/ How are riders allowed to compete using corticosteroids?

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Yanis Nayu - on 13 Sep 2016
Having just been on prednisolone for 3 days, during which I felt like Cancellara, I find it hard to see how riders competing using these drugs are allowed to compete with TUEs. Surely they should be made to sit out competition for a suitable period until they've recovered and the drugs have cleared? I struggle to see the justification for allowing them to compete.

As an aside, given how far down the doping pecking order corticosteroids are, EPO etc must be like rocket fuel...
Greasy Prusiks on 13 Sep 2016
In reply to Yanis Nayu:

Was it really that noticeable? I'm intrigued.

Fwiw I've heard that EPO makes you shift like a tabasco enema.
Dave Kerr - on 13 Sep 2016
In reply to Yanis Nayu:

Interesting.

Have you read Tyler Hamilton's account of how EPO feels? He said you don't feel much different but can just keep going and ride through the pain and fatigue.
Yanis Nayu - on 13 Sep 2016
In reply to Greasy Prusiks:

> Was it really that noticeable? I'm intrigued.

> Fwiw I've heard that EPO makes you shift like a tabasco enema.

Yes! It was weird. I have no endurance and if I go on a long ride (40-60 miles for me) I get heavy-legged after about 40 miles and I'd generally average about 17.5mph on a flattish route. On Saturday I rode 88 miles at 18.5mph in the pissing rain, barely fatigued, then cleaned and lubed my bike. I didn't have more than a hint of fatigue until I was over 4 hours into it.

And my house, car and bike have never been cleaner...
Greasy Prusiks on 13 Sep 2016
In reply to Yanis Nayu:

That's a huge difference. You can only guess at what the strong stuff would do.

You don't have any left do you? ;-)
gethin_allen on 13 Sep 2016
In reply to Yanis Nayu:

I get quite bad hayfever and this year I tried a different nasal spray treatment Pirinase, I didn't really read the instructions (who does?) but noted it contained Fluticasone proprionate, not one of the ones I've heard of before like Cetrizine Hydrochloride or Loratadine.

I first took it just after breakfast, 10 min before riding to work. This stuff sent my head spinning and my heart pounding. I was thrashing it all the way to work like a mad man.

After this experience I had a quick google and found out that the nasal spray I was taking was a corticosteroid.

I kept taking it for a week because it seemed to sort out the hayfever but in the end I gave up on it because I was buzzing when I got to work and couldn't deal with being so wired.
KevinD - on 13 Sep 2016
In reply to Greasy Prusiks:

> Fwiw I've heard that EPO makes you shift like a tabasco enema.

This is an interesting read about drug taking. From a journalist/casual athlete who decided to see what it can do.
http://www.outsideonline.com/1924306/drug-test

On professionals using TUEs to get an advantage. Might be some interesting things coming out of a Russian hack of the wada db.
https://www.theguardian.com/sport/2016/sep/13/wada-russian-cyber-attack-espionage-group
alasdair19 on 14 Sep 2016
In reply to KevinD:

the outside article is excellent thx for linking.
Dauphin on 14 Sep 2016
In reply to gethin_allen:

Sorry but steroid hormones take hours to have any effect.

D
Yanis Nayu - on 14 Sep 2016
In reply to Greasy Prusiks:

> That's a huge difference. You can only guess at what the strong stuff would do.

> You don't have any left do you? ;-)

10mg) It's probably worth noting that I put on a kilo over 3 or 4 days and slept about 6 hours over the whole weekend.
Yanis Nayu - on 14 Sep 2016
In reply to KevinD:

That's an interesting read.
cb294 - on 14 Sep 2016
In reply to KevinD:

Interesting link! Thanks,

CB
ceri - on 14 Sep 2016
In reply to Dauphin:

> Sorry but steroid hormones take hours to have any effect.

