Why (and How) Bert Should Appeal

[Merckx index]

So you argue that it is possible that the athlete has done everything possible to avoid contamination due to supplements, but still should be sanctioned if he is found positive from a supplement?

Sorry, I didn't make myself very clear. In responding to your post, I was referring to a threshold in an athlete's doping test. This has to be distinguished from a threshold, or a limit of detection, in a test of meat or supplements.

I'm saying that there is no value in a threshold for a dope test of an athlete below which he will automatically be cleared. But there could be such a value in a test of supplements, IMO, yes. The latter is one of the factors that would determine whether an athlete, regardless of his level, should be cleared.

Bert's case was atypical in that he had that negative test before the positive. In a more usual case, the athlete would not have a very recent negative test, and therefore one could not rule out taking of CB intentionally in large doses, with a small level resulting some time later. To be sure, an athlete could still claim it was from a supplement, and if one used a definite limit of detection for clenbuterol like 100 ng/g, one could calculate a corresponding possbile level for the athlete, if one assumed the test occurred soon after consumption of the supplement. So in this case a LOD for a supplement would translate into an effective threshold for the athlete. Of course I can see athletes trying to take advantage of this.

But I'm envisioning that the athlete would have to provide some evidence that he took supplements at that time, and in large enough amounts to cause the positive. Again, Bert has an advantage in that the panel itself ruled contaminated supplement the most likely cause; thus they did the heavy lifting for him. In a future case, the athlete wouldn't have that benefit. From Bert's case, I take it the team has a record of what supplements each rider took or might have taken, and at least could have a record of how much they took. Records like those would be crucial in fairly evaluating a tainted supplement claim. The athlete couldn't just say, I took 100 g of such-and-such that day, he would have to provide some record of it. If that is too much to ask, and maybe it is, then I think the alternative is lower the LOD for supplement testing.

Here is a copy of an email I sent to Efraim Barak, chair of the CAS panel; Mike Morgan, one of Bert's lawyers; and Michael Ashenden:

Mr. Efraim Barak
Attorney-at-law
Tel Aviv
Israel

Dear Mr. Barak:

I’m writing to you about the recent CAS hearing, which you chaired, on cyclist Alberto Contador. Like everyone else, I don’t know whether Mr. Contador intentionally took performance-enhancing substances or not. Your panel’s conclusion that he most likely took a contaminated supplement may be correct.

Nevertheless, there is a serious problem with this conclusion. His maximum reported urine level for this substance was 50 pg/ml. Using various pharmacokinetic models, we can estimate that this corresponds to an ingestion of roughly 500 ng of the substance, with 1 ug a reasonable upper bound. If a contaminated supplement was the source of this clenbuterol, the level of contamination was extremely low. So low, in fact, that it would very likely be below a widely used standard for detection of contaminants in supplements.

For example, the Dutch have set up a system, NZVT, that tests various supplements batch for batch, and issues approvals for those that meet their standards. For stimulants such as clenbuterol, this standard is 100 ng/g. The rationale for this limit of detection (LOD) is explained by de Hon and Coumans in their article “The continuing story of nutritional supplements and doping infractions” Br J Sports Med 41, 800-805 (2007):

Based on the published facts that a precursor of an anabolic steroid in an amount between 1–10 μg can cause a positive doping test,18,24 and based on the fact that athletes easily use 50 g of supplements per day or more, a reporting threshold value of 10 ng/g or 10 ppb for all anabolic steroids is used in all tests. This value also allows for individual variations in metabolism. Excretion studies for stimulants are rare, but similar considerations led to the conclusion that for stimulants, a reporting threshold value of 100 ppb is opportune.

Since Mr. Contador has denied using any supplements during the time period in which he tested positive for clenbuterol, we can’t ask the pertinent question: how much supplement did he consume? But if we use the 50 g amount suggested by de Hon and Coumans, and the 100 ng/g standard, we can calculate that an athlete could ingest as much as 5 ug of clenbuterol from consumption of a supplement approved for use by NZVT. This is five times the likely maximum level of clenbuterol present in Mr. Contador’s system.

Thus we can conclude with a very high degree of probability that if Mr. Contador’s clenbuterol positive did in fact result from a contaminated supplement, this supplement would have met the standard for contaminant-free of NZVT, a standard used by other organizations as well. How can an athlete possibly be sanctioned for using a supplement approved by a national federation, on the basis of a widely used industry standard?

