Gordon Adds Another Dee to PED Discussion – The Steroid Dilemma Continues for MLB

Baseball Stadium – 2000 Sydney Olympic Games, Photo by Oliver Catlin

While most people were waking up to a wonderful Friday morning, baseball fans were discovering some more depressing news in the announcement that Dee Gordon, infielder for the Miami Marlins, has been suspended 80 games due to test results revealing two performance-enhancing drugs (PED) in his system. Gordon had originally appealed the decision, but decided against appealing Friday morning.

Thursday night, Gordon revealed to his teammates, after a 4-game sweep of his former team in Los Angeles, that he tested positive earlier this year for synthetic testosterone and Clostebol, an anabolic steroid. He released a statement this morning through the MLB Players Association saying the following:  “Though I did not do so knowingly, I have been informed that test results showed I ingested something that contained prohibited substances. The hardest part about this is feeling that I have let down my teammates, the organization and the fans. I have been careful to avoid products that could contain something banned by MLB and the 20+ tests that I have taken and passed throughout my career prove this. I made a mistake, and I accept the consequences.”

Responses to the statement have been coming faster than Dee Gordon stealing second. Players, from all teams, are showing concern and making comments on the news about Gordon’s suspension.

Figure 1 Tweets by MLB players in response to Dee Gordon’s PED suspension

Justin Verlander’s Twitter response adds powerful perspective to the issue and shows how personal it is to the players, the majority of whom love and respect our national pastime.

Figure 2 Twitter post made by Justin Verlander from the Detroit Tigers. 

Why was Gordon Allowed to continue playing when these test results came in?

Gordon won the National League batting title in 2015 and was an All-Star player while with the Dodgers and the Marlins. Having him on the field obviously makes him a valuable asset to a team. You can ask anyone who was at Dodger Stadium Thursday night when Gordon “delivered the game-tying RBI single for the Marlins in the seventh inning,” which more or less solidified the series sweep.

Gordon had originally appealed the test results, meaning that nothing was going to be released publicly until the situation had been decided, which is in accordance with MLB policy. He was allowed to continue to take the field while the case was going through the appeal process. The news became public Friday morning, because Gordon decided to no longer appeal the results. But his answer just leads to more questions.

Should the punishment be more severe for players who cheat?

The topic of performance-enhancing drugs in the league has been trending lately due to the recent announcement of the Chris Colabello doping violation a week ago, Taylor Teagarden’s suspension earlier this month, as well as allegations of Chicago Cubs’ pitcher, Jake Arrieta, cheating after his recent successes on the field drew attention. Gordon’s suspension has further catalyzed conversations already in motion about what to do with his test results as well as the punishments associated with them.

The USA Today summarized the MLB penalties as of March 28, 2014 as follows: “Players and owners announce penalties will increase to 80 games for a first testing violation and to 162 for a second, and a season-long suspension will result in a complete loss of that year’s salary, rather than 162-183rds. A player who serves a PED suspension during the season will be ineligible for that year’s postseason.”

Even with these changes made, is it enough to incentivize players to not cheat? Many aren’t so sure. In an article released on April 21, by Fox Sports, the opinions players have about the MLB drug-testing program were discussed. Ever opinionated on the topic, Verlander discussed a potential way to clean up the league. “Maybe more severe punishments,” he said. He also mentioned that “It’s too easy for guys to serve a suspension and come back and still get paid,” which is what will happen with Gordon.

Another player, Matt Holliday from the St. Louis Cardinals, gave his take on punishments for cheating players in the article. “If you’re caught taking something where they prove that you’re trying to cheat,” he said, “that it’s a legitimate steroid or testosterone. I’m all for a year, two years, to keep guys from trying to cheat…for as harsh a penalty as possible. I’m all for second chances. But if you make the penalty super, super stiff, guys will think twice. They’ll look at 80 games and think, ‘That’s not that big a deal.’ But if you start taking away two years, that’s a lot of money. That might be different.”

We can all speculate that harsher punishments would make it a more difficult decision for players to take banned substances. They would also make it even more of a priority to be aware of what is in dietary supplement products or other medications athletes use. Lack of knowledge in this area can lead to problems, just ask Maria Sharapova, who tested positive at the Australian Open for the banned substance Meldonium. Thankfully, in the case of supplements, third-party certification programs like the BSCG Certified Drug Free® program are available that evaluate and test supplements to ensure they are free of banned substances to help mitigate the risks for athletes.

