Last night I did a bit more research into cortisone/glucocorticosteroids testing methods, courtesy of a European correspondent who emailed me a link to the proceedings from the 2005 Cologne anti-doping conference. In a long list of articles, I found three that reference various methods used to detect the presence of glucocorticosteroids at different WADA-accredited labs. (One by A. Gotzmann, M. Thevis, M. Bredehöft, W. Schänzer of the Cologne anti-doping lab; another by C. Goebel, G.J Trout, R. Kazlauskas of the Australian anti-doping lab; and a third article by E. Palonek, F. Österwall, M. Garle of the Swedish anti-doping lab.) Each article is about 10 pages long, and each discusses a particular method developed at a given lab for the detection of glucocorticosteroids.
One particular item of interest in the articles (in addition to the novel ways for detecting glucocorticosteroids) was a bit of history. It turns out that glucocorticosteroids were added to WADA’s list of banned substances starting in 2004. So WADA-accredited labs, while they may have been testing for this class of drugs before then, weren’t under any WADA requirements to report their findings as doping violations. Whether various athletic federations had different rules regarding such findings is another matter, however.
As Art pointed out in a comment to the previous post, the UCI banned corticosteroids in 1999. During Lance Armstrong’s first successful Tour campaign, the future seven-time TdF champion ran afoul of the UCI’s ban — sort of. On July 19, 1999, L’Equipe reported that a source within the French anti-doping lab claimed that Armstrong and several other riders had provided urine samples that showed traces of corticosteroids. After the predictable firestorm of controversy erupted, Armstrong said he had a doctor’s prescription for Cemalyt, a topical ointment he was using to treat saddle sores. The UCI backed Armstrong’s claims and stated that because of the small amount found, along with the doctor’s prescription, they did not consider Armstrong’s results to be a “positive” test.
What can we glean from the knowledge that the UCI had banned corticosteroids in 1999, and that it appears WADA didn’t follow suit until 2004? First, we need to remember that WADA only came into existence at the very end of 1999, so they would not have been in a position to issue a banned substances list with any effect before the beginning of the year 2000. But why would it be four years before they issued a list specifically banning glucocorticosteroids? It’s not as if the drugs hadn’t been around and hadn’t been used for doping before then.
One thing we can glean from the UCI’s ruling on Armstrong (and the other riders) is that the governing body seems willing to recognize that in small concentrations, from use in topical ointments or patches or such things, these drugs have no performance-enhancing effect. Initially, WADA required a TUE for topical ointments and patches, but even they thought better of it starting with the 2005 banned substances list, relaxing their rules to allow the use of such medications without a TUE. Again, that implies there is a threshold below which the agency is willing to concede that no performance-enhancing effect occurs.
That being the case, such drugs do not fall into the same class as amphetamines, where even the tiniest amount in one’s system is a doping violation. Just ask Alain Baxter, the British skier who lost his bronze medal at the 2002 Olympics in Salt Lake City. He used a Vicks inhaler that contained trace amounts of an isomer of methylamphetamine. (Baxter didn’t realize the inhaler contained a banned substance, as the same inhaler in the UK does not.) Again, the inhaler didn’t contain methylamphetamine, but a compound with the same chemical formula as meth. The two compounds are structurally different. The isomer is not known to have the same degree of effect as meth, if it has a stimulant effect at all. But they metabolize very similarly, which means a test that looks for the metabolites of meth will likely find the same things as metabolites of its isomeric cousin.
Since there must be some threshold for glucocorticosteroids, above which there is a doping violation and below which there isn’t, it would stand to reason that a standard would exist that says “the threshold value is X.” Well, from all I’ve found so far, there isn’t. Each one of those papers talks about how to detect glucocorticosteroid use, but none of them defines a standard that says, “above this is a positive test.” Perhaps with some additional research, such a standard may be found, but if it exists it is certainly not easy to locate.
This leaves the anti-doping labs in an interesting quandary. These drugs are banned, but it’s not so absolute as to say any presence is a violation. So the labs are left to figure out not only how to detect the drugs in a cost-effective way, but also what constitutes a violation. We know from WADA’s Technical Document TD2004MRPL that the agency requires their accredited labs be able to detect a concentration of 30 ng/ml of glucocorticosteroids. But in the same document, they go out of their way to note that the performance levels listed are not meant to be taken as values to be used for determining adverse analytical findings.
