Contador is not alone; clenbuterol positives are not uncommon

The international sport media has been thrown into a fervor again today over the announcement of Alberto Contador’s positive drug test for clenbuterol.  Unfortunately, he is not alone, as clenbuterol positives have been a recurring problem.  The table below summarizes some of the other cases.  We also highlight some of the things we have learned about clenbuterol and the realities of detecting it through drug tests.

What we have learned:

1) The best way to know if clenbuterol was deliberately used for doping purposes is to evaluate the amount present in the athlete’s urine.

2) Labs can detect minute amounts of clenbuterol on drug tests.  As a result, even very small amounts of contamination in a supplement product can cause a positive drug test.  The Jessica Hardy case is a perfect example.  She was pulled out of the Beijing Olympics at the last minute and was sanctioned because very low levels of clenbuterol were found present in her urine.  Clenbuterol contamination was discovered in a supplement she had been taking.

3) Athletes from China account for the most cases, but Spanish athletes have also been involved.   Twenty years ago there was an epidemic of serious clenbuterol toxicity in Spanish persons – non-athletes.  It was thoroughly investigated and traced to a farm that was using huge doses to bulk up cattle.  Athletes were not involved.   The Spanish authorities responded by establishing new controls, which remain in effect today.

Below is a table of clenbuterol drug test violations as summarized by Zack Bilgake on SportsNickel.com, http://sportsnickel.com/2010/09/30/contadors-clenbuterol-positive-and-what-it-really-means-for-tour-champ/:

ATHLETE	NATION	SPORT	EVENT/DATE OF POSITIVE	RESULT OF POSITIVE
Djamolidine Abdoujaparov	UZB	Cycling	1997 Tour de France/Stage 2 (July 6)	Retired
Xiong Guoming	CHN	Swimming	out of competition test in 1999 (March 8 )	3-year suspension
Wang Wei	CHN	Swimming	out of competition test in 1999 (March 8 )	3-year suspension
Mariano Puerta	ARG	Tennis	2003 ATP Viña del Mar (February 12) *ARGUED FOOD CONTAMINATION	9-month susp. + $5600 fine
Zhou Jie	CHN	Swimming	out of competition test in 2005 (Sept 6) *ARGUED FOOD CONTAMINATION	2-year suspension
Karol Beck	SVK	Tennis	2005 Davis Cup semi v. Argentina (Sept 25)	2-year suspension
Anzhelika Gavrilova	KAZ	Speed skating	positive test before 2006 Olympics (Jan 4)	1-year suspension
Mitchil Mann	AUS	Weightlifting	2 positive samples in 2006 (Oct 30, Nov 3)	2-year suspension
Ouyang Kunpeng	CHN	Swimming	tested positive before 2008 Olympics (July 1) *ARGUED FOOD CONTAMINATION	lifetime ban
Jessica Hardy	USA	Swimming	2008 U.S. Olympic trials (July 4) *TAINTED NUTRITIONAL SUPPLEMENT/ADVOCARE	voluntary Olympic withdrawal/1-year suspension
Reni Maitua	AUS	Rugby	positive test by ASADA (May 20/2009)	2-year suspension
Tong Wen	CHN	Judo	stripped of 2009 world title (May 10/2010) *ARGUED FOOD CONTAMINATION	2-year suspension
Li Fuyu	CHN	Cycling	In-competition test at 2010 Dwars Door Vlaanderen (March 24)	2-year suspension
Callum Priestley	GBR	Hurdles	tested positive February 2010 (Sept 5) *ARGUED FOOD CONTAMINATION	2-year suspension

Another positive drug test related to dietary supplement contamination

Sadly, another positive drug test related to use of a dietary supplement surfaced yesterday, this time in equine sport, http://www.horseandhound.co.uk/news/397/302201.html.  Don’t let this situation happen to you; there are ways to protect yourself.

According to the story, a British endurance rider, Christine Yeoman, had her horse test positive for ractopamine, a potent beta agonist, at an event on August 9, 2009.  She had been giving the animal Neigh-Lox, used to prevent gastric ulcers.  Neigh-Lox was manufactured in the United States by Kentucky Performance Products.  Traces of ractopamine were found in the product in subsequent testing, and the company has admitted to the contamination.

