroactive tue and no ban or issue. Which is fair I guess, as previous use is clear.

However if using this over the non tue type, there should be a reason as to why you can take non performance enhancing one.

Do the crime, do the time.

I've yet to see the evidence that terbutaline (TUE required) is performance enhancing beyond it's designated therapeutic effect. There is (limited) evidence that salbutamol (no TUE required) is performance enhancing. As such, I'm not yet sure why WADA treat the two drugs differently.

The detail/link I posted earlier for a small study indicated terbutaline is not performance enhancing.

And if it's your team that is supposed to be doing the admin for you while you do YOUR job then it's hardly "doing the crime".

If it's YOU that's taking an inhaler for asthma that YOU know you don't have, then YOU certainly are doing the crime and if you're doing all this and leaving it to someone else to fill in the forms, well that's just asking for trouble.

But if YOU are a teenager, being told by your bosses that you have to do it, trying desperately to make a go of YOUR career, being told it was all OK (after all a third of the Sky team do it) and they'd take care of all the paperwork, YOU'RE not totally to blame.

Interesting article which explains why so many pros do have asthma:

http://www.theguardian.com/sport/2016/apr/29/elite-athletes-asthma-simon-yates-team-sky-swimmers

He has asthma. He has a team doctor. Why on earth would he be doing the admin for his meds?

It'd be like me being fired because my office manager forgot to sign a purchase order for coffee beans.

Interesting article

Albeit one containing an error; you don't need a TUE for the most common steroidal preventer inhaler, beclomethasone, or for four other inhaled glucocorticosteroids

The more I read about this, the more sympathetic I am to Yates. The bloke indicated on his Paris-Nice dope testing form that he was on the drug, ffs. Hardly the actions of someone who a) was trying to get away with sneakily taking a performance enhancer and b) someone who didn't think he had a TUE.
Oh well. Monitor him very very closely from now on, but I'd argue for leniency on the evidence we've heard so far.

Shane Stokes - not someone known for his forgiving attitude to doping - and a very anti-doping doctor discuss the issue here and seem to conclude Yates hasn't done much empirically wrong, even though he's obviously foul of the actual rules.
http://cyclingtips.com/2016/04/cycling-federation-doctor-nothing-surprising-about-prevalence-of-asthma-amongst-pro-riders/

He has asthma.

But does he, really?

He has a team doctor.

Which is presumably where the asthma diagnosis came from?

But does he, really?

Obviously none of us can really know this, but presumably an independent doctor could verify it pretty easily. Evidence posted in this thread suggests that:

1. As an elite athlete there's a much higher than average chance that he does.
   
2. The substance he's tested positive for doesn't seem to have any performance enhancing affect if he doesn't anyway.
   
   

But does he, really?

I'm sure his spirometry results will be part of his defence submission, the people who have to judge him will know whether he has asthma or not

Which is presumably where the asthma diagnosis came from?

It's more likely that the asthma diagnosis came from either his own GP or from a previous team doctor, since he claims to have a history of asthma which I assume predates joining OGE.

He's mentioned having asthma previously, so isn't doing a particularly good job of hiding it.

But hey, you carry on judging him based on your own prejudices.