Dertie Contador's allergies and his TUEs

[Mrs John Murphy]

Apologies for being ignorant here, what would be the negative effects of Acetazolamide for an endurance athlete and would they outweigh any masking benefits?

 

[131313]

Edit: I just checked out Acetazolamide which is the first on the list of diuretics on the primer and it turns out that it is used in the treatment of epilepsy http://en.wikipedia.org/wiki/Acetazolamide

Again, I'm not trying to bore you to death: http://www.ncbi.nlm.nih.gov/pubmed/16499476

This was interesting to me because if indirectly looks at the effects of muscle pH and endurance performance. Carbonic anhydrase increases muscle acidosis. As it turn out, that's about as bad as it sounds. The effect seems to go away at altitude; i.e. it has a deleterious effect at sea level, which seems to go away at altitude.

So, if you wanted to use a diuretic, you'd be better off using one which didn't otherwise negatively affect your performance.

I certainly think it's reasonable to be suspicious of anyone who's won several grand tours, but if these were actually masking agents of choice, I suspect you'd see more professional athletes claiming seizures!

 

[Mrs John Murphy]

Thanks. I'll read through it before asking anymore questions. (before asking another question)

I know that baseball has published a list of TUEs - which is how we have the 106 players claiming ADHD. Does the UCI have a similar list of riders and what is being claimed for? All I've seen is a figure that says 60% of 105 tested riders had TUEs.

 

[Oldman]

There are a lot of different airborne pollens, and all affect different people differently or not at all. From what is written (not here, press statements etc), I would guess his problem is an early season perennial grass although it might also be some tree.

The thing is, pollen allergy season depends on the location and the allergen. It will be early in warm climates, later in cold climates: the same species of plant needs a certain number of degree-days to come into flower no matter where on earth it grows. Corsica, being surrounded by the Mediterranean, will have been ahead of most of Europe by a significant amount. There is also a short-term weather effect: dry windy days will enable the pollen to lift off and spread, while rain will wash most of the pollens out of the air. Pollen is a living thing with a limited life once it leaves the plant, too, so it doesn't hang around in ditches waiting for a dry day to whip it up again, because by then it is just a dust particle.

Tabulated pollen counts concentrate on several high-profile species which may or may not represent what goes on in the countryside; often the pollen counts key on cities because that is where the population concentrations are, but outside of the cities there are often different species making up the plant concentrations, or many more of the same ones resulting in a much higher pollen count. So it's all rather complex once you look below the surface of the topic.
Hopefully answered more questions than I created here?

Tree pollens are particularly concentrated in our neighborhood in the Spring. Evergreen trees blow off huge amounts of pollen and the response, if you're susceptable; is very similar to the flu at first. Other trees can do the same and if you're near cultivated tree nursuries you can get non-native versions offing pollen as well. A very good rider I know moved to the Northeast only to discover he was initially very allergic to trees there to which he'd never been exposed and had no tempering in response.
I imagine the Old World areas have alot of tree hybrids for reforestation that would really mess with non-native individuals.

 

[bobs nob]

yawn

have we not seen 1000's of iterations of this thread and argument before, it involves just bout any rider, not just AC, this circular discussion existed about 5 minutes after the BB concept was born and will plod on pointlessly until the internet has long since been dead.

tedious.

 

[mercycle]

Tree pollens are particularly concentrated in our neighborhood in the Spring. Evergreen trees blow off huge amounts of pollen and the response, if you're susceptable; is very similar to the flu at first. Other trees can do the same and if you're near cultivated tree nursuries you can get non-native versions offing pollen as well. A very good rider I know moved to the Northeast only to discover he was initially very allergic to trees there to which he'd never been exposed and had no tempering in response.
I imagine the Old World areas have alot of tree hybrids for reforestation that would really mess with non-native individuals.

I'm not a very good rider, but I do live in Southern NH, and I'm in my fourth day of the 7 day hacking and coughing like I have emphysema. The Pine trees just got done blowing yellow goop into the air (looks like smoke from a fire when it's at peak). My wife works in landscape industry: weather conditions have conspired this year to compress and overlap a bunch of things so crap in the air is greater than usual.

Following along this line, has anyone given thought to what reaction your body may have if you've been riding for a long time, breathing in all kinds of crap? I'm talking about just someone who rides everyday, sometimes long, for say 15 or 20 years. Is it possible that you could wind up developing asthmatic symptoms? Think of people breathing in fine particulates, they often wind up with lung issues, so why not someone riding a lot? Before I get jumped on as trying to excuse the pros, I'm not. I'm simply asking a question that the answer may affect ones thinking about "How can so many of the pros have allergies".