I don’t know whether or not cognizance of this point would affect your conclusion in this specific case or not. But at the very least, I think CAS is remiss in not pointing out the implications of its decision: that athletes can be sanctioned for consuming supplements that are approved by national anti-doping organizations. Several athletes have tested positive for levels of clenbuterol in urine substantially lower than Mr. Contador’s, and though they were not sanctioned, this was because they were able to make the case that the clenbuterol derived from contaminated meat in the country where they were competing at the time. Had they tested at such levels in Europe, however, this rationale probably would not have been accepted, and they very likely would have faced sanctions.

In addition to this problem, CAS has to my eyes also seriously misreported a value in its award. In article 16, and again in article 416, it’s stated that a blood test for clenbuterol in Mr. Contador determined a value of 1 ug/ml. This value cannot possibly be correct. Assuming a total blood volume of approximately 7 liters, it would indicate a consumption of at least 7 mg of clenbuterol. No one could take a dose remotely close to this and not experience very severe adverse symptoms, if not death itself. A level of 1 ug/ml is also grotesquely inconsistent with the reported urine values of Mr. Contador in the low pg/ml range, all four of which are reasonably consistent with each other and suggest, as I noted earlier, an ingestion of roughly 500 ng.

CAS has already acknowledged an inconsistency in its report regarding the date of this blood test. I hope it will now issue a clarification regarding this value, as well as acknowledge that there is a very serious problem when an athlete can be sanctioned for taking a supplement that is determined to be clean by a national antidoping organization.

Sincerely yours,

 

[nevada]

CN seems to have botched the “error” story worse than the error itself. It was reported 1 ug/ml, not “1 picogram” (which by itself is not even a concentration), at least in the report i have been reading.

Is it possible there is an updated or revised report, that says "1 picogram"? As I have pointed out before, the reported 1 ug/ml value is the real error, much worse than the date of the test. It should be some value in picograms/ml, so CN's reported value is a start in the right direction, though it should picogram per unit volume, and 1 pg/ml. would not be consistent with the subsequent urine values, eiher.



It’s not a value found in a single study, it’s a widely used standard, the basis, as I noted, for the Dutch system, and I believe also MLB and the NFL. It’s certainly true that much more sensitive detection standards can be used, but they depend on the appropriate technology being available. It may be difficult and expensive to ask supplement manufacturers to use the most sensitive methods available, so a reasonable standard is put into place, one that it is agreed everyone will follow.

Meat is different from supplements in two key ways. First, taking supplements is considered much more of a choice. It would be very difficult for WADA to discourage athletes from eating meat under any circumstances. That is considered a right that should take precedence over any doping rules in a way that consuming supplements is not.

And second, in theory, there should be no CB in meat. If there is, it results from intentional doping. CB may contaminate supplements from accidental causes, and is therefore more difficult to control.



For the same reason they do other stuff that many of us watching regard as ill-advised if not downright crazy: perceived low risk/reward ratio.

Understand that I have no problem with athletes getting sanctioned for contaminated supplements when they have been warned in advance (though you and I know that many, maybe most, contaminated supplement cases are really about intentional doping; that in effect is a major reason why sanctions are considered necessary. To discourage using the supplement as an excuse). But the key word is “contaminated”. When the supplement is not contaminated by a widely used standard, it’s hard to argue that the athlete did not do everything reasonable to avoid a positive.



Yes, it probably does, but I’m not. Bert remains a special case. Most athletes do not get tested twice in a short period of time, revealing a negative before the positive. So a very tiny level of CB can result from a very large intentional dose taken a week or more earlier. That being the case, a threshold does nothing to separate intentional from accidental doping. I continue to believe these cases can only be resolved on an individual basis, taking all the contingent facts into account. If athletes were tested regularly several times a week I might change my mind, but I don’t expect that to happen.

It got in his blood because he infused blood that they thought was clean as they didn't test to that level.

 

[ChrisE]

Sorry, I didn't make myself very clear. In responding to your post, I was referring to a threshold in an athlete's doping test. This has to be distinguished from a threshold, or a limit of detection, in a test of meat or supplements.

I'm saying that there is no value in a threshold for a dope test of an athlete below which he will automatically be cleared. But there could be such a value in a test of supplements, IMO, yes. The latter is one of the factors that would determine whether an athlete, regardless of his level, should be cleared.

If there is a threshold in supplements or meat, and it is more than 0, that threshold could be met and still cause the athlete to test positive. Whether the athlete tests positive could depend on where his urine is tested, ie Cologne. The innocent athlete gets their name splashed all over the paper with doper attached to it all because of events out of their control.

What you are arguing is that the athlete would have to go throught the time and expense of coming up with what he/she ingested, proving it was below that threshold ie they took "approved" supplements, and corresponding it to the levels in their AAF to be cleared. All of this on a substance that is common in certain parts of the world and is in supplements that pass. This puts alot of unreasonable burden on an athlete.

