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Chris Froome returns adverse analytical finding for Salbutamol


Andrew Steer

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Clearly they have not used salbutamol in high enough doses to see an anabolic effect.... you will have heart palpitations and assorted nervous system side effects LONG before you get to those doses - and I would venture to say that you would not voluntarily maintain a regime long enough to see any effect....

 

Kind of like a caffeine overdose on steroids - nobody will maintain those levels for long - it's really unpleasant - even for an asthmatic mid asthma attack they generally don't like therapeutic doses effects.... and those are far below the doses "thought" to create an anabolic effect.

 

The science is pretty clear that performance during exercise is only maintained for asthmatics by salbutamol (not increased above what they have normally outside bronchospasm) - and there are downsides to it's use - increased heart rates even at rest, and associated side effects.

 

I feel for Chris - the clearance of salbutamol from the body is very variable - so it's completely possible he stayed within the legal dose limits, but his urinary metabolite levels are too high - and it going to be VERY difficult to replicate the physiological and environmental conditions exactly to do a proper controlled test - next best thing to impossible, although they may get lucky - but my guess is they will try all other routes possible first to get around it.

Great post. Be interesting to see how the armchair experts respond

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Would he not have tested above the limit before if there was a metabolic issue.. as far as we know he hasn't been on the naughty chair before..or is that something that can vary from day to day?

 

There is talk that using it in either nebulizer or pill form would also result in high numbers..but of course they say it would be much higher...I suppose depending on when it was taken?

 

A few days ago they said he had taken 3 puffs after the stage but before the press conference to appear healthy...would that result in a high reading?

 

 

 

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I don't think we really know (beyond any shadow of a doubt) everything that influences salbutamol clearance - but he was tested every day and didn't show abnormal levels - it's just the one day he showed very very high levels - levels that assuming he has not taken oral salbutabol (and he is not stupid enough to do this) you wouldn't normally see - BUT and its a huge BUT.... dehydration - even at low levels - seems to have an affect on clearance - and the single study I have seen shows that big variability in excretion is probable - much more than in sedentary subjects where dehydration and excercise are not a major factor.

 

Salbutamol has a very quick effect on bronchospasm - so asthmatics feel improvements within 30 seconds after taking a puff - so after 3 puffs and 5 minutes wait/rest, someone would appear fairly normal - what is an indication of issues during some of the interviews is you can hear the wheezing and coughing  - these generally subside within around 30 minutes post treatment for EIA sufferers like Chris (and there is NO MEDICAL DOUBT that he suffers from EIA - this is really quite easy to test for in a proper respiratory lab - and he has been tested properly for sure - a competent pulmonologist can identify EIA sufferers from their test results even when they are not suffering from bronchospasm at the time of the test) and field tests (much cheaper) are also pretty easy - I have posted about how to do a simple field test before here if one thinks one suffers from EIA.

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If his treatment is to the disadvantage of other competitors, then he should give up cycling, to avoid an unfair situation.

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A response from someone that actually studied medicine :)

I also suffer from Exercise Induced Asthma.... and treat it with amongst other things salbutamol... and if I could get it in SA, I would have a go at Kenalog too.... (Bradley Wiggens TUE drug for Asthma)

 

While respiratory medicine is not my normal field - I have a huge personal interest in it.

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Great post. Be interesting to see how the armchair experts respond

I am happy to run a controlled study on any armchair expert for them to experience Salbutamol use at the max legal dose limits - they are not going to enjoy that experience at all.

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I don't think we really know (beyond any shadow of a doubt) everything that influences salbutamol clearance - but he was tested every day and didn't show abnormal levels - it's just the one day he showed very very high levels - levels that assuming he has not taken oral salbutabol (and he is not stupid enough to do this) you wouldn't normally see - BUT and its a huge BUT.... dehydration - even at low levels - seems to have an affect on clearance - and the single study I have seen shows that big variability in excretion is probable - much more than in sedentary subjects where dehydration and excercise are not a major factor.

