I don’t understand – salbutomol, according to reports I’ve read, offers no enhancement to performance, requires no TUE to use and is not even illegal to use in competition.

So why does WADA put a limit on the doesage you can receive; what purpose does that limit serve?

Covering up other things? That’s one possible reason for banning/limiting stuff that is not intrinsically performance enhancing. But perhaps more likely in this case, to limit self-harm of the athletes who may be over-using to cope with serious health problems.

My understanding is to effectively allow the use of inhalers which provide a small dose of the stuff, vs. oral and IV use of the stuff where much larger doses that could have an effect on performance. You don’t want to ban people with Asthma from competing and if you do suffer from Asthma using an inhaler will not give you a performance edge, rather just treat the symptoms of your condition and stop you from dying.

The limit is 1000 NANO grams, which is a tiny amount. They’ve got to set a limit, and what limit they set I assume is subject to making some assumptions about what normal use of Salbutomol is for a typical Asthma sufferer. Not sure how they do that as the amount needed varies, I know from experience (not asthma but dust allergy for which I use Salbutomol – sometimes a couple of puffs will do, other times might require a few more), but they have to set a limit somehow to protect over those looking to abuse it via oral and IV uses.

Doesn’t it increase your lung capacity by a percentage ? Which makes it easier to breath.

I’d read that used in sufficient quantities, it could act as a weight loss drug? Similar to clenbuterol or whatever Contador was accused of abusing.

So the reason Froome was thrown under the spotlight was because he showed a level in his bloodstream that *might* indicate abuse for weight control, although I think this possibility was easily dismissed as his levels the day before/after were normal.

I only read about three articles on it before getting bored, so all that ^ could be hugely inaccurate 8)

Doesn’t it increase your lung capacity by a percentage ? Which makes it easier to breath.

No, it relaxes the muscles in your lungs which constrict when you get an asthma or allergic reaction. The concern over its possible performance enhancing properties is that it is a steroid. But I think you’d have to be hammering the inhaler constantly to get enough of the stuff in your system to use an inhaler as a way to deliver it for performance enhancing purposes.

If you have no symptoms of anything and use it, it doesn’t really have any affect at all, which is why doctors like to give out salbutamol inhalers like sweeties every time someone goes to them with breathing difficulties – if might treat their symptoms, if not then it has no other ill effects.

No, it relaxes the muscles in your lungs which constrict when you get an asthma or allergic reaction

It actually relaxes your airways not the lungs themselves.
But if you don’t have asthma it wont make them bigger.

I think the restriction maybe due to the worry that some inhalers contain steroids – while that is true they are not anabolic performance enhancing steroids and Salbutamol does not contain any steroids whatsoever.

At my last lung function test at work (which I have annually for soldering) I just barely passed despite almost blacking out. apparently I have the peak flow of a seventy year old despite being only 30 – and that was after using my inhaler.

Anyone who suffers from Asthma symptoms of any type and can compete at all demands serious respect in my opinion.

I think the restriction maybe due to the worry that some inhalers contain steroids – while that is true they are not anabolic performance enhancing steroids and Salbutamol does not contain any steroids whatsoever.

So the worry is unfounded then.

I’ve also only read a few articles on the (Froome) issue and noted the conclusions in all of them that Salbutomol offers no performance enhancement of any kind at any doesage when inhaled. It ‘might’ offer something if ingested in a large enough quantity orally but it also comes with serious performance limiting side effects of palpitations.

I just don’t understand why if all that really is true, what the restriction on doesage actually achieves (and nothing suggested here so far really answers that).

I thought i read somewhere about it being a masking agent if used in high enough doses.

I just don’t understand why if all that really is true, what the restriction on doesage actually achieves (and nothing suggested here so far really answers that).

I guess if the benefits are somewhat unknown, if they exist at all, then they set a limit at a high therapeutic dosage. When someone seriously exceeds that dosage then there are some questions to be answered, whether the drug itself is considered beneficial or not.

Like clenbuterol, it is used to lose weight. People keep confusing the fact that it may not directly boost performance, but it can improve the overall performance package by other means.

It is the same as thinking steroids etc are an easy path, they are not they allow you to train more and harder than anyone else, because they improve recovery, without the extra training they do nothing.

