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All About Salbutamol

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Re: Re:

10 Jan 2018 16:38

Merckx index wrote:The enantiomer test does not actually distinguish oral from inhaled, it's designed to distinguish oral or inhaled beyond the allowed amounts from inhaled within the allowed amounts.


Is this a matter of semantics, because otherwise what would be the purpose of the testing by Bergés, and the methods developed since then based upon it ? In the original paper it reads on the one hand :

The larger the discriminant score (D), calculated from Eq. 1,
[involving free vs. conjugated salbutamol and S vs. R enantiomer]
the more likely it is that the sample was in the oral group rather than in the inhaled group.

and on the other,

"Therefore, a definitive distinction between prohibited oral and authorized inhaled salbutamol in doses that are adequate for all asthmatic athletes to compete can be achieved by HPLCconfirmatory urinalysis of suspicious samples"
ClassicomanoLuigi
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Re: All About Salbutamol

10 Jan 2018 17:30

ScienceIsCool wrote:
ClassicomanoLuigi wrote:
Merckx index wrote:I'm quite surprised that Froome is going to take the lab test. I thought he felt he couldn't pass, and would take the case directly to CAS. And I'm also puzzled that he's waited so long to do this. What was he doing last fall? This is a big gamble for him, because if he fails, he should get suspended, and while he can appeal, he will stay suspended until the process finishes. His only hope if he is suspended is that the suspension is back-dated and short enough to allow him to ride the Giro or at least the Tour. But it would certainly mess up his preparation for them.
Exactly, in essence Froome / Sky want for him to fail the Lausanne testing - since Froome is certain to fail it in the same manner as Ulissi. So what's the strategy behind that ? With months to have come up with something, Froome now chooses to fail the lab test..

Could it be that he would rather fail on the irreproducible salbutamol levels now, thereby making the enantiomer test moot later? Accept a suspension, rather than have proof of oral salbutamol come out, since the results of future proceedings would not be made public? Is that a possible scenario, or would that not work anyway ?

I don't get it.
They must know already that Froome is gonna fail the Lausanne testing if he goes to the lab

I think they're going to game this.

My bet is that the delay is because they HAVE been in the lab, testing the various combinations of legal dosages and intervals and their effect on Froome. If they can manage to convince everyone that's what happened on the day in question then maybe Froome can get close enough to 2000 during the test. Say he gets a 1370. Now it's up to the lawyers to do some hand-waving and poking at the uncertainties.

It's transparent as hell, but it would be his best shot given the evidence.

John Swanson


This is exactly my conclusion. I would like to add just one point. Since I consider Sky team to be real professionals, I would expect, that they were testing even the various combinations and it's influence of food and drinks. I would bet, that if they decided to pass the test, that they have something in mind. E.g.: Froome will not drink anything before the test for longer time etc. I am quite sure that pre-dehydration can also influence the outcome.
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Re: All About Salbutamol

10 Jan 2018 17:48

lartiste wrote:
ScienceIsCool wrote:
ClassicomanoLuigi wrote:
Merckx index wrote:I'm quite surprised that Froome is going to take the lab test. I thought he felt he couldn't pass, and would take the case directly to CAS. And I'm also puzzled that he's waited so long to do this. What was he doing last fall? This is a big gamble for him, because if he fails, he should get suspended, and while he can appeal, he will stay suspended until the process finishes. His only hope if he is suspended is that the suspension is back-dated and short enough to allow him to ride the Giro or at least the Tour. But it would certainly mess up his preparation for them.
Exactly, in essence Froome / Sky want for him to fail the Lausanne testing - since Froome is certain to fail it in the same manner as Ulissi. So what's the strategy behind that ? With months to have come up with something, Froome now chooses to fail the lab test..

Could it be that he would rather fail on the irreproducible salbutamol levels now, thereby making the enantiomer test moot later? Accept a suspension, rather than have proof of oral salbutamol come out, since the results of future proceedings would not be made public? Is that a possible scenario, or would that not work anyway ?

I don't get it.
They must know already that Froome is gonna fail the Lausanne testing if he goes to the lab

I think they're going to game this.

My bet is that the delay is because they HAVE been in the lab, testing the various combinations of legal dosages and intervals and their effect on Froome. If they can manage to convince everyone that's what happened on the day in question then maybe Froome can get close enough to 2000 during the test. Say he gets a 1370. Now it's up to the lawyers to do some hand-waving and poking at the uncertainties.

It's transparent as hell, but it would be his best shot given the evidence.