Is there incentive for players to cheat, regardless of the current punishments?

Gordon was traded to the Miami Marlins at the end of his best season with the Los Angeles Dodgers in 2014. Flash Gordon looked great in Dodger blue. Many fans in Chavez Ravine were sad to see him leave, especially having seen his stats soar after leaving. Of course, now that Gordon added another Dee to the PED discussion opinions have changed as we don’t need another superstar turned PED poster boy in L.A.

Last season, Gordon won the National League batting title with a .333 average. That was a big deal, due to the fact that he was neck-and-neck with Washington Nationals outfielder, Bryce Harper. He also led the league in stolen bases, with 58, a number not seen since JACKIE ROBINSON (yes, that guy) did it in 1949. Dee Gordon ended 2015 with the label “Big Deal” associated with his name and, as a result, was given a five-year, $50 million contract extension with the Miami Marlins.

Interviews were conducted before the 4-game series against the Dodgers on April 25th, prior to Gordon’s announcement. It was there, when Don Mattingly, who you might know as Donnie Baseball or the manager of the Los Angeles Dodgers from 2011 to 2015, discussed being the new manager of the Marlins and his thoughts of Gordon as a player, “What I always liked about him was his swing. You have to remember he was 140-something pounds when he started and now he’s brought it up to about 170. This is a kid that’s put on a lot of mature strength and his speed tools aren’t going away. That’s something that makes you feel really good about what he can do.”

As his manager ironically noted, Gordon was getting bigger, stronger, and better. The pressures that come with playing at this level include maintaining his skills in order to prove he is deserving of that label “Big Deal”. It isn’t unfathomable for a player to resort to taking performance-enhancing drugs in order to keep oneself at that professional level. It has been done before!

Gordon’s current punishment, aside from the 80-game suspension, includes a fine of $1.65 million. One might think that is a lot of money, until you realize it doesn’t even touch the $48.35 million he is still guaranteed on his contract. This being said, one could conclude that Gordon fought hard to earn this big paycheck, at any means possible, because cheating was worth close to fifty million dollars for him.   

Did Gordon use performance-enhancing drugs with mal intent? Did he cheat to gain weight and strength throughout his career? Was he trying to keep that “Big Deal” label while in Miami, or make it even bigger? Could this be something that happened unknowingly as his public statement claims?

While those questions linger, a single theme seems to resonate in professional baseball; even though a player’s failed test leads to a tarnished reputation, or demotion to the minor leagues, or retirement, or 80 game sanctions, he still makes millions of dollars. This is perhaps one reason why the issue of abusing banned substances in professional sports can be rationalized by players. Buster Olney’s statement about Gordon’s suspension puts it well, “the incentive to cheat will far outweigh the risks involved in being caught. Whatever the intent, whatever the justification, PED crime in baseball pays well.”

If we can learn anything from the past two days, it is that the PED discussion is far from over in MLB. Those who thought the steroid era was over may need to reconsider. We also need to reconsider how the system can be improved and made stronger for the sake of the players and the fans who love our nation’s pastime. For now, Gordon is just another name added to the list of MLB players that have tested positive for PEDs. He isn’t the first, sadly–he won’t be the last.

Maria Sharapova and Meldonium – Consideration of a Therapeutic Use Exemption After a Positive Drug Test

Maria Sharapova – London 2012 – Photo by Oliver Catlin, http://www.bscg.org

The coverage of Maria Sharapova’s announcement of her positive drug test for meldonium, or mildronate, has been astounding. Her case is yet another amazing example of a great champion falling victim to performance-enhancing drugs in one way or another. We wrote an immediate blog post about it an attempt to consider the two potential sides to a doping issue. That post still provides an interesting view of the perspective we were aiming to provide and we stand behind the bulk of the content.

In our haste to give Ms. Sharapova the benefit of the doubt in the situation, however, as we did in our conclusion and in the suggestion that perhaps her therapeutic use would be considered retrospectively, we did not fully consider the realities behind Ms. Sharapova’s claim of therapeutic use. Thankfully our friends in the anti-doping doping community have elegantly expounded on this element of the case.

The expert analysis below on therapeutic use and application in World Anti-Doping Agency (WADA) doping control is important to consider. It corrects the notion that a TUE could be granted retroactively and impact a pending sanction, which would be extremely rare if not completely unique in the field of anti-doping.