 

[Mrs John Murphy]

Again, I'm not trying to bore you to death: http://www.ncbi.nlm.nih.gov/pubmed/16499476

This was interesting to me because if indirectly looks at the effects of muscle pH and endurance performance. Carbonic anhydrase increases muscle acidosis. As it turn out, that's about as bad as it sounds. The effect seems to go away at altitude; i.e. it has a deleterious effect at sea level, which seems to go away at altitude.

So, if you wanted to use a diuretic, you'd be better off using one which didn't otherwise negatively affect your performance.

I certainly think it's reasonable to be suspicious of anyone who's won several grand tours, but if these were actually masking agents of choice, I suspect you'd see more professional athletes claiming seizures!

I had a look at the article you posted. The data seems a little bit contradictory to me (although I may be reading this wrong - so please correct me otherwise). While there was a negative impact on performance at sea level (table 2), at simulated altitude there was a slight improvement but as the authors say this may have been caused by other factors.

What I noticed with the set up of the experiment is that exercise was taking place 2.5 hours after consumption of the drug. My question would be - if you were taking it with a longer interval before starting your exercise what would be the effect then?

Perhaps you can help unpack this passage? It seems to me to say 'we can't say for certain that it has either a performance enhancing or inhibiting effect'.

Acetazolamide causes incomplete hydration of carbon dioxide in cells, increased renal excretion of bicarbonate, water, sodium and potassium, and increased arterial and venous blood H+ concentrations [2–4,22]. Although acetazolamide has been useful in the prophylaxis of AMS [1], the metabolic acidosis induced can impair ability to buffer increases in organic acids during exercise [13,14] and may adversely affect metabolic processes involved in muscular contraction [23]. Although it is commonly reported that endurance exercise performance is impaired as a result of induced acidosis or acetazolamide treatment at sea level [9,11–13,15,23], findings of impaired exercise performance during acetazolamide treatment at altitude are reported in some [7,9,12,24], but not all [3,6,11], studies.

Conflicting findings may relate to inconsistencies in experimental conditions that make it difficult to reach a consensus regarding the effect of acetazolamide on exercise performance at altitude. Among studies, there have been differences in: drug dose and administration schedule between subjects; altitude elevation, duration, ascent rate and degree of altitude acclimatization; variability and intensity of the exercise mode; recovery times between consecutive exercise bouts; diet; and degree of altitude sickness during testing [6,7,9,11,12,25,26]. A reduced hydration status due to acetazolamide treatment [27] and a central circulatory and pulmonary diffusion limitation associated with intense whole-body exercise at altitude may also have contributed to uncertainty regarding the effect of acetazolamide on exercise performance [7,16].

I can see the potential downside of the medication, and presumably if Contador is taking this medication as a result of his epilepsy then he would already be suffering from the negative side effects for an endurance athlete?

It seems from the information in the article that the negative effect is at sea-level rather than at altitude - so in a TDF context the negative impact would be on the early flat stages around Northern France, rather than the mountain stages?

However, my question would be, if it were being taken as part of a doping program, in conjunction with other peds, and being taken on a different schedule - as a diuretic, would this not further minimise the negative effects? I guess what we need is a study of its effectiveness as a diuretic.

BTW - did you ever read that article about the long term benefits of doping even after you have come off the peds? It was a study done with a group of Swedish weightlifters.

I'll have a look at the other article (the first long article) you posted later. Apologies if I have raised any questions which are already answered in that article.

 

[Oldman]

I'm not a very good rider, but I do live in Southern NH, and I'm in my fourth day of the 7 day hacking and coughing like I have emphysema. The Pine trees just got done blowing yellow goop into the air (looks like smoke from a fire when it's at peak). My wife works in landscape industry: weather conditions have conspired this year to compress and overlap a bunch of things so crap in the air is greater than usual.

Following along this line, has anyone given thought to what reaction your body may have if you've been riding for a long time, breathing in all kinds of crap? I'm talking about just someone who rides everyday, sometimes long, for say 15 or 20 years. Is it possible that you could wind up developing asthmatic symptoms? Think of people breathing in fine particulates, they often wind up with lung issues, so why not someone riding a lot? Before I get jumped on as trying to excuse the pros, I'm not. I'm simply asking a question that the answer may affect ones thinking about "How can so many of the pros have allergies".

