All About Salbutamol

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What will the verdict in Froome's salbutamol case?

  • He will be cleared

    Votes: 43 34.1%
  • 3 month ban

    Votes: 4 3.2%
  • 6 month ban

    Votes: 15 11.9%
  • 9 month ban

    Votes: 24 19.0%
  • 1 year ban

    Votes: 16 12.7%
  • 2 year ban

    Votes: 21 16.7%
  • 4 year ban

    Votes: 3 2.4%

  • Total voters
    126
Jun 7, 2011
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Hello everyone, I have one question: wih regards to Froome, this whole process, what are the actual chances of Froome riding the TDF 2018?

Appreciate any replies.
 
Jul 6, 2014
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Re:

Poursuivant said:
Hello everyone, I have one question: wih regards to Froome, this whole process, what are the actual chances of Froome riding the TDF 2018?

Appreciate any replies.

I can't say I've been reading this thread all that closely, but from what I've gathered, most likely scenario = 9 month back dated ban, lose 2017 Vuelta, miss 2018 Giro and therefore, ride 2018 tdf.
 
Dec 30, 2009
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Re: Re:

The Hegelian said:
Poursuivant said:
Hello everyone, I have one question: wih regards to Froome, this whole process, what are the actual chances of Froome riding the TDF 2018?

Appreciate any replies.

I can't say I've been reading this thread all that closely, but from what I've gathered, most likely scenario = 9 month back dated ban, lose 2017 Vuelta, miss 2018 Giro and therefore, ride 2018 tdf.
I have been following and pretty much agree, probably Bergen 3rd in the ITT gone as well. TDF 2018 would be really tough though, given he would only be able to ride the Dauphine or more sensibly Suisse as the only pre TDF prep races . That all said, I will be the most unsurprised person in the world if Froome gets his double after it all goes away in March...
 
Jun 7, 2011
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Re: Re:

ferryman said:
The Hegelian said:
Poursuivant said:
Hello everyone, I have one question: wih regards to Froome, this whole process, what are the actual chances of Froome riding the TDF 2018?

Appreciate any replies.

I can't say I've been reading this thread all that closely, but from what I've gathered, most likely scenario = 9 month back dated ban, lose 2017 Vuelta, miss 2018 Giro and therefore, ride 2018 tdf.
I have been following and pretty much agree, probably Bergen 3rd in the ITT gone as well. TDF 2018 would be really tough though, given he would only be able to ride the Dauphine or more sensibly Suisse as the only pre TDF prep races . That all said, I will be the most unsurprised person in the world if Froome gets his double after it all goes away in March...


But I read somewhere that Because he hasn't been suspended, he can't have it backdated, or is that bull?
 
May 11, 2013
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Re: Re:

Poursuivant said:
ferryman said:
The Hegelian said:
Poursuivant said:
Hello everyone, I have one question: wih regards to Froome, this whole process, what are the actual chances of Froome riding the TDF 2018?

Appreciate any replies.

I can't say I've been reading this thread all that closely, but from what I've gathered, most likely scenario = 9 month back dated ban, lose 2017 Vuelta, miss 2018 Giro and therefore, ride 2018 tdf.
I have been following and pretty much agree, probably Bergen 3rd in the ITT gone as well. TDF 2018 would be really tough though, given he would only be able to ride the Dauphine or more sensibly Suisse as the only pre TDF prep races . That all said, I will be the most unsurprised person in the world if Froome gets his double after it all goes away in March...


But I read somewhere that Because he hasn't been suspended, he can't have it backdated, or is that bull?

If it's not his fault that the process is taking a long time then it can be backdated which is what happens usually. Anyway all his results after the date of the positive will be nullified until his ineligibility expires. Since Froome did not suspend himself or Sky didn't suspend its rider until the final verdict the big problem is with the organizers of Giro and Tour. They can't have a rider who potentially can win these races just to be potentially stripped of the title afterwards. That's why ASO already warned that an outcome should be reached as soon as possible.
 
Jun 7, 2011
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Re: Re:

Rollthedice said:
Poursuivant said:
ferryman said:
The Hegelian said:
Poursuivant said:
Hello everyone, I have one question: wih regards to Froome, this whole process, what are the actual chances of Froome riding the TDF 2018?

Appreciate any replies.

I can't say I've been reading this thread all that closely, but from what I've gathered, most likely scenario = 9 month back dated ban, lose 2017 Vuelta, miss 2018 Giro and therefore, ride 2018 tdf.
I have been following and pretty much agree, probably Bergen 3rd in the ITT gone as well. TDF 2018 would be really tough though, given he would only be able to ride the Dauphine or more sensibly Suisse as the only pre TDF prep races . That all said, I will be the most unsurprised person in the world if Froome gets his double after it all goes away in March...


