There sort of is though, that’s what the TUE system does. If a rider is prescribed a treatment by a qualified doctor and that treatment is confirmed by the UCI/WADA as being appropriate, shouldn’t the rider be able to have confidence in that?

Riders aren’t qualified to make medical judgements any more than the average STWer is and they should be able to have confidence in their own medical staff and the TUE approval mechanism, no?

As an aside, I thought Will Fotheringham’s Guardian follow-up opinion piece where he mentioned using an analogy to explain the suspicion of cycling fans to a rider was interesting. He said – paraphrase – that the Lance era was like finding your trusted partner had been involved in a long-term adulterous relationship and lied to you consistently and brazenly.

As a result, you not unreasonably, carry that suspicion with you either in the same relationship or into a new one, so the slightest hint sets off alarm bells – late home? Oh, he/she must have been shagging Howard from accounts behind the photocopier…

I’d take it a stage further though (not the shagging, the analogy) and suggest that if you hold onto that level of near paranoid suspicion, it actually damages you and your relationship, particularly if its a new partner, who’s reaping the aftermath of the original, bad relationship. It’s a toxic way of thinking.

If you look at some of the swivel-eyed, anti-doping loons on twitter in particular, you wonder if they derive any pleasure at all from the spectacle of elite bike racing, or if they’re so eaten up with suspicion and barely controlled hate, that they can’t see beyond that.

I watched the peleton come over Holme Moss the other year and it was genuinely one of the most moving experiences of my life. The sheer spectacle of several hundred elite riders flying up my local climb in a shimmering, organic blaze of colour and life and motion was just amazing.

I don’t for one moment believe that every rider in that race was clean, I’m sure that doping still goes on, but it just seems sad to me that near paranoia eats some people up to the point where all they can see is the possibility – sorry the certainty – that any rider or team who performs well must be cheating.

Because, well you know, Lance, he was cheating. With Howard. Behind the photocopier. And then Bradley smiled at the waitress and looked at another man in the pub, and his credit card statement from 2012, I mean, Lance used to stay in Holiday Inns as well…

I’m not saying we should be naive about doping, but I’m not sure going to the other extreme works very well either. Somewhere along the line you have to start trusting again or you might as well simply walk away. Sometimes you have to make an effort to let go of the past and live in the presnt. It’s not risk free, but it’s arguably a better, healthier and happier way of being.

Medical confidentiality understood. This isn’t something that a rider would need to keep confidential for personal reasons though. Professionally it’s quite relevant.

medical confidentiality means that the doctors would technically only be able to discuss medical specifics with the rider’s permission. It would be unethical to do that with specific consent.

No issue with that. I’m talking about a rider not mentioning to the team manager that he’s injecting stuff needing a TUE that’s been previously-abused by others, in his case is suggested to be perfectly OK, in a team with a very clean image where it could be seen as suspect. Of course they didn’t expect all the info to get hacked but isn’t that part of the point – now it’s known about it’s raised questions.

Anyway, if management didn’t know and the team are happy with it all that’s fine, it’s for them to handle this. I’m not signing up to the doping accusations, I’m not defending it all either.

If a rider is prescribed a treatment by a qualified doctor and that treatment is confirmed by the UCI/WADA as being appropriate, shouldn’t the rider be able to have confidence in that?

Yes, they should. But if there’s stuff that can be abused for performance advantage that can also have a TUE, rightfully some will wonder how robust the system is and whether it can prevent abuse being hidden behind medical confidentiality (the stuff Wiggins injected may or may not be performance-boosting in that way, no comment on that). After all, sport doctors haven’t got a clean sheet either.

some will wonder how robust the system is and whether it can prevent abuse being hidden behind medical confidentiality

The registered testing pool, which is currently 1206 athletes across all cycling disciplines, have to get UCI TUEs (not national anti doping TUEs). The UCI issued 13 for 2015, so they are not exactly handing them out like sweeties.

I read that number, yes. Not sure a low number of TUE issues is an indicator of a lack of abuse but it should be read as reassuring.

Do we have the figure for 2012?

Sorry I know I could Google it, but you probably already know where to find it.

47
http://www.uci.ch/clean-sport/therapeutic-use-exemptions/

It looks like the UCI only has to issue TUE’s to athletes not monitored by national anti doping authorities in most major countries. The number of TUE’s issured by the UCI is probably not the same as the number of professional cyclists that have been granted TUE’s.

It would be interesting to know if massive drop the number of TUE’s issued by the UCI since 2009 is due to a tightening of regulations or changes to accounting.

Please note that the UCI automatically recognizes TUEs decisions made by the following NADOs.

This means that if a rider’s TUE has been delivered by a NADO listed below, he/she does not need to apply to the UCI for recognition of that TUE, insofar as the TUE is still valid. The TUE is automatically recognised by the UCI, without further action required by the Rider.

