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[Closed] Naughty Froome?

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People have been banned for less - from Daniel Friebe on Twitter:
Sky say Froome's salbutamol concentration was 2000ng/ml.

Diego Ulissi got a nine-month ban for 1920ng/ml in 2014.

Petacchi got a year for
1320ng/ml in 2007.

BUT Leonardo Piepoli got no ban for levels reportedly similar to Petacchi's in 2007

My understanding is that they weren't banned for these concentrations; these concentrations just trigger a requirement to explain why the concentrations would be as they are. If there is a (legit) reason, then there is no price to pay. Simply triggering the threshold is not necessarily indicative of an offence. So you can't say they were banned (or not) for these (similar) levels, they were banned because they couldn't explain the levels.

Hence

That said, there IS a limit (as there is with caffeine) which has been breached.
That's it, unfortunately rules are rules.

to parrot my learned friend from another thread - Nope.

A good analogy on a similar case from a cycling friend is that it's like a police car triggering a traffic light camera. Does he automatically get a ticket? No, if he can show he was on a call and needed to then it's wiped off; if he was just heading to Dunkin' Donuts for a round for the station then yes he'll get the punishment the offence deserves.


 
Posted : 13/12/2017 10:10 am
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On one hand, salbutamol is not exactly tasty steak/epo/transfusion. If it was I'd be going a lot quicker up hills.

this. It's hardly a drug that has a significant effect if any at all even though it is steroid based. I don't have Asthma and never have, but did go through a period for a couple of years of Asthma like symptoms. It was never diagnosed as anything because in true NHS style they were not interested in actually understanding what the cause of the issue was and just treated the symptoms, so just chucked me a repeat prescription of Salbutamol which did ease my symptoms. Eventually the condition, whatever it was, subsided and I've been fine and off Salbutamol ever since.

What I can say it didn't to anything to improve any aspect of performance in my life other than enabling me to breathe normally. I noticed no improvement in any physical activity and certainly didn't become a ripped gym god over the time I was using it. I'm sure if Froome was going to go to the trouble of abusing the TUI system to legitimate take a performance enhancing drug then he'd have gone for something that would have actually had a performance enhancing effect unlike Salbutamol. Why risk the fall out and doubt over something that is not going to actually provide a performance benefit. He's got the benefit of my doubt on this one. False news.


 
Posted : 13/12/2017 10:11 am
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Only one study but oral delivery appears to have a different effect than inhaled, 4.1% increase in power output.

[url= http://suppversity.blogspot.co.uk/2014/09/albuterol-salbutamol-doping-works.html?m=1 ]oral v inhaled[/url]

As others have said, not surprised


 
Posted : 13/12/2017 10:16 am
 beej
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My understanding is that they weren't banned for these concentrations; these concentrations just trigger a requirement to explain why the concentrations would be as they are. If there is a (legit) reason, then there is no price to pay. Simply triggering the threshold is not necessarily indicative of an offence. So you can't say they were banned (or not) for these (similar) levels, they were banned because they couldn't explain the levels.

Good point. Would be interesting to see what they did to try and explain it, that got rejected.


 
Posted : 13/12/2017 10:22 am
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A good analogy on a similar case from a cycling friend is that it's like a police car triggering a traffic light camera. Does he automatically get a ticket? No, if he can show he was on a call and needed to then it's wiped off; if he was just heading to Dunkin' Donuts for a round for the station then yes he'll get the punishment the offence deserves.

It's not quite like that. The WADA permitted intake is based on a specific number of actual inhaled doses. The urine concentration is just an indicator that the actual intake may have been exceeded. It's up to the rider/team to show that the urine levels can be explained by something other than an excessive intake of the salbutamol.

If he's used too much, that's illegal regardless of whether it's performance enhancing or not. However if he's used a legal dosage, but there are other factors that could have increased its concentration in the urine - some sort of kidney problem or interaction with other medicine for example - and Sky can demonstrate that, then he hasn't broken any rules.

Your analogy suggests that he could come up with a reason for having exceeded the legal-permitted dosage, but that's not quite the same. He has to show that he didn't exceed the dose and the urine levels can be explained by other factors.


 
Posted : 13/12/2017 10:24 am
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Wiggo's gonna be rubbing his hands together reading this, eh? Christmas come early.


 
Posted : 13/12/2017 10:27 am
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all analogies will fall down in the end. The point is that triggering the camera is just an indication that the light was jumped. It's not an offence if there's a reason why they jumped the light.