As Cyclopeon pointed out, the pollen is a living thing with a lifespan. I doubt there would be a cumulative affect from the actual dead pollen. Mature riders have complained of greater sensitivity but so have non-riders; it may be a sign of aging as well. Also as Cyclo and your wife pointed out; the weather patterns can create unique conditions for multiple species' pollen release which could make new cocktails to fend off. All I know is when it's bad there is not much you can do about it. All of the prescription remedies proposed to me had little if any effect on the symptoms. Having a TUE to use them makes it legal but how effective?

 

[131313]

What I noticed with the set up of the experiment is that exercise was taking place 2.5 hours after consumption of the drug. My question would be - if you were taking it with a longer interval before starting your exercise what would be the effect then?

Well, it depends "how long". Acetazolamide hits the blood stream pretty quickly, and it's mostly excreted through urine (it's not metabolized at all). The half life is around 8 hours, which is a pretty long time, and a small %, around 10% IIRC, binds permanently to the red blood cells.

Perhaps you can help unpack this passage? It seems to me to say 'we can't say for certain that it has either a performance enhancing or inhibiting effect'.

I should probably mention the reason they did that study in the first place. Acetazolamide is used by mountaineers doing rapid ascents at really high altitude to combat mountain sickness. The studies were an attempt to see if the drug negatively impacted athletic performance. It's easy to hypothesize that it would, given the mechanism by which it works. The results indicate that it definitely impacts performance at sea level, but the results at altitude are equivocal. No one has really put forth a good hypothesis as to why that's the case, though. At a certain point, the actual reaction will be someone individual.

I can see the potential downside of the medication, and presumably if Contador is taking this medication as a result of his epilepsy then he would already be suffering from the negative side effects for an endurance athlete?

It seems from the information in the article that the negative effect is at sea-level rather than at altitude - so in a TDF context the negative impact would be on the early flat stages around Northern France, rather than the mountain stages?

However, my question would be, if it were being taken as part of a doping program, in conjunction with other peds, and being taken on a different schedule - as a diuretic, would this not further minimise the negative effects? I guess what we need is a study of its effectiveness as a diuretic.

BTW - did you ever read that article about the long term benefits of doping even after you have come off the peds? It was a study done with a group of Swedish weightlifters.

I think you're barking up the wrong tree with the diuretic angle. I say that because when you combine blood volume depletion of any diuretic and the other side effects of the drug, it just seems like a poor choice for a doping regimen for a cyclist. I think that more likely the drug of choice would be plasma expanders. At this point, I'm not even sure they test for all of them (I could be wrong on this, though. I'm not doping, so I'm not that concerned about what they're testing for!).

I didn't see the article, though I'd like to check it out. Do you have a link? Thanks.

 

[fbhidy]

Claims have been made that Contador suffers from the same condition as his brother - which as I have said seems unlikely as Contador's own website says his brother has Cerebral Palsy (not congenital), while Contador's problem is cavernoma, which is congenital. Maybe someone who is an expert on central nervous system disorders can shed more light on it. So is it up to those make the claims to 'prove' that both brothers have the same problem? Or just the person claiming that they don't have the same condition?

http://www.about-cerebral-palsy.org/diagnosis/causes.html

"Ten to fifteen percent of cerebral palsy is caused from a recognized brain injury, such as infection (like meningitis), bleeding into the brain..."

http://www.roneurosurgery.eu/atdoc/3IPoeataCerebral.pdf

"Most cavernoma's show evidence of hemorrhage, microscopic or gross, and many show evidence of repeated hemorrhage."

So, Cerebral Cavernoma's can result in bleeding on the brain which, and I assume, if happened early enough in development, could result in Cerebral Palsy. Also Cerebral Cavernoma's can cause seizures.

This is no way precludes Bertie from being a PED user, it just simply creates a possible and plausible link between Bertie's condition and his brother's, which has been repeatedly questioned here.

 

[cyclopeon]

I'm not a very good rider, but I do live in Southern NH, and I'm in my fourth day of the 7 day hacking and coughing like I have emphysema. The Pine trees just got done blowing yellow goop into the air (looks like smoke from a fire when it's at peak). My wife works in landscape industry: weather conditions have conspired this year to compress and overlap a bunch of things so crap in the air is greater than usual.

Following along this line, has anyone given thought to what reaction your body may have if you've been riding for a long time, breathing in all kinds of crap? I'm talking about just someone who rides everyday, sometimes long, for say 15 or 20 years. Is it possible that you could wind up developing asthmatic symptoms? Think of people breathing in fine particulates, they often wind up with lung issues, so why not someone riding a lot? Before I get jumped on as trying to excuse the pros, I'm not. I'm simply asking a question that the answer may affect ones thinking about "How can so many of the pros have allergies".