I do follow your logic but it can still be cheated. Somebody could take CB and then have some "approved" supplements on hand that will trigger an AAF as an excuse.

I am of the opinion that since not all tests are done with the same level of sensitive equipment, and the time and expense the athlete and the sport(s) would still have to go through to prove innocence (on something we know will trigger an AAF like a threshold in supplements or countries where CB in cattle is prevelent), and finally the bad press the sport(s) would get from the whole ordeal, zero threshold is not worth catching the small percentage of cheats (IMO) that would game a threshold AAF system.

Awhile back you came up with a maximum of CB that would show up in an athlete's urine per some reasonable amount in the cattle. WADA should do the same math on supplements, set a threshold corresponding to the athlete, and be done with it. I think this would be a much better way than the 1.5 years the sport was just put thru. Especially on a substance like CB we know could be in meat or supplements, and is common in many a country's livestock.

BTW, nice letter MI. I appreciate all your contributions to the forum and to the sport.

 

[Nilsson]

Great job, Merckx Index. I wonder if they'll react to this...

 

[Ripper]

DBD should not appeal. Another appeal just makes a greater mockery of the affair. If the original ban had been held then this whole thing would already be over and he could be back racing this spring. There may be great technical arguments as to why/how he should appeal, but the bottom line is he should not. The entire matter should have never gotten this far.

 

[mastersracer]

DBD should not appeal. Another appeal just makes a greater mockery of the affair. If the original ban had been held then this whole thing would already be over and he could be back racing this spring. There may be great technical arguments as to why/how he should appeal, but the bottom line is he should not. The entire matter should have never gotten this far.

It's expected the UCI will fine him for over 3M Euros, which is probably just the start of civil actions against him. Plus, he was stripped of 2 grand tour wins, etc. There's plenty at stake for thinking about an appeal, especially if the scenario promoted by CAS opens the door to one...

 

[cycladianpirate]

There is an assumption in many of the arguments postulated here that CAS made a finding that contaminated supplements was the cause of Contador's positive test. This is not the case.

Convinced by a spurious argument (itself liable to appeal - against Contador) that the onus on the appellants and the arbitrators was to promulgate alternative hypotheses for the cause of the positive test, the 'blood doping' and 'contaminated supplement' scenarios were put forward, considered and weighed in the balance against Contador's 'contaminated meat' case. That is not to say that any finding was made in respect of any of the alternative scenarios.

Oddly enough, on this basis alone (i.e. that the arbitration panel addressed themselves to the wrong question) an appeal might have some chance of success but this would hardly assist Contador.

In finding, as a matter of fact (not law) that the possibility of his defence was "vanishingly thin", the panel have disposed of the matter entirely. On any view 'vanishingly thin' is a great deal less than the 50.1% required by Contador.

As to an appeal against the sanction, having disposed of the only defence put forward by Contador, there was only one sanction available to the panel.

Game over.

 

[Merckx index]

If there is a threshold in supplements or meat, and it is more than 0, that threshold could be met and still cause the athlete to test positive. Whether the athlete tests positive could depend on where his urine is tested, ie Cologne. The innocent athlete gets their name splashed all over the paper with doper attached to it all because of events out of their control.

This is a good point. Reading about the Hardy case, I can appreciate she went through hell. Based on the facts of the case, I’m not entirely convinced that she really was the innocent victim of a tainted supplement, but she could have been, and of course there have been other tainted supplement cases.

I do follow your logic but it can still be cheated. Somebody could take CB and then have some "approved" supplements on hand that will trigger an AAF as an excuse.

This gets to the nub of the problem. Yes, I can well imagine having a supplement excuse on hand. OTOH, if there is a threshold, athletes, helped by their enablers, will calculate how much of a dose they can take to pass the threshold at a certain time later (much as they know how much EPO they can microdose and still pass that test). IOW, even if the % of cheats is small now (obviously this is highly debateable), a threshold might bring them out of the woodwork.

This argument over a threshold will continue. More information would help a lot, particularly studies of supplement contamination. As I noted, several studies have been carried out, but generally at a relatively high LOD like 100 ng/g. Studies using lower sensitivity would be very helpful. It wouldn’t have to be at Cologne-levels, but below 10 ng/g.