NADO of the French Community of Belgium
Canadian Centre for Ethics in Sport
Agence Française de lutte contre le dopage
Agencia Española de Protección de la Salud en el Deporte
Antidoping Switzerland
Antidoping Denmark
NADO Vlaanderen
National Anti-Doping Agency Austria
Anti-Doping Norway
UK Anti-Doping
South African Institute for Drug-Free Sport Science Institute
United States Anti-Doping Agency
Swedish Sports Confederation
Nationale Anti Doping Agentur Deutschland

It looks like the UCI only has to issue TUE’s to athletes not monitored by national anti doping authorities in most major countries.

Athletes in the Registered Testing Pool (RTP) have to get TUEs via the UCI. From the UCI website:

If you are included in the UCI RTP, you must apply for a TUE directly to the UCI through ADAMS exclusively.

If you are not in the UCI RTP, you can apply for a TUE via one of the recognised national anti doping agencies. My interpretation of the UCI web page is that the 13 TUEs in 2015 is the total number of TUEs issued for athletes in the UCI RTP (currently 1206 cyclists across all disciplines). There is an unknown number of TUEs issued by national anti doping agencies for athletes outside the UCI RTP.

You can see the criteria for selecting the UCI RTP, and a list of all the UCI RTP athletes here:
http://www.uci.ch/clean-sport/international-registered-testing-pool-uci-rtp/

It would be interesting to know if massive drop the number of TUE’s issued by the UCI since 2009 is due to a tightening of regulations or changes to accounting.

The large drop after 2009 was because Salbutamol was reclassified, allowing athletes to use asthma inhalers (below a certain threshold) without a TUE.

Apart from anything else, I’ve yet to see any definitive, evidence-based facts that show that the corticosteroid used by Wiggins is genuinely performance enhancing.

There’s a lot of conjecture and stuff about people having used it in the past and David Millar talking about how it made him ‘feel’, but nothing I can find which shows the performance enhancing effects outweigh the negative side effects like muscle wastage.

For context, for years – and yes, this is going back a long way – Tour riders drank brandy ffs. And it’s well documented that alcohol makes drivers ‘feel’ relaxed and in control even though they’re not

I don’t know the answer. I’m not a doctor or a sports scientist, but it’s right at the very heart of this thing. Putting everything else to one side, is it definitely a performance enhancing drug in the quantity and delivery method used by Wiggins? Because if it isn’t, the whole thing starts to look like a slightly hysterical, narrative and click-bait driven storm in a tea-cup.

Can someone come up with some evidence-based proof?

Haven’t bothered looking (obvz) but I’m not sure there’s masses of evidence about any of these drugs and elite athletic performance (even the ituitively obvious and probably hugely effective stuff – it was mid-2000s before a credible investigation into EPO in “decent” riders) – how would you run the trial with genuinely elite athletes who might win/lose with a 5% lift in output vs their competition ?

Regarding that Guardian analogy, this is a bit like brad going away to a conference and being made to share a hotel room with Howard from accounts – he can even show you the email that says he has to (edit: … but he didn’t show you this until after you heard about it from Svetlana in IT, and prior to that he’s promised you that Howard wasn’t even going)

Top-flight cycling hasn’t been ruined for me but there’s a lot of shit going on that’s not natural, even if it’s within the rules. How can they reconcile being allowed to sleep in an oxygen-poor environment (tent/training camp, whatever) but not micro-dose EPO, for example?

Can someone come up with some evidence-based proof?

No, there’s a maddening lack of convincing evidence either way.

FWIW (which is probably not much), I’m still getting allergies in October and anti-histamines and a prescription nose-spray are not cutting it for me. I’m half-tempted to ask my GP for a Kenalog jab, then if I get quicker we’ll have an answer.

Haven’t bothered looking (obvz) but I’m not sure there’s masses of evidence about any of these drugs and elite athletic performance (even the ituitively obvious and probably hugely effective stuff – it was mid-2000s before a credible investigation into EPO in “decent” riders) – how would you run the trial with genuinely elite athletes who might win/lose with a 5% lift in output vs their competition ?

Well, I guess what you’d do would be to run it out of competition. My point is that it seems unfair to trash a rider and a team’s reputation without any sort of evidence-based proof that what they did was definitely performance enhancing – leave the bit about it being legal to one side.

It’s all a bit like post-truth politics where people go with ‘gut feelings’ as opposed to confirmed facts.

Top-flight cycling hasn’t been ruined for me but there’s a lot of shit going on that’s not natural, even if it’s within the rules. How can they reconcile being allowed to sleep in an oxygen-poor environment (tent/training camp, whatever) but not micro-dose EPO, for example?