But I read somewhere that Because he hasn't been suspended, he can't have it backdated, or is that bull?

If it's not his fault that the process is taking a long time then it can be backdated which is what happens usually. Anyway all his results after the date of the positive will be nullified until his ineligibility expires. Since Froome did not suspend himself or Sky didn't suspend its rider until the final verdict the big problem is with the organizers of Giro and Tour. They can't have a rider who potentially can win these races just to be potentially stripped of the title afterwards. That's why ASO already warned that an outcome should be reached as soon as possible.


Thanks
 
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I'm coming pretty late to this, but here are some thoughts as an asthmatic/cyclist/molecular bio PhD:

  • I don't think salbutamol has any performance-enhancing effects from normal, medically approved inhaler usage. Also in my personal experience if I take a normal dose (1-2 puffs) when I don't need it it doesn't do anything.
  • Salbutamol targets the beta 2 adrenergic receptor that's present in the smooth muscle in the lungs to cause the muscles to relax. In general though, when you up the dose of a drug, it becomes less selective and starts binding to other receptors. In this case you have the other adrenergic receptors - the ones involved in the fight or flight response. Higher doses of salbutamol will cause increased heart rate, jitteriness etc. I've needed salbutamol in nebuliser form (ie breathing it in continuously with a mask) in hospital emergency rooms a few times and definitely felt wide awake after it.
  • A legal drug with stimulant properties in higher doses will presumably tempt riders to sail close to the WADA limit. The benefits of stimulants in cycling are obvious, given the amphetamine era of the 50s-80s, although they're certainly not a gamechanger the way EPO is - they just allow the rider to push closer to their limit, rather than changing what that limit is.
  • Since Froome's case was about a high dose in-competition, I won't go into any reasons to take it OOC here.
  • There's no way salbutamol is what turned Froome from donkey to racehorse. It really is a marginal gain. If he goes down for this it'll be like Al Capone getting done for tax evasion.
  • It's marginal even in terms of grey-area TUE stuff. I've needed prednisolone quite a few times (it quite possible it saved my life a couple of times when I had severe chest infections) and that stuff's rocket fuel. And triamcinolone is supposed to be quite a bit stronger that that in turn.
  • It's complete speculation, but Froome is probably taking a ton of different stuff and it's possible something interfered with salbutamol metabolism. These interactions are common, for example grapefruit famously stops many drugs being broken down. Sky are probably scouring the literature looking for plausible interactions with (legal) substances to boost their case.
  • Froome's "I took a few puffs after the finish so I wouldn't cough on the podium and hence show weakness to my rivals" is pretty comical. I remember Rasmussen coughing badly on the podium in 2007 for example, right after riding everyone off his wheel.
  • I think the most likely explanation is that Froome took salbutamol with a nebuliser, which is allowed by WADA but also playing with fire because you're taking a continuous dose so it would be very easy to overshoot the limit.
  • It's possible him or others have overshot the limit in the past but talked their way out of it so he may not have been too concerned.

This one is going to run and run.
 
May 11, 2013
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Froome's "I took a few puffs after the finish so I wouldn't cough on the podium and hence show weakness to my rivals" is pretty comical. I remember Rasmussen coughing badly on the podium in 2007 for example, right after riding everyone off his wheel.

Not only funny but also incriminating. Negligence is punishable under anti-doping rules.
 
Jul 27, 2010
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Re:

Rollthedice said:
If it's not his fault that the process is taking a long time then it can be backdated which is what happens usually.

I don’t know whose fault it could possibly be that’s it’s dragging out if not Froome’s. How much time do you need to take a lab test? The problem is that one can always argue that a lot of time is needed to look for all the possible causes, so even if he’s intentionally stalling, it would be very difficult to prove that. One possible approach, though, is to note that some ADAs, as noted by John S, have time periods during which the AAF is supposed to be resolved, and Froome is way over that period. Obviously, the ADAs that set those time periods didn’t think it would take this long to do the needed research.

vedrafjord said:
I don't think salbutamol has any performance-enhancing effects from normal, medically approved inhaler usage. Also in my personal experience if I take a normal dose (1-2 puffs) when I don't need it it doesn't do anything.

Yes, and this is one of the problems here, as the South Bay blogs linked upthread pointed out. Froome is arguing that it wouldn’t be of any benefit to inhale more than the allowed amount, which distracts from the real issue, viz., was he taking oral doses? There the evidence for PE effects is better.