Also the systemic bioavailability of nasal spray is very low, that's why they can sell it over the counter.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014420/
Are you sure it wasn't a placebo effect?
Chris the Tall - on 14 Sep 2016
In reply to Yanis Nayu:

I was on prednisolone for a week in the summer, after a bad asthma attack that came 4 days after doing the Fred Whitton. Have to say I was disappointed, nothing like the effect that my wife had led me to expect and which you experienced. Got me over the asthma and back on my bike, but it was at least a month before I was back to my previous level of fitness on the bike, whilst my running is still some way off.

That did get me thinking about the temptations of PEDs and the grey area of TUEs. With TUEs the principle seems to be that it's ok to medicate to bring you up to the norm, for example to allow an asthmatic to breathe normally. So I could see how someone could cross the line by convincing themselves that all they are doing is getting back to how they felt on a good day. I went from dropping my mates on Hardknott to being sat in a hospital feeling like an old man a week later, pretty depressing stuff.

As to TUEs in the peleton, I believe the rules are being tightened, less are being authorised and as Simon Yates found out, "administrative errors" are no longer overlooked. The issue over whether you should be able to ride with a TUE isn't simple - suppose you are are on a drug for life ? And what about surgical modifications - such as laser eye treatment ?

ClimberEd - on 14 Sep 2016
In reply to Yanis Nayu:

Will depend a lot on what dose you are on, how long for and how you react to it (side effects etc. - they tend to build over time)

On 20mg/day I was bouncing off walls - but I was also struggling not to mainline biscuits (sugar) and my immune system was suppressed enough I got seriously ill.

Dropping to 10mg I generally just feel a bit shitty all the time. I'm also told that when I finally stop them I'll feel worse before I feel better.

I compete in triathlon with a TUE. I have a long term long condition (or should that be a lung condition that requires long term treatment) and don't see why treatment should preclude me from taking part.
malk - on 14 Sep 2016
In reply to Yanis Nayu:

saw a cyclist puffing on something like that before attempting a 5 m incline-lol
gethin_allen on 14 Sep 2016
In reply to Dauphin:

> Sorry but steroid hormones take hours to have any effect.

Hey, I've no idea what the effect was, I didn't even know what I was taking when I felt this effect (which I thought was some sort of control), I just thought it was an alternative to beconase.

Who knows what I was experiencing but it sure got me racing on my bike made me feel massively on edge.

ebdon - on 14 Sep 2016
In reply to gethin_allen:

Just read the outside article, this stuff sounds great! Where do i get some?
balmybaldwin - on 14 Sep 2016
In reply to Yanis Nayu:

Prednisolone is on the banned list. There are some corticosteroid creams that have been allowed in the past (most notably Armstrong had a post dated TUE) I think that loophole has since been closed. This is why a few have been caught out for using vicks inhalers in foreign lands which contain them (but UK versions don't) (I forget who now)
Yanis Nayu - on 16 Sep 2016
In reply to balmybaldwin:

> Prednisolone is on the banned list. There are some corticosteroid creams that have been allowed in the past (most notably Armstrong had a post dated TUE) I think that loophole has since been closed. This is why a few have been caught out for using vicks inhalers in foreign lands which contain them (but UK versions don't) (I forget who now)

It's on the banned list but it can be used under a TUE. My original question was about whether it's medically and sportingly ethical for riders to use it for say chest infections and then compete. Wouldn't it be better to say if you're too ill to compete without it you're better to rest for a few days? It's a difficult one. I guess I'm coloured by my experience of dramatic improvement - as others have said it doesn't seem to affect everyone the same.
Mike Highbury - on 17 Sep 2016
In reply to balmybaldwin:
> Prednisolone is on the banned list. There are some corticosteroid creams that have been allowed in the past (most notably Armstrong had a post dated TUE) I think that loophole has since been closed. This is why a few have been caught out for using vicks inhalers in foreign lands which contain them (but UK versions don't) (I forget who now)

Slight misunderstanding of the Armstrong TUE but that's a red herring, ain't it?
tim000 - on 17 Sep 2016
In reply to balmybaldwin:

> Prednisolone is on the banned list. There are some corticosteroid creams that have been allowed in the past (most notably Armstrong had a post dated TUE) I think that loophole has since been closed. This is why a few have been caught out for using vicks inhalers in foreign lands which contain them (but UK versions don't) (I forget who now)

I think that was the skier alan baxter
DaveN - on 17 Sep 2016
In reply to Yanis Nayu:

What were you on it for?

