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Tom Dumoulin questions Wiggins TUEs while former team doctor expresses ‘surprise’ that powerful corticosteroid injection was prescribed

‘It will drain the body of excess fat’ says Michael Rasmussen

Dutchman Tom Dumoulin has questioned the timing and need for the triamcinolone injections received by Bradley Wiggins prior to three Grand Tours, including before the 2012 Tour de France which he won. Wiggins’ former team doctor has also said that he was ‘surprised’ that the drug was prescribed.

Dumoulin, who finished third when Wiggins became World Time Trial Champion in 2014, said he had never applied for a therapeutic use exemption (TUE) and he told De Limburger he found it ‘strange’ that Wiggins had received the injections immediately before Grand Tours.

“And injecting? So then you have very bad asthma. This is not something they do with normal asthmatics, let alone athletes who only have exercise-induced asthma. Apparently Wiggins’ injection also worked for weeks – then in my opinion you should be out of competition for weeks. That thing stinks. "

Speaking to BBC Newsnight, Dr Prentice Steffen, who was team doctor at Wiggins's former team Garmin Slipstream in 2009, expressed similar sentiments.

"I was surprised to see there were TUEs documented for intramuscular triamcinolone just before three major events – two Tours de France and one Giro d'Italia.

"You do have to think it is kind of coincidental that a big dose of intramuscular long-acting corticosteroids would be needed at that time of year, at that exact time, before the most important race of the season.

"I would say certainly now in retrospect it doesn't look good, it doesn't look right from a health or sporting perspective."

Steffen said that when he worked with Wiggins, the rider had TUEs permitting the use of an asthma inhaler containing salbutamol – something for which a TUE is no longer required.

Wiggins’ TUEs applications are understood to have been made by Dr Richard Freeman, who is now team doctor at British Cycling.

Newsnight also spoke to convicted doper Michael Rasmussen, who said the pattern of Wiggins’ TUE use looked familiar. He also agreed with David Millar’s assessment earlier in the week that triamcinolone was a powerful and potentially performance-enhancing drug.

"There is no doubt in my mind that corticosteroids [are] very, very strong and performance enhancing.

"It would postpone the sensation of fatigue, increase your recovery speed and most importantly and quite easily I would drop one or two kilograms, which is very important when you want to climb mountains.

"It will drain the body from all excess fat in a quite short period of time. It's a very fast and very effective drug in that sense."

TUE application and approval

Steffen said Wiggins was ‘probably at the bottom of the list’ when it came to weighing who was responsible for deciding on the treatment.

"I think his doctor and his team, to make the decision to apply for that TUE is questionable and then I think for the UCI or UK Cycling or Wada to sign off on that application, all things considered, really that is the end point where the TUE committee should have looked at that and said no, this is not acceptable, so we are not going to approve it."

A spokesman for Team Sky said:

"TUEs for Team Sky riders have been granted by the appropriate authorities and in complete accordance with the rules.

"This is a complex area given the obvious issues around medical confidentiality. There is a legitimate debate across sport on where best to draw the line on transparency.

"It is very rare that a rider needs a TUE and we have robust internal processes in place that we are confident in and which we constantly review.

"Team Sky's approach to anti-doping and our commitment to clean competition are well known."

Cannondale-Drapac Pro manager Jonathan Vaughters was famously not permitted a corticosteroid injection for an allergic reaction to a bee sting while riding the 2001 Tour de France. While emphasising that some TUEs are legitimate with the athlete in question needing treatment, he advocates greater transparency.

 

 

Dumoulin, for one, agrees with this."Then you have no hassle, everyone knows what you're doing, even if it runs counter to medical confidentiality,” he said. “If we are getting closer to a clean sport, I'm for it."

Latest Fancy Bears leak

The latest batch of athletes to have TUE data released by the Fancy Bears hackers includes Fabian Cancellara and this year’s Tour of Britain winner, Steve Cummings.

A statement from Trek-Segafredo said:

“Trek-Segafredo and Fabian Cancellara confirm that Cancellara received therapeutic use exemptions (TUE) for the treatment of severe allergic reactions to bee stings on August 17, 2011, and May 18, 2013.

“The treatments were administered in respective urgent care centres where Cancellara was treated, and not by a team doctor.