So what would happen to altitude natives like some of the Colombian riders? Should riders not be allowed to train and rest at altitude? Is that really the same as micro-dosing? You’d end up with regulations saying that riders were only allowed to train and sleep below a certain altitude and, presumably, altitude natives would be banned for having a genetic advantage?

I take your point on altitude chamber-type sleeping environments being ‘not natural’, but if you effectively banned them, you’d just end up with more riders using altitude camps. Hello Bolivia, here we come… 😉

Just levelling the playing field.

FWIW (which is probably not much), I’m still getting allergies in October and anti-histamines and a prescription nose-spray are not cutting it for me. I’m half-tempted to ask my GP for a Kenalog jab, then if I get quicker we’ll have an answer.

Go for it… My girlfriend was on a corticosteroid for a shoulder injury last year. It didn’t appear to have any noticable impact on her riding, though it did sort her shoulder out nicely – it’s all on Strava if Team Sky would like to get in touch 🙂

Just levelling the playing field.

You could stop them training altogether and leave it up to genetics then. That would work… 😉

I take your point on altitude chamber-type sleeping environments being ‘not natural’, but if you effectively banned them, you’d just end up with more riders using altitude camps. Hello Bolivia, here we come…

Yeh, they’re both essentially ways of boosting EPO production and TBH I don’t draw a distinction, at least until they do a trial of 4 weeks living at altitude vs 4 weeks in a tent vs 4weeks microdosing “undetectably” (at the current state of the art)

I’ll just leave this here……….

The analogy of a cheating girlfriend is apt. But, it falls down because the ‘girlfriend’ has been cheating for well over 50 years on an almost annual basis. Its true he did not in the eyes of the law break the laws but, what he has done is fundamentally wrong and, is cheating in my mind. Regards proof of this drug enhancing performance, surely his statement that ‘he was leveling the playing field’ goes way beyond implying that it enhanced his performance

Its true he did not in the eyes of the law break the laws but, what he has done is fundamentally wrong and, is cheating in my mind.

If you take a step back though, for it actually to be cheating in the real world, instead of ‘in your mind’, you’d want:

1. Some sort of proof that there was definitely intent to cheat and not just take an approved medical treatment to prevent the impact of allergies disadvantaging him relative to opponents who don’t suffer from allergies. Which is probably what he was trying to say.

2. Evidence-based proof that the treatment he used in the dosage and delivery method he did are performance enhancing rather than all the anecdotal stuff that been presented so far.

And then 3, I’d want to know, if both 1. and 2. were proven, how on earth the TUE process allowed that to happen.

Otherwise it’s just post-truth, gut feeling stuff based on, what? Assumptions? Prejudice? A hunch? A lot of anecdotal stuff largely from ex-dopers who have their axes to grind and belief systems to reinforce.

The analogy of a cheating girlfriend is apt. But, it falls down because the ‘girlfriend’ has been cheating for well over 50 years on an almost annual basis.

So then you just rely on gut feeling because that’s how it’s always been and you don’t believe anything can change?

Anyway, I don’t suppose anyone here is likely to change their opinion any time soon. I’m trying to believe in the capacity of people for change and decency because, to be honest, the alternative which seems to be a knee-jerk cynicism, feels corrosive and a little bit sad.

buckster – Member
surely his statement that ‘he was leveling the playing field’ goes way beyond implying that it enhanced his performance

Or, as BWD says, it was more a clumsy way of saying ‘the allergies reduce my capacity to perform at my optimal level, so the treatment was intended to negate that disadvantage compared to other world class riders who don’t suffer from serious hay fever’

Well, Judging by his recent performances it would appear “to me” not you lot, because he can do no wrong!

I’d say hes not been taking his Cortiscosteroid for Allergens, or has he and its hindered his performance or has not taken it and the plight of Human Nature has restricted his Oxygen uptake? I’m confused.
But rather than listen to press statements and Team tactics, i’ll just stick to what i think is right,

Pitch forks out again

Double Olympic triathlon champion Alistair Brownlee has become the latest British athlete to have medical documents made public by hackers.

Files show Brownlee was given a therapeutic use exemption (TUE) for the drug acetazolamide,
but

which helps glaucoma and altitude sickness.

Brownlee confirmed the drug was given in October 2013 “to treat altitude sickness while climbing Kilimanjaro”.
Is this absolutly wrong, perfectly fine or just one of those things

Is this absolutly wrong, perfectly fine or just one of those things

It’s not even a story. Why was it reported? It tells you everything you need to know about clickbait-driven media facilitating a bunch of faceless hackers who are smearing athletes using confidential data obtained illegally.

Of course, if Brownlee were an elite cyclist someone would point out that Lance used to lace his tea with Diamox because he liked the sensation of tingling in his fingertips – horrid btw – and therefore… etc… ad nauseum.

Giving Diamox to someone halfway up Kili doesn’t exactly strike me as an inappropriate clinical use. Certainly performance enhancing, but only in the sense he could make back down without dying.