I just don’t understand why if all that really is true, what the restriction on doesage actually achieves (and nothing suggested here so far really answers that).

This article suggests that the reason is primarily to prevent athletes from exceeding clinical recommendations and potentially suffering from unpleasant side-effects as a result:

‘This is most likely the reason why WADA set an upper limit for the drug, to discourage dangerous dosage and poor control of the condition rather than performance enhancements. ‘

Also, most Adverse Analytical Findings don’t get leaked to the media, so we only know know about cyclists who haven’t been able to explain the AAF. I’ve seen it suggested that in 2016, according to WADA figures, there were more than 200 AAFs.

Fwiw, the Guardian who broke the story did a web Q&A thing on their site and didn’t really have a clear answer as to why, given that there don’t seem to be any performance-enhancing benefits that would be relevant to Froome at that stage in a tour and given that he knew that he’d almost certainly be tested, why would he take a huge dose of the stuff at that point?

Their reply was pretty much that this was why it was so interesting, but they didn’t really have a cogent answer except that it was hard to explain logically.

That’s the same as Contador getting busted for clenbuterol, and why I see such parallels in both cases. The amount he had in his blood could only come from either microdosing (and microdosing clenbuterol has no effect they need a much higher quantity to be effective) or he did indeed get it from tainted supplements or meat like he claimed.

Salbumatol isn’t a steroid. It’s a beta agonist like clenbuterol. When used in supratherapeutic doses it can increase your aerobic capacity and so reduce muscle fatigue (e.g. https://www.ncbi.nlm.nih.gov/m/pubmed/23559124/ ). It needs to be available to use to allow genuinely asthmatic athletes to compete but the acceptable blood level is supposed to correlate to what you would see with “legitimate” use (no idea if it actually does).

(Guardian point ^^ )

Which pretty much leaves the possibility it was an accident or a double bluff to cover some other magic drug that would have disappeared without trace from his system the next day.

Don’t know how possible that is. Bored by whole topic, it’s hardly epic systematic abuse of the sort we’ve been seeing, now, is it?

I thought i read somewhere about it being a masking agent if used in high enough doses.

I read that it’s a masking agents for thyroid treatment. And that the thyroid medicines are what riders are using to get large weight loss with no performance loss. But I’ve no idea where I read it as I was jumping from one link to another. I think it may have been something to do with weightlifters experimenting with odd drugs, and the cycling dopers keeping an eye open for interesting anecdotal results.

Bored by whole topic, it’s hardly epic systematic abuse of the sort we’ve been seeing, now, is it?

I think the point is that nobody knows whether it is related to widespread systematic abuse or not because nobody really knows why he was busted for it. My feeling is that it shows that something is going on which the media haven’t caught up with yet.

I don’t see how salbutamol could be used to mask thyroid hormone abuse or other doping, the analysers are pretty good. Also a fairly pointless exercise if you exceed the allowed salbutamol threshold! There’s some speculation that Froome could have been unlucky with his personal pharmacokinetics or e.g more dehydrated than usual. There is a study where some (deliberately) dehydrated cyclists exercising in a lab had salbutamol levels above the cutoff after a normal asthma dose.

The amount he had in his blood could only come from either microdosing (and microdosing clenbuterol has no effect they need a much higher quantity to be effective) or he did indeed get it from tainted supplements or meat like he claimed.

Or… you know, given there were reportedly plasticisers in his blood, he had blood taken after he thought the clenbuterol was out of his system then used the blood on the tour. TBH, the plasticisers are the worrying thing with Contador as they were ruled as outside the case and therefore not discussed in his hearing. Obviously he hit an age peak around then but his performance dropped a lot after the ban so there’s always going to be suspicions unless you’re a fan of his.

There’s some speculation that Froome could have been unlucky with his personal pharmacokinetics or e.g more dehydrated than usual.

That’s why he’s been given time to explain/replicate/whatever. But it sounds like he needed to take such a massive dose plus be so massively dehydrated that he shouldn’t have been anywhere outside intensive therapy.

Also a fairly pointless exercise if you exceed the allowed salbutamol threshold!

Well exactly!

Someting that occured to me this week is: how accurate are inhalers? An inhaler hasn’t changed in any way, shape or form in the 25yrs I’ve been using them. Is a 100ng dose actually accurate? Or is there risk that a puff could be over/under dosing?
Couple of other questions:
1) How and who leaked the AAF?
2) What parameters set the limit (1000/1600?) – this appears to a figure set with no real scientific basis.