So, in the absence of any clear-cut standard, each lab is left to fend for itself. For an agency whose mission is to develop reasonably uniform practices throughout the anti-doping world, failing to provide some guidance to the labs as to what constitutes a positive (or “non-negative,” to use WADA-speak) result is a serious abdication of their duty. Why? Because the sports world could end up with a situation where one lab would declare a doping violation and another wouldn’t when given the same data from the same person.
Sounds awfully familiar, doesn’t it? Like, say, knowing that Floyd Landis’ results would not have been declared a positive test at UCLA or in Australia, based on the data LNDD provided.
One can make an argument that WADA might wish to steer clear of specifying specific equipment or techniques for the labs to use. Not all labs are equally blessed with the budget to own the latest, greatest, most specialized equipment, or to have the staff who know how to properly use such equipment. (Though, given the nature of the testing and the impact of a wrong result, I would argue that they all should be given the budgets and equipment necessary to do their jobs properly.)
But regardless of that issue, someone has to set some standards. An athlete competing in Australia, Europe, the United States and other parts of the world should be able to rest easy in the knowledge that no matter where he or she goes, the standards for what constitutes a doping violation will be the same. And the labs testing his/her samples will be held to the same standards. And that those labs that violate the standards will suffer consequences up to and including loss of their accreditation.
The job of WADA, whatever it’s other functions may be, is to set those standards. Their mission, they say, is to “harmonise” the practices of the various anti-doping labs. Well, you can’t bloody well harmonise things if you don’t set some clear-cut standards — including the standards related to positive tests for all the various banned substances.
After almost eight years of existence, WADA has not been able to develop a clear set of standards for what a positive test for each banned substance is. When John Fahey steps into the president’s job in a few weeks’ time, he will have his work cut out for him. What the agency needs is not another zealot at the helm, it needs a pragmatic leader who can marshal the forces necessary to turn WADA, and the anti-doping system, into a credible leader in the fight against performance-enhancing drugs.
It’s not about having a system that is all wins and no losses against accused dopers. It’s about having a system where everyone can look at the rules and standards, and we all can easily understand what’s banned, why it’s banned, and what results trigger punishment for doping. When someone goes looking for information on what results lead to a sanction for the use of glucocorticosteroids (or any other banned drug), the documents listing the standards should be easily accessible. Today, many such documents may not even exist. After eight years, this is unconscionable. WADA is failing in their mission. One can only hope that John Fahey will be able to turn things around.
Rant,
you’ve nailed the nail on the head.
The labs need standard equipment and procedures with published limits on criteria for an AAF. In addition, any existing or new test methodology must pass a Gage Capability measurement with a precision to error ratio of 10% or less. If not capabable, the test should be held back until it can be certified as reliable in duplication of results with multiple lab technicians.
We have to do this in industry to get reliable results. We aren’t damaging the careers of hard working athletes. At the minimum, WADA owes these athletes the same high level of chemical testing reliability that medical and industrial labs operate under.
Rubber Side Down
While it certainly is true that not all labs have the same budgetary resources, this should not be an excuse not to develop minimum standards for labs. If these were medical labs, analyzing our body fluids and tissues for possible disease, we would want them to meet certain standards and would not except limited financial resources as an excuse for failure to meet those standards, or for not having standards in the first place. If the East Elbonian lab can’t meet a given standard (assuming such were to exist), tough! You don’t get certified and you don’t get to do testing for WADA, UCI, or any other international sports organization.
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There can be some room in standards to allow for some variation. If both brand A and brand B chromatographs are able to meet standards then there is no reason to specify brand. If test X and test Y both are able to, when properly conducted, produce acceptable results, it can be allowed to the lab’s discretion as to which test to run. But there needs to be standards so that any lab’s work, both in general and as regards to any particular case, can be meaningfully reviewed and definite conclusions can be drawn. What we are seeing in the Landis case is that the WADA standards are so vague that it is very difficult if not impossible to reach a consensus about what the standards are and whether or not LNDD met the standards. It has become a sort of Roshack (sp?) test: depending on your initial belief regarding Landis, you reach your own conclusion. LNDD used its own ideas (or lack thereof) about how to conduct and interpret tests. The hearing panel used its own (including the illustrious Dr. Botre’s) ideas in deciding the case. This is unacceptable.
William, I don’t think this is a question of whether there are standards in place. There ARE standards in place. And it appears that WADA moves forward to add to these standards, like they did with this year’s standards on how to intepret EPO tests.