The benefits of stimulants in cycling are obvious, given the amphetamine era of the 50s-80s, although they're certainly not a gamechanger the way EPO is - they just allow the rider to push closer to their limit, rather than changing what that limit is.

There's no way salbutamol is what turned Froome from donkey to racehorse. It really is a marginal gain. If he goes down for this it'll be like Al Capone getting done for tax evasion.

Three comments on this. First, there are studies suggesting salbutamol can promote weight loss and muscle growth. Weight loss could be a game-changer. While Swart’s "he just lost the fat" may be an overstatement, it was certainly a major factor. You wouldn’t expect him to take a weight loss drug during a GT, but if salbutamol promotes muscle growth, it might aid recovery. And as always, it’s not the effects that matter, but the perceived effects.

Second, for most if not all methods of PE, there are going to be wide individual variations. Just because a substance doesn’t help much for many, perhaps most athletes—and thus no significant effect is seen in laboratory studies—doesn’t mean that it might not have a significant effect for some individuals.

Finally, with regard to stimulant effects, one of the points Froome’s supporters have claimed again and again is that he used to show flashes of brilliance, but was inconsistent. This was used to support the schisto story, but despite all the holes in that, there is some truth to the notion that he couldn't perform at his best consistently throughout a GT. In fact, that's a problem for most promising riders. To the extent this was the case, a stimulant might help his consistency, by providing him with more confidence. In fact, if you substituted "lack of confidence" for "sick with schisto" and "use of a stimulant" for "killing the worms" in all the team's public statements on the matter, you could pretty much make exactly the same claims Sky was trying to make with that story.

It's complete speculation, but Froome is probably taking a ton of different stuff and it's possible something interfered with salbutamol metabolism. These interactions are common, for example grapefruit famously stops many drugs being broken down. Sky are probably scouring the literature looking for plausible interactions with (legal) substances to boost their case.

A lot of people are talking about this, but is there any hard evidence? Many athletes have gone over the threshold in the past, of course, and their cases clearly would have benefited by being able to show an effect of interactions on metabolism/excretion, but AFAIK they all came up with nothing. Certainly no cyclist has used this as an effective defense. Also, remember that not only does Froome have to come up with a magic bullet, but he has to explain why it only had an effect on one stage. If it were something in his diet, e.g., he would have to establish that he only consumed that food the one time, not at any other time in the Vuelta, or apparently, in his entire career.

I think the most likely explanation is that Froome took salbutamol with a nebuliser, which is allowed by WADA but also playing with fire because you're taking a continuous dose so it would be very easy to overshoot the limit.

His level would certainly be consistent with that, but AFAIK, he hasn’t made that claim, and if he does, he runs the risk of tripping himself up again. When it came out in 2014 that he was asthmatic, he said he only needed it for “big efforts”. IOW, only during a race, and then only on MTF and the like. His statement really doesn’t allow for the possibility that he takes it when he’s not riding, which not only is inconsistent with use of a nebulizer, but also sets severe constraints on any lab test. We're seeing here a continuation of what happened with the schisto story, a number of inconsistent claims that don't add up, and which certainly suggest a lot of making stuff up.

It's possible him or others have overshot the limit in the past but talked their way out of it so he may not have been too concerned.

Yes, particularly since there is no AAF up to the DL of 1200 ng/ml. If he came in with 13-1400, I can see his talking his way out of it. But again, if this goes very far, his past results will be on the table, and it’s not going to look good if he was even close to the DL multiple times.

This one is going to run and run.

Only if his USG isn’t high enough. On that subject, what I would really like to know is whether whoever leaked the AAF—I mean, the individuals in the media who actually obtained this information—accessed the lab document, or were simply told by someone in the lab of the result. If the former, then they should know what his USG was. Simply by furnishing that information, they could end all the speculation, and we would know with virtual certainty whether Froome was going to be cleared in March, or if the case will go to CAS.

What I do know is that BBC reported the rule change about a week later, noted that Froome might get off if his USG was high enough—yet never pointed out the obvious corollary: Froome and his team must know that value, and so must know right now whether he can get off in March. Incredible that BBC never followed up on that. What were they thinking?

Also, some of the earliest responses provide no support for the conclusion that anyone was aware of this issue at the time. The day after the leak, Vegni lamented how unlucky the Giro was to have what could be potentially another Contador situation. He clearly didn’t know that Froome might skate in March. About a week later, Prudhomme said it was urgent that the case be resolved quickly. He didn’t know. Team Sky spoke about unpredictable variations in salbutamol metabolism, interaction with food, timing of doses, and even dehydration, all the kinds of things people say when they have no idea what the explanation is and are desperately searching for one. The Guardian said that “informed sources expect the case to drag on for several more months”. Doesn’t appear they knew about a magical clearing in March. And asthma researcher John Dickinson gave an interview about a week after the leak, in which he reiterated the old WADA rule that a USG correction is not allowed for salbutamol. So at the time he wasn’t even aware that the rule had been changed.
 
