All About Salbutamol

[Merckx index]

I wouldn't call 5-10% insignificant to the final reading and, if we are assuming that it is being used for doping which would necessitate a very high dose I don't think 40-50mg is unreasonable. 24mg over 24 hours certainly isn't unheard of for oral dose treatment regimes. Again, it's not going to explain the very high reading by itself, but it could certainly be a contributory factor to that high number.

So if Froome “only” had 1800-1900 ng/ml, would that make any difference? No. That's within lab error, e.g., Ulissi's A sample was 1920, while I believe the B sample was reported as 1805.

And when I said 40-50 mg, I meant all at once. If that dose is taken over a long period of time, the peak blood value is going to be far less. You can see this clearly, e.g., in the Sundby CAS case, when he took 15 mg via nebulizer over a period of five hours, and had urine levels considerably lower than what a single 15 mg dose would have produced (blood levels not measured there, but it's the same principle). So even a contribution of 5-10% is quite unlikely.

This is grasping at straws. I understand why some people are pushing the transfusion theory, it makes a very neat explanation for how Froome got such a high level on just one stage, plus ties him to a much more serious form of doping. I wish it made sense, but it doesn’t.

So you'd found a paper that shows it gets to the lungs. If that's the case why did you ask me?

I looked for it after I saw your post, because you were postulating that Froome might have taken salbutamol orally for his ashthma. Studies like the one I linked, and I have seen others, indicate it’s highly unlikely he would do that.

To use your own words, science is not all or none. But it frequently does come down to levels of significance, in fact, that's one of the main goals. Transfusion wouldn't contribute zero to Froome's level, but it would contribute so tiny an amount that it's insignificant. It doesn't aid in understanding what happened. In the same way, some orally dosed salbutamol gets to the lungs, but it's such a small amount that this would not be an efficient way of treating asthma.

I don't see what we are gaining from speculating that .1% of the dose is from some mysterious blood bag. Much more of the dose is down to when Froome stopped to take a piss, which we haven't clarified yet either.

Of course. This makes a huge difference, and could conceivably explain how he took about the same dose as he did on other stages, yet had a much higher urine level. Particularly if in those other stages his levels were close to the threshold/DL, another possibility that we can't assess yet.

 

[samhocking]

Re: Re:

We all agree then, which is not how you appear to be answering MI. sorry, maybe I read wrong? Happy to go with 10% from a blood transfusion and we can now get back to finding the other 90% that sees a urine amount of 2000. What did Sky miscalculate by a further 90% after the alleged transfusion?

So that means we need to find the remaining 1800. Actually only the remaining 601, since anything under 1200 doesnt get reported.

Is that so? Lab has to find +1200ng/ml not +1000ng/ml? That's not been reported has it?

 

[70kmph]

'Circumstances and context are more enlightening than concentration and exceeding the threshold. They bring us more wealth of information.'

-Scientific Director of WADA, Dr. Olivier Rabin

 

[Merckx index]

Re:

Is that so? Lab has to find +1200ng/ml not +1000ng/ml? That's not been reported has it?

It's been discussed here. The decision level is 1200 ng/ml. Basically, it means that while 1000 ng/ml is the maximum allowed amount, because of measurement uncertainty, only a level > 1200 is considered over the threshold with 95% certainty.

That's why I calculated that Froome needs a USG of 1.034 or greater. That would raise the DL from 1200 to 2000.

'Circumstances and context are more enlightening than concentration and exceeding the threshold. They bring us more wealth of information.'

-Scientific Director of WADA, Dr. Olivier Rabin

Circumstances and context didn't help Petacchi or Ulissi. Meanwhile, Renato Di Rocco, President of the Italian Cycling Federation and a member of the UCI Management Committee, expressed concerns just a couple of days ago about the uncertainty in the Froome case. In the absence of any reporting on Froome’s USG, I take statements like this as further evidence that he isn’t going to get off automatically on that basis in March. I just can’t see him hiding this information from someone like Di Rocco, nor can I see Di Rocco going out of his way to pretend that he didn’t know what was going on.

http://www.tuttobiciweb.it/2018/01/08/107973/di-rocco-froome-soluzione-lontana-tuttobiciweb-contador

 

[Merckx index]

I've already posted links to a lot of studies of cyclists in which USG was measured. Values above 1.030, even under dehydrating conditions, are fairly rare except in hot weather, > 30 degrees, when a significant portion of the subject pool may exhibit them. Petacchi's USG as stated in the CAS decision was 1.033, but the temperature at one point in that stage was reported as 34 degrees. Values > 1.040 aren't impossible. I saw a study of women soccer players in a tropical climate, a few of whom had values higher than this before the game even started.

 

[gillan1969]

Re:

I've already posted links to a lot of studies of cyclists in which USG was measured. Values above 1.030, even under dehydrating conditions, are fairly rare except in hot weather, > 30 degrees, when a significant portion of the subject pool may exhibit them. Petacchi's USG as stated in the CAS decision was 1.033, but the temperature at one point in that stage was reported as 34 degrees. Values > 1.040 aren't impossible. I saw a study of women soccer players in a tropical climate, a few of whom had values higher than this before the game even started.

thanks..I think this was the info I had missed previously....a couple of points arising

first...if 1200 is the trigger, presumably it drops back down to 1000 for the actual analysis? Otherwise, why even have 1000 formally recognised if it's only a staging post to get to the actual level of 1200?

and

if he's over 1.030 then would this not have all been wrapped up by now?

