Froome Vuelta salbutamol problem

smithy21

phreak wrote:

Why would Froome ride the Giro if he had the Vuelta taken from him? The effect it would have on his Tour is only really sensible if he's going for holding all three. Without the Vuelta that becomes irrelevant so I'd imagine he would skip it and go straight for 5 tour wins.

Maybe he would use the Contador method of counting GT wins.

Pross

redvision wrote:

RichN95 wrote:

Pross wrote:

Reading that UCI summary it stated that sanction starts at a reprimand. Does that ever get used? Even in the cases where there seems to be near universal acceptance that rules were not deliberately broken I can only recall there being bans given out.

In football: http://www.bbc.co.uk/sport/football/36404943

Was lower than froomes level though.

Plus in his hearing the player stated he may have taken 20-25 puffs of his inhaler in the 24hrs prior to the test.

Yet he still had a 20% lower salbutamol level than Froome.

Comparing two different people in two different sports seems pretty pointless when it appears that changes in things such as rate of hydration can impact so much on the urine results though. The amount in doesn't necessarily equate to the amount out.

I'm struggling to see any reason why someone would use salbutamol as a deliberate attempt to cheat and even if you go to the doomsday solution of a blood bag with excess salbutamol in it the timing seems odd so late in the race and surely a team going to those lengths would run tests on the blood to check it's clean?

I can only see two explanations here, Froome either took more puffs than he should have (either accidentally or deliberately as the asthma was unusually bad that day) or the urine results are for some reason unreflective of intake.

daniel_b

phreak wrote:

Why would Froome ride the Giro if he had the Vuelta taken from him? The effect it would have on his Tour is only really sensible if he's going for holding all three. Without the Vuelta that becomes irrelevant so I'd imagine he would skip it and go straight for 5 tour wins.

+1

bobmcstuff

Pross wrote:

redvision wrote:

RichN95 wrote:

Pross wrote:

Reading that UCI summary it stated that sanction starts at a reprimand. Does that ever get used? Even in the cases where there seems to be near universal acceptance that rules were not deliberately broken I can only recall there being bans given out.

In football: http://www.bbc.co.uk/sport/football/36404943

Was lower than froomes level though.

Plus in his hearing the player stated he may have taken 20-25 puffs of his inhaler in the 24hrs prior to the test.

Yet he still had a 20% lower salbutamol level than Froome.

Comparing two different people in two different sports seems pretty pointless when it appears that changes in things such as rate of hydration can impact so much on the urine results though. The amount in doesn't necessarily equate to the amount out.

I'm struggling to see any reason why someone would use salbutamol as a deliberate attempt to cheat and even if you go to the doomsday solution of a blood bag with excess salbutamol in it the timing seems odd so late in the race and surely a team going to those lengths would run tests on the blood to check it's clean?

I can only see two explanations here, Froome either took more puffs than he should have (either accidentally or deliberately as the asthma was unusually bad that day) or the urine results are for some reason unreflective of intake.

I think that's about right, the only real explanations are:

1. Too much inhaler
2. Unusual circumstances leading to increased urine concentration from legal dose
3. Taking salbutamol by other means for performance enhancement
4. The dodgy blood bag theory
5. Salbutamol as a masking agent

Common issue with 3, 4 and 5 are that salbutamol is easily detected. AIUI performance gains from salbutamol taken orally needs a much higher dose, so if anything you would expect an even higher urinary concentration. Apparently this also has the effect of increasing metabolic rate which would seem undesirable that late in a GT.

With 4., as above it is easy to detect so I would have thought Sky would have been able to check. Have to say this does seem the most plausible nefarious ("proper doping") explanation, since if elevated salbutamol was being used as a performance enhancer it would likely be used outside of competition in large doses for fat loss (apparently common in weight loss circles - how well it works I have no idea). It just seems like such a stupid mistake as to be unlikely.

5 seems to have been roundly disproven, and in any case masking with something so easily detected in those quantities seems daft.

So 1 or 2 seem to be the most likely given the circumstances and results. 2 appears to be possible based on various laboratory tests reported in this thread, and 1 has precedent from the bans of other riders/athletes. As has been said dozens of times in this thread, we'll have to wait and see.