The information below was written by Dr. Ken Fitch and distributed by Jim Ferstle, both valued friends and colleagues who care deeply about clean sport and anti-doping and have spent their careers fighting for the cause as we have. The points of primary interest: retroactive TUEs would be unlikely to be considered from a standpoint of sanction relief, and the defined timeframe and clinical guidelines for use of a drug should always be scrutinized when evaluating potential therapeutic use. Thank you, Ken, for providing an insightful explanation of the criteria involved in the consideration of therapeutic use exemptions and the potential application to meldonium.

Dr. Ken Fitch is an Australian doctor and Professor, School of Sports Science, Exercise and Health, Faculty of Life Science University of Western Australia. Dr. Fitch wrote the original rules for TUEs in 1991 for the IOC, chaired the IOC’s TUE Committee for 20 years, chaired WADA’s interim committee (2001-2003) that established the initial International Standard for TUE (2004) and chaired Australia’s national TUE Committee for 22 years.

Maria Sharapova’s lawyer exploring a possible TUE to exempt a sanction
by Ken Fitch, M.D.

The ludicrous suggestion by Sharapova’s lawyer that she might seek a retroactive Therapeutic Use Exemption (TUE) to avoid a sanction for testing positive to meldonium demands a response. Ignoring whether the 2016 World Anti-Doping Code and the 2015 International Standard for TUEs does or does not make a retroactive TUE a possibility in her circumstances, if anybody examines the criteria that must be met to grant a TUE, he/she would understand that no respectable TUE Committee could approve any such application.

WADA states that there are four criteria, all of which must be met to grant a TUE.

1. The drug is necessary to treat an acute or chronic medical condition and the athlete would experience a significant impairment to health if it were to be withheld.
2. The therapeutic use of the prohibited drug is highly unlikely to produce any additional enhancement of performance beyond what might be anticipated by a return to the athlete’s normal state of health following the treatment.
   
3. There is no reasonable therapeutic alternative to the use of the prohibited drug.
4. The necessity to use of the prohibited drug is not a consequence of prior use of a prohibited drug or method.

Would Sharapova’s health be significantly impaired if she was denied a TUE? The Latvian makers of meldonium advise that it should be taken in intermittent courses of 4-6 weeks and for what period of time Sharapova administered meldonium during the past ten years, has yet to be disclosed. As the only acceptable medical indications are for ischemic cardiac and ischemic cerebral conditions, it is unthinkable that Sharapova has either. Hence any claim that should she be denied the right to take meldonium would impair her health is simply fanciful. Any TUE application must fail criterion 1.

The second criterion was introduced because some athletes had an essential need to take a prohibited drug. For example, an insulin dependent diabetic would die if denied insulin which has been prohibited in sport since 1998 and their daily insulin injections that are permitted with a TUE do not enhance performance. Whether meldonium actually enhances performance in humans has yet to be demonstrated. That WADA has advised that in less than two months since it was added to the Prohibited List, 99 athletes have tested positive for meldonium would appear to indicate that many athletes and their advisors believe that it does. No athlete could claim that meldonium was essential to restore their health back to normal levels. To claim that without it, a person’s health would be less than normal is surely fictitious. Fails criterion 2.

There are many drugs that have been demonstrated in scientific trials to be valuable in cardiac ischemia and the vast majority would be far superior to meldonium. The few meldonium studies performed in humans have been on persons who recently had experienced a myocardial infarction or an acute coronary syndrome. That the makers of meldonium recommend that it be administered only in intermittent courses in contrast to most of the widely acceptable, prescribed alternatives that are to be taken daily, is further evidence of the non-essential status of meldonium to treat cardiac ischemia. As the drug is marketed in only ten countries globally and Sharapova has lived in the USA for much of her life where meldonium is not approved for human use, this poses further questions for the tennis player.

Drug therapy for cerebral ischemia is generally ineffective and less frequently used than for cardiac ischemia but those patients on whom meldonium was trialled had had either a recent stroke or evidence of deteriorating brain function. As Sharapova could not possibly demonstrate that she has either of these or indeed significant cardiac or cerebral ischemia, and if she could, alternative permitted drugs are at least as effective if not more so, she fails criterion 3.