John Swanson


This is exactly my conclusion. I would like to add just one point. Since I consider Sky team to be real professionals, I would expect, that they were testing even the various combinations and it's influence of food and drinks. I would bet, that if they decided to pass the test, that they have something in mind. E.g.: Froome will not drink anything before the test for longer time etc. I am quite sure that pre-dehydration can also influence the outcome.


Judging by his South African Strava rides sans dope control in 40 degree heat he is getting ready for the test (whilst deleting his heart rate data).
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Re: Re:

10 Jan 2018 18:55

70kmph wrote:
Rollthedice
tuttobici says that in all other tests for salbutamol in Vuelta he did not surpass the 600 level


It doesnt sound like hes an outlier, they would have known this already
The only good argument is its below the threshold which has built-in cushion
But 600ng/ml would normally represent a lot of puffing, a supratherapeutic dose
Its higher than Petacchi whose max was 537
And Petacchi was found to be supplementing his inhaler use
Ullissi numbers were like 80-140, very modest amounts as he would only take 2 puffs
Froome is using 6 times what Ulissi took


IF we believe that Froome was only taking a couple of puffs and getting readings up towards 600, wouldn't this support the theory that he is an outlier?
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Re: Re:

10 Jan 2018 20:05

brownbobby

IF we believe that Froome was only taking a couple of puffs and getting readings up towards 600, wouldn't this support the theory that he is an outlier?


Yes, that's what he is suggesting without using that specific term
Then all his other controls would be closer to 2000ng/ml with his normal dose
Because he says he always takes the same amount
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Re: Re:

10 Jan 2018 20:36

thehog wrote:
Wiggo's Package wrote:
Rollthedice wrote:
Wiggo's Package wrote:
Rollthedice wrote:The Italian Corriere dela Serra suggests that Froome is waiting to be summoned in Lausanne for a counter analysis (pharmacokinetic testing). Sky will provide a detailed memo on what happened on that day, what he ate and drank, the number of puffs and at what moment they were inhaled. This memo will set the rules and circumstances under which Froome will have to ride the rollers for 2 hours and then provide a urine sample. If the sample is in the vicinity of the values of the AAF then he walks free, if not he's done.


If true then can we assume that the Dawg's lawyer's have given up on looking for legal/procedural loopholes...? Including that his USG is low enough that there's no point in waiting for the new rule to come in in March...?


There's another piece on tuttobiciweb where they say that Mike Morgan, the lawyer is talking with LADS (Legal Anti-Doping Services) in order to demonstrate through technical analyses, testimonies, documents and tests that there is no fraud and that only physiological causes made Froome to reach that level. Interesting thing is that tuttobici says that in all other tests for salbutamol in Vuelta he did not surpass the 600 level " un risultato che in tutti gli altri controlli della Vuelta non ha mai superato quota 600". The logic dictates that during January or February LADS will propose Froome an "Acceptance of consequences". If he accepts it's over. If not then the UCI Anti-Doping Tribunal steps in and everything will take months and months with appeals on the horizon.


So Froome's lawyer is still looking for legal/procedural loopholes. Not sure why he'd go into the UCI lab with that ongoing

Btw, would an "acceptance of consequences" result in Froome getting a ban and losing the Vuelta?


I’m surprised his lawyer has direct access to LADS but assume this is to get all of the information regarding the test rather than to poke holes and apply pressure.

Considering this is Froome there’s abound to be some twists and turns. What is surprising is Froome hired his lawyer so late on he game. Only after the leak.


How do you know when Froome hired Morgan? Musta missed that link!
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Re: Re:

10 Jan 2018 21:01

70kmph wrote:
brownbobby

IF we believe that Froome was only taking a couple of puffs and getting readings up towards 600, wouldn't this support the theory that he is an outlier?


Yes, that's what he is suggesting without using that specific term
Then all his other controls would be closer to 2000ng/ml with his normal dose
Because he says he always takes the same amount


But I thought he initially said he increased his dose (within limits and under doctors orders) on the day of the test?
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Re: Re:

10 Jan 2018 21:40

brownbobby wrote:

But I thought he initially said he increased his dose (within limits and under doctors orders) on the day of the test?


Hey you are free to believe he can get to 600 on 2 puffs

Ulissi showed 140-180 on 2 puffs in the lab, to get up to his 1820 control he would have had to take 10 times that amount- 20 puffs
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10 Jan 2018 21:43

Katie Compton has cast doubts
http://www.cyclingnews.com/news/compton-questions-chris-froomes-asthma-medication-claims/
When asked if Froome's anti-doping troubles made her worried about treating her own asthma with salbutamol, she laughed.