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But if you leave it to the labs to interpret and implement the standards, you’re going to end up with variation on what is done from lab to lab. Meaning, as we saw in the FL case and as we’re seeing in the Basso case, you might have two labs performing under the standards who could come to different results for the same athlete’s sample. There’s no way around this, unless we impose a uniform system of procedures on every WADA lab.
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Since I’m not a lab guy, I don’t know if it’s possible to set up one set of procedures and require every lab to follow it. However, in the U.S. at least, we’re willing to live with variations between how people are treated in different states (or cities or counties) for the same offense. Is such a state of affairs tolerable in cycling? I’ll leave that question open for the moment.
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William, from my current standpoint, the biggest problem with lack of standards arises when an athlete tries to fight a doping finding. The ISL is available to the athlete, but the lab’s procedures and criteria are not. Unless there’s a change in this state of affairs, athletes should push for more detail in the ISL and less discretion given to the labs … because that’s the only way the athlete will ever understand how his or her case was handled by the lab.
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Rant, I’m feeling humble at the moment, given my public struggles over at TBV trying to figure out the most basic rules governing the FL case. But on this topic of standards, maybe we should note the distinction under the ISL between “Threshold Substances” and “Non-threshold Substances”. A “threshold substance” is a prohibited substance where the detection of an amount in excess of a stated threshold is considered to be an Adverse Analytical Finding. A “non-threshold substance” is a substance where the documentable detection of any amount is considered to be an anti-doping rule violation. There’s a related concept in the ISL called the “Minimum Required Performance Limit” (sometimes abbreviated as MRPL), which is the minimum concentration of a given prohibited substance that a lab is expected to be able to detect.
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So, the first question I’d ask is whether WADA classifies cortisone as a threshold substance or a non-threshold substance. If cortisone is a non-threshold substance, then we’d expect to find a MRPL for cortisone but not a threshold. Then we’d move to the question of whether WADA has improperly categorized cortisone as a non-threshold substance. Since you’ve done the research and I have not, I’ll hold any further discussion here until you’ve had a chance to weigh in.
Larry,
You raise an interesting question about threshold vs. non-threshold substances. By their actions (allowing the use of topical ointments and patches without a TUE), WADA has made cortisone/glucocorticosteroids threshold substances. Which is not to say that’s how they’re listed in WADA’s compilation of banned substances. I’ll double-check which way cortisone and glucocorticosteroids have been classified this evening and report back.
“This is unacceptable.” William, that was beautiful put. “If the East Elbonian lab can’t meet a given standard (assuming such were to exist), tough! You don’t get certified and you don’t get to do testing for WADA, UCI, or any other international sports organization.” – Find fault with that logic? You can’t.
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Not that I’m particularly offended but I once had an East Elbonian girlfriend, sweet woman…
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I find myself amazed by the way you guys think – I think nothing like that – yet – I cannot agree with Larry and William more! I will even admit to finding my brains running out my ears while I was trying to follow what both were saying…but darn it – I do agree with their thinking.
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It is absolutely absurd that such “officiating bodies” are able to get away with creating such an atrocity to antipathies of fair play and fair justice. As more is “revealed ” of the “inner workings of cycling” – we’re finding that it would seem that the basic philosophy of “The End Justifies the Means” – but I think that some of those people setting the “rules” are as dirty if not more then the doping racer-they keep finding.
Interestingly (to me anyway) the 2008 Prohibited Substances list calls glucocorticosteroids out not based on threshold/non-threshold, but based on how they are administered:
“S9. GLUCOCORTICOSTEROIDS
All glucocorticosteroids are prohibited when administered orally, rectally, intravenously or intramuscularly. Their use requires a Therapeutic Use Exemption approval.
Other routes of administration (intraarticular /periarticular/ peritendinous/ epidural/ intradermal injections and inhalation) require an Abbreviated Therapeutic Use Exemption except as noted below.
Topical preparations when used for dermatological (including iontophoresis/phonophoresis), auricular, nasal, ophthalmic, buccal, gingival and perianal disorders are not prohibited and do not require any form of Therapeutic Use Exemption.”
So how the heck does the lab, or WADA, or anyone else decide if there’s a violation or not?
Hi folks – forgive me if this is slightly off topic, but I’m always looking at the bigger picture here. In a perfect world, yes, there should be standards, even international standards (a much harder case to work on) that would cover every base. I would have to defer to my medical friends to know exactly what other medical standards are in world medicine.