Hence Sharapova fails 3/3 and the fourth criterion has no relevance. Finally, should an unscrupulous or ignorant TUE Committee happen to grant Sharapova a retroactive or even a prospective TUE for meldonium, WADA would be certain to appeal to CAS and the decision would be or should be overturned.

Maria Sharapova and Meldonium – Consideration of a Positive Drug Test

Maria Sharapova – 2012 London Olympic Games – Photo by Oliver Catlin, www.bscg.org

Before jumping to conclusions and lambasting Maria Sharapova as a deliberate doper over recent revelations, we should attempt to educate ourselves and arrive at an informed decision based on the circumstances at hand. There is much to consider when reviewing Ms. Sharapova’s recent positive drug test at the Australian Open for the drug Meldonium.

First, we start with the drug, Meldonium, also known as Mildronate. You can review the pubchem listing for mildronate if you are interested. Other synonyms for the drug include “Quaterin; 76144-81-5; Kvaterin.” The long IUPAC chemical name is 3-[(trimethylazaniumyl)amino]propanoate.

In medicine, Meldonium is used to treat cardiac conditions like angina and vascular disease. It was developed by a Latvian company Grindeks and is approved in the Russian Federation and other countries but not in the Unites States. The description on Drugs.com describes it in two therapeutic categories; “treatment of cardiac disorders” and “inhibitor of carnitine synthesis.” Drugs.com includes 11 brand names across the Russian Federation, Latvia, Georgia and Lithuania: “Cardionate, Meldonium Olainfarm, Meldonium-MIK, Mildronat, Mildronat Grindeks, Mildronats, Mildroxyn, Vazomag, Midromax, Mildronate, Milkor.” There are 189 publications to explore via PubMed if you want to want to spend the time perusing them.

It appears Ms. Sharapova tested positive for the drug in an ITF (International Tennis Federation) drug test on Jan. 26 at the Australian Open. This information comes from her own accounts and the various media summaries of her case, including one from the New York Times that includes a video of her press conference in which she disclosed the positive test results. She explains the details saying, “I was legally taking the drug for the last ten years. I was getting sick very often, I had a deficiency in magnesium. I had irregular EKG results, and I had a family history of diabetes.” She added she had used the drug since 2006 based on treatment advice from her doctor.

Meldonium was added to the World Anti-Doping Agency (WADA) Prohibited List for 2016 under the category ‘S4. Hormone and Metabolic Modulators’. Prior to 2016, Meldonium was on WADA’s monitoring program list, meaning they were watching to see if it was being abused by athletes. The notes from WADA’s 2016 Prohibited List – Summary of Major Modifications and Explanatory Notes that came out on September 16, 2015, says that “Meldonium (Mildronate) was added because of evidence of its use by athletes with the intention of enhancing performance.”

More specifically, an abstract from a publication on Meldonium in Drug Testing and Analysis from December 2015 mentions, “the anti-ischemic drug Mildronate demonstrates an increase in endurance performance of athletes, improved rehabilitation after exercise, protection against stress, and enhanced activations of central nervous system (CNS) functions.” A good explanation on the logic and research leading WADA to prohibit of Meldonium is included in a blog from March 3, 2016, noting the positive drug tests of runners Abebe Aregawi and Endeshaw Negesse, who also recently tested positive for Meldonium.

According to a Roidadvisor.com article, “Performance-enhancing Drugs Used by Athletes That Are Surprisingly Common,” (Oct. 17, 2015),“Meldonium has generally been used by athletes in various sports for its mild stimulant-like properties.” The piece goes on to say, “Of interest to athletes is the finding that it consistently and significantly improves exercise tolerance. Some pharmaceutical companies have recently marketed it explicitly as a performance-enhancing drug. It’s also used as a ‘smart drug’ by non-athletes. Athletes have been using it for over 5 years.” Of additional concern, the article mentions other similar drugs “telmisartan (Micardis) and T3 liothyronine (Cytomel) – are currently being used by numerous elite athletes particularly in endurance sports.”

So, on the one hand there appears to be a plausible and legitimate medical reason for Ms. Sharapova to have used Meldonium. It could have simply been a mistake that she continued to use it in 2016 without realizing it had become prohibited or seeking a therapeutic-use exemption for the drug, which presumably she could have and still might receive if her account holds true. It’s possible that will be evaluated retrospectively. It would appear there was enough time to consider the potential concern as Meldonium was on the WADA monitoring program list since January 1, 2015 and notification of it being added to the Prohibited List came out more than three months before the start of the year. It is not known if the ITF provided any notification to its players in addition to the information WADA provided.

