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Use of unproven therapies in elite athletes

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Craig Payne, Dec 6, 2014.

  1. Craig Payne

    Craig Payne Moderator

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    There has been a bit of biz around this in the last 24. A number of twitter links to these papers:

    Funky treatments in elite sports people: do they just buy rehabilitation time? (from 2010)
    Athletes’ Use of Unproven Stem Cell Therapies: Adding to Inappropriate Media Hype? (from 2012)
    Sports and exercise medicine—specialists or snake oil salesmen? (from 2011)

    The context being that Rafael Nadal may be undergoing stem cells therapy for his injury

    @AshPaul tweeted:
    Karim Khan tweeted:
     
  2. docbourke

    docbourke Active Member

    I am constantly bewildered and dismayed at the expense and time wasted by elite teams sending athletes for untried and possibly harmful treatments. This includes overseas trips and the use of possibly banned substances. I can only question the knowledge and ethics of any medical person involved in this type of human experimentation. Unfortunately it has extended to the surgical world and "New Operations" are being invented for "Newly discovered conditions" without any science behind then let alone clinical trials or evidence. One surgeon I talked to has been reported as saying he operates on conditions that would get better with conservative treatment but by operating it keeps the sportsmed. docs out of the picture from interfering with the non operative treatment. Perhaps it is time sports med practitioners are subject to more stringent audit processes and peer review to justify both the efficacy and cost of experimental treatments.
     
  3. Admin2

    Admin2 Administrator Staff Member

    Press Release:
    NFL athletes are seeking unproven stem cell treatments
     
  4. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Full text available:
    U.S. National Football League Athletes Seeking Unproven Stem Cell Treatments free access
    Kirstin R.W. Matthews, Maude L. Cuchiara
    Stem Cells and Development. December 2014, 23(S1): 60-64.
     
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    NewsBot The Admin that posts the news.

    Articles:
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  6. BEN-HUR

    BEN-HUR Well-Known Member

    Being that this thread is a (potential) performance enhance type topic/thread... & that a tennis player (i.e. Rafael Nadal) has been mentioned above... & that yesterday (7-3-16) Maria Sharapova has received a provisional 12-month ban by the International Tennis Federation due to testing positive for the drug Meldonium, I thought the following would be of interest...

    It is interesting that Maria Sharapova has been given a provisional 12-month ban by the International Tennis Federation due to testing positive for the now (as of 1-1-16) banned substance *Meldonium* (http://www.msn.com/en-au/news/world...arapova-has-been-taking/ar-AAgvdnS?li=AAgfLCP).

    Maria has been taking this drug for "10 years" as prescribed by her "family doctor" (she stressed "family" doctor in a recent interview) for apparent legit medical reasons (that meaning not performance enhancing reasons). Maria didn't state these legit medical reasons (fair enough)... but I do struggle why a young healthy athlete would use such a drug for such legit medical reasons this drug is designed for (i.e. used to treat angina & myocardial infarction). However, there is a performance enhancing aspect (surprised?) of this drug i.e. improves exercise capacity ("significantly improves exercise tolerance"). There is also reports suggesting that Meldonium may improve the ability of learning & memory (maybe a form of "smart drug"?).

    Another interesting (or maybe curious) fact is that Maria is not the only athlete now banned for taking Meldonium. The following is taken from the Meldonium Wiki page (https://en.wikipedia.org/wiki/Meldonium#Doping):

    Now that is an interesting athlete profile above... & subsequently I am quite suspicious as a result of the claims, facts & circumstances outlined above (pertaining to Maria Sharapova's claims for taking the drug for the past 10 years). Based on the claimed profile/benefits of Meldonium... & that I am an endurance/distance runner... I would be certainly interested in its use... if still legal that is.
     
  7. Craig Payne

    Craig Payne Moderator

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    Her explanation given in the press conference for taking that drug is just not plausible. Her "medical reasons" for taking that drug are not plausible.
     
  8. toomoon

    toomoon Well-Known Member

    the typical timeframe for legitimate therapeutic Meldonium use is 4-6 weeks. Sharapova has been using it for 10 years and has had 86 prescriptions filled. Not sure my family doctor would be OK with that...
     
  9. Craig Payne

    Craig Payne Moderator

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    Ross Tucker just tweeted this:
     

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  10. Craig Payne

    Craig Payne Moderator

    Articles:
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  11. BEN-HUR

    BEN-HUR Well-Known Member

    Yes. Maria claims she has taken Meldonium/Mildronate since 2006 - hence since she was around 18 - 19 years old! Now Meldonium/Mildronate is an anti-ischemic type drug... yet according to this article (http://www.msn.com/en-au/news/world...rsight/ar-BBqrW2n?li=AAgfYrC&ocid=mailsignout) she has claimed the following...

    Now maybe I'm missing something here... but Meldonium/Mildronate is just not used for the above conditions... & why would a very fit, young (18-19 year old at the start of treatment) be concerned about diabetes (presume Type 2)... there is just no way in the world that a fit, young, healthy (who I presume is eating healthy) world class athlete need to be concerned about diabetes (regardless of "family history"). Does Maria have Type 1 diabetes or not? What were these "signs of diabetes"?

    As for the "magnesium deficiency" issue. This can happen in athletes. I've been through it myself... where I suspect it has been a contributing factor to a few bouts of Atrial Fibrillation. However, there are numerous products on the market to address magnesium issues... & sport specific products (obtained from health food stores or sports stores) i.e. in tablet form or in powder/sports drink form.

    Whoever is advising Maria on this Meldonium/Mildronate issue is doing a terrible job.

    I suspect Maria has taken Meldonium/Mildronate for the recognised sport/performance enhancing traits the drug possess i.e. improves exercise capacity ("significantly improves exercise tolerance"). The evidence is certainly pointing to this direction... whilst Maria's reasoning is just not adding up. Based on this evidence to date I find it frustrating when the likes of Serena Williams applauds "courage" of Sharapova (http://www.msn.com/en-au/news/world...rapova/ar-AAgxEC8?li=AAgfYrC&ocid=mailsignout).

    Time will tell... maybe the experts will express their views on Maria's reasoning for taking Meldonium/Mildronate... & if that reasoning stacks up for legitimate medical use.

    Have a bit of a sore spot for drug cheats at the moment due to