"In Bredene, I had an asthma attack. I used my inhaler four times before the race, and then I had an attack, so I used it three times post-race to get me back to where I needed to be," Compton told Cyclingnews. "That was a legit[imate] asthma attack. That still is underneath the legal limit of salbutamol."
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Re: Re:

10 Jan 2018 22:05

Wiggo's Package wrote:
How do you know when Froome hired Morgan? Musta missed that link!


I would expect in September after Sky knew.
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Re:

10 Jan 2018 22:57

TourOfSardinia wrote:Katie Compton has cast doubts
http://www.cyclingnews.com/news/compton-questions-chris-froomes-asthma-medication-claims/
When asked if Froome's anti-doping troubles made her worried about treating her own asthma with salbutamol, she laughed.

"In Bredene, I had an asthma attack. I used my inhaler four times before the race, and then I had an attack, so I used it three times post-race to get me back to where I needed to be," Compton told Cyclingnews. "That was a legit[imate] asthma attack. That still is underneath the legal limit of salbutamol."


Well said but she forgot Froome has a crazy adaptive physiology and a weird metabolism that allows him to test positive and be let off.
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Re: All About Salbutamol

11 Jan 2018 00:20

From a Dr who actually knows about doping spoke about Froome’s positive:

Dr. Ferrari re Froome's salbutamol positive: “On a broad discourse, I could say that Froome, without salbutamol, would probably have never won 4 TdF. Like a cyclist with a 38 hct (hematocrit) without EPO. Both things (salbutamol and EPO) remedy the injustices of genetics...”


Image
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Re: Re:

11 Jan 2018 00:25

ScienceIsCool wrote:
My bet is that the delay is because they HAVE been in the lab, testing the various combinations of legal dosages and intervals and their effect on Froome.


Yeah, I can’t believe Froome did nothing for two months. That would only be the case if he was assured by someone that the positive would go away.
ClassicomanoLuigi wrote:
"Therefore, a definitive distinction between prohibited oral and authorized inhaled salbutamol in doses that are adequate for all asthmatic athletes to compete can be achieved by HPLCconfirmatory urinalysis of suspicious samples"


This is it in a nutshell. The distinction is between oral and allowed inhaled, not between oral and inhaled beyond the allowed amount. I discussed this paper upthread, and pointed out that they need to do a study to develop the discriminative function between oral and inhaled doses beyond the allowed amount, say 1200 or 1600 ug in 12 hr. Then if a rider wants to claim he made a mistake and inhaled too much, his claim can be examined. As it stands now, anyone who fails the enantiomer test can say he inhaled too much by mistake.

Another loophole is that even when inhaling, some of the drug is swallowed. If you were doing a lab test and wanted to demonstrate that you have a naturally high S/R ratio, I assume you could probably purposely swallow more of the inhaled amount than an asthmatic normally would, though this would probably also lower urinary levels, which you wouldn’t to do in a lab test.

brownbobby wrote:
IF we believe that Froome was only taking a couple of puffs and getting readings up towards 600, wouldn't this support the theory that he is an outlier?


Yes, and it would also be a good reason to have confidence in passing the lab test. It’s just that getting to 600 on 2-3 puffs would be extremely uncommon. E.g., in the Pichon study, where subjects took 2 x 100 ug, the mean urinary levels were < 100 ng/ml:

http://sci-hub.la/10.1055/s-2005-865627

Froome would be like that Swiss athlete who reportedly hit levels as high as 8000. And even if he really is that extraordinarily rare subject, as I pointed out upthread, I would think he would be following his levels, so that if he really got concentrations as high as 600 after two puffs, he should have realized that taking 6-8 puffs would probably put him over the threshold. I would have thought that he would have sat down with UCI/WADA before, and pointed this out to them.

Another thing to keep in mind is that 600 is a maximum. For all we know, he usually was at 200-300, and reached 600 only once or a very few times. We don’t know that he repeatedly was close to 600. We also don’t know how many puffs he has taken in the past, whether he frequently took all or most of the allowed 800 ug, or never more than 2-3 puffs.
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11 Jan 2018 00:41

It should not even be suggested Froom is some sort of outlier. He's never shown it up till now as far as we know.
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Re: All About Salbutamol

11 Jan 2018 01:14

Compton articulates very well the use of the Salbutamol based “rescue” inhaler. The preventive inhaler which in most cases is not Salbutamol based is used pre race or training. Froome stated exactly this in the Kimmage interview from 2014. His story just keeps changing.