Jul 14, 2015
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Merckx index said:
Only if his USG isn’t high enough. On that subject, what I would really like to know is whether whoever leaked the AAF—I mean, the individuals in the media who actually obtained this information—accessed the lab document, or were simply told by someone in the lab of the result. If the former, then they should know what his USG was. Simply by furnishing that information, they could end all the speculation, and we would know with virtual certainty whether Froome was going to be cleared in March, or if the case will go to CAS.

What I do know is that BBC reported the rule change about a week later, noted that Froome might get off if his USG was high enough—yet never pointed out the obvious corollary: Froome and his team must know that value, and so must know right now whether he can get off in March. Incredible that BBC never followed up on that. What were they thinking?

I've been wanting to post this, but it's more of a frustration so it doesn't really add to the thread here. It's so unfortunate no journalists do original research anymore - the USG is such a crucial value that at the same time is readily available and recorded as part of the sample "metadata". Someone doing cursory research on this could stumble upon Petacchi and others and go back to their source and ask for that simple value. But here we are.
 
Jul 27, 2010
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Looking through Petacchi’s CAS report, I see something interesting I hadn’t realized before. Here is the timeline of events. Petacchi’s sample was given following a Giro stage on May 23, 2007. Apparently it was sent to the lab and immediately tested, because by the very next day the salbutamol concentration of 1350 ng/ml had been recorded. But then there was a three week delay to allow the enantiomer test, which helps distinguish inhaled from oral doses. That test concluded that Petacchi’s salbutamol level was not consistent with an inhaled dose within the allowed limits. He was informed of his AAF on June 27, about a week after the enantiomer test was completed, and waived his right to have the B sample tested. The hearing was held on July 24, two months after giving his sample, and one month after he was informed of his AAF.

What I hadn’t realized is that Froome’s sample must also have been subjected to an enantiomer test. Though I haven’t seen this in the WADA protocols, I think this must be standard whenever a result exceeds the threshold or DL. Since Froome was informed of the AAF on Sept. 20, I assume the enantiomer test result was known at that time. At the very least, it surely would have been performed some time later. I think, though I’m not sure, that if the test was consistent with an inhaled dose within the allowed limits, there would have been no AAF (or any AAF withdrawn). If so, it follows that Froome’s level is considered inconsistent with an allowable inhaled dose, and in fact, is probably more consistent with an oral dose. To understand that, we need to know a little more about the enantiomer test.

The test at the time of Petacchi’s case was based on a study published in 2000, though I’m not sure if that’s still the one used:

http://clinchem.aaccjnls.org/content/46/9/1365.long

They found a false negative rate of about 12%, i.e., 88% of oral doses would be identified, while 12% would be considered the result of inhaling. This relatively high false negative rate is tolerated in order to have a very low false positive rate, i.e., virtually every case of inhaled dose is correctly identified as such. But this 12% figure probably underestimates the problem, because the oral dose used was quite high—4 mg every 6 hr for 24 hr. A lower oral dose—say, 2 mg every 6 hr, or just one dose of 5-10 mg in a 24 hr period--would be somewhat harder to distinguish from an inhaled dose. In order to maintain a very low false positive rate, one would have to tolerate a higher rate of false negatives.

So even if an athlete passes the test, it hardly offers a lot of confidence that he didn’t orally dose, and if he doesn’t pass it—as was the case with Petacchi, and as I think must have been the case with Froome—it seems to me that the probability is quite high that he did orally dose. All the test is really designed to do is distinguish between an inhaled dose within the limits and a dose, either inhaled or oral, that is over the limit. It appears that it would be very easy to beat it by using lower oral doses, which one would want to do, anyway, to keep urine levels down.

Another interesting point made by the authors is that drugs that block the sulfation of salbutamol, such as Tylenol, would actually shift the enantiomer test in favor of the athlete, i.e., it would appear more likely that he was inhaling when he might have been dosing orally. Another substance that does this is Vitamin C.

Finally, the Petacchi timeline is also interesting because his hearing was held one month after he was informed of his AAF. Yet here we are, more than three months after Froome knew of his AAF, and still no hearing in sight.
 
Mar 7, 2017
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"What I do know is that BBC reported the rule change about a week later, noted that Froome might get off if his USG was high enough—yet never pointed out the obvious corollary: Froome and his team must know that value, and so must know right now whether he can get off in March. Incredible that BBC never followed up on that. What were they thinking?"