The concern over its possible performance enhancing properties is that it is a steroid

No it’s not a steroid. Indeed, some studies are suggesting it reduces the effectiveness of steroids.

As widely reported it does not help non asthma etc. sufferers.

It has a half life of about 6hrs and is then peed out. The effects last about 2-4hrs only.

When used for weight loss (body builders) the effect or length of action is for just 4 hrs. It is something done about 4x per day on the lead up to competition and would serve absolutely no purpose whatsoever to take a massive dose during a competition for this purpose. At this point it’s too late to have any effect. If he has used it for this then it was for weeks before and would now be gone from his body. Also, a top tier pro cyclist mid grand tour would have absolutely no need to think about weight loss.

From personal experience as an asthmatic it makes you shake like a shitting dog and feel panicky and sometime disorientated when taken in large doses (10+ puffs on standard ventolin inhaler).

My opinion is you have to look at Froome throughout his career. You see it regularly in TV; On days of massive effort he can hardly talk straight off the bike. He has a classic asthma cough and sound like he has a very dry throat. Compare him to say Cav’ who sounds like he has a dry mouth.

It’s not inconceivable that he was having a bad asthma day, took his dose but was struggling to breathe and had a bit more an hour or so before the finish. This way he’d still have the 1st dose in his system plus the second… not a massive stretch of the imagination and really not the big deal it’s being made out to be.

For the purists he has an adverse doping result and that’s that, but I think there’s a bigger picture here. I think there’s time that either it’s inclusion on the controlled list or it’s dosing level was reviewed.

Having administered IV and oral salbutamol to patient’s I can guarantee you it makes you incredibly tachycardic, shaky and generally feel like one is having some kind of cardiac event. Hence we only use it in very extreme circumstances. Hard to see that over a 4-6 hour stage this would be beneficial to anyone!

given there were reportedly plasticisers in his blood

Hadn’t seen that (not following it closely tbh) – reportedly with some foundation or speculation reporting?

My feeling is that it shows that something is going on which the media haven’t caught up with yet.

My feeling is that it shows that nothing is going on and the media are making a mountain out of a molehill.

The “plasticisers” comment above needs a source

Googling has produced nothing other than stories about Contador

jameso – Member

given there were reportedly plasticisers in his blood

Hadn’t seen that (not following it closely tbh) – reportedly with some foundation or speculation reporting?[/quote]

ampthill – Member
The “plasticisers” comment above needs a source

Googling has produced nothing other than stories about Contador

Ignore me/it – re-read it as a comment re Contador that got quoted in part and read as re Froome. Did seem a bit out there tbh.

Thanks James I misread it as well

@ndthornton

At my last lung function test at work (which I have annually for soldering) I just barely passed despite almost blacking out. apparently I have the peak flow of a seventy year old despite being only 30 – and that was after using my inhaler.

I hope that you have good extraction at your soldering iron tip.

Rosins in the flux can act as a sensitizer and generate athsmatic conditions.

I want to believe Froome/Sky are clean, and my gut feeling says this is a mix up/screw up but not anything malicious.

However, I would caution those people saying there is ‘no evidence’ of performance benefit because the trial hasn’t been published. Sports medicine is a bit ‘fringe’ as far as medical research goes at the best of times, but more importantly there are vast commercial interests here – I think it’s naive to think that everyone is publishing all their data. We’ve seen in the past with Ferrari et al, the top Doctors’ methods are kept under wraps. Who knows what are the benefits of salbutamol (or any other compound), in a specific sport, at a specific time in training/racing?

See also the Sharapova / Meldonium thing. Meldonium is a pretty niche drug not used in the UK, but available in Eastern Europe. Top athletes are taking all these compounds because they think they help, or more accurately someone thinks Meldonium is useful to athletes, but certainly they haven’t published that data.

Bear in mind that a lot of medical trials look for deltas (in this case performance improvement) of 20% ish. Whereas Sky are looking for the half a percent benefit that puts them above everyone else. It’s a murky world.

I’m looking forward to the UCI retrospectively leaking all the other Adverse Analytical Findings from the past few years, which seems only fair, though not on the riders involved.