Replying also to Oldman, yes, I had forgotten about the conifer pollens-- falling into the common trap, unobvious flowers being most likely to be wind-pollinated!

I can't speak to whether full scale asthma or asthma-like symptoms can develop from long term exposure, but I do know from personal experience that one can become allergic to something to which one was previously immune (not sure that's the right word, but in any case, 'unaffected by') after a single bad exposure. I was never allergic to wasp stings until I got nailed by about 30+ stings in one fell swoop after stepping on a nest; there was no reaction then, but a week later a single wasp sting on the forearm gave my a Popeye arm. More relevant to current discussion, I grew up in an area with no nut trees to speak of, then moved to an area where beech is abundant. For several years, no problem that I noticed. Then one spring the beech pollen was so abundant that my car was yellow for a week, and after that I have had an allergy to beech pollen and to hazelnuts (a related tree).

So, yes, it is quite possible for a rider to develop, slowly or suddenly and dramatically, a sensitivity to an allergen as a result of breathing in a lot more of it than a normally (in-)active person would. To me, then, it is not a surprise that many pro cyclists have allergies, and in fact I'd be more surprised if they had less compared to the general population. Partial answer, and I can't quote any studies or anything: just an extension of personal experience and a bit of casual reading.

 

[mercycle]

Replying also to Oldman, yes, I had forgotten about the conifer pollens-- falling into the common trap, unobvious flowers being most likely to be wind-pollinated!

I can't speak to whether full scale asthma or asthma-like symptoms can develop from long term exposure, but I do know from personal experience that one can become allergic to something to which one was previously immune (not sure that's the right word, but in any case, 'unaffected by') after a single bad exposure. I was never allergic to wasp stings until I got nailed by about 30+ stings in one fell swoop after stepping on a nest; there was no reaction then, but a week later a single wasp sting on the forearm gave my a Popeye arm. More relevant to current discussion, I grew up in an area with no nut trees to speak of, then moved to an area where beech is abundant. For several years, no problem that I noticed. Then one spring the beech pollen was so abundant that my car was yellow for a week, and after that I have had an allergy to beech pollen and to hazelnuts (a related tree).

So, yes, it is quite possible for a rider to develop, slowly or suddenly and dramatically, a sensitivity to an allergen as a result of breathing in a lot more of it than a normally (in-)active person would. To me, then, it is not a surprise that many pro cyclists have allergies, and in fact I'd be more surprised if they had less compared to the general population. Partial answer, and I can't quote any studies or anything: just an extension of personal experience and a bit of casual reading.

Thanks. As to the wasp stings: I knew from an early age that I was allergic (single beesting on a toe, had Popeye leg up to hip, got shots for about 4 years to desensitize). I know from my personal experience that there is a real effect on me when the pollen in in the air. I was partly wondering if basically spending a lot of time breathing in crap would have a culmulative effect that could eventually lead to issues. Not just the allergic reaction, but the fact that one is sucking down a lot of fine particulates (think a dry Paris-Roubaix dust bowl) that could lead to symptoms in the lungs.

 

[Mrs John Murphy]

Well, it depends "how long". Acetazolamide hits the blood stream pretty quickly, and it's mostly excreted through urine (it's not metabolized at all). The half life is around 8 hours, which is a pretty long time, and a small %, around 10% IIRC, binds permanently to the red blood cells.



I should probably mention the reason they did that study in the first place. Acetazolamide is used by mountaineers doing rapid ascents at really high altitude to combat mountain sickness. The studies were an attempt to see if the drug negatively impacted athletic performance. It's easy to hypothesize that it would, given the mechanism by which it works. The results indicate that it definitely impacts performance at sea level, but the results at altitude are equivocal. No one has really put forth a good hypothesis as to why that's the case, though. At a certain point, the actual reaction will be someone individual.




I think you're barking up the wrong tree with the diuretic angle. I say that because when you combine blood volume depletion of any diuretic and the other side effects of the drug, it just seems like a poor choice for a doping regimen for a cyclist. I think that more likely the drug of choice would be plasma expanders. At this point, I'm not even sure they test for all of them (I could be wrong on this, though. I'm not doping, so I'm not that concerned about what they're testing for!).

I didn't see the article, though I'd like to check it out. Do you have a link? Thanks.

Apologies for my tardiness in replying.

The Swedish article can be found here http://www.springerlink.com/content/n5717w7u3x0754t3/

If you can't access the full version let me know. I have copy on here somewhere I can send you.

I get where you are coming from with the diuretic angle - that makes sense - it just struck me as interesting that the first of the substances I checked out should be one found in epilepsy medicine. I'll have to check the rest on that primer.