I think one thing which is skewing things here is we don't know the frequency of riders tripping the urine salbutamol limit and not receiving any penalty. We know that it has happened but not how frequently, whereas we do know there is precedent for bans. The ratio could be 80:20 bans vs. exonerated or it could be 20:80, we don't know.

RichN95.

^^^ The blood bag theory was dismissed as 'science fiction' by one doctor I saw interviewed. The amounts of the stuff he would have had to have taken to register that much in his urine are astronomical and utterly unrealistic.

It was used as theory for Contador due to the absolutely miniscule amounts found.

bobmcstuff

RichN95 wrote:

^^^ The blood bag theory was dismissed as 'science fiction' by one doctor I saw interviewed. The amounts of the stuff he would have had to have taken to register that much in his urine are astronomical and utterly unrealistic.

It was used as theory for Contador due to the absolutely miniscule amounts found.

Sure, I've not read much about that - got a source? I've been avoiding the asylum so this is all my supposition.

I'm assuming that full on blood bag use is very difficult these days, and therefore micro dosing with smaller amounts of blood (similar to EPO micro-dosing) is what riders are more likely to be doing, since sticking a big bag of blood in will be really obvious in the bio passport. But I have very little to support that

Thinking about it more it does seem less likely that he could have got that much in his system that way. He still inhaled some so it wouldn't all have had to come from blood, but still to get to 2000 ng/ml from 1000 ng/ml would be a lot.

RichN95.

bobmcstuff wrote:

Sure, I've not read much about that - got a source? I've been avoiding the asylum so this is all my supposition.

From an interview on CyclingTips with an Irish doctor called McGrane (who is habitually anti-Sky on twitter so would have every motivation to give lip service to it)

Former pro Joerg Jaksche suggested that if somebody used a blood bag, and had been using an inhaler at the time when the blood was taken out, that this could be carried over. Is this suggestion unfounded?

I think that would be very, very unlikely. That would be within the grounds of science fiction, rather than a real scenario.

You would have to have an absolutely massive dose of Ventolin the day he gave the blood. And then it would have to stay stable and not degrade over the period of time that it was being kept. It is off the wall, that, I think.

argyllflyer

RichN95 wrote:

bobmcstuff wrote:

Sure, I've not read much about that - got a source? I've been avoiding the asylum so this is all my supposition.

From an interview on CyclingTips with an Irish doctor called McGrane (who is habitually anti-Sky on twitter so would have every motivation to give lip service to it)

Former pro Joerg Jaksche suggested that if somebody used a blood bag, and had been using an inhaler at the time when the blood was taken out, that this could be carried over. Is this suggestion unfounded?

I think that would be very, very unlikely. That would be within the grounds of science fiction, rather than a real scenario.

You would have to have an absolutely massive dose of Ventolin the day he gave the blood. And then it would have to stay stable and not degrade over the period of time that it was being kept. It is off the wall, that, I think.

His quotes could describe 99% of what the Asylum comes up with.

bobmcstuff

RichN95 wrote:

bobmcstuff wrote:

Sure, I've not read much about that - got a source? I've been avoiding the asylum so this is all my supposition.

From an interview on CyclingTips with an Irish doctor called McGrane (who is habitually anti-Sky on twitter so would have every motivation to give lip service to it)

Former pro Joerg Jaksche suggested that if somebody used a blood bag, and had been using an inhaler at the time when the blood was taken out, that this could be carried over. Is this suggestion unfounded?

I think that would be very, very unlikely. That would be within the grounds of science fiction, rather than a real scenario.

You would have to have an absolutely massive dose of Ventolin the day he gave the blood. And then it would have to stay stable and not degrade over the period of time that it was being kept. It is off the wall, that, I think.

I had assumed that the argument would be that he had been ingesting it by another means (oral, injection) in much higher quantities to aid with weight loss during training, rather than just taking his inhaler? The doses required for that use seem to be much, much higher.

But even if he is doing that you would assume he/Sky would be switched on to the fact he had shedloads of salbutamol in his system at the point he gave blood.

RichN95.

bobmcstuff wrote:

I had assumed that the argument would be that he had been ingesting it by another means (oral, injection) in much higher quantities to aid with weight loss during training, rather than just taking his inhaler? The doses required for that use seem to be much, much higher.

But even if he is doing that you would assume he/Sky would be switched on to the fact he had shedloads of salbutamol in his system at the point he gave blood.