There are two issues which IMO an enterprising journalist could follow up:

- As you say, is Froome's USG high enough that he could skate when the rule change comes into force in March?
- How did the rule USG change come about (i.e. can it be established that Froome's AAF was the trigger for the rule change)?

The BBC are perhaps unlikely to follow up these points but Martha Kelner or Matt Lawton might:

- https://twitter.com/marthakelner?lang=en
- martha.kelner@guardian.co.uk

- https://twitter.com/matt_lawton_dm?lang=en
- m.lawton@dailymail.co.uk
 
Mar 13, 2013
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I wonder if Froome was using functional dehydration for the stage 18 finish as it was a relatively short simple stage but with a decisive long finish drag with kick to the finish where function dehydration could make significant power to weight difference? Both Sky & BMC are said to now be using Brock's dehydration research for some uphill finishes, so if done correctly, they would be finishing with about a 3% weight loss but with no effect on power. In Froome's case, 3% off his 69kg hydrated body weight, would mean he finished about 2000ml (2kg) lighter. I'm not sure how much this would affect his USG, but no doubt will be argued by Sky if that's what they were using.
 
Jul 5, 2009
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samhocking said:
I wonder if Froome was using functional dehydration for the stage 18 finish as it was a relatively short simple stage but with a decisive long finish drag with kick to the finish where function dehydration could make significant power to weight difference? Both Sky & BMC are said to now be using Brock's dehydration research for some uphill finishes, so if done correctly, they would be finishing with about a 3% weight loss but with no effect on power. In Froome's case, 3% off his 69kg hydrated body weight, would mean he finished about 2000ml (2kg) lighter. I'm not sure how much this would affect his USG, but no doubt will be argued by Sky if that's what they were using.
Functional dehydration is a complete oxymoron. 2% loss by weight is highly associated with fatigue in endurance sports. It also reduces VO2max. Increased plasma viscosity, reduction in blood pressure, etc. There's absolutely nothing functional about it.
http://www.humankinetics.com/excerpts/excerpts/dehydration-and-its-effects-on-performance

The best part is that dehydration is a big no-no for anyone with exercise induced asthma due to the drying of the lungs.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5451531/

The only time I've ever heard the words functional and dehydration together was when Palfreeman offered them up. It's a term that appears nowhere else and has no meaning. It's pure distilled BS and I advise against consuming it.

John Swanson
 
Mar 13, 2013
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Functional Dehydration was last researched in 2015 by Stephen Cheung, a renowned kinesiologist at Brock University in Ontario. Nothing to do with Palfreeman, although Palfreeman commented on that research in 2016 after he worked at BMC to El Pais. Cheung's research published in the Journal of Medicine and Science in Sports & found upto 3% dehydration doesn't result in power loss. What tends to happen however is athletes being denied hydration and the symptoms of feeling thirsty affects motivation to hold that power. This is where taking paracetamol, menthol drinks and thirst suppressing drugs can offset the negative psychological effects of feeling thirsty and being denied hydration.
Cheung's study separated the conscious awareness of hydration or not by using fake IV drips doing nothing and real IV drips maintaining hydration I believe.
 
Jul 27, 2010
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Following up on Sam's post, I went back and looked at some of the studies on USG changes in cyclists. In the Armstrong (not that Armstrong) study of riders completing a 164 km ride in temperatures averaging 35 degrees, the mean weight of the men at the start was about 86 kg and the mean fluid loss was 1.7 kg or about 1.9%. The mean USG rose slightly from pre- to post-race, but the latter was 1.024, with about 20% of the riders > 1.030.

In a TT study carried out at 35 degrees under different conditions of hydration, riders in the dehydrated states lost about 3% of their body weights, but their USG at the end was not significantly different from that of the hydrated group (about 0.5 weight loss), about 1.020.

A study of ultra-marathon MTBers at cool temperatures found they lost an average of 2% of body weight, with no effect on USG. Another study of marathon bikers in a 720 km ride at moderate (20-25) temps. reported an average loss of 1.7% body mass with no significant change in USG.

Most of the studies reported losses of BM in the range of 1-2%, and certainly to this point there was no evidence of a significant increase in USG. The TT study is the one with a loss of 3%, and still no evidence of an increase.

With regard to effects on performance, most of the studies were of cyclists in races/rides in which they were trying to maximize performance, and clearly the 1-2% loss of BM was not detrimental, though in some cases I'm not sure how much of it was from dehydration. In the TT study (by Cheung, whom Sam referred to), power was measured, and there was no effect of 3% dehydration on performance. The authors end by stating:

Therefore, we conclude that current guide-lines advocating the importance of rehydration to maintain body mass loss within < 2% body mass during exercise in the heat as an ergogenic aid may be overly conservative in fit and trained populations.
 