What does concern me, however, is that there is an undertone to the messages that I’m not sure has been detected. The reference to East Elbonia (yes, from Dilbert, but still just a bit too colonialst and ‘great white hunter’ for me…) makes me cringe, because many of us know that there are countries worldwide that can barely feed their population, let alone have the funds to maintain a lab up to the nearly unreachable perfect standards that are being asked for. East Elbonia wouldn’t quite be up to western white european standards. I think my concern is that you can use a reference like that without thinking first “hmm… that’s awfully elitist to say, and might give the wrong impression.” My 2 cents.
But to the issue of standards, and creating universal testing standards that could be economically applied, has anyone thought that perhaps the list of banned substances needs to be revisited? IF there is such difficulty in interpreting results, then it may be time to say ‘If there is no standard for testing, then we can’t ban it.’ That strikes me as a far better tack.
The next question is about action. The rules are there, standards are there or not there, but the stage is set. Writing letters to U.S. congressmen and women have proven (from examples I’ve seen) to not be useful. There is no standard forum as yet for free citizens of the world to ‘complain’ about a member of the E.U., and let’s be frank: if one were to go that far, it would probably only be read if it were in reference to issues of far higher importance, such as the transportation of so-called terrorists, or world court criminal trials. Does anyone here have any ideas about how to 1) connect with the correct people to suggest standards that CAN be accurately tested at any lab, or 2) reviewing the criteria for lab accredidation so that it can meet a universal standard? Complaining about the lack of standards is not going to do much of anything. Any ideas about how to actually take it to the stage of action?
Hey cycleT what exactly are you on about? Discussing standards is certainly not an “elitist” pastime. As to arguing against standards being forced on the poor “Elbonian Peoples” as a “reason” to ignore standards – because the Elbonian Peoples live a whole year on what us rich capitalists make in a month”¦come off it — “Elbonian” — there is no social, racial, or economic slur there”¦never was.
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People expressing sincere and earnest thinking, attempting to solve a present problem — are not “elitists” for making the attempt, in a public forum. I see their actions as admirable.
Larry (and others):
There are 2 levels of standards, and perhaps we are somewhat talking past each other here.
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It is true that, for example, there are (or have been in the past) different “standards” between the different states in the US regarding certain offenses. DUI springs to mind; different states and at different times have used .12, .10. and now .08 blood alcohol level as the standard. But at least each state had a standard. You could look it up, and if accused of DUI, you could know what the level needed for a conviction was. But what I am seeing in the Landis case and some others is that there is no fixed standards, but rather ad hoc standards cobbled up during the course of any particular case to fit the circumstances.
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If France decided that a 4/1 T/E ratio was enough and only one metabolite was necessary, but Australia went with 6/1 level and required 3 metabolites; with these standards being published for all to see, I could live with that. Any rider would know what was what before hand, and if accused could evaluate the lab findings to determine if there was a basis to contest the findings. The same thing should apply to the SOPs, equipment, etc. standards for a lab. A lab should be able to say “Here’s our SOP for how we conduct this test, here’s the documentation of how this particular instance of the test was done, showing that it conforms to our standards, and here is our analysis.” But LNDD is in effect saying “Well, we sort of did it like this, as best we recall, trust us.”
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It’s rather like trying to nail jello to a wall trying to figure out just what happened, whether or not that was a violation, if it was a violation who has the burden to show what else, what does the data that LNDD produced at the hearing actually show, etc. Imagine you were defending someone for DUI. The cop says “I had the suspect blow into this thing, and it looked like he was over the limit.” The state DUI law says that standards should be developed, but does specify a blood alcohol limit. The judge says “yeah, the police did sloppy work and if they do this in the future someone might get off, but I think [after having talked to someone who wasn’t a witness] that all this is good enough.”
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WADA has one stated mission (among others) of harmonizing anti-doping efforts across international borders, but it is falling down there. Our US states can a do have some different laws, but they all have to operate under the standards set by the US Constitution.
William, couldn’t agree more. “Nailing Jello to a wall.” I think that’s the best sum-up I’ve seen to date describing the task facing an athlete in a doping case.
Morgan – you completely lost the point of my post (there were 2 points, actually) – first, I thought the reference to East Elbonia was just silly, and I didn’t like the connotation from it. I never once suggested that a lab that can’t be accredited should somehow be allowed to be accredited (show me where I said that, because I can’t see it…?) – My second point was about ACTION, and what can be done to help create standards and any lab can follow… Why jump on me prematurely before reading my entire post? Weird…
RobW,
Interestingly, at the end of the Prohibited List is a section on “Specified Substances” which also lists glucocorticosteroids. And in that section they note the possibility of unintentional use of the medications and that some violations could be subject to reduced sanctions.