He'd need to be drinking the stuff by the pint.

dish_dash

maybe he is...

Mad_Malx

bobmcstuff wrote:

RichN95 wrote:

bobmcstuff wrote:

Sure, I've not read much about that - got a source? I've been avoiding the asylum so this is all my supposition.

From an interview on CyclingTips with an Irish doctor called McGrane (who is habitually anti-Sky on twitter so would have every motivation to give lip service to it)

Former pro Joerg Jaksche suggested that if somebody used a blood bag, and had been using an inhaler at the time when the blood was taken out, that this could be carried over. Is this suggestion unfounded?

I think that would be very, very unlikely. That would be within the grounds of science fiction, rather than a real scenario.

You would have to have an absolutely massive dose of Ventolin the day he gave the blood. And then it would have to stay stable and not degrade over the period of time that it was being kept. It is off the wall, that, I think.

I had assumed that the argument would be that he had been ingesting it by another means (oral, injection) in much higher quantities to aid with weight loss during training, rather than just taking his inhaler? The doses required for that use seem to be much, much higher.

But even if he is doing that you would assume he/Sky would be switched on to the fact he had shedloads of salbutamol in his system at the point he gave blood.

Even at fat-burning doses the total amount of salbutamol in a unit of blood (or even 10 units) will be far below the amount in a single puff of the inhaler. The blood bag theory is plausible for trace amount (e.g. Bertie's clen) but remember that you are putting 0.5 litre of a low concentration salbutamol solution into 70kg body - that's a massive dilution.

RichN95.

Mad_Malx wrote:

Even at fat-burning doses the total amount of salbutamol in a unit of blood (or even 10 units) will be far below the amount in a single puff of the inhaler. The blood bag theory is plausible for trace amount (e.g. Bertie's clen) but remember that you are putting 0.5 litre of a low concentration salbutamol solution into 70kg body - that's a massive dilution.

For the actual numbers:

Contador's urine had 50 picograms per millilitre of clenbuterol

Froome's had 2000 nanograms per millilitre of salbutamol (that's 2 million picograms - 40,000 times as much)

tailwindhome

Is the relationship between the drug input through inhalation and output in urine linear?

ie if 8 puffs is 640 ng/ml will 16 puffs result in 1280 ng/ml (all other things being equal)

gsk82

TailWindHome wrote:

Is the relationship between the drug input through inhalation and output in urine linear?

ie if 8 puffs is 640 ng/ml will 16 puffs result in 1280 ng/ml (all other things being equal)

Nope. That's what causes the problem with the rule relating to how much you can take, not how much you can have in your blood.

bobmcstuff

gsk82 wrote:

TailWindHome wrote:

Is the relationship between the drug input through inhalation and output in urine linear?

ie if 8 puffs is 640 ng/ml will 16 puffs result in 1280 ng/ml (all other things being equal)

Nope. That's what causes the problem with the rule relating to how much you can take, not how much you can have in your blood.

Not quite - strictly speaking it's other factors which have been shown to affect the relationship between inhaled and excreted salbutamol (exercise, dehydration etc).

That's not exactly the same as what TWH says, i.e., if you kept everything else the same, doubling the dose doubles the amount you p!ss out. That may or may not be true.

Mad_Malx

TailWindHome wrote:

Is the relationship between the drug input through inhalation and output in urine linear?

ie if 8 puffs is 640 ng/ml will 16 puffs result in 1280 ng/ml (all other things being equal)

the total output (over a day or so) does correlate because salbutamol isn’t metabolised much - what goes in mostly comes out in the urine eventually. But to calculate this you would need to collect all the urine and add up the total mass. Maybe a bit sweated and sh****d out too.
For most drugs including salbutamol concentration at any given time point is very dependent on time since dosing, how well it passes and accumulates between blood, muscle, fat, urine volume, body composition, kidney function, individual variation and other stuff.

(Contrast With alcohol which passes rapidly and easily between blood, urine, tissues and breath, so levels are closely correlated).

sloppyschleckonds

iainf72 wrote:

SloppySchleckonds wrote:

I dont believe it was "just an asthma inhaler". Others can speculate.

But you're speculating. There is an indication that more than the allowed amount of salbutamol may have been inhaled.

No I am not. And you're making stuff up now.