If it turns out that a very large % of supplements have traces of CB and other stimulants at very low levels, this would be a major argument in favor of a threshold for the athlete. If it turned out that contamination at even the lowest level detectable was very rare (i.e., that the less sensitive studies have been picking up all or most of the contamination that exists), I think zero threshold could be defended. As I noted before, while steroid contamination of supplements is quite high—no doubt a lot of this is intentional—CB contamination seems to be very rare. In arguing for Bert to appeal, I have been assuming that more sensitive detection methods would pick up more such contamination, but this might not be the case.

I want to emphasize that my opposition to a threshold has been based on meat. The Euro standard for that is such that an athlete would have to test very low--5-10 pg/ml or less--to have a reasonable argument in these countries. I'm not opposed to a threshold around there, but it would not affect Bert nor any other athletes except I guess one of the ping-pong players. But I have always favored an athlete getting off immediately if he tests at a level that could result from eating clean meat.

I wasn't aware of the supplement problem until recently. In principle it could be addressed in the same way. If the standard were low enough, one could likewise ensure that "clean" supplements would not result in positives above the same 5-10 pg/ml. value, making it possible to have a single universal threshold that would address both meat and supplement contamination. I wouldn't have a problem with this. While some cheaters might get away, they were getting away before, anyway, when the LOD was much higher.

The question is how expensive ensuring this standard would be. The expense of meat testing is held down by sampling only a very small fraction of all meat. In any case, the government is considered responsible for ensuring public health and safety, and so must foot the bill, whatever it is. The supplement market is somewhat different. It is more a buyer-beware situation, with citizens consuming them at their own risk. The athletic organizations themselves would have to pay for this. Moreover, random sampling may not be appropriate when you have many different manufacturers producing a large variety of different products, with the necessity of testing batch by batch. If a farmer is doping his cattle, a test of any of them is likely to detect that. If a supplement manufacturer has an accidental contamination problem, it might take very thorough testing to discover.

 

[ChrisE]

This gets to the nub of the problem. Yes, I can well imagine having a supplement excuse on hand. OTOH, if there is a threshold, athletes, helped by their enablers, will calculate how much of a dose they can take to pass the threshold at a certain time later (much as they know how much EPO they can microdose and still pass that test). IOW, even if the % of cheats is small now (obviously this is highly debateable), a threshold might bring them out of the woodwork.

But then we get back to the "benefit" argument that so many AC supporters toss around due to his low levels in the AAF. If somebody microdoses CB to get under a threshold, what is the benefit? Probably not much, if any.

This argument over a threshold will continue. More information would help a lot, particularly studies of supplement contamination. As I noted, several studies have been carried out, but generally at a relatively high LOD like 100 ng/g. Studies using lower sensitivity would be very helpful. It wouldn’t have to be at Cologne-levels, but below 10 ng/g.

I don't agree that more study needs to be done. You yourself calculated what is possible due to ingestion. If somebody transfuses and has a low level that passes the threshold, then that is how the ball bounces. Then we don't have these long arguments and legal shenanigans by those that are truly innocent. Plus, the bio passport is supposed to monitor things that can point to transfusions. So why screw with an athlete that may have taken a supplement that passed or ate a steak somewhere all in the name of catching somebody that should be caught by other means?

I want to emphasize that my opposition to a threshold has been based on meat. The Euro standard for that is such that an athlete would have to test very low--5-10 pg/ml or less--to have a reasonable argument in these countries. I'm not opposed to a threshold around there, but it would not affect Bert nor any other athletes except I guess one of the ping-pong players. But I have always favored an athlete getting off immediately if he tests at a level that could result from eating clean meat.

Right. And that is why AC's amount would not let him off for meat because the threshold, if established, would be less than his levels.

I wasn't aware of the supplement problem until recently. In principle it could be addressed in the same way. If the standard were low enough, one could likewise ensure that "clean" supplements would not result in positives above the same 5-10 pg/ml. value, making it possible to have a single universal threshold that would address both meat and supplement contamination. I wouldn't have a problem with this. While some cheaters might get away, they were getting away before, anyway, when the LOD was much higher.

Agreed. This is my position.

The question is how expensive ensuring this standard would be......

Versus how expensive it is to fight a zero threshold basis, in terms of rights of the athlete and slander of sport in general, or have a soap opera like AC? I think you know the answer to that.....

I am not a fan of supplements (I never took them). The easy way around the expense issue is if an athlete plans to take them and they are not from a source that has records of testing or if the athlete doesn't test his supplements to some formal threshold, then they get busted if they are over the AAF threshold.

Meat is the same because the level in the AAF can be resonably calculated due to excretion in the animal and the athlete in a worse case.

 

[Nilsson]

But then we get back to the "benefit" argument that so many AC supporters toss around due to his low levels in the AAF. If somebody microdoses CB to get under a threshold, what is the benefit? Probably not much, if any.