 

Salbutamol has a very quick effect on bronchospasm - so asthmatics feel improvements within 30 seconds after taking a puff - so after 3 puffs and 5 minutes wait/rest, someone would appear fairly normal - what is an indication of issues during some of the interviews is you can hear the wheezing and coughing - these generally subside within around 30 minutes post treatment for EIA sufferers like Chris (and there is NO MEDICAL DOUBT that he suffers from EIA - this is really quite easy to test for in a proper respiratory lab - and he has been tested properly for sure - a competent pulmonologist can identify EIA sufferers from their test results even when they are not suffering from bronchospasm at the time of the test) and field tests (much cheaper) are also pretty easy - I have posted about how to do a simple field test before here if one thinks one suffers from EIA.

I understand that the tests with dehydration was the reason that WADA made changes to the limits a few years ago because of all the variables.

 

One thing is sure.. it's really a very complicated issue .. the WADA guy said the difficulty is that they have no scientific way of determining what method was used to administer the substance or how much was administered..

 

Are they able to test the pee to see if dehydration was a contributing factor.

 

For the sake of the sport it would be really good for them to be able to prove that there was no funny business going on.

 

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If his treatment is to the disadvantage of other competitors, then he should give up cycling, to avoid an unfair situation.

This is at best uninformed on the physiology of EIA and it's treatment.

 

There is no known performance advantage to a normal person for salbutamol use, and there are in fact some downsides - so if you don't suffer from Asthma you get no benefit.

 

And if you do suffer from EIA - then all it does is reduce the restriction of the airways - it does NOT open them up more than they are normally, and it does come with downsides to performance - heart rates get elevated, you feel shakey and a bunch of others.

 

What also is a fact is that EIA sufferers also have their recovery impacted - possibly significantly - because their O2 sats at rest are often far below normal levels - and that's not good for recovery at all - tissues don't recover as fast, heart has to work harder to compensate - etc etc.

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Are they able to test the pee to see if dehydration was a contributing factor.

 

 

Not with any accuracy at all.

 

Kidney function is very complex - its nearly a miracle it works as well as it does - but it is such a finely balanced chemical process, it's easily impacted by just about anything.

 

You have been around a while - you know how I rant on about NSAIDS usage impact on kidney function during excercise... :)

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From personal experience:

A few years ago during the Cape pioneer trek my lungs closed up after riding in sleet and driving winds. I had to go for inhalations. Also the next morning before the ride.

I subsequently nearly died on that day. 

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From the Cyclingtips article:

Using the level of salbutamol that seems to have been used here was either a very severe attack after the stage before the doping control, or just using unhealthy doses to try to push things to the limit.

 

If he took some puffs afterwards (but before the test) which pushed him over the limit -  or not realistically an option? 

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From personal experience:

A few years ago during the Cape pioneer trek my lungs closed up after riding in sleet and driving winds. I had to go for inhalations. Also the next morning before the ride.

I subsequently nearly died on that day. 

High volumes of cold dry air are an EIA sufferers worst nightmare... it's one of the primary instigators of symptoms.... and once you have symptoms you are in trouble - this is why most EIA sufferers use salbutamol prophylactically about 10 - 15 minutes before starting exercise.

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High volumes of cold dry air are an EIA sufferers worst nightmare... it's one of the primary instigators of symptoms.... and once you have symptoms you are in trouble - this is why most EIA sufferers use salbutamol prophylactically about 10 - 15 minutes before starting exercise.

I did the morning before the ride. And still nearly ended up bottoms up. Not in a cheerful way. We did not win the stage. Like Froome. The next day I was totally useless. Seretide 500 of te not.

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I am happy to run a controlled study on any armchair expert for them to experience Salbutamol use at the max legal dose limits - they are not going to enjoy that experience at all.

But that would be an inhaled dose; would an oral dose not be tolerated much better? Clen was hugely popular (still is amongst bodybuilders and figure athletes and they go up to around 200mcg daily) for its fat loss and muscle retention properties whilst dieting, and side effects aren't that severe especially after a week or two of use.
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