Doping

Given Sky’s recent history with keeping records of what their riders
are taking in the jiffy bag case. How can anyone take seriously
records they produce of what Froome has been taking?

Martha replies:

User avatar for Martha Kelner Guardian staff Martha Kelner 14
December 2017 1:15pm There's an irony in the fact that Team Sky and
British Cycling's lack of medical records (see Doctor Richard
Freeman's stolen laptop) was cited by the UK Anti-Doping Agency as one
of the reasons they were unable to fully investigate allegations
levelled at Bradley Wiggins over the mystery jiffy bag delivery in

1. Now Sky will be presumably invoking medical records and previous test results in a bid to clear Froome's name.
   

ouch.

If Froome needed the upper limit of what’s allowed. Surely he’d be in a state that would see him granted a tue from prednisolone. I wonder.

a lot of those studies claiming no
benefit to Beta 2 Agonists do not use particularly relevant (to elite
sport) dosages of the drug under investigation

Depends what you're trying to prove. Most of the studies I've seen are testing the performance enhancing effect of therapeutic doses of inhaled drugs, to determine whether giving TUEs to asthmatics has unintended consequences. Testing large systemic doses (e.g. 4-8mg orally) is a different matter, but that kind of regime would be an out of competition thing, you'd have to be unbelievably stupid to keep it up in the racing season.

use a performance measure (like VO2max) that is irrelevant to an
athlete like Froome.

Did I miss a meeting? Surely VO₂max is pretty relevant to a GC contender.

List Time

Guilty

1. GWGS
   
   

Not Guilty

Abstain

Surely if there is plenty of debate and testing that leads to ambiguities about whether something is performance enhancing or not, probably means it isn't. Sounds like caffeine or beetroot juice are more performance enhancing than salbutamol.

This is all very strange, and all rather depressing. I think the leak has done Froome a great disservice: let the investigation run its course and give us an outcome, positive or negative, and issue a sanction on the rider if guilty. Instead we get an immediate guilty assumption from all corners that will always stain the rider's reputation. I tried to ask a question about the ethics of reporting on the leak and prejudicing the investigation but it wasn't answered. I was snarled at by one person saying 'I bet you defended Lance'. But it's not a defense: I'm struggling to understand what exactly this all means, I mean even if the authorities decide against him it's not a doping positive, as the substance isn't banned. There's no performance advantage to be gained from it, it just seems now Froome is a considered a doper even though he didn't dope.

Surely if there is plenty of debate and testing that leads to ambiguities about whether something is performance enhancing or not, probably means it isn't

Or it means the studies conducted so far have used the wrong metrics or the wrong subjects. I don't think there's much doubt that some β2 agonists in large systemic doses have performance enhancing effects on some metrics. The doubt is whether any of that translates to therapeutic inhaled doses, and I haven't gone into that much detail in the various study reports which do show some effect to see how well they eliminated effects which were the usual therapeutic performance enhancement due to some subjects having undiagnosed asthma.

All of which is moot in the case of salbutamol, since everybody is allowed to take it if they want to, up to 1600μg a day, whether they have asthma or not. Anybody who believes that therapeutic inhaled doses are performance enhancing for people without asthma can buy the stuff online for under £2 a pack by simply giving the right answers to an online consultation, without having to go through the tiresome rigmarole of meeting a pulmonologist face to face and drawing pretty pen traces with his spirometer (although I expect they're all digital now, so it would be drawing pretty graphs on a computer screen)

So why is there a limit on how much you can take and how much you can have in your urine?

Did I miss a meeting? Surely VO2max is pretty relevant to a GC contender.

I think the implication was that focusing exclusively on the effect of Salbutamol on V02 Max on someone who already has an exceptionally high scores is not relevant and you should instead be testing how how it might improve other physiological responses.

Saying that salbutamol doesn't increase your V02 Max is not the same as saying it's not performance enhancing. Quick google-fu turned up this which also indicates that V02 capacity being the primary limitation of performance in elite athletes might be inaccurate, seems fairly well argued.

http://www.scienceofrunning.com/2009/12/fallacy-of-vo2max-and-vo2max.html

I fear you need to do some research on the Sky company if you think they're the slightest bit bothered about fair play and ethics.

Cos they ain't.

They're cunts.

It is perfectly possible that after the Wiggins debacle, Sky made certain that all their medical records were accurate and up to date. I don’t think it is unreasonable to accept that.

They'll care when it costs them money

For masking? RaceRadio on Twitter was speculating he was using to mask AICAR.

Team Sky’s costs are, I believe, less than 1% of Sky’s UK marketing spend.

The team sponsorship is continued mainly because James Murdoch likes hanging out at the Tour.

Extremely doubtful he will stay in charge surely.

The head of the French Anti-Doping agency has dismissed any evidence of Salbutamol being used as a masking agent. I think I’d take his word ahead of a snarky, anonymous US lawyer.

I totally agree, but it doesn't nullify the deep irony that they get out of one doping scandal by claiming they don't have any records and then try to argue their way out of another by saying they do. It undeniably undermines public confidence in what they're saying

You've missed the point somewhat.

Also I still can't find any article where Ulissi admits to taking more than the dosage.

So why is there a limit on how much you can take and how much you can have in your urine?

Because, as I said, large systemic doses are known to be performance enhancing, whereas small inhaled doses seem to have no measurable effect on athletic performance.

Yet WADA still have the set level

So Large is over 1000?
I don't get why this is the limit if it's not equivalent to Large

I think the implication was that focusing exclusively on the effect of Salbutamol on V02 Max on someone who already has an exceptionally high scores is not relevant and you should instead be testing how how it might improve other physiological responses

Studies have looked for other responses, and found nothing when using the dosing regime permitted by WADA. Science being what it is, we can't say that there's nothing to find if you looked in the right places using the right test subjects, but it's all irrelevant anyway under current regulations, because you don't need a TUE for 1600μg/day inhaled, so the playing field is level regardless of whether there is some as yet undiscovered benefit.

It was in the team press release when he accepted his ban.

Which CAS have previously criticised as being arbitrary.

So Large is over 1000?

Which 1000 are you talking about? The trigger for enquiry is 1000ng/ml in urine, because that is the maximum elimination rate expected from somebody taking 1600μg/day spread normally throughout the day. The permitted daily dose is 1.6mg inhaled, one example of a study which found anabolic effects used 16mg orally every day for 9 weeks. The whole point of inhaling β2 agonists is that they bind to the β2 receptors in the airways and, presumably, don't fall off until they break, so the active group is not available to other systems to provide other effects even compared with alternative routes of administration of the same dose.