It's not so much about dosing under the threshold, which would lead to no benefit, but more about the time you have to catch a doper. Unlike Alberto Contador, most cyclist and other athletes, aren't tested on such a regular basis. Testing normally is more or less 'out-of-the-blue', and installing a threshold means the time frame to catch them is smaller. In the case of Contador that's not the case. During the Tour he was almost tested on a day to day basis, which enables you to make some sort of reconstruction (leading to a 200-500 ng ingestion, which is a case of some sort of contamination) that normally isn't possible...

Personally I don't see this as a big problem, and could very well live with a threshold (and thus a somewhat smaller time frame and possibility to catch dopers) if it reduces impossible and long arguments, smooths up doping processes and diminishes the chance of innocent guys getting punished, etc.

I don't agree that more study needs to be done. You yourself calculated what is possible due to ingestion. If somebody transfuses and has a low level that passes the threshold, then that is how the ball bounces. Then we don't have these long arguments and legal shenanigans by those that are truly innocent. Plus, the bio passport is supposed to monitor things that can point to transfusions. So why screw with an athlete that may have taken a supplement that passed or ate a steak somewhere all in the name of catching somebody that should be caught by other means?

Totally agree with that, except for the need to study. More study could help to establish a fair threshold.

Right. And that is why AC's amount would not let him off for meat because the threshold, if established, would be less than his levels.

That has to be seen. The current MRPL for clenbuterol is 2ng/ml. Scientists who are in favor of a threshold think 10 percent of that number could be a good threshold. That would mean 200pg/ml, which is 4 times the max. amount found in Alberto Contador's urine. Even Rabin and the lab in Los Angeles, which, like Cologne, can find very low levels like to approve something like that. UCLA has (or had) even already implemented it, unofficially, which turned out when they didn't report Mexican soccer players who had an adverse analytical finding under 200pg/ml...

 

[Ripper]

It's expected the UCI will fine him for over 3M Euros, which is probably just the start of civil actions against him. Plus, he was stripped of 2 grand tour wins, etc. There's plenty at stake for thinking about an appeal, especially if the scenario promoted by CAS opens the door to one...

Of course there's plenty at stake, that was not my point. Part of the thread is "why" he should appeal, I am simply stating why he should not. This thing has been dragged out far too long and regardless of all the 'extra stuff' about this case, a sanction is the only outome that makes sense based on the rules.

 

[Merckx index]

The tas-cas website now links to a version of the award where the 1 ug/ml value for clenbuterol detected by the blood test has been changed to 1 pg/ml. This is in article 16. However, article 416 still reports 1 ug/ml. So apparently they went through it for editing rather hastily.

The 1 pg/ml value is more reasonable, though it is still quite low to be associated with a urine value about twelve hours later of 50 pg/ml. I would have expected a blood level 5-10 times higher than that. However, the wording of the article suggests that this is only an approximate value.

An accurate value could actually have been quite useful in the decision, because the relationship between blood and urine levels should be somewhat different for transfusion vs. ingestion (meat or supplement). I'm a little surprised that this approach wasn't pursued, but again, maybe the blood test was more qualitative than quantitative.

P.S. - A source tells me the case may not yet be over. The source is very good, though only an opinion was expressed.

 

[ChrisE]

P.S. - A source tells me the case may not yet be over. The source is very good, though only an opinion was expressed.

I thought it could only be appealed based upon procedure?

Is the rumor now that it will be one year instead of two?

 

[Nilsson]

The tas-cas website now links to a version of the award where the 1 ug/ml value for clenbuterol detected by the blood test has been changed to 1 pg/ml. This is in article 16. However, article 416 still reports 1 ug/ml. So apparently they went through it for editing rather hastily.

I noticed this too. Rather sloppy, indeed...

The 1 pg/ml value is more reasonable, though it is still quite low to be associated with a urine value about twelve hours later of 50 pg/ml. I would have expected a blood level 5-10 times higher than that. However, the wording of the article suggests that this is only an approximate value.

An accurate value could actually have been quite useful in the decision, because the relationship between blood and urine levels should be somewhat different for transfusion vs. ingestion (meat or supplement). I'm a little surprised that this approach wasn't pursued, but again, maybe the blood test was more qualitative than quantitative.

Considering the digestion of meat/supplement versus intravenous transfusion of contaminated plasma? That should indeed differ from one another. With 1 pg/ml in the blood and 50 pg/ml in urine over ten hours later, you'd expect a transfusion was done right before the blood test and not the day before, am I right?

P.S. - A source tells me the case may not yet be over. The source is very good, though only an opinion was expressed.

