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t-72

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I have been toying with the idea of comparing the recent scandal if I can call it that regarding Wiggin's TUE with Martin Johnsrud Sundy's case which became publicly known in the middle of summer. I think the comparison is interesting for a few reasons, as both athletes were clearly performing like world no. 1 at the time Wiggins 2012 Tour de France and Johnsrud Sundby 2014 Tour de Ski. These multiday events in question are among the most prestigeous if not the most prestigeous event in the sport (in XC skiing the Worlds and Olympics would be ranked clearly higher). The teams have similar reputations: almost unbeatable when in shape, skyborgs, robots, supermen - and they like to be seen as clean, in contrast to some others. One could say there is a holier than thou attitude towards some of the competing teams but in both cases there are histories of proven doping with some of the competing teams while Sky and the Norwgian XC team have no previous positives , at least not related to key athletes. This has been a key element in their marketing.

Team involved Team Sky Norwegian XC-skiing
Team results reputation unbeatable robots unbeatable robots
Team doping reputation pure (self-proclaimed) pure (self-proclaimed)
Team doping history no prior positives no prior positives
Athlete tested positive? no yes
TUEs involved? yes yes
condition TUE was granted for asthma asthma
substances involved? triamcinolone salbutamol
method? injections special inhaler 
grand tour involved? yes sort of
when was the substance taken Pre-tour Pre-tour
athlete convicted? No Yes

I'll pass no judgement, but in my eyes these cases are quite similar and I think Sundby got a very relaxed sentence (two months suspension, served in summer months and loss of tour de Ski results (sets him back ~100 000 Euro, but the skiing federation will likely compensate for that :angry).  This is compared to Diego Ulissi, Simon Yates and Vegard Robinson Bugge who were more severely punished for same type of offences (most of them had to sit out 4 months of competitions not 2 months of off season).  However, it seems like there is more or less a consensus that triamcinolone is more powerful as a performance enhancing drug compared to salbutamol (there are claims it does not affect performance).

For both Team Sky and for the Norwegian Skiing Federation there are claims that TUE drugs have been taken as a precaution against something which otherwise might become a problem in competition. That is stretching the TUE, to the limit, if not beyond, and that is the main problem here with both teams.

I wouldn't speculate on any direct connection but Team Sky has been the most Norwegian of the WT teams since its inception, and currently they have 1 Norwegian rider and 2 Norwegian DS's. In Norway, knowledge on training at top level is shared between various sports through the Olympiatoppen performance center. It is not inconceivable that this could also include knowledge about various forms of treatment of exercise induced asthma, as there are very many similarities around these cases.
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  • « Last Edit: September 26, 2016, 20:42 by t-72 »

    LukasCPH

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    Also, Sundby used a salbutamol inhaler. Something that probably sees as much use as caffeine gels (only slightly exaggerating). ;)
    Wiggins got injected with triamcinolone.

    In my book, it's clear which is the 'worse' thing to do.


    For both Team Sky and for the Norwegian Skiing Federation there are claims that TUE drugs have been taken as a precaution against something which otherwise might become a problem in competition. That is stretching the TUE, to the limit, if not beyond, and that is the main problem here with both teams.
    This is the main problem indeed.
    With these two teams, but generally in elite sports.

    Athletes will take just about anything that
    a) isn't on the WADA list
    b) might give them an advantage
    even if they don't actually need it.

    Ideally, we'd have to get away from that 'philosophy'.
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    Also, Sundby used a salbutamol inhaler. Something that probably sees as much use as caffeine gels (only slightly exaggerating). ;)
    Wiggins got injected with triamcinolone.

    In my book, it's clear which is the 'worse' thing to do.

    I don't know about Sundby in particular, but I read that the Norwegians use(d) nebulizers
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    t-72

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    I don't know about Sundby in particular, but I read that the Norwegians use(d) nebulizers

    I did not know that word in english, but yes, this is not a type of  inhaler that you put in your pocket. That is why I wrote special inhaler. I'll correct that to nebulizer. In the Johnsrud Sundby case, the doctor administered salbutamol to be taken with the nebulizer based on the expected uptake in the body, but the amount in the nebulizer itself was above the limits.  If I have understood correctly WADA has ruled that it is not the uptake but the intake which is the criterium to be used.

    EDIT: the Sundby case probably escaped some international media attention, particularily in UK, as it is related to snow sports something few British relate to (with the notable excpetion of the Scot who won the Norwegian championship a few years back :D )
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  • Joelsim

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    Salbutamol limits.


       B.   Beta-2 agonists for asthma

    Whether or not you need to apply for a TUE before using a beta-2 agonists for the treatment of asthma depends on the medication. Please pay utmost attention to the substance which is included in your inhaler.

    Salmeterol /Salbutamol/Formoterol

    Inhaled salbutamol (maximum 1600 micrograms over 24 hours), inhaled formoterol (maximum 54 micrograms over 24 hours) and inhaled salmeterol in accordance with the manufacturers’ recommended therapeutic regimen are not prohibited and therefore do not require a TUE.

    You must obtain a TUE only if you need to inhale more than 1600 μg per day of salbutamol.
    You must obtain a TUE only if you need to inhale more than 54 μg per day of formoterol.
    You must obtain a TUE if you take salmeterol, salbutamol and/or formoterol by any other routes of administration.
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  • LukasCPH

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    I don't know about Sundby in particular, but I read that the Norwegians use(d) nebulizers
    I stand corrected.
    But it's still administered orally, right? That's a far cry from an intramuscular injection.
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    orally, yes - not sure I would agree with the 2nd part

    there's a lot to read about it in the ~pdf CAS report

    Quote
    WADA   has   never   addressed   the   issue   of   nebulised   Salbutamol   but   it   is  acknowledged to be an acceptable method of administration as it is ‘by inhalation’. The manufacturer’s recommended dose of Salbutamol for nebulisation by adults is 2.5-5mg three times a day – i.e. a maximum of 15mg per day which is nine times greater than 1,600mcg.

    Nebulisers to administer drugs to manage respiratory conditions have been used for many years but mainly in hospitals. Their primary advantage over MDIs is the ability to deliver higher doses of drugs such as Salbutamol faster to the airways to manage acute severe asthma. Nebulisers can also be useful in young children with asthma  who  cannot  manage  an  MDI  and  spacer.

    about Sundby there's to say, that he - contrary to other Norwegian XC runners, who were treated the same way - actually has obvious breathing problems, and some kind of asthma. It's often to be seen during/after the competitions, and he is basically coughing all day in really cold conditions
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  • LukasCPH

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    orally, yes - not sure I would agree with the 2nd part
    It's a more efficient way to administer it orally ... and therefore you're also more likely to fall foul of the WADA maximum limits.
    But it's still administered orally.

    I'm no expert of course, we'd need a doctor to weigh in on this.
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