The high urine result is at this stage just an indication there was a higher than permitted conc in the urine. It's now up to Froome / Sky to justify why which includes showing he didn't exceed the dose.


 
Posted : 13/12/2017 10:29 am
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Thank God it is only this, from the title I was expecting to see him in a provocative pose in a revealing santa suit, and was wondering why I was actually drawn to open the thread!! Let us hope its cleared up for Christmas and he will be able to take his new bike out. 🙂


 
Posted : 13/12/2017 10:31 am
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I just hope that this is concluded quickly and not dragged out until next season...


 
Posted : 13/12/2017 10:32 am
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WADA: The presence in urine of salbutamol in excess of 1000 ng/mL [...] will be considered as an Adverse Analytical Finding (AAF) [b]unless the Athlete proves, through a controlled pharmacokinetic study, that the abnormal result was the consequence of the use of the therapeutic dose[/b]


 
Posted : 13/12/2017 10:55 am
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So Froome has to take the legal amount of puffs under supervision then thrash himself on the turbo trainer with the heating on full blast to try to replicate the result?


 
Posted : 13/12/2017 10:57 am
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the principle with Froome should be that if he is having a major asthma exacerbation in competition, his medical team should be managing it better out of competition with long-acting preventer drugs so he doesn't need to take a larger dose on the day.

This is a really good point that deserves repeat, why is he needing big does of Salbutamol?

TBH looks dodgy to me, I think at least a ban like Petacchi got seems fair.


 
Posted : 13/12/2017 11:06 am
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Only one study but oral delivery appears to have a different effect than inhaled, 4.1% increase in power output.

So about the same performance boost that some studies have shown caffeine to produce. So Salbutomol is no better performance enhancing drug than a good stiff espresso.


 
Posted : 13/12/2017 11:10 am
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Why does it look dodgy?


 
Posted : 13/12/2017 11:13 am
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Given the preventers (ie what asthmatics take daily to try and minimise the use of salbutamol) are cortico steroids, is there a disincentive for athletes to take them?


 
Posted : 13/12/2017 11:16 am
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Would be intersting to know how accurate and reliable the test is ? If you drink more during a race does your result go down ? That’s why this is being challenged scientifically as many if these tests are less accurate than you might think.

For most stuff it's done relative to other chemicals in the blood/urine which give a correlation for that compound to the amount in the blood.

Some drugs/chemicals only get flushed out at the same concentration they exist in the body (sweeteners like aspartame for example), some the kidneys actively filter out (or the body metabolises them into compounds they can filter out e.g. Urea), and others go the other way and the kidneys pass them back into the blood (unless you have a problem like diabetes or a kidney disease, normal sugar).

So in theory you could claim a false positive because your kidneys were doing the wrong thing (after two grand tours in a season that might not be too much of a stretch that they might be). But I'd assume WADA/UCI have validated the tests and that SKY have probably exhausted that deffence if they haven't.

Why does it look dodgy?

Because he's tested positive with levels that would imply he took 32 successful puffs (which is difficult in itself) on his inhaler a day.


 
Posted : 13/12/2017 11:16 am
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Given the preventers (ie what asthmatics take daily to try and minimise the use of salbutamol) are cortico steroids, is there a disincentive for athletes to take them?

Yes, I do wonder if Froome has resisted TUEs and cortico-steroids after seeing Wiggo's woes.

Still rules is rules, I'm sure he'll be treated reasonably but if there's no valid excuse I won't cry if he gets a ban. Would certainly shake things up a bit.


 
Posted : 13/12/2017 11:19 am
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The news has come out three months after the test as Team Sky have been trying to explain it so I think it isn't explainable otherwise they wouldn't have released it like this.


 
Posted : 13/12/2017 11:29 am
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Why does it look dodgy?

It looks dodgy because there are better ways to control asthma, and the amount of salbutamol taken is way above the WADA limit.


 
Posted : 13/12/2017 11:42 am
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Clearly what they need to prevent abuse is a gadget that automatically administers drugs when it detects the rider is at risk of death through asphyxiation. Only then can we know for sure they really needed them.