 

[Rollthedice]

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.

 

[Wiggo's Package]

Re:

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...?

 

[Rollthedice]

Re: Re:

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.

 

[Robert5091]

The UCI Anti-Doping Tribunal who could decide Dawg's fate - one of these -
http://www.uci.ch/news/article/anti-doping-tribunal/

Helle Qvortrup Bachmann (DEN)
Prof. Ulrich Haas (GER)
Emily Wisnosky (USA)
Andreas Zagklis (GRE)
Julien Zylberstein (FRA)

 

[Wiggo's Package]

Re: Re:

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?

 

[TourOfSardinia]

Re:

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.

Here the link to the article in Italian.
http://www.corriere.it/sport/18_gennaio_07/ciclismo-doping-froome-accerchiato-pedala-ritiro-studia-strategia-db981f44-f319-11e7-a586-43e3ef84081a.shtml

 

[Djoop]

Deleted post

 

[70kmph]

Re: Re:

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

 

[Craigee]

Could Froome really be the only human being on the planet to produce such a high reading without overdosing? Yeah I know we all agree he is an Alien anyway but gee is everyone really so naïve?

If a driver gets breathalysed and is double the allowed limit, can he tell the court that he produces such high alcohol readings even on just one glass of beer or could he say that he was dehydrated which spiked up his alcohol readings? Can there be that one driver on the planet?

 

[Merckx index]

Great find, RolltheDice. 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.

Also very interested to hear that his previous levels were all < 600 ng/ml:

http://www.tuttobiciweb.it/2018/01/09/108011/chris-froome-la-battaglia-E-cominciata-lads-uci-salbutamolo

This is what i expected, a little higher than i would have thought--remember, he claims he only inhales when he's making great efforts--but consistent with inhaling the allowed amounts. So he can't claim he's an outlier, and while he's quoted as saying he has trouble metabolizing salbutamol, or something to that effect, it doesn't appear that he does, unless those 600 ng/ml levels follow just one or two puffs. But if that were really the case, he should have been aware that taking a lot more puffs would put him over the threshold.

As someone mentioned, this pretty much ends speculation that he was going to skate based on his USG. His taking the lab test also has to mean that his team does not have a very plausible explanation for his high level. Of course they will be working on that, in anticipation of an appeal if he's initially suspended, but I can't see his taking the lab test if they thought they had a convincing explanation.

 

[Rollthedice]

Great find, RolltheDice. 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?

I think he can't take anything to CAS until he's handed a decision by the UCI anti-doping tribunal.

 

[Merckx index]

Re:

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 ?

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. And it's quite possible that Froome's sample has already been subjected to the enantiomer test, Petacchi's was before he was notified of the positive.

In fact, if his sample did fail the enantiomer test, that could be why he wants to take the lab test. The combination of a high level of salbutamol, plus an S/R ratio of > 2.5, would be very difficult to beat with any kind of scientific presentation. Showing that he could reproduce those results in the lab might be his only hope.

I think he can't take anything to CAS until he's handed a decision by the UCI anti-doping tribunal.

Yes, he can: Article 8.5 of the WADA code. He can take it directly to CAS. WADA or UCI have to agree, but in a case this high profile, I think they would. The only reason they wouldn't is because he would be in limbo for a very long time, riding the Giro and probably Tour before a decision was announced.

 

[Craigee]

Re:

So Uncle Brian is notifying Froome of the AAF he will never have to answer? Is that not like a corrupt policeman filling you out a speeding ticket and giving it to the magistrate even though he's accepted money to not issue you with a ticket? WADA has to be notified of the result at some point, AAFs can't simply be deleted off an athletes ADAMS file you know because UCI don't have the access to do that.

Are you saying that nothing has ever been swept under the carpet by the UCI? Really? It's strange that Lance and his whole team admitted to full on doping, yet they got away with it. The whole team doped during the Tour for years. No one at the UCI can have a connection with someone at WADA either? You do realise the world is full of corruption don't you.

 

[thehog]

Re: Re:

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.

 

[ScienceIsCool]

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

 

[Red Rick]

Yeah. They're basically giving Froome the chance to cheat his way out. If they can't distinguish oral from inhaled, what's to stop them from gaming it with pills if they want.

DId other riders who tested positive for this drug get the opportunity to test it in a lab?

 

[thehog]

Re:

Yeah. They're basically giving Froome the chance to cheat his way out. If they can't distinguish oral from inhaled, what's to stop them from gaming it with pills if they want.

DId other riders who tested positive for this drug get the opportunity to test it in a lab?

Yes.

 

[Catwhoorg]

Re: Re:

first...if 1200 is the trigger, presumably it drops back down to 1000 for the actual analysis? Otherwise, why even have 1000 formally recognised if it's only a staging post to get to the actual level of 1200?

Its all about measurement uncertainty and making a case defensible in court.
Set the limit at 1000, and any reading above 1200 is pretty much bullet proof assuming no test abnormalities.

Set the limit at 1200, then you need ~1450 to have just a strong a case.

 

[lartiste]

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.