“These therapeutic use exemptions are currently being reported in the media without any context provided, damaging the image of both the athlete and the team.”

The team says that the correct procedures to find and document the treatment with the authorities were followed and also points to Cancellara having documented the incidents via social media at the time.

Cummings’ TUE relates to the use of the anti-asthma drug, salbutamol, via an inhaler. The certificate is from December 10, 2008 and was for 12 months’ use. As was mentioned above, a TUE is no longer required for salbutamol delivered in this way.

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12 comments

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Rapha Nadal | 7 years ago
1 like

"It would postpone the sensation of fatigue, increase your recovery speed and most importantly and quite easily I would drop one or two kilograms, which is very important when you want to climb mountains.

"It will drain the body from all excess fat in a quite short period of time. It's a very fast and very effective drug in that sense."

Doping or not, this stuff sounds great.

Avatar
tritecommentbot | 7 years ago
0 likes

Yes TUE's should be made public on a register. There's loads of organisations that can grant TUEs too for cycling alone. I think at least a dozen, doesn't have to be WADA. There needs to be one register where all TUEs granted from all organisations are up there in plain sight.

 

If it's not dodgy, then what's the problem? If you're sick and take medication, that's fine. Why would you hide it? You can claim other teams will know when to test  you. Well that's good, more tactics. Spice it up.

Avatar
MandaiMetric replied to tritecommentbot | 7 years ago
0 likes
unconstituted wrote:

Yes TUE's should be made public on a register. There's loads of organisations that can grant TUEs too for cycling alone. I think at least a dozen, doesn't have to be WADA. There needs to be one register where all TUEs granted from all organisations are up there in plain sight.

 

If it's not dodgy, then what's the problem? If you're sick and take medication, that's fine. Why would you hide it? You can claim other teams will know when to test  you. Well that's good, more tactics. Spice it up.

"If you have nothing to hide, then you don't have a problem" is the kind of reasoning governments have tended to use while illegally snooping on private citizens.

While making this data public would certainly go some way to fixing the current process. I think there are ethical and potentially legal impediments to what is tantamount to forcing people to make aspects of their personal medical data available to the public.

I'm no doctor but if for example, an elite female athlete is undergoing fertility treatment whiel competing, is that data which should be made public? Or is their only choice going to be make it public or don't compete? That's harsh IMHO. 

The current process is clearly horribly broken, and I believe it is being abused by some elite athletes, including cyclists.

Avatar
tritecommentbot replied to MandaiMetric | 7 years ago
0 likes
MandaiMetric wrote:
unconstituted wrote:

Yes TUE's should be made public on a register. There's loads of organisations that can grant TUEs too for cycling alone. I think at least a dozen, doesn't have to be WADA. There needs to be one register where all TUEs granted from all organisations are up there in plain sight.

 

If it's not dodgy, then what's the problem? If you're sick and take medication, that's fine. Why would you hide it? You can claim other teams will know when to test  you. Well that's good, more tactics. Spice it up.

"If you have nothing to hide, then you don't have a problem" is the kind of reasoning governments have tended to use while illegally snooping on private citizens.

 

Dangerous stuff you're putting out there. The sort of logical slight of hand that the we've seen from creationists and nationalists and apologists for all sorts of nastiness.

 

In case anyone was conned by that, let me be clear. The govt. bulk collects all data, vastly innocuous and deeply personal in all aspects of your life, not simply one rather suspect type of activity you may be up to. They can use innocent data, which taken out of context and pieced together can be made to make anyone look like a terrorist. Ever browsed porn? You're a deviant. Ever looked at news about a mass murderer? You're obssessed with murder. Ever argued about Islam and looked up the Koran or wiki for a source? You're a radical. Ever played Duke Nukem? You're a satanist. (Last one was actually used in evidence in an entirely circumstantial murder trial in Scotland).

 

What we have here in sport is a drug use problem, and we're simply seeking transparency as we know that the devil is very clearly in the detail here. Transparency and accountability are important parts of those seeking public gain and large financial reward.

 

To even equate these two situations because of a similar thread of reasoning is a pretty low move. Definitely not impressed by that at all. I have no problem with the Govt. collecting data and seeking warrants for people who are of interest for example, and have no problem with transparency for drug use in sports.