 
Posted : 13/12/2017 12:23 pm
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Salbutamol is renally excreted, but one of the issues is accumulation. Although it only has a relatively short active half-life at the beta adrenergic receptor in the lung, it is eliminated with a half-life of 4-6 hours. If you take it every half-life, then you will see concentrations in blood effectively double. A bit like when you drink more than one unit of alcohol per hour 😉

Now the urine bit... Salbutamol can be concentrated in urine. Cyclists have to give a sample immediately after a race - when they are dehydrated. That leads to an over-concentration of salbutamol in urine, and the thresholds take this into account. We were asked to review this issue for WADA a few years ago - it was possible to fail a salbutamol urine test (and test for inactive metabolite) without having taken excessive doses.

Nothing to see here, and back to my day job (Oncology today)

A Clinical Pharmacologist

EDIT: and this publication may be useful in the defence https://www.ncbi.nlm.nih.gov/pubmed/21083771


 
Posted : 13/12/2017 12:36 pm
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The news has come out three months after the test as Team Sky have been trying to explain it so I think it isn't explainable otherwise they wouldn't have released it like this.

They released it because it had been leaked to the Guardian and Le Monde rather than because they'd failed to explain it I think. The process is ongoing. Otherwise he'd have been sanctioned no?


 
Posted : 13/12/2017 12:37 pm
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When I was at school the asthmatic kid was always the last to be picked for playground footie. It's fabulous to see so many pro cycling teams righting that wrong.


 
Posted : 13/12/2017 12:44 pm
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Thanks for that input TiRed, good to have some facts.

@JeroenSwart on Twitter is making some good points on this subject this morning. (I can't get onto twitter on work laptop to copy & paste).


 
Posted : 13/12/2017 12:45 pm
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[quote="molgrips"]Why does it look dodgy?Probably as the vast majority of the people commenting get their "understanding" of the rules from reading the papers. Rather than the rule book.


 
Posted : 13/12/2017 12:46 pm
 scud
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I have low level asthma, i never get attacks as such, and very rarely use inhalers at all in summer months, i only seem to get symptoms when it is cold and when i am going down with something.

The GP states to take 1-2 puffs first thing in morning, then the same in evening, but when i get a thick cold and this goes down on to my chest, then the advice is to up the dose to 7-8 times a day, so could easily be 14-16 puffs a day, even then it doesn't seem to have much effect.

The thing is he would have declared to WADA his condition and the fact that he was Salbutomol, he would of been tested every day as well so to purposefully taken to excess such a simple drug that gives little performance enhancement and for which he knows they would definitely have been testing for as he'd declared would be pretty stupid by anyones standard?


 
Posted : 13/12/2017 12:47 pm
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[quote="scotroutes"]When I was at school the asthmatic kid was always the last to be picked for playground footie.Yeah, it's amazing how they actually manage illnesses these days, rather than assuming it's due to not doing enough exercise.


 
Posted : 13/12/2017 12:48 pm
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Why does it look dodgy?
Because he's tested positive with levels that would imply he took 32 successful puffs (which is difficult in itself) on his inhaler a day.

We were asked to review this issue for WADA a few years ago - it was possible to fail a salbutamol urine test (and test for inactive metabolite) without having taken excessive doses.


 
Posted : 13/12/2017 12:49 pm
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scotroutes » When I was at school the asthmatic kid was always the last to be picked for playground footie.

nah to be fair it was because I was crap.


 
Posted : 13/12/2017 12:54 pm
 Leku
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Because he's tested positive with levels that would imply he took 32 successful puffs (which is difficult in itself) on his inhaler a day.

As an asthma sufferer and if it flares up then 32 puffs in a day would be very easy to do. That's only 2 - 3 puffs an hour for 12 hours.

It's no smoking jiffy bag.


 
Posted : 13/12/2017 1:21 pm
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Probably as the vast majority of the people commenting get their "understanding" of the rules from reading the papers. Rather than the rule book.

I quoted WADA upthread. It's dodgy.


 
Posted : 13/12/2017 1:28 pm
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I'm sure Dave B. will have all the necessary paperwork. Won't he?


 
Posted : 13/12/2017 1:32 pm
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So, is this an actual technical anti-doping violation?

I'd piss myself laughing if it turns out Wiggins gets away with 'legal' doping but Froome gets popped for 'legal' use. 😆

Now, where's that DAF youtube clip of Froome sucking on a respirator then disappearing up the mountain leaving everyone for dead.... DAF is DAF...


 
Posted : 13/12/2017 2:02 pm
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As an asthma sufferer and if it flares up then 32 puffs in a day would be very easy to do. That's only 2 - 3 puffs an hour for 12 hours.

As a fellow sufferer I agree. However if I was that sick I'd barely be able to ride a bike let alone at world class pace.