Now, the cynics will probably look at the message board information and say it appears clear that athletes have known about the doping potential of drugs like Meldonium for years now. They may conclude that Ms. Sharapova has come up with a convenient explanation of what happened after the fact. Sadly, that explanation is also plausible.

This issue is the perfect example of a primary challenge we face when confronting the need to conduct anti-doping testing to keep sport clean. All we have is the test results that indicate a positive or negative finding in a urine sample. The results do not speak to the motivations or intentions of the athlete. In situations like this one, or in cases that involve dietary supplement use, it is hard to know whether the athlete is being truthful in their explanation or if they have developed a convenient explanation for their use of the substance involved.

We will see how things conclude in this case. Given what we know about the character of Ms. Sharapova, we have to think this is accidental doping. Of course one can never be certain and the rules of strict liability still apply as they always do in the anti-doping realm, and as she herself notes in her statement. Sadly, she is now subject to a possible two years of sanctions and has had a pall pulled over the culmination of a fabulous career. Tennis will miss her and her the game. This case is the perfect illustration of the need for drug tested athletes to take it upon themselves at the end of each year to be vigilant and review changes in the WADA Prohibited List to ensure their medications and dietary supplements are compliant with the drug testing rules for the next year.

By Oliver Catlin, President, Banned Substances Control Group, www.bscg.org

FDA warns that tainted products marketed as dietary supplements are potentially dangerous – Anti-Doping Research’s Dietary Supplement Survey – A strategy in response

The Good, the Bad, and the Dirty in the Dietary Supplement Industry – Anti-Doping Research’s (ADR) Dietary Supplement Survey

Despite being widely available today, dietary supplements can contain unsafe and illegal substances that pose significant health risks to consumers.  Novel designer steroids, stimulants like ephedrine, pharmaceutically active ingredients like sibutramine, and other untested or unsafe ingredients continue to slip into the dietary supplement marketplace.  The FDA has responded with a significant and laudable new effort to work with the industry to combat the issue as described in, “FDA: Tainted Products Marketed as Dietary Supplements Potentially Dangerous.”  We would like to assist the effort through ADR’s Dietary Supplement Survey, for which we are currently raising financial support.

In ‘Tainted Body Building Products,” the FDA issued a warning that, “FDA cannot test all products on the market that contain potentially hidden ingredients.  Enforcement actions and consumer advisories for tainted products only cover a small fraction of the tainted over-the-counter products on the market.”  The numbers of tainted products are vast and the problems real.  According to the press release, “In recent years, FDA has alerted consumers to nearly 300 tainted products marketed as dietary supplements and received numerous complaints of injury associated with these products.”  Yet this is just a small fraction.  We would like to use our experience to help test and expose more, one of the primary goals of our Dietary Supplement Survey.

In the words of the FDA Commissioner, Margaret A. Hamburg, “These tainted products can cause serious adverse effects, including strokes, organ failure, and death.”  The dangers, as we know first-hand, are all too real, as we have dealt with numerous cases of acute liver injury in young adults who have used such products.  Colleagues such as Don Hooton have had lives forever changed by the suicide of a son using steroids to pursue athletic advancement.  Unfortunately, the issues are not isolated to body-building products as they span other categories like weight loss and sexual enhancement as well.  If such products are manufactured in the same facilities as legitimate supplements, the potential for contamination is also a concern.

In the FDA Letter to Industry, a fine point is made. “These products not only pose risks to consumers,” it states, “but undermine confidence in legitimately marketed dietary supplements in these and other categories.”  The majority of the dietary supplement industry produces products that do not contain illicit ingredients or contaminants and that should also be showcased.  In the letter, the “FDA is also seeking continued input and collaboration from the trade associations to educate the industry about this problem and to develop strategies to combat it.”

We believe that ADR’s Dietary Supplement Survey initiative could be such a strategy.  To sum up our goals:  We aim to explore which products are good, which products are bad, and which products exhibit contamination with low but potentially harmful levels of illicit ingredients.

More specifically, we will perform focused testing on problem categories to expose dangerous new products.  We will also conduct testing on a variety of randomly selected products to evaluate the prevalence of contamination and to demonstrate that the majority of products are indeed clean.  In the process, we will help audit the current retail environment to assist with enforcement and will characterize new supplement ingredients that have the potential to cause harm or lead to a positive drug test.  The results of our work will available via an interactive website portal complete with testing data, public service announcements and more.