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MandaiMetric replied to tritecommentbot | 7 years ago
0 likes

Back on track. I'm interested to hear what people think about potential legal pitfalls on mandatory publication of individual's TUE related medical data? Maybe I'm seeing problems which have already been overcome elsewhere?

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ColT | 7 years ago
3 likes

I'm with Tom. It stinks.

Let's have full transparency on all TUEs.

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FatBoyW | 7 years ago
1 like

Really? Reputable Rasmussen? Er, no. Dr Millar? Er no. 

Taking it to the limit, probably yes. UCI TUE committee approved? Yes.

other than hacking- any story? No.

cheating? Definitely NO - bored by all this, whilst the reusing government are able to control anti coping and not control such illegal activities as this fancy bear stuff the only consequence of this tardy claptrap should be greater and harsher sanctions of Russia.

 

though compared to what is happening in Syria this is irrelevant

Avatar
MandaiMetric replied to FatBoyW | 7 years ago
1 like
FatBoyW wrote:

other than hacking- any story? No.

Fancy Bears is definitely not some group of altruistic whistleblowers. It is clearly a deliberate attempt to take the spotlight and associated criticism away from the Russian state sponsored intentional doping and test falsification.

However, the Fancy Bears leak has given the public a snapshot into the frequency and timing which some elite athletes have applied for TUEs, along with the selected treatements for their medical conditions.

A popular British athlete applied for a "long-release" injected treatment TUE, where short-term oral treatment is available has since widely been deemed reasonable. Additionally said athlete has repeatedly applied for such TUEs coincidently timed to coincide with multiple grand tours.

The Fancy Bears leak indicates this is not isolated to one athlete, but a similar pattern across multiple elite athletes in varying sports.

I'm not suggesting athletes broke any rules regarding TUEs, but it is definitely newsworthy.

There have been enough rumour, veiled accusasation and denial over the years about TUE (ab)use. Perhaps this data will begin a real honest debate on the subject, with hopefully some clarity in the future. 

Since it is not open to public scrutiny, I believe the TUE process is far from perfect and open to abuse. TUE use is personal medical data, therefore requireing this data be made public is quite possibly illegal in some countries.

If to become an elite athlete, you need to exercise so much, that you get sick (eg exercise-induced asthma), perhaps that's your body saying you need a rest - no shame in that. That so many elite athletes develop training-induced ailments, then seek medication to overcome it without interruption to their training regime - this to me is blurring the boundaries of athletic performance vs drugged athletic performance.

By the way, just for the record, I feel the specific timing of Wiggins' TUEs and the selection of drug by injection are suspect.

It's like stepping back in time. Lots of cyclists loudly and repeatedly espousing "I am clean", "I don't dope", "I have never failed a drug test". True, but that doesn't mean they aren't leveraging opportunities within a dubiously rigorous TUE framework to gain an advantage.

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sanderville replied to FatBoyW | 7 years ago
0 likes
FatBoyW wrote:

though compared to what is happening in Syria this is irrelevant

Absolutely right.  US/UK air forces launch a sustained attack on Syrian troops in support of ISIS ground forces.

Russia launches a missile strike on ISIS command centre near Aleppo, killing over 30 Israeli, US, UK and Saudi commandos who are running the operation against Assad.  http://en.farsnews.com/newstext.aspx?nn=13950631000607

UN convoy is hit by US-made Hellfire missile and the Western cartel blames Russia.  http://www.zerohedge.com/news/2016-09-23/caught-tape-did-us-target-syria...

Once again we are about to plunge into an illegal war against a secular Middle-Eastern government based on a catalogue of lies about war crimes that we committed.

There were no WMDs in Iraq.  Gaddafi was not bombing his own people.  But let's just keep believing the hype and blame Russia for everything anyway.  Third time lucky, right?

 

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Gourmet Shot | 7 years ago
0 likes

Weight loss....increased power?  I need this.  Is it available on Amazon?

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Edgeley | 7 years ago
0 likes

We did all wonder at the time how WIggins was whippet thin but still strong, didn't we. 

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Yorkshire wallet | 7 years ago
0 likes

This is no different that any other sporting TUE really.

Find out how far the rules go

Take to limit 

Profit

Get named dragged through mud at some point

Go on question of sport a few years later once everyone has forgotten about it

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