Mar 13, 2013
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Thanks for the post MI. So looking unlikely, even if he was using Brock's 3% Functional Dehydration, USG is not seeing that much difference anyway than simply finishing with a more typical 1% dehydration for this short, not too hot stage. Obviously we don't know if Froome was already dehydrated before the stage, but can't believe he would have been as we know Sky do analyse riders hydration already and even take urine samples too iirc. Likewise, we don't know if 3% functional dehydration was even used by Froome. Cheung's research might suggest more than 3% dehydration is not detrimental in highly trained athletes. I'm sure with Palfreeman again at Sky now since June 2016, he would have experimented with Cheung's research if he was talking about it at sports science conferences and El Pais.

This is the El Pais Palfreeman piece from where we first heard about Functional Dehydration in CN, Broadsheets & road.cc etc google translated from https://elpais.com/deportes/2016/12/04/actualidad/1480880811_593191.html

This conference was the Aspire Sport Science Conference titled "Monitoring Athlete Training Loads - The Hows and Whys" in 2016 in Qatar i believe and where ElPais has taken Palfreeman's words from I assume.

I would say, the significant part of the talk is actually the use of Wellbutrin (smoking cessation aid) being used as a thirst cessation aid and WADA is very concerned of its use in sport. Also interesting is the World Marathon record was broken by Dennis Kimetto in 2014 using Functional Dehydration.

The weight of a runner is the biggest mystery of cycling, the biggest obsession. Losing eight kilos between 2007 and 2012, dropping from 75 to 67 kilos, Chris Froome went from being a rider in the bunch to winning the Tour. With less total displacement (measured in oxygen consumption) and less absolute power in watts, the Briton achieves the same relative performance as Miguel Indurain, who was practically the same but weighed, at the time of breaking the record of the hour in 1994, 14 kilos more. "And losing two kilos in a few hours a day of Mountain Tour, Froome is able to ascend the Alpe d'Huez in 47s less, which is not little considering that in 2015, for example, won the Tour only for 72s. And two kilos can be lost through controlled, functional dehydration, drinking less than a certain logic would demand. "


The blunt statement came out of the mouth of Roger Palfreeman, doctor of the Sky in 2016, who delivered a conference in Doha (Qatar) last week on heat and cycling.

Palfreeman's argument was based on a simple arithmetic operation: if weighing 67 kilos, Froome was able to ascend with a power of 6.25 watts per kilo, weighing 65 would move 6.45 watts per kilo, so it would rise to more speed with the same expense. The simplicity of the basic proposition presupposes, also contrary to the general belief, that with a dehydration of 3%, the necessary to lose two kilos, there is no decrease in performance. And a series of premises that Palfreeman threw away in his presentation, in which he spoke of how athletes can learn to tolerate the sensations of drinking less than what the body asks of them so that it does not affect their performance. "Optimal hydration is not balanced hydration," he said.

To do this, to reduce the nocebo effect (believing that something will go wrong determines the final result, and run urged by thirst is not bad detonating for it), Palfreeman, doctor in his time also of the BMC team and the British Federation of Cycling, advocated that had runners misinformed hydration status to eliminate negative thoughts and recommended mouthwash with menthol to deceive thirst and generate a cold sensation. He called this process "thermal perception training", and also includes, according to Palfreeman, medication with paracetamol, which helps to alter the thermal perception and has analgesic effects, and the antidepressant Wellbutrin (bupropion), which improves performance at 30 degrees. Its use worries the World Anti-Doping Agency (AMA),

Before the start of the Tour, Palfreeman said that training should be done to adapt to heat, as if prepared to compete at 40 degrees but after the actual temperature was lower, by dehydration and 40-minute baths in 40-degree water. With them a weight gain is achieved because it increases the volume of plasma, just the fluid that is lost most with the sweat of the effort, and also an increase in oxygen consumption, because the capillaries are increased to bring oxygen-laden blood to all muscles and increases the pumping power of the heart. Froome arrives at the Tour with overweight, willing to lose it dehydrating to weigh less on the mountain.

"Then there, everything is a calculation", explains the Spanish physiologist Alfredo Santalla who recalls that Dennis Kimetto broke the marathon world record using a strategy of low hydration. "With the decrease in plasma the power of cardiac pumping decreases in systole and less oxygen reaches the muscles. It is estimated that with a 2% dehydration the yield drops by 10%. That technique would only work if the gain for climbing with less weight is greater than that loss. "

Other doctors of active cycling teams did not see any meaning to these theories and, maintaining their anonymity, considered them "part of the marketing" of a team, the Sky, which self-defends itself as the most scientific and careful team with the detail. "I would never reveal the secrets that make my cyclists run more," says a doctor, who recalls that nothing Palfreeman said is based on scientific studies.