"As someone who has exercise-induced asthma and allergies - if I have an asthma attack, I can't finish the race. I can barely pedal, let alone keep pushing hard. The rescue inhaler is exactly that - it's there for a few puffs to get you back to normal. It helps you breathe better, but granted, if I went hard again, I'd have another attack.

"It doesn't make sense that you could have that much in your system and still be able to pedal that hard. I don't know. I feel like something else is going on.”

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Re: All About Salbutamol

11 Jan 2018 06:06

ScienceIsCool wrote:I think they're going to game this.

My bet is that the delay is because they HAVE been in the lab, testing the various combinations of legal dosages and intervals and their effect on Froome. If they can manage to convince everyone that's what happened on the day in question then maybe Froome can get close enough to 2000 during the test. Say he gets a 1370. Now it's up to the lawyers to do some hand-waving and poking at the uncertainties.
It's transparent as hell, but it would be his best shot given the evidence.

John Swanson

That would be awesome !
Nerve-wracking moment of suspense, how many ng/ml can our Vuelta champion Froome pull out of this unforgiving test? Kind of like watching nervously for the finish-line results of a really close contre-la-montre time-trial. Will he beat it? Will he not? Will he beat it ..

And the logic from Sky behind the scenes, for 3 months of maneuvers, could very well have been

(1) Can we just make this positive go away somehow ?
No, it's real and being really pursued
(2) In that case, can we beat the testing using every known 'marginal' tweak to the human body?
Let's get cracking on that.

Thriller! Thank you John for lending us this screenplay in advance
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Re: All About Salbutamol

11 Jan 2018 06:09

thehog wrote:Compton articulates very well the use of the Salbutamol based “rescue” inhaler. The preventive inhaler which in most cases is not Salbutamol based is used pre race or training. Froome stated exactly this in the Kimmage interview from 2014. His story just keeps changing.


"As someone who has exercise-induced asthma and allergies - if I have an asthma attack, I can't finish the race. I can barely pedal, let alone keep pushing hard. The rescue inhaler is exactly that - it's there for a few puffs to get you back to normal. It helps you breathe better, but granted, if I went hard again, I'd have another attack.

"It doesn't make sense that you could have that much in your system and still be able to pedal that hard. I don't know. I feel like something else is going on.”



That has the stench of BS about it. Ventolin doesn't work that way. If the attack is severe you are still climbing off the bike and a few puffs doesn't get you back to normal, it lessens the wheezing and constriction and you will soon need more. It's a temporary fix. Rescue inhaler ? I wonder how many times Froome has quit a race because of an asthma attack ? I can never remember it happening at least not being reported.
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Re: All About Salbutamol

11 Jan 2018 07:22

ScienceIsCool wrote:I think they're going to game this.

My bet is that the delay is because they HAVE been in the lab, testing the various combinations of legal dosages and intervals and their effect on Froome. If they can manage to convince everyone that's what happened on the day in question then maybe Froome can get close enough to 2000 during the test. Say he gets a 1370. Now it's up to the lawyers to do some hand-waving and poking at the uncertainties.

It's transparent as hell, but it would be his best shot given the evidence.

John Swanson

marginal games!
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Re: Re:

11 Jan 2018 10:07

Robert5091 wrote:
Wiggo's Package wrote:
How do you know when Froome hired Morgan? Musta missed that link!


I would expect in September after Sky knew.


David Walsh has said that Sky are not funding Froome's defence because Froome didn't back the team and Brailsfraud last year over the Wiggo's jiffybag debacle

So if Froome is funding his own defence that might have led to a delay in him getting lawyered up. Especially if he was expecting the problem to go away

But realistically, even if Brailsfraud is hanging Froome out to dry on the legal fees, surely he would have still told Froome to hire Morgan, the best doping case lawyer in the business, PDQ
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Re: Re:

11 Jan 2018 10:59

Wiggo's Package wrote:
Robert5091 wrote:
Wiggo's Package wrote:
How do you know when Froome hired Morgan? Musta missed that link!


I would expect in September after Sky knew.


David Walsh has said that Sky are not funding Froome's defence because Froome didn't back the team and Brailsfraud last year over the Wiggo's jiffybag debacle

So if Froome is funding his own defence that might have led to a delay in him getting lawyered up. Especially if he was expecting the problem to go away

But realistically, even if Brailsfraud is hanging Froome out to dry on the legal fees, surely he would have still told Froome to hire Morgan, the best doping case lawyer in the business, PDQ


I wouldn't be surprised if DB sees it as a way of getting rid of Froome. Lot's of new young riders and a chance for G etc.
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