Mr. Barak/Morgan/Ashenden finally answered your mail?

 

[Porphyry]

Is it typical for CAS to be so sloppy in their published rulings? There seems to be no excuse for typos, since it only requires a proofreader. They are the international high court! It's baffling that they would not be meticulous about the final document.

 

[LaFlorecita]

P.S. - A source tells me the case may not yet be over. The source is very good, though only an opinion was expressed.

Care to elaborate on that?

 

[sniper]

The tas-cas website now links to a version of the award where the 1 ug/ml value for clenbuterol detected by the blood test has been changed to 1 pg/ml. This is in article 16. However, article 416 still reports 1 ug/ml. So apparently they went through it for editing rather hastily.

The 1 pg/ml value is more reasonable, though it is still quite low to be associated with a urine value about twelve hours later of 50 pg/ml. I would have expected a blood level 5-10 times higher than that. However, the wording of the article suggests that this is only an approximate value.

An accurate value could actually have been quite useful in the decision, because the relationship between blood and urine levels should be somewhat different for transfusion vs. ingestion (meat or supplement). I'm a little surprised that this approach wasn't pursued, but again, maybe the blood test was more qualitative than quantitative.

P.S. - A source tells me the case may not yet be over. The source is very good, though only an opinion was expressed.

"not over"... As in AC taking this to the Swiss court?
Aint gonna win him any friends.
Nonetheless it wouldn't come as a big surprise, would it?
He's spoken about that option from the start, and he hired the Belgian lawyer particularly for this situation, right?

 

[The Hitch]

P.S. - A source tells me the case may not yet be over. The source is very good, though only an opinion was expressed.

There may some hope yet for The Great One. Not much hope. Just a fools hope.

 

[Merckx index]

With 1 pg/ml in the blood and 50 pg/ml in urine over ten hours later, you'd expect a transfusion was done right before the blood test and not the day before, am I right?

Not exactly. The panel concluded that any transfusion was probably right before the blood test, this is correct. But their reasoning was based not on the concentration itself, simply that the purpose of an alleged second transfusion would be to bring the blood parameters back to near normal. IOW, they were considering psychology, not physiology, the likely behaviour of a doper in that situation.

My point was that a urine value of 50 pg/ml implies a blood level of much higher than 1 pg/ml for blood, assuming transfusion. Now this level, I think, is very close to the detection limit, so it may be very rough. They may have just meant “some clenbuterol was detected in the blood”.

But if that is the case, what was the point of testing the blood in the first place? It was already accepted by both sides that he was positive for CB. Showing it was also in his blood at that time adds no new information to the case. It is confirmatory of CB ingestion, but no confirmation was required. It also moves up the timeline about twelve hours, but that doesn’t shed anything new on the circumstances, either. That is, none of the three possibilities considered by the panel is particularly favored or disfavored by knowing the CB was in his system at this time.

This brings us to my second point. The pharmacokinetics are different for oral (contaminated meat or supplement) vs. intravenous (transfusion) ingestion of CB. When CB goes into the body via a transfusion, all of it gets into the blood immediately. This means that the peak concentration of CB is reached immediately, and it then begins to decline, as it is absorbed into other tissues and is metabolized and cleared in the urine. When it enters the body orally, it has to be absorbed from the digestive system into the blood. This takes time, meaning there is a lag between ingestion and the peak level of CB in the blood. The peak value is reached when the rate of CB absorption from the digestive system is exactly balanced by the rate at which it goes into tissues and is cleared into the urine.

So in principle, it might be possible, from a comparison of blood and urine values, to conclude which route of administration was more likely. It seems to me that if the 1 pg/ml value for blood is really correct, it strongly favors oral ingestion, not transfusion.

Here’s why. 1 pg/ml. corresponds to about 7 ng. in the total circulation. Since the urine test on July 20 was negative, the CB must have gotten into his system during the period between that urine test and the blood test. Let’s say eighteen hours maximum. CB is cleared from the blood with a half-life of 35 hours, so at most it was in the blood for one half of a half-life before the blood test. This means that if the CB got into the blood through transfusion, it could have dropped at most to about 70% of its peak value.* So if he transfused, the 1 pg/ml. value indicates a transfusion of just 10 ng. (7 ng/0.70).

In one sense, this supports the transfusion theory. Assuming he transfused 200 ml of blood or plasma, the concentration of CB in the blood just preceding withdrawal would be 10 ng/200 ml., or 50 pg/ml. One could get this level from just a single oral dose of CB of about 10 ug. So all the objections about massive CB doses of several hundred micrograms being necessary are thrown out the window. That was one major point against the transfusion theory.