The key thing with Wiggins is whether the corticosteroid was an appropriate clinical tool given his symptoms. His Guardian interview suggested he had tried all the ‘lower’ approaches – various asthma drugs anti-histamines etc – to no avail, in which case you could argue that the jab could be justified.

Only he and the medical team are privy to the exact rationale and know whether the decision was medically sound or overkill.

The key thing with Wiggins is whether the corticosteroid was an appropriate clinical tool given his symptoms.

My understanding is that at the time that the TUE was granted and the triamcinolone administered, Wiggins wasn’t experiencing any symptoms, it was taken as purely a preventative measure.

From the Brailsford interview in the Guardian;

Asked whether it was right that Wiggins appeared to receive the TUE as a preventative measure, Brailsford said: “You don’t wait until you have an asthma attack to take a puffer.”

Brownlee confirmed the drug was given in October 2013 “to treat altitude sickness while climbing Kilimanjaro”.

Is this absolutly wrong, perfectly fine or just one of those things

Depends on whether he climbed Kilimanjaro or not? 🙂

So then you just rely on gut feeling because that’s how it’s always been and you don’t believe anything can change?

Anyway, I don’t suppose anyone here is likely to change their opinion any time soon. I’m trying to believe in the capacity of people for change and decency because, to be honest, the alternative which seems to be a knee-jerk cynicism, feels corrosive and a little bit sad.

You’ll be new to cycling then

Is it not about time WADA / UKAD Started taking the storage of their On Line records a bit more seriously, There’s no doubt that Fancy Bears are quite proficient at obtaining these records illegally but is it not time that measures were put in place.

All that providing that All this info was’t obtained on the first cull they did when they sifted the data?

AND, I’d love to know if Andy Murray has been given anything on the banned list, that’s not actually banned nor illegal providing your under performing or not at the reqired level, i mean, if i was racing up Mount Kilimanjaro and were pipped to the post by Brownlea to find out 3 years later that he suffered at altitude but had been prescribed Med’s to help combat the effects i’d be sat spitting feathers now.

I know you all think i’m wrong, bitter, twisted or indeed jealous but……….. If you suffer at altitude then FFS DO NOT attempt to run up a mountain, its a way of your body telling you to stay lower and let the ones who dont suffer or who live at altitude revel in their comfort zone and play out their advantage.

I hear what your all saying, “Why shouldn’t he”

But this win at all costs mentality is pathetic.

How do you know you suffer with altitude sickness unless you up though?

Acetazolamide (Diamox) – when I first went to the Himalaya we took Diamox along with us as one of the general medical kit. Some took it to alleviate Acute Mountain Sickness (AMS) but I chose not to as my thoughts were that it was potentially dangerous: basically it lowered the effective altitude your body thought it was operating at. I forget how much altitude difference it was said to make. We were on a pretty technical peak (it’s only ever had three ascents despite quite a number of expeditions to attempt it) so taking Diamox would essentially put you further in to deep doo-doo and away from safety if/when things went wrong.

For someone to be given Diamox on Kilimanjaro (which is one of the world’s worst mountains in terms of incidents of AMS) isn’t unusual, it’s probably quite common given its guided nature and being one of the Seven Summits. Kilimanjaro and Mt Kenya are bad for AMS because they rise directly from a low surrounding landscape so it’s easy to get to high altitude very quickly without giving the body time to acclimatise. In the case of Kilimanjaro, it’s particularly bad because you must be guided and the guides have a schedule they keep to in order to get you up and down. When we were on Mt Kenya one of our party got Pulmonary Odaema and had to be helicoptered off and she’d been to altitude many times.

In terms of Alastair Brownlee being given it – a complete non-story.

If you suffer at altitude then FFS DO NOT attempt to run up a mountain,

Did it say he was running up? As far as I can see it wasn’t a race just a leisure trip.

According to this http://publications.americanalpineclub.org/articles/12200116300/print, Diamox isnt a performance enhancer.

I though it was on the list as a masking agent.

I see Sharapova has gotten her already lenient ban reduced 🙄

Paradoxically if he was running up then he wouldn’t need Diamox. While the body takes time to acclimatise it also takes time to begin that process. Climbing quickly and getting back to low altitude before the effects of AMS begin to take place is a known strategy in super-alpinism but you have to be bloody fit to do it.

If you can’t then you have to go the full acclimatisation process.

FFS just FFS, it makes me feel physically sick, sport makes MPs expenses etc. look like kids taking raisins from their Mums larder

#WeStoodWithMaria #WereAfraidOfTheFancyBears #PleaseDontHackUs

I think it’s great that people like Tiernan-Locke can speak out so courageously on the subject of TUEs 🙄
http://www.bbc.co.uk/sport/cycling/37577688

I just saw that bit from jtl.. What’s that about glass houses and stones.