8 oct. 2019

Triathlon and Asthma

This post is a follow up of the two previous posts.  The job done by WADA is sloppy regarding doping; many fault positives and nonsense regarding persecutions.  Is it possible to go after the real problem, TUEs?

During the 2008 Beijing Olympics, 17 percent of cyclists and 19 percent of swimmers were diagnosed with asthma. These asthmatic athletes went on to win 29 and 33 percent of the medals in those sports, respectively. At the 2012 Olympic Games in London, 700 of approximately 10,000 competing athletes had confirmed asthma diagnoses and, surprisingly, they were almost twice as likely to win a medal as their non-asthmatic peers. If trends from past Olympic Games continue, there may be similar statistics in Rio.

Some webpages considered asthma a bless: “It may seem like elite athletes don’t ever have asthma. After all, athletes need a robust supply of oxygen during their competitions. And symptoms like wheezing and coughing might seem to hinder someone from training and performing at their peak.

Chris Froome had twice the salbutamol level in urine authorized by the WADA.  The urine sample was taken after one of the last stages of La Vuelta a España, 2017.  He mentioned the report done to a Swiss athlete where the value was extremely high after taking three puffs of salbutamol.
The first reported instance in an athlete and the most publicized involved a young Swiss male who appeared to have consistently unique pharmacokinetics for salbutamol. 14 This was discussed in detail in a recent paper. 15 Briefly, his post-race urinary salbutamol concen- tration was ~8000 ng/mL and subsequently, when he received the same inhaled dose, 900 μg in five hours on two occasions, the concen- trations were 3000-4000 ng/mL. ...

To treat asthma does not need more than 400 μg in a three-hour period, something that could be done in the ER; otherwise the salbutamol level will be high as above and more importantly, the athlete needs a more aggressive treatment and he or she is not able to compete.
The permissible level of inhaled Salbutamol is 1600 μg (16 puffs of the reliever inhaler) over 24 hours and no more than 800 μg every 12 hours [1]. If the presence of Salbutamol in urine exceeds 1000 ng/mL, it is presumed not to be an intended therapeutic use and considered as an adverse analytical finding by WADA.

The above brings us to the problem that asthmatic patients are winning one third of the podium in the Olympics.  If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck.

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