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Larry,
Glucocorticosteroids are intended to be threshold substances, according to a discussion at the meeting in 2004. From the minutes of that meeting:
I have yet to find out whether the reporting threshold has ever been established, and what it might be. But these meeting minutes give us a glimpse into the intentions of those who create and add to WADA’s Prohibited List.
cycleT,
Finding an effective way to foment change is the challenge, to be sure. As much as we might be able to do (assuming we reach the right people), it would be much better if the pro cyclists band together to form a union that can fight for their rights. The best hope, from where I’m seeing it today, is if the riders have a strong and united voice advocating change. Especially if the demands come with the implied threat, “You don’t do what we want, we won’t ride.” That will hit the organizers, federations, etc. where it hurts — in their pocketbooks. Forums like this one can offer hope to those who would form such a group, in that they would see support from the grassroots.
William,
Excellent analogy. Nailing jello to the wall. Couldn’t have come up with a more apt phrase. Well done.
CycleT:
I have debated whether or not I should respond to you. I have no wish to start a flame war. But I will respond.
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I chose to use East Elbonia, a totally fictitious country from Dilbert comic strip, to avoid any unintended slight to any real national, ethnic, racial, linguistic, religious, or other group. Rant suggested above that one reason there might not be standards is some labs might not have the financial resources to meet those standards. My point is that should not be a reason to not have standards. I am sorry that you took offense by the remark.
Rant, from the prohibited substance list, it looks for the moment like cortisone is a non-threshold substance:
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S9. GLUCOCORTICOSTEROIDS
All glucocorticosteroids are prohibited when administered orally, rectally,
intravenously or intramuscularly. Their use requires a Therapeutic Use Exemption
approval.
Other routes of administration (intraarticular /periarticular/ peritendinous/
epidural/ intradermal injections and inhalation) require an Abbreviated
Therapeutic Use Exemption except as noted below.
Topical preparations when used for dermatological (including
iontophoresis/phonophoresis), auricular, nasal, ophthalmic, buccal, gingival and
perianal disorders are not prohibited and do not require any form of Therapeutic
Use Exemption.
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But Rant, explain to me how the WADA labs can test urine to see the “route of administration” for a banned substance!
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In any event … from the information you posted, it does not appear that cortisone should be a non-threshold substance.
This has been a weird thread.
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I think that the simple way to change the system is also impossible. The only people in cycling with real power to cause change are the riders. 400 of the top riders in the world refuse to ride any event between Roubaix and the Tour and someone will listen.
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However, due to the frighteningly short life span of a rider (especially a tour rider) there is little chance that they would be willing to toss a season, or even a part of a season in the hopper over this. Listening to the enlightening comments of such riders as Wiggins, Pereiro, Miller, etc. it seems woefully unlikely that they are even educated enough about the topic to make an informed decision regarding justice and fairness. It shocks me to hear them talk of doping and testing in terms less lucid than the casual fan. Most of them work too hard and get paid too little to even put on the appearance of caring.
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Think about this whole blog: months of thoughtful discussion and research by intelligent people who apparently have way too much time on their hands (bored at work? too much rain to ride? can’t sleep?) and only now do we have a decent understanding of what really happened. We still can’t figure out the arcane rules of WADA and the UCI. Standards. Don’t make me cry. The fact that we are still piecing it all together means that the standards don’t exist in anything resembling a codified set of rules. If fairness were even a factor. . .Hah.
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Alas, Floyd is the first Pennsylvania-Dutch martyr (which I believe is only 13-miles from the north-central border of Elbonia). And sadly, I don’t expect his martyrdom to accomplish anything more than Tyler’s did.
Larry,
The verbiage in S9 from the current list is very similar to the verbiage in the 2005 list, which came out of the meeting I referred to in my previous comment. It seems to read the way you suggest, but those minutes show a different side to the story. The intention was for it to be a threshold substance. And clearly, by allowing the use of topical treatments, the agency suggests that minimal levels of glucocorticosteroids won’t result in an adverse finding, which also suggests a threshold. Ultimately, because no clear-cut technical document exists, the whole issue is as clear as mud.
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As for “route of administration,” I can’t imagine how they’re going to glean that bit of information out of a urine test. Unless there are different metabolites depending on how the drug gets into one’s body.