The experience of Iñigo Mujika
"We studied the possibility that the decrease in performance could be compensated by the lower weight, but we saw that it was not the case, since the time to exhaustion and the power at a certain speed in ascent to 8% decreased very much. important in a hot environment ", explains the Biscayan physiologist Iñigo Mujika, author of a book, Resistance training, who has just seen an infographic edition and in which he studies in detail the problems of competing in a hot environment and hydration. "In this study I was a participant and researcher, and I remember the sensations perfectly. When I was voluntarily dehydrated I felt very light at the beginning of the climb, and I thought I was going to go like a shot, but suddenly, booom!, you go through thermoregulation problems. However, when it was well hydrated the fatigue came in a much more progressive way, and allowed you to somehow regulate better. "
 
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vedrafjord said:
I'm coming pretty late to this, but here are some thoughts as an asthmatic/cyclist/molecular bio PhD:

  • I don't think salbutamol has any performance-enhancing effects from normal, medically approved inhaler usage. Also in my personal experience if I take a normal dose (1-2 puffs) when I don't need it it doesn't do anything.
  • Salbutamol targets the beta 2 adrenergic receptor that's present in the smooth muscle in the lungs to cause the muscles to relax. In general though, when you up the dose of a drug, it becomes less selective and starts binding to other receptors. In this case you have the other adrenergic receptors - the ones involved in the fight or flight response. Higher doses of salbutamol will cause increased heart rate, jitteriness etc. I've needed salbutamol in nebuliser form (ie breathing it in continuously with a mask) in hospital emergency rooms a few times and definitely felt wide awake after it.
  • A legal drug with stimulant properties in higher doses will presumably tempt riders to sail close to the WADA limit. The benefits of stimulants in cycling are obvious, given the amphetamine era of the 50s-80s, although they're certainly not a gamechanger the way EPO is - they just allow the rider to push closer to their limit, rather than changing what that limit is.
  • Since Froome's case was about a high dose in-competition, I won't go into any reasons to take it OOC here.
  • There's no way salbutamol is what turned Froome from donkey to racehorse. It really is a marginal gain. If he goes down for this it'll be like Al Capone getting done for tax evasion.
  • It's marginal even in terms of grey-area TUE stuff. I've needed prednisolone quite a few times (it quite possible it saved my life a couple of times when I had severe chest infections) and that stuff's rocket fuel. And triamcinolone is supposed to be quite a bit stronger that that in turn.
  • It's complete speculation, but Froome is probably taking a ton of different stuff and it's possible something interfered with salbutamol metabolism. These interactions are common, for example grapefruit famously stops many drugs being broken down. Sky are probably scouring the literature looking for plausible interactions with (legal) substances to boost their case.
  • Froome's "I took a few puffs after the finish so I wouldn't cough on the podium and hence show weakness to my rivals" is pretty comical. I remember Rasmussen coughing badly on the podium in 2007 for example, right after riding everyone off his wheel.
  • I think the most likely explanation is that Froome took salbutamol with a nebuliser, which is allowed by WADA but also playing with fire because you're taking a continuous dose so it would be very easy to overshoot the limit.
  • It's possible him or others have overshot the limit in the past but talked their way out of it so he may not have been too concerned.

This one is going to run and run.

I agree that it is very unlikely that Froome is taking Salbutamol alone and that it is Salbutamol alone that is upping his performance and the effects from Salbutamol wear off quite quickly when the wheezing is constant but if he did need to take it a lot during the race he would not be performing the way he did. A high speed long bike race is not the place for even moderate wheezing and a full blown asthma attack would be a withdrawal from the race. Even though a huge amount of Salbutamol was found, maybe something else was undetected. And if he wasn't wheezing at all and the Salbutamol was mostly taken before the race started I can't see him receiving any benefit from that at all really. Long term there may be something in the high doses for muscle building and weight loss but even then, such high doses for how much gain ? But Froome can't be taking such doses ongoing otherwise it would have been flagged before. Very odd.
 
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samhocking said:
Functional Dehydration was last researched in 2015 by Stephen Cheung, a renowned kinesiologist at Brock University in Ontario. Nothing to do with Palfreeman, although Palfreeman commented on that research in 2016 after he worked at BMC to El Pais. Cheung's research published in the Journal of Medicine and Science in Sports & found upto 3% dehydration doesn't result in power loss. What tends to happen however is athletes being denied hydration and the symptoms of feeling thirsty affects motivation to hold that power. This is where taking paracetamol, menthol drinks and thirst suppressing drugs can offset the negative psychological effects of feeling thirsty and being denied hydration.
Cheung's study separated the conscious awareness of hydration or not by using fake IV drips doing nothing and real IV drips maintaining hydration I believe.