I've only been on it with chest infections, so generally found that my performance with steroids is pretty shit, due to the chest infection.
Yanis Nayu - on 17 Sep 2016
In reply to DaveN:

Bee sting inside my lip. I deserved a day of cycling super humanness for all the piss taking I had to endure.
Dom Whillans on 18 Sep 2016
In reply to Yanis Nayu:

As a lifelong asthmatic, who has to take steroids on a daily basis just to be "normal" and who ends up on 5-day courses of Preds a couple of times a year due to the propensity that asthmatics have for picking up lung infections, this thread reads a little like the old arguments around pistorius's use of blades during competitions... "let's see how quick he runs without his performance enhancing tech"... if you need TUEs for an infection, any perceived performance enhancing affect is nullified by the underlying illness. if you're well enough to notice a perceived benefit during your exercise i'd wager you weren't ill enough to be prescribed the meds in the first place! during a lung infection my peak flow will drop from 700 to 450 or so, sometimes as low as 250. A TUE would be essential for someone like me if i was to compete with a lung infection (which i will be next weekend in Berlin, hopefully reducing my marathon PB from 04:04:09 to 03:45:00, but with no lung infection right now!!!).
donrobson - on 21 Sep 2016
In reply to Yanis Nayu:

One problem with oral steroids is that in high dose they can have a significant effect on mental health causing hypomania where people can feel omnipotent amongst other things, that type of steroid has negative effects on muscle.

I suspect your effect was psychological.
Yanis Nayu - on 21 Sep 2016
In reply to donrobson:

I did feel like that tbh - kind of indestructible and a bit manic. The utter lack of fatigue, pain and discomfort seemed physical though. I was on 20mg a day for 3 days - I don't know if that counts as a high dose.
malk - on 15:45 Thu
In reply to Yanis Nayu:

> I was on 20mg a day for 3 days - I don't know if that counts as a high dose.
these research papers used 50-60mg/day:
http://www.ncbi.nlm.nih.gov/pubmed/18048433
http://www.ncbi.nlm.nih.gov/pubmed/19669785

here are some guidelines but can't see your drug (and also in micrograms)
http://www.usada.org/substances/prohibited-list/athlete-guide/

all very confusing - as highlighted by the norway cross-country asthmatic skiers..
https://en.wikipedia.org/wiki/Martin_Johnsrud_Sundby

malk - on 15:59 Thu
In reply to donrobson:

> One problem with oral steroids is that in high dose they can have a significant effect on mental health causing hypomania where people can feel omnipotent amongst other things, that type of steroid has negative effects on muscle.

that's why they inject- fewer side effects and longer lasting..

> I suspect your effect was psychological.

how would you know?
ClimberEd - on 22:54 Thu
In reply to Yanis Nayu:

Yes that's a high dose. (because of the short term use of it in your case.)

50-60mg in that research paper would send you totally off the wall - have never heard anyone have that unsupervised.
Martin W on 23:54 Thu
In reply to tim000:

> I think that was the skier alan baxter

Alan Baxter's Vick inhaler contained levMethamphetamine, an inactive isomer of methamphetamine (which itself is a stimulant, not a steroid). The levMethamphetamine was included as a decongestant in the formulation of Vicks sold in the USA.

His three-month ban from competition was overturned on appeal, allowing him to participate in the 2002-3 World Cup ski season.

He was unsuccessful in appealing his disqualification from the Olympic slalom in which he won the bronze medal, despite medical testimony at the Court of Arbitration for Sport that the levMethamphetamine isomer had minimal stimulant properties.
Yanis Nayu - on 07:57 Fri
In reply to ClimberEd:

A friend of mine was prescribed 60mg a day for about 2 weeks for a similar issue to mine!
ads.ukclimbing.com
mark s - on 10:30 Fri
In reply to Yanis Nayu:

if i ever get back into cycling i will try epo just once to see how much effect it has and see what the fuss is about

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