For those who are not aware, drug testing usually works according to strict liability, meaning if a drug is detected resulting in a positive test, the individual is responsible for the presence of the substance in the body regardless of where it might have originated.  If the issue is related to a contaminated supplement, the athlete or rider still faces possible sanctions.  The human sport system considers supplement use to be voluntary, and thus even if supplement contamination is the source of a positive drug test the athlete is usually held responsible.

In this equine case, the rider had to spend more than €200,000 to clear her name and win an unprecedented ruling from FEI.  The ruling stated: “Even ordinary feed is often mixed and includes several additives which may be contaminated. Even feed without additives may be contaminated.  Equestrian sport on a high level can be said to require the use of feed supplements to care properly for such elite horses.  In the tribunal’s opinion, PRs [persons responsible, i.e. the rider] are not the proper party to bear the risk of supplements contaminated at the manufacturer level.”

Unfortunately, testing for banned substances in dietary supplements is not mandatory and the risk of contamination remains an issue.  Testing options that can protect against these issues are available to the general public, athletes, and the dietary supplement industry.  We operate our own such program at Banned Substances Control Group.  For more details, please explore http://www.bscg.org/.

Despite numerous efforts to the contrary, prohormones remain widely available today

The supplement industry, sporting groups, the FDA and more have been combating the issue of prohormones, or steroid precursors, for years. Prior to 2004 these substances were available at practically all retailers. They were available in many forms and made by many different manufacturers. This grew to be quite a concern and forced additional regulatory action to be taken.

In 2004, the Anabolic Steroid Control Act was passed, which added many prohormones to the list of controlled substances illegal for sale in the dietary supplement industry. The language included in the act stated, “The term ‘anabolic steroid’ means any drug or hormonal substance, chemically and pharmacologically related to testosterone (other than estrogens, progestins, corticosteroids, and dehydroepiandrosterone).” It goes on to name more than 43 drugs by name that were now controlled and illegal to put in dietary supplements.

Enacting new regulations is one thing but enforcing them is a different story. Even after the act passed in 2004, prohormones remained widely available for years to come. These products continued to have controlled substances boldly listed on the label. These were things like Superdrol, Halodrol 50, Madol, Turinabol, Androstenedione and more.

At Anti-Doping Research, we helped expose the sales of several designer steroids in a story for ESPN.com in September of 2007, http://www.shaunassael.com/pdf/made-in-china.pdf. Again, in March of 2009, we worked on a two-part story for CBS that exposed a new designer steroid, ‘Tren’, that was being unknowingly used by high school athletes, http://www.cbsnews.com/stories/2009/03/18/earlyshow/health/main4874182.shtml. These examples demonstrate the harsh reality that despite the new legislation, the pipeline of designer steroids and prohormones was still healthy long after 2004.

In late 2009, the FDA finally began to get more assertive in their attempts to curtail the sales of these products. They approached one of the largest retailers of supplement products, Bodybuilding.com, and informed the company that they were selling 65 products that were currently classified as steroids. This resulted in a voluntary recall of the products http://www.fda.gov/Safety/Recalls/ArchiveRecalls/2009/ucm188929.htm.

You might think that his was the beginning of the end for these products, but a quick Internet search today demonstrates that this is not the case. Amazon.com, in fact, is still selling several of the products that were part of the Bodybuilding.com recall, http://www.amazon.com/Competitive-Edge-Labs-CEL-tren/dp/B002W2X8BM/ref=pd_sim_hpc_6. A quick glance at the bottom of the page shows that more like M-Drol and H-Drol are also for sale. The problem doesn’t stop with Amazon. Nutrition Arsenal is also selling Competitive Edge Labs M-Drol and H-drol today, with a note that the manufacturer has discontinued the product and supplies are very limited, http://www.nutritionarsenal.com/Search.aspx. There are 84 products available on this site listed as prohormones. Another site where prohormones are widely and publicly available is BuySupps.com. They only have six prohormones listed, one CEL’s H-drol is at least no longer available. The five other products, however, are marketed as new clones of old favorites like Halodrol, Superdrol, Tren, and more.

More time spent searching the Internet will find more of the same issues. Certainly, the efforts of the FDA to curtail the sales of these products at major retailers should be applauded and the voluntary response by the retailer to recall products is commendable. That several of these products are still available at a retailer like Amazon.com, however, demonstrates that huge holes remain. Why is it not possible to stem the sales of these products at all retailers? If it is a resource issue then hopefully the resources can be found to address this concern. If not, then we must continue the process of clearing these products from the marketplace completely.