As a public charity, Anti-Doping Research, a leader in performance-enhancing drug and toxicology research and testing, is working to raise $1.5 million to conduct the Dietary Supplement Survey.  We hope to gain broad support from a variety of sources to provide for a collective solution.  We have reached out to our friends in the dietary supplement community, the sporting community, anti-doping, collegiate and high school athletics, sporting sponsors, pharmaceutical companies and others in pursuit of support.  We would also welcome the involvement of the general public through volunteer activity or small contributions.  All donations are tax deductible.

If you have any questions, please contact us at 310-482-6925 or by e-mail at dcatlin@antidopingresearch.org or ocatlin@antidopingresearch.org.

Consumers, athletes and other elite professionals deserve a marketplace offering legitimate and safe dietary supplements.  With your help, we are confident that we can help make this happen.   Please join us and help support this important initiative with your contribution today.

Dietary supplement manufacturing and why designer steroids should matter to the general public

Perhaps you might think that you are far removed from the issues related to designer steroids.  Some see it as a problem for professional or Olympic sport to deal with but don’t see the issue influencing their daily lives.  Well, if you take dietary supplements on a regular basis, as more than half the population of the United States does, according to a recent Nielsen survey, designer steroids should matter to you.

Why, you might ask; I only take vitamins or herbs?  Well, the answer comes from the manufacturing process, which often occurs in co-packing facilities in the case of dietary supplements.  Co-packers simply mix and package the formulas provided by various supplement manufacturers and turn them into final products.  If your vitamin, protein powder, amino acid supplement or other product is processed in the same facility as one of the many designer steroids that continue to be produced you may have a problem.

A quick tour of a co-packer manufacturing facility illustrates the potential for contamination…

First, the raw materials are obtained and are warehoused for use.

The raw materials

The ingredients for a particular formula are then gathered and sent for measuring.

Gathering raw materials on pallet

The ingredients are weighed out according to the formula for the product.

Weighing the ingredients

The ingredients are combined in a huge blender to be mixed for hours.  If the blender is not completely cleaned and sanitized between mixes of different products, one can see how cross-contamination between products can occur.

The giant blender

If your protein powder is produced just after a designer steroid, one can see how cross-contamination might occur.    Many co-packers in the industry make an ethical choice not to participate in the manufacturing of dangerous products like designer steroids, but not all.  O.K., so there are regulations in place to protect against possible contamination of the finished products with potentially harmful unlabelled ingredients right?  Wrong.  (In fairness to the many competent and capable co-packers we should mention that we test products regularly from the facility shown above and have yet to find any contamination)

Certainly dietary supplement industry regulations have come a long way.  The phase-in of the Current Good Manufacturing Practice (CGMP) for dietary supplements over the last few years is likely to significantly improve quality of products as manufacturers are held to the new standards that CGMP dictate.  All manufacturers are now subject to CGMP, although the industry recognizes that the benefits will only be as good as the enforcement and auditing of the CGMP.

The new CGMP requirements, however, DO NOT include the need to test finished goods for contaminants such as designer steroids.  This is surprising given the prevalence of such compounds still today, even though they should be illegal to put in supplements.  CGMPs do require raw materials to be tested for purity prior to being formulated in the product and they also require testing for adulterants like arsenic or lead.

Some argue that purity checks will ensure that contaminants like designer steroids do not enter the marketplace.  However, if you explore the concept of purity testing and you realize that purity checks are often done at the microgram level, the problem is exposed.  Microgram testing is done at parts per million, testing for contaminants like designer steroids is usually done at the parts per billion level (nonograms).  Say you do a purity check on an ingredient and it comes back 99% pure after testing at the microgram level.  Well, how do you know the other 1% does not contain a hidden steroid, stimulant or otherwise unlabelled pharmaceutical ingredient? 

Is it O.K. if your protein powder, amino acid, or vitamin contains microgram quantities of a steroid or stimulant?  How does that magnify itself in your body with daily use of a protein powder where a serving size might be 100 grams, three times daily?  We don’t think that such contamination is acceptable as it could reach levels significant enough to lead to harm for a consumer.  Certainly, such levels of contaminants could cause positive drug tests for elite professionals like athletes or police officers; in fact, even contamination in the low parts per billion can lead to positive drug tests.