But as I said earlier, the 1 pg/ml. value is not consistent with a 50 pg/ml urine level. One urine sample of 200 ml alone would account for all of the ten nanograms. In fact, we know from the cumulative four urine tests that Bert passed in his urine around 75-100 ng of CB in the following 3-4 days, and from studies of this substance, we know that this would be only about 20% of the total dose. Hence the estimate of 500 ng dose.

Now consider oral ingestion, through contaminated meat or supplement. A single dose of 500 ng, based on extrapolation of data using higher doses, would suggest a peak blood level of about 2.5 pg/ml. After eighteen hours, it would drop to about 1.75 pg/ml. This is pretty good agreement with the 1 pg/ml. value, particularly considering the likely substantial error in measuring at these low concentrations.

To summarize, if the 1 pg/ml value for blood is accurate, I think it provides fairly strong support against transfusion, and in favor of contaminated meat or supplement. The reason, in a nutshell, is because when a given amount of CB enters the blood through transfusion, all of it gets there at once, resulting in relatively high blood values relative to urine values. When it enters the body orally, it must be absorbed from the digestive system. It takes time to reach a peak level, and even when this level is reached, it does not represent the entire dose that went into the body, because much of it is still being absorbed into the blood, even after it starts to clear into the urine and the blood levels fall.

Unless I missed something, this argument was never presented at CAS. I myself missed it at first, because I was looking at the wrong data. I was considering the relationship of blood values to urine values when CB is taken daily for a period of several days. On this basis, the 1 pg/ml value would be too low even for oral ingestion, which is what I said in an earlier post. But I have to correct this; the kinetics following a single dose are the proper model here.

*I have made one major simplifying assumption—that CB is cleared from the blood following transfusion at the same rate as it is following oral administration. This is probably not correct (( don't have the data to judge), but I don’t think the difference is enough to change the conclusion.

Is it typical for CAS to be so sloppy in their published rulings? There seems to be no excuse for typos, since it only requires a proofreader. They are the international high court! It's baffling that they would not be meticulous about the final document.

I can be forgiving of a few small typos in a long, detailed document. But. I wouldn’t call reporting 1 pg as 1 ug a typo. This is a misstatement of fact. You don’t get this by hitting the wrong key, you get it by not understanding the significance of these concentrations. This is just emphasized by its being corrected in one place and not another.

Care to elaborate on that?

That’s all I know. It might not be over.

Speaking only as a scientist, certainly not as a lawyer, I now see two crucial points that could be brought up in an appeal:

1) that if the positive resulted from a contaminated supplement, that supplement was nevertheless very likely clean by the standards of many laboratories, including ones involved in anti-doping research.
2) the blood test strongly supports contaminated supplement or meat over transfusion as the source of CB.

 

[GJB123]

So we are back to square 1 on a way. Let me see if I understand you correctly. There are two possible, separate eventts that happened at the same time. Although there is some strong indication a transfusion may have taken place (the residu from transfusion bags in his blood), that seems to hold no relation whatsoever to the CB that might indeed have come from a supplement or meat, based on the pharmokinetics. How unlucky can you get? Possibly transfusing and then get knicked for something that was not within your control.

Regards
GJ

 

[Nilsson]

This brings us to my second point. The pharmacokinetics are different for oral (contaminated meat or supplement) vs. intravenous (transfusion) ingestion of CB. When CB goes into the body via a transfusion, all of it gets into the blood immediately. This means that the peak concentration of CB is reached immediately, and it then begins to decline, as it is absorbed into other tissues and is metabolized and cleared in the urine. When it enters the body orally, it has to be absorbed from the digestive system into the blood. This takes time, meaning there is a lag between ingestion and the peak level of CB in the blood. The peak value is reached when the rate of CB absorption from the digestive system is exactly balanced by the rate at which it goes into tissues and is cleared into the urine.

So in principle, it might be possible, from a comparison of blood and urine values, to conclude which route of administration was more likely. It seems to me that if the 1 pg/ml value for blood is really correct, it strongly favors oral ingestion, not transfusion.

This was my point exactly...

Thanks for a fantastic post again, Merckx Index. Great work!

 

[GJB123]

Just to show that it can go either way:

http://www.triathlon.org/news/artic...r_6_months_due_to_anti-doping_rule_violation/

Not in line at all with Contador's CAS-ruling, who went to much greater lenght to ensure his supplements were safe and also how does this rhyme with Jessica Hardy's 1-year suspension for contaminated supplements. Another WADA-appeal in the making then?