 
Posted : 13/12/2017 2:14 pm
 nerd
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My thoughts:

Contador was busted because he was using Clen in the off season to control his weight and extracted a blood bag when he thought it was out of his system. When he microdosed the blood bag at the 2010 TdF, he tripped the test for Clen. That's why the amount was so miniscule.

Froome has been busted as he's been using Salbutamol (taken orally) during the off season to control his weight. He has also extracted a blood bag. When he's microdosed the blood after his bad stage 17 performance, the amount of Sal was enough that, when combined with his normal usage of Sal the next day, it tripped the test for excessive Sal.

Contador took the punishment for Clen as it was much less than the punishment for blood manipulation. Froome will probably do the same.

Just a theory. Feel free to demolish it! (and everyone should read "The Secret Race". There's nothing in there that still couldn't be done today.)


 
Posted : 13/12/2017 2:25 pm
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It's in the public interest to know why he doubled the dose during the Vuelta

This is my biggest problem with this story. I thought he has been asked to explain why he had double the permitted amount in his urine. This has been twisted into he has taken double the amount allowed. Two very different things.


 
Posted : 13/12/2017 2:26 pm
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As an asthma sufferer and if it flares up then 32 puffs in a day would be very easy to do.

Surely you should be looking at a better control drug, rather than being reliant of using subutamol to relieve the symptoms.


 
Posted : 13/12/2017 2:39 pm
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Froome has been busted as he's been using Salbutamol (taken orally) during the off season to control his weight. He has also extracted a blood bag. When he's microdosed the blood after his bad stage 17 performance, the amount of Sal was enough that, when combined with his normal usage of Sal the next day, it tripped the test for excessive Sal.

It's not impossible. Except he was tested pretty much every day, so I'd want to see the inter-occasional variability in his urine tests during the race, along with his previous Tour tests. As I said, it is possible to fail a test by taking the legal dose.


 
Posted : 13/12/2017 4:02 pm
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I am just dipping into this thread having read as much of the coverage as I could, and I agree with you TiRed. I am no chemist, but it does seem entirely possible that Froome's results are a result of taking the legal dose.

I am inclined to accept his own suggestion that, as someone under scrutiny and subject to testing every day he was in the red jersey, there is no way he would be so stupid as to deliberately exceed what was permitted.

In any case, I am afraid that, after Lance Armstrong's industrial-strength doping - it is hard to convince me that something like salbutamol is all that scandalous.


 
Posted : 13/12/2017 4:27 pm
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From that +4.1% [u]maximal[/u] power link - sounds more like a sprinter's drug, doesn't it

Interestingly, the provision of salbutamol did not have an effect on maximal voluntary contractile force (MVC), exercise performance at 110% of VO2max or isometric endurance (all could have been accomplished by adding caffeine, though

I think maybe TiRed's explanation is favourite over nerd's but a quick look at st7 reports suggests that Froome finished in the sky-driven peloton on a blustery day when a bit of rain fell. Can't see a temperature figure but no mention of "blistering heat" etc. Seems unlikely that he was unable to hydrate properly.

They'd better have some good science 😕


 
Posted : 13/12/2017 4:38 pm
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They'd better have some good science

Well if it's possible to fail a test by taking the legal dose then surely the only conclusion you can draw from that is that the test is not fit for purpose. It looks like maybe the testing authorities are the ones needing some better science.


 
Posted : 13/12/2017 4:49 pm
 MSP
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It may be possible, but it isn't probable, however the rider/team are given a chance to argue their case before the authorities decide.


 
Posted : 13/12/2017 4:52 pm
 poah
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atlaz - Member

There's a scientific paper to read but I can't be arsed paying for it. The conclusion though:

here you go

http://docdro.id/tDg9zwe


 
Posted : 13/12/2017 4:53 pm
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it is hard to convince me that something like salbutamol is all that scandalous.

If it helps in any way at all and gives advantage over those not using it then it needs an element of control - How many riders suffer from asthma, is it more than the general population and is that suspect ?


 
Posted : 13/12/2017 5:03 pm
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Well if it's possible to fail a test by taking the legal dose then surely the only conclusion you can draw from that is that the test is not fit for purpose. It looks like maybe the testing authorities are the ones needing some better science
Trouble is the presumption of guilt unless they can demonstrate how it happened - and presumably how it hadn't happened on other days to the satisfaction of the authorities' scientists/docs


 
Posted : 13/12/2017 5:08 pm
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