Unfortunately, it is not only products labeled with prohormones or steroids that cause problems. At Banned Substances Control Group (BSCG), we test products on behalf of manufacturers for banned substances to assure that they are not contaminated. The products we test do not have any banned ingredients on the labels but at times we do find contamination of these products. Even manufacturers that try to make products responsibly fall victim to raw material contamination that leads to finished product contamination. There is no requirement to test raw materials for banned substances so it is not surprising that this occurs. The reality is that prohormones and steroids continue to be present as contaminants in supplement products and this too must be addressed and curtailed.

We will continue to work on such pressing supplement issues. They are not only important to elite athletes and professionals such as police and fire people, but also to the general public who use these products widely and with more and more frequency.

Methylhexaneamine, the recent positives, and the larger issues

Methlyhexaneamine is back in the news again, this time after 14 Indian athletes tested positive for it. This is not the first time this substance has caused a problem with positive drug tests.

Methylhexaneamine is a weak stimulant that was added to the WADA list of banned substances in 2010. It is very similar to the banned substance tuaminoheptane, which was added to the WADA list of banned substances in 2008. In 2009, five Jamaican athletes returned positive drug test results after using methyhexaneamine. Although methylhexaneamine was not banned at the time, sanctions were pursued based on the rarely invoked “and related substances” clause in the WADA rules. Methylhexaneamine is chemically similar to tuaminoheptane. It was added to the WADA banned list largely in response to this situation.

Methylhexaneamine has an interesting history. It was first trademarked under the name “Forthane’ by Eli Lilly in 1971 as a nasal decongestant. That trademark has since expired. Patrick Arnold of BALCO fame and the creator of THG and other designer steroids, was part owner of Proviant Technologies until recently. Proviant Technologies currently holds a patent on Geranamine, a synonym for methylhexaneamine. You can also find it under the synonyms Forthan, Forthane, Floradrene jack3d, DMAA, shizandol A, 1-3 dimethylamine and Geranamine. It is often used as a “party pill” in New Zealand. It is included in many dietary supplements around the world using synonyms that may not be recognizable as banned substances. Methylhexaneamine has been shown to be naturally present in geranium oil at amounts less than 1%. This natural presence is why it is argued that the drug should be allowed to be used in dietary supplements. Given all the confusion it is certainly plausible that the Indian athletes were unaware that they were taking a banned substance.

The larger issues here are why is methylhexaneamine banned in sport and still legal in dietary supplements. If it is a stimulant then it should be banned in sport but should it not also be considered a controlled substance and thus not be allowed as an ingredient in dietary supplements? If the reason it is allowed to be in dietary supplement is that the drug is present naturally in geranium oil in small amounts, then why is androstenedione not legal? Androstenedione too can be derived from plants. Anyone who takes dietary supplements, vitamins, minerals or anything in this category should be vitally interested in the question, what is actually in my dietary supplements?

New Zealand cyclist Adam Stewart banned for two years for attempted use of EPO and hCG

Unfortunately, another story has come out regarding the attempted use of the banned substances EPO and hCG, this time by Adam Stewart, a cyclist from New Zealand. It is attempted use, because the drugs were found during a customs search, not as the result of a positive drug test. On the surface this seems like just another story about doping in cycling, but there are some harsh realities hidden within this story.

The cycling community has done a great deal to clean up the sport by implementing the passport program and taking an aggressive stance on doping as a whole. Some teams even pay for independent testing to add a further layer of protection. Comments by Floyd Landis recently have caused the community to evaluate whether EPO doping is part of the past or whether it continues to be used today. Landis has suggested that it is possible to engage in micro-dosing with EPO combined with traditional blood doping and not test positive in the current drug-testing system. Regardless of what you think about Landis and his allegations, these questions remain as significant concerns and must be answered and evaluated by the scientific community.

What the Adam Stewart situation does answer is a sad but true reality: EPO and its many analogues continue to be sought out and used today by elite cyclists. If Mr. Stewart was caught possessing the drug, one has to think that he had been using it for some time and not testing positive or producing blood values that are suspicious in the passport program. Or, perhaps this is the first time Mr. Stewart got the drug and he had not used it yet? One does have to wonder. If this was not the first time he used the drug then the question needs to be asked, why did he not get caught by the drug-testing system? If he was using EPO and not getting caught then we must look at why and try to address the cause.