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Michael,
Point taken about the amount of time I put into this thing. Let’s just say I’m not as fit as I once was. 😉 You’re right, the fact that it’s taken so long and we still haven’t pieced everything together does mean that standards aren’t up to … well … standards.
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I only hope that Floyd’s approach has made more people aware of what’s going on, and in some way will contribute to change. But it’s easy to make the case that his approach may not accomplish much more that Tyler Hamilton’s appeal. It would be sad if that’s the ultimate epitaph for his case.
Floyds’ approach — his case — has brought to light that cycling as it is run today is being manipulated by the powers that be — there is a question — “Are they doing it intentionally or are they simply inapt?” — Some feel that they are a bunch of bozos running about doing things without thinking. Others feel that there is intent behind their actions. Without the “public spot light” that Floyd gave us in approaching his own case, none of us would be wiser as to what the state of cycling actually is.
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I for one am very grateful that there are people with “too much time on their hands” who are willing to put their minds to work to do something about the apparent mess that is the cycling governing bodies. Or do people actually believe that the “mess” will clear itself up all by itself?
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Yes — months and months of people investing their time and interest has shown that “standards” as they are in cycling — don’t exist in a fair and codified manner. All the people involved in this and other blogs, TBV for instance — are managing not only to point out the situation but have come up with logical and fair solutions — something that the cycling governing bodies seem to ignore as necessary.
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As to ACTION, action for its own sake seems to be the philosophy of the controlling powers in cycling — they act apparently without doing much thinking. It may not appear as action to some people — but meticulous identification of a “problem” is the first step. Coming up with logical solutions to accomplish the work is another step to get a “fair system.” THIS IS ACTION with reason behind it.
Hi again Rant!
I totally agree (And have published similarly at my blogs) about WADA’s failure to act.
I am ACCEPTED as a WADA World Conference on Doping in Sport OBSERVER, and will be in Madrid for the three days of the conference.
I am not yet certain if they’ll accept my request to offer an ‘Intervention’ (that’s diplomat-speak, means: ‘Microphone time’).
I intend to have printed, copies of my Questionnaire for WADA Laboratories
( http://crystelzenmud.blogspot.com/2007/09/part-i-questionaire-for-wada.html )
That questionnaire pinpointed the likely Articles that *Should* be, and are not anticipated to be modified, in order to build-up Athlete confidence that harmonization issues are addressed, as well as implementing valid evaluation techniques and a means for IFs to request investigation of an lab gone ‘hors-le-loi’ (FR for “outlaw”; heh heh)
And I invite you, as well as TbV and anyone else, to visit my WADAwatch blog for (if I can find an easy connection!) daily summaries of the conference. http://WADAwatch.blogspot.com
From the other side of the Big Pond,
ZENmud
ZENMud,
Congrats on getting official accreditation. Good to know that someone will be there covering the event. Looking forward to seeing what comes of the Madrid meeting, and what kinds of answers you will get to any questions you’re able to pose to the participants. Keep up the good work over at WADAwatch and crystelzenmud.
Rant, are you looking more into how cortisone/cortisol metabolizes and whether one of the metabolites could elute at the same time as the 5A of testosterone?
One problem with the cortisone theory has always been the timing of the injections and the tests. Intuitively, it makes sense to think that the metabolites of cortisone would generally come out in urine in a pattern something like a bell curve over the following few days. If that is true (and it may well not be, as I said it just sort of makes sense), then that pattern does not match with the up and down non-pattern of Floyd’s tests over the days of the Tour. (There was some long thread at DPF about this question months ago.)
For the cortisone theory to work, based on the possible days of administration, and the pattern of Floyd’s results as shown in the B-sample tests, the metabolites of cortisone would have to be excreted in an odd, uneven pattern. It could be, but it is one thing that has to be worked out.
Peace
It was the “What the case is really boiling down to, science only” DPF thread. I’m not sure we got too far with it, as nobody seems to know much about how cortisone really metabolizes. Maybe some of you Rantheads can help?
Michael:
My excuse is that I’m retired!
Swim,
I’ll be looking into that. What I find most interesting is something that Duckstrap pointed out last March, and quoted at TBV, regarding the CIR value for cortisone or a metabolite of cortisone and the one extremely negative reading in Floyd’s CIR (both being the same value before LNDD “corrected” the data).
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Lots of issues to look into. One thing I can tell you is that depending on the drug and how it’s administered, cortisone can have a very long half-life, which means it can be around in small amounts (perhaps even detectable) for a very long time. And one source tells me that the metabolites that would be found could vary, depending on the way the drug is administered, too. So it’s going to be rather complicated, assuming that I can track all this down.