We would like to evaluate how prevalent contamination is in today’s supplement marketplace.  Nobody knows the scope of the issue since there are no requirements to test.  We want to survey the industry to characterize the issue through random sampling of a variety of products.  We also want to work to expose the bad products in the industry, like the new designer steroid options that continue to pop up daily.

If you are interested in such issues and would like to support our efforts to conduct a survey of products from the industry, please reach out to us at info@antidopingresearch.org or explore our Dietary Supplement Survey concept, which we are currently raising funding to conduct.  All contributions to our 501c3 public charity Anti-Doping Research are tax deductible.  We would welcome your support of this public-health initiative as we believe it will lead to improved consumer protection, better regulations, and much-needed improved quality control of dietary supplements.

Strict liability rules in doping violations for clenbuterol: the Ovtcharov, Contador and Hardy cases

Clenbuterol

The recent news reported by Associated Press on September 22 that German Olympic Table Tennis medalist Dimitrij Ovtcharov was suspended over a positive doping test was likely missed by many in the United States, but it was certainly not missed in Germany.  What should be notable to all is that this is yet another violation due to clenbuterol, the same drug that Tour De France Champion Alberto Contador tested positive for a few months ago.  Also at the core of this case is the long-held rule of strict liability that has been a core tenet of the anti-doping system and is undergoing a series of tests currently due to the influx of recent clenbuterol positive drug-test reports.

This core tenet, described on page 19 in section 2.1.1 of the World Anti-Doping Code – 2009 says that athletes are responsible for any substance found in their body.  The comment provides a good history of the rule and describes that “in the exceptional circumstance where a Prohibited Substance entered an Athlete’s system through No Fault or Negligence or No Significant Fault or Negligence on the Athlete’s part” modified sanctions may be considered.  The consideration of fault or negligence has been adopted over the course of time based on experiences similar to that of American swimmer Jessica Hardy, who also tested positive for clenbuterol back in 2008 and lost her opportunity to compete in the Olympics because of it.

In her case, our laboratory found that the supplements she was taking were contaminated with clenbuterol.  After a long legal fight, she did receive a reduced sanction of one year based on this consideration, though she has to continue to fight to be allowed to compete in the next Olympic Games as drug test violations in today’s system are supposed to keep you out of the next Olympics.

Apparently as of October 15, 2010 news indicates that Ovtcharov’s doping suspension has been lifted after the report by Cologne doping expert Wilhelm Schaenzer noted that “the intake of clenbuterol through contaminated food was the likeliest explanation for the finding.  A doping related use of clenbuterol is highly unlikely.”

We are not surprised by the notes of our friend and colleague Dr. Schaenzer, as we have had similar musings ourselves in regards to the Contador case.  We do note that nothing in the comments quoted from his report in the article above seem to definitively state where the source of clenbuterol originated.  It is also noteworthy that the Ovtcharov suspension seems to have been lifted after only three weeks based on the statements that he was ‘likely’ not at fault.  Comparing this situation to Jessica Hardy’s one-year sanction and two-year-plus legal battle is perhaps most striking.

Now, we have no inside knowledge or information regarding this matter and we suspect that Dr. Schaenzer would not make such statements without data to demonstrate that the likelihood of doping does not exist in this case.  We would like to find out more information.  We are also curious about the hair test noted in the article, how it was done and what it demonstrated.

Meanwhile we have to wonder about the Contador case as he too has blamed contaminated meat for the clenbuterol finding, according to an article in The New York Times on September 30, 2010.  According to the article, Contador’s hired expert, Dutch scientist Douwe de Boer, “has already generated a paper concluding that ‘it is extremely likely and would be only fair’ to say that the existence of clenbuterol in Contador’s system was from an accidental ingestion of contaminated meat.”  The article goes on to note, “An expert in clenbuterol contamination in meat, however, characterized Contador’s explanation as almost impossible.”  Certainly, the swirling rumors surrounding placticizer tests and blood transfusion possibilities do not help his cause.  Perhaps a hair test will exonerate him as well, we will see.  Meanwhile, Contador must move on to month two of his fight; time will tell if it is as long as Jessica Hardy’s.

Once all is said and done, it will be interesting to examine how the strict liability rules are applied in these cases and the others that are out there.

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