Pross

SloppySchleckonds wrote:

iainf72 wrote:

SloppySchleckonds wrote:

I dont believe it was "just an asthma inhaler". Others can speculate.

But you're speculating. There is an indication that more than the allowed amount of salbutamol may have been inhaled.

No I am not. And you're making stuff up now.

So you actually have proof that it wasn’t just an asthma inhaler rather than just not believing it? I assume you’ve contacted CADF / WADA with this proof?

smithy21

I am bored of this now. Let’s call it quits at a 6 month ban and move on.

bobmcstuff

SloppySchleckonds wrote:

iainf72 wrote:

SloppySchleckonds wrote:

I dont believe it was "just an asthma inhaler". Others can speculate.

But you're speculating. There is an indication that more than the allowed amount of salbutamol may have been inhaled.

No I am not. And you're making stuff up now.

I'd really like a bit more detail please?

DeVlaeminck

bobmcstuff wrote:

I think that's about right, the only real explanations are:

1. Too much inhaler
2. Unusual circumstances leading to increased urine concentration from legal dose
3. Taking salbutamol by other means for performance enhancement
4. The dodgy blood bag theory
5. Salbutamol as a masking agent
.

6. Froome took a legal dose but used a nebuliser rather than an inhaler - incompetent doctor didn't realise that the legal dose was calculated taking into account the inefficiencies of inhalers and hence the legal dose becomes illegal taken from the nebuliser.

7. Foul play, someone spiked his drink. Apparently Dave hates him, Geraint wants to ride as leader, ASO want a French winner, Nibali got some of his mates from back home to help him out etc etc.

Vino'sGhost

smithy21 wrote:

I am bored of this now. Let’s call it quits at a 6 month ban and move on.

12 months and a public flogging with wiggins to lick the wounds and youve got a deal

larkim

6. is plausible. Unlikely, but plausible.

7. we'd know about by now if that was Froome's defence.

Mad_Malx

larkim wrote:

6. is plausible. Unlikely, but plausible.

You guys know what a nebuliser looks like? You are not going to get one mixed up with an inhaler. Or get it in your jersey pocket.

Edit - and the dose is much higher (5 milligram dose, but only a small fraction actually ends up in the patient), which is into TUE territory, so there shouldn't be any defense here.

DeVlaeminck

Mad_Malx wrote:

larkim wrote:

6. is plausible. Unlikely, but plausible.

You guys know what a nebuliser looks like? You are not going to get one mixed up with an inhaler. Or get it in your jersey pocket.

Edit - and the dose is much higher (5 milligram dose, but only a small fraction actually ends up in the patient), which is into TUE territory, so there shouldn't be any defense here.

I'm not suggesting Froome accidentally picked up a nebuliser, more a doctor suggested a nebuliser would be a more effective way of making sure the "legal dose" got into Froome without realising the legal dose was calculated taking the inefficiencies of an inhaler into account. Only suggest that as there was a case with (I think) an ice hockey player who argued his positive was down to him doing just that - he lost his case btw.

DeVlaeminck

Actually yes it was a xc skier and the actual dose you take is higher so you are right that wouldn't be a defence, the skier argued because it was a normal prescribed dose he should have been allowed it.

Mad_Malx

I'll correct myself too - there are some small battery operated nebulizers that are only a bit bigger than inhalers.

Matthewfalle

DeVlaeminck wrote:

bobmcstuff wrote:

I think that's about right, the only real explanations are:

1. Too much inhaler
2. Unusual circumstances leading to increased urine concentration from legal dose
3. Taking salbutamol by other means for performance enhancement
4. The dodgy blood bag theory
5. Salbutamol as a masking agent
.

6. Froome took a legal dose but used a nebuliser rather than an inhaler - incompetent doctor didn't realise that the legal dose was calculated taking into account the inefficiencies of inhalers and hence the legal dose becomes illegal taken from the nebuliser.

7. Foul play, someone spiked his drink. Apparently Dave hates him, Geraint wants to ride as leader, ASO want a French winner, Nibali got some of his mates from back home to help him out etc etc.

I wouldn't say (6).

Doctors are quite clever, which is why they are doctors and don't work in an office in the city.

A doctor working for any professional team in any sport may have an inkling as to what the rules are and how they are calculated.

Incompetent is a very insulting word.

Mad_Malx

So we agree it was Dave & G wot did it then?