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Given the different conditions between the GC/MS and GC/IRMS, it may even be possible that it was cortisone that was detected, and not synthetic testosterone. But there’s a lot of steps between suspecting that’s the case and being able to prove it. And I’m not sure, given that the raw data was manipulated, erased, and what have you, that we’ll ever be able to track down such possibilities completely.
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Most likely, the metabolites come out in larger quantities at first, and decrease as the amount of cortisone in the system decreases. But that’s also something to keep an eye out for.
William, Morgan – No worries, and no flames here! I understand your reference better now, and understand what your point was. There are just some times when I think a point of reference can occasionally irk me, and I just felt the need to speak about that one. But I appreciate your sincerety, no problem.
Rant, I agree that a grassroots discussion online is one of a few ways that a message can go out. How it will help to reshape dialogue on a bigger scale, I guess that’s what will be found out in subsequent months/years. As much as I remain on the fence on the Landis issue, I am more and more convinced that the lack of standards (particularly relating to your above article) is so strangely antiquated and unscientific. I still believe that any substances that cannot be traced within a universally reasonable method of interpretation cannot be a banned substance. I believe that this may be a starting point for a cyclists’ union.
From Cycling News:
Lab director alleges blood doping at Tour
The director of the WADA-accredited Swiss Laboratory for Analysis of Doping in Lausanne, Switzerland, has told Belgian newspaper Het Laatste Nieuws that he believed there was still widespread doping in the Tour de France this year. “47 out of 189 riders raced on blood transfusions or EPO,” Martial Saugy alleged. “We have been able to show this from the samples taken at the health controls.”
Still, Saugy added that these test results did not fulfil the requirements to be declared as ‘positive’. “It is appalling, but we find so many test results that undoubtedly point to manipulation,” he continued. “But there is a big difference between a suspicious sample and one that can be declared positive.”
Saugy also found indications for the use of testosterone and growth hormone. “Especially the latter product is very popular at the moment,” he added. “As soon as there will be a water-proof test for growth hormone, it will show that 80 percent [of the peloton] is taking it. I am disillusioned: the use of growth hormone is as bad as was the use of EPO and blood doping in the 90’s.”
FREE FLOYD!
Sorry guys if I offended anyone. My point was, we have spent a lot of our personal time (or perhaps our employer’s time?) trying to figure out what happened to Floyd. It is very unlikely that the people most effected, the riders, have spent as much time.
And MORE!!!
Hingis Retires After Drug-Use Report
By THE ASSOCIATED PRESS
ZURICH, Switzerland (AP) — Martina Hingis said Thursday she has been accused of testing positive for cocaine at Wimbledon, but she denied using the drug. She also announced her retirement from professional tennis.
”I find this accusation so horrendous, so monstrous that I’ve decided to confront it head on by talking to the press,” she said. ”I am frustrated and angry. I believe that I am absolutely 100 percent innocent.”
The 27-year-old Swiss player lost in the third round at Wimbledon to Laura Granville, 6-4, 6-2.
Hingis returned to the sport two years ago after a four-year absence because of injuries.
She won three straight Australian Open titles from 1997-99, and Wimbledon and the U.S. Open championships in 1997.
Hingis, who lost in the third round of the U.S. Open, hasn’t played since her second-round loss to Peng Shuai of China, 7-5, 6-1, in Beijing on Sept. 19.
Hingis said she was accused by ”an outsource testing company” of taking cocaine during Wimbledon. She said she was ”shocked and appalled” when notified that her urine sample came back positive after the loss to Granville.
”They say that cocaine increases self-confidence and creates a type of euphoria,” she said in a statement. ”I don’t know. I only know that if I were to try to hit the ball while in any state of euphoria, it simply wouldn’t work.
”I would think that it would be impossible for anyone to maintain the coordination required to play top class tennis while under the influence of drugs. And I know one other thing — I would personally be terrified of taking drugs.”
Hingis said she later underwent a privately arranged hair test which came back negative for cocaine. The official backup ”B” sample test on her Wimbledon urine sample, however, tested positive for the drug.
Hingis said she hired an attorney who found ”various inconsistencies” with the urine sample taken during Wimbledon.
”He is also convinced that the doping officials mishandled the process and would not be able to prove that the urine that was tested for cocaine actually came from me,” she said.
Hingis said it could take years to fight her case and decided it was time to retire.