Regards
GJ

 

[Nilsson]

Just to show that it can go either way:

http://www.triathlon.org/news/artic...r_6_months_due_to_anti-doping_rule_violation/

Not in line at all with Contador's CAS-ruling, who went to much greater lenght to ensure his supplements were safe and also how does this rhyme with Jessica Hardy's 2-year suspension for contaminated supplements. Another WADA-appeal in the making then?

Regards
GJ

No It's not sure that WADA will appeal this, of course depending on the exact facts. Methylhexaneamine is very well known contaminant in supplements (in pharmacy itself it's rarly used anymore in the last 20 years). The Costa brothers also received a six months ban, WADA didn't appeal this, and Rui could even ride the Tour last year.

In fact, several Rugby players tested positive on this substance and didn't receive a ban at all. Others have had bans up to four months (because they were warned). WADA never appealed...

BTW: Hardy was only suspended for 1 year...

Ban reduction, as a result of a contaminated supplement, isn't clear-cut. Swimmer César Cielo Filho even got off with a warning, in spite of an appeal by FINA. CAS judged that a warning was the minimum sanction (taking in consideration no significant fault or negligence) and therefore the Brazilian federation made a correct decision. Kolobnev, who tested positive on a comparable substance, is trying the same defence at the moment. Before the Russian federation he got off with a warning plus a fine. The UCI (in spite of CAS jurisprudence) appealed anyway...

 

[sniper]

nice link gooner.

from the article:

This defence is particularly intriguing to me, because it has evidence supporting it, and therefore can be "proved" (in so far as "proof" seems to exist in these cases). That evidence was described by Prof Michael Ashenden, one of the leading biological passport scientists. He reported to Cas that Contador's reticulocyte percentages during the race were abnormally high, which would be indicative of EPO use, because that switches on red blood cell formation (for more on the biological passport, reticulocytes and how all this works, read this article that I wrote last year). Contador's haemoglobin levels were also abnormal, compared with his biological passport history, leading the UCI, Wada and Ashenden to suggest that they were consistent with blood doping.

Ultimately, the Cas tribunal ruled that a blood transfusion was "very unlikely to have occurred", though I'm not sure why they came to this strong decision. It was perhaps related to the biological passport's own internal requirements for a "strike", which I explained previously. It was Ashenden's testimony, the legal back-and-forth it caused, its ultimate dismissal and then the Cas judges' refusal to allow Ashenden to have a final session of questioning that was leaked to the press after the hearing, so unhappy were the Wada/UCI lawyers.

(...)
To me, the findings of abnormal reticulocytes and haemoglobin concentration point very strongly to a likelihood of transfusion. It doesn't prove it – the biological passport cannot prove anything in that way, and it has been designed like this to protect cyclists against false positive tests. However, it points there, and so when a tribunal, dealing with the same evidence I'm seeing, concludes that a transfusion is "very unlikely to have occurred", I'm left mystified at their thought processes. At worst, they can conclude that a "transfusion is possible, but cannot be upheld given the physiological complexity of blood parameters". But to dismiss it as "very unlikely" … ?

I share his surprise. everything points towards a transfusion, even though, ironically, and as several posters have already pointed out, the clen may not have resulted from the transfusion.

It was pointed out here in the forum on several occasions prior to the CAS verdict (but for some reason not afterwards), that in AC's worst case scenario, he could have been sentenced for two doping offences (4 years?), CLEN and blooddoping.
Perhaps building a school in Israel wasn't in vane after all.
In any case, we should ask ourselves again why Ashenden was denied testimony, and why WADA twittered the whole case was a joke.

 

[Dr. Maserati]

nice link gooner.

from the article:

I share his surprise. everything points towards a transfusion, even though, ironically, and as several posters have already pointed out, the clen may not have resulted from the transfusion.

It was pointed out here in the forum on several occasions prior to the CAS verdict (but for some reason not afterwards), that in AC's worst case scenario, he could have been sentenced for two doping offences (4 years?), CLEN and blooddoping.
Perhaps building a school in Israel wasn't in vane after all.

Well, who said that?
I don't remember that argument, but regardless I do remember saying this case was all about the Clen, which it was.

The blood-doping scenario was only presented (and entertained by CAS) as it related to a theory on how the clenbuterol was found in ACs system.

In any case, we should ask ourselves again why Ashenden was denied testimony, and why WADA twittered the whole case was a joke.

You can keep asking but the answer never changes - Ashenden did testify, however WADA were denied an opportunity to recall him to discuss the idea of phthalate-free bags.

And WADA did not 'tweet' their annoyance, it was a text message (probably from someone involved) - I am sure all sides found the whole process annoying.