That said - I can't see the benefit in taking ADHD medicine but it seems to be in vogue in MLB at the moment.

The interesting question would be who in the Astana team has manic depression?

 

[sartoris]

... blah blah blah ...

Seems like Contador's doping didn't work that well for today's time trial. Ah, no, he decided not to push it hard to avoid the controls!! Clever ******* ...

 

[Mrs John Murphy]

Since he said he was taking it easy this week it is hardly a shock now is it? And besides, Fuentes likes to use the DL as an opportunity to take blood ready for next month.

Once a Fuentes boy, always a Fuentes boy.

 

[MacRoadie]

Since he said he was taking it easy this week it is hardly a shock now is it? And besides, Fuentes likes to use the DL as an opportunity to take blood ready for next month.

Once a Fuentes boy, always a Fuentes boy.

Man, I'm no fan of Contador's by any stretch of the imagination, but I must have missed the VeloNews article reporting that Alberto drove over to your house and took a dump in your Wheaties...

 

[Mrs John Murphy]

Nice scat fetish you have going there, but no.

 

[MacRoadie]

Nice scat fetish you have going there, but no.

What's next?

"This morning, Dertie Contadoper ate a breakfast comprised of bacon and eggs (from non-free range chickens); a breakfast fare favored by convicted doper Alejandro Valverde and also found in the kitchen of the clinic owned by notorious doping doctor Eufemiano Fuentes."

 

[Mrs John Murphy]

That wouldn't happen. He always has "Nada o igual a J.J." for breakfast

 

[MacRoadie]

That wouldn't happen. He always has "Nada o igual a J.J." for breakfast

Ferrari always prescribed "O.J.". Of course, it's "Not just for breakfast anymore".

 

[cyclopeon]

Thanks. As to the wasp stings: I knew from an early age that I was allergic (single beesting on a toe, had Popeye leg up to hip, got shots for about 4 years to desensitize). I know from my personal experience that there is a real effect on me when the pollen in in the air. I was partly wondering if basically spending a lot of time breathing in crap would have a culmulative effect that could eventually lead to issues. Not just the allergic reaction, but the fact that one is sucking down a lot of fine particulates (think a dry Paris-Roubaix dust bowl) that could lead to symptoms in the lungs.

Like farmer's lung or miner's lung. Interesting question, and I don't even have an inkling. (are people allowed to say that on internet forums?) Anyone out there to this kind of medical study?

 

[auscyclefan94]

And when it's Cadel's bad days, it's always someone else's fault....

You haven't responded as People will defend Conti all the time like they are now but when it comes to lance they get stuck into him. You can't have it both ways.
If that's true it's better than using it up as a cover up for dope.

 

[peacefultribe]

I'm a Contador fan because of the way that he races, and also because of the way that he handled all of the crap that LA threw at him last year. Everybody saw it. LA showed no class whatsoever during the Tour. I still can't believe how he announced his new team on the day that his current teammate won the ITT. This came after tweeting all that nonsense about Contador not being a team player. LA is a really big man. Even after trying to publicly humiliate AC for three weeks straight, AC still had the decency to try to help Lance up the final big climb. Whatever AC is, he looks saintly compared to Lance.

If AC is ever banned for doping, it will not surprise me. I believe that most of the top guys dope. It will not make me like him any less. The reason why some people hate LA, yet look the other way when other riders are questioned, is because LA has behaved like an ***. It goes way beyond what he did to Contador. Everybody knows it. Why are LA's fans so surprised at all of the hate?

 

[auscyclefan94]

I'm a Contador fan because of the way that he races, and also because of the way that he handled all of the crap that LA threw at him last year. Everybody saw it. LA showed no class whatsoever during the Tour. I still can't believe how he announced his new team on the day that his current teammate won the ITT. This came after tweeting all that nonsense about Contador not being a team player. LA is a really big man. Even after trying to publicly humiliate AC for three weeks straight, AC still had the decency to try to help Lance up the final big climb. Whatever AC is, he looks saintly compared to Lance.

If AC is ever banned for doping, it will not surprise me. I believe that most of the top guys dope. It will not make me like him any less. The reason why some people hate LA, yet look the other way when other riders are questioned, is because LA has behaved like an ***. It goes way beyond what he did to Contador. Everybody knows it. Why are LA's fans so surprised at all of the hate?

What about LA V Hitler? I would have to think about that one.

 

[Deagol]

.... Whatever AC is, he looks saintly compared to Lance.

True, that.

(former LA fan and never an AC fan) but that in undeniable..