”I have no desire to spend the next several years of my life reduced to fighting against the doping officials,” she said. ”The fact is that it is more and more difficult for me, physically, to keep playing at the top of the game.
”And frankly, accusations such as these don’t exactly provide me with motivation to even make another attempt to do so.”
WTA Tour chief executive Larry Scott said the tour had not received any official information about a positive test and ”as a result we are not in a position to comment on the matter.”
”However, it is important to remember that in the area of anti-doping, all players are presumed innocent until proven otherwise,” Scott said.
Referring to her retirement, he said, ”Martina Hingis is a tremendous champion and a fan favorite the world over. In her most recent comeback, she proved again that she can perform at the very highest levels of the game.”
Props to Rant, Larry, William, and Mr. Idiot for continuing the science discussion. Larry, in particular, your posts here and at TBV have been brilliant and insightful, and allow even a non-science mope such as myself to follow you along the road to discovery of the truth. I continue to be hopeful that detailed analysis and thought will get to the bottom of the FL case. I can only hope that the CAS proceeding will be more productive and fair to Floyd.
“Floyd’s hematocrit was 44 before the start of the 2006 Tour and 48 on the first rest day. That’s very suspicious. His hemoglobin rose as well, from 15.5 to 16.1 (the threshold is 17). This mirrors his unnatural testosterone readings, which started very low-around 10 ng/ml IIRC, and spiked to the mid 40s after stage 17.”
From DPF
http://www.dailypelotonforums.com/main/index.php?showtopic=6055&st=20
Can someone explain this to me in English, arent these values supposed to decrease during a hard race ,or what am I missing here?
Thanks!!
bamalaw, thanks! I’m proud to be a Ranthead and a fellow science mope.
Sara, good question! I saw the discussion you referenced on DPF. I did ask a doctor friend about this, and he said that hematocrit levels could rise during a race as a result of a number of natural factors, including dehydration. From what I’ve read, the natural male hematocrit level is anywhere from 43 to 49, so FL’s levels did not exactly rise off the chart. And I’ve seen nothing to link hematocrit levels to testosterone levels. Finally, at this point there’s no allegation left that FL’s testosterone levels were higher than normal — LNDD’s T/E tests were thrown out by the arbitrators, and his purportedly high T/E ratios were caused by low epitestosterone levels. The accusation against FL at this point rests solely on whether he used testosterone from a creme or other outside source.
Sara,
In addition to what Larry said (dehydration can be a huge factor in one’s hematocrit levels, and as major stage races go on the likelihood of a cyclist becoming more dehydrated rises), there’s the issue of the accuracy of the tests. There’s a plus/minus 5% accuracy to those spot tests done during the tour, which is not close enough to determine anything definitive — even by WADA’s own standards. Much more accurate tests have to be used. And, in addition, 48 is still below the threshold value that triggers a sanction.
…
There’s no correlation between hematocrit and testosterone levels that I’m aware of. What you’re hearing is likely the sound of someone looking for any way he/she can to implicate Floyd as a dirty rider.
WADA needs John Fahey see http://evidencebasedonly.blogspot.com/
He is a good honest man. His background is impeccable.
Diego,
Fahey certainly does sound like a remarkable man. I hope that he will do both WADA and Australia proud. We need a good, honest person running the show, without all the inflammatory rhetoric and zealotry that emanates from certain current leaders.
Rant,
I view Floyd Landis as the Curt Flood challenging the anti-trust situation with MLB in 1970. As we all know, Curt Flood never realized the benefits of his fight against an unfair baseball “slave” system but now baseball players make more in one season than the 1970 players made in a lifetime of play. While we would all hope that Floyd will regain his TdF win have his good name restored, it is more likely that his fight will only help future cyclists and other elite athletes in competing on a much more level doping playing field. Floyd will never get the respect for the greatest comeback in Tour history, his prize money and the endorsements that he so richly deserved. No matter how many judgements he might get from ASO or WADA, he will probably never recoup one red cent of what he rightly earned. Just like Curt Flood.
Cheers
RSD,
You could well be right. If Floyd does turn out to be the Curt Flood of cycling, at least some good will come out of his predicament. Whatever happens with the CAS, even if they exonerate him, the damage to Floyd’s reputation may never fully be undone. And the financial rewards he should have reaped for winning the Tour may never come his way … unless he wins the Tour again. But the cynic in me suspects that the ASO will use every trick possible to keep him from entering the Tour in the future.