You're hanging your hat on a single study of 11 subjects. The reality is that the effects of dehydration on performance has been studied since the 1940's and there's a large body of work. Here's a review study from an author at my Alma Mater, http://www.nrcresearchpress.com/doi/pdf/10.1139/h99-014

Note that the author cites some studies that have had inconclusive results, but supposes that the length of exercise was either not long enough, or the environmental conditions not extreme enough. It's a great read because it also details some studies that mirror Cheung's, such as one by our dear friend Coyle. However, the consensus is still that even moderate dehydration will affect performance (time to exhaustion, peak output, etc) with the effects proportional to the level of dehydration.

Despite Cheung and Palfreeman, my personal belief is that "functional dehydration" is complete BS. Even by some miracle it wasn't BS, how would you even implement that in a race? You'd have to be continuously taking blood samples to keep hydration in the range of "functional".

John Swanson
 
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I'm not hanging any hat? I'm simply looking at what the minimal arguments Sky could use, specifically in relation to Merckx index's comments about USG and dehydration and Sky's legal case and remembered Palfreemans comments about using functional dehydration for mountain finishes and Froome's AAF is after such a finish and if they would link USG to using that. I was simply interested if it could make much difference to USG and Merckx's kindly replied suggesting it probably would not. I'm fine with that, not hanging onto anything.
 
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samhocking said:
I'm not hanging any hat? I'm simply looking at what the minimal arguments Sky could use, specifically in relation to Merckx index's comments about USG and dehydration and Sky's legal case and remembered Palfreemans comments about using functional dehydration for mountain finishes and Froome's AAF is after such a finish and if they would link USG to using that. I was simply interested if it could make much difference to USG and Merckx's kindly replied suggesting it probably would not. I'm fine with that, not hanging onto anything.

Oh I see. Thanks. I had the wrong idea about your perspective, and agree with you.

John Swanson
 
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I'm no authority in this area, but I get the sense from what I've read that most people seem able to lose 1-2% of BM through dehydration without much problem (unless they're actually riding sub-optimally and aren't aware of it), while maybe some riders can do more. Armstrong was cited in the link John posted, and since he was one of the researchers I was also citing I looked to see if he made any mention of this. He just briefly alluded to possible individual variation. I'd just add that if 1-2% is normal, 3% may only provide a 1% extra benefit, probably not enough to be worth the risk of bonking. But maybe Andy C or Alex know something about this and will weigh in.

Also, Palfreeman mentions Froome's dropping from 75 to 67 kilos, but he was well below 75 before the transformation in 2011.I'd have to go back and check, but he mentioned some weights in the Kimmage interview, and I think he was around 71 when he joined Sky. Grappe said he was 69 when he studied him in I think it was 2012/13.
 
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69kg is what I see written the most regarding Froomes' weight today. I guess for GTs he might drop to 67kg though. Interestingly Froome said he gained 1.5kg in last week of 2017 Tour de France so hard to be precise.
From Palfreemans comments about the direct relationship between entering the race with additional plasma from 40 minute baths and then functional dehydration having an almost EPO effect was interesting unless I've missed Palfreemans meaning of how it works with the 40 minute 40 degree baths and increasing blood plasma just before a race after Google translate? Suggests Sky have been experimenting with it either way.
 

thehog

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Wiggo's Package said:
"What I do know is that BBC reported the rule change about a week later, noted that Froome might get off if his USG was high enough—yet never pointed out the obvious corollary: Froome and his team must know that value, and so must know right now whether he can get off in March. Incredible that BBC never followed up on that. What were they thinking?"

There are two issues which IMO an enterprising journalist could follow up:

- As you say, is Froome's USG high enough that he could skate when the rule change comes into force in March?
- How did the rule USG change come about (i.e. can it be established that Froome's AAF was the trigger for the rule change)?

The BBC are perhaps unlikely to follow up these points but Martha Kelner or Matt Lawton might:

- https://twitter.com/marthakelner?lang=en
- martha.kelner@guardian.co.uk

- https://twitter.com/matt_lawton_dm?lang=en
- m.lawton@dailymail.co.uk


At the very least it will allow for Froome to get a significantly reduced ban. He doesn’t need to bring himself beneath the allowable linit but close to will be good enough.

I have no doubt the rules introduction is solely due to Froome. What would be the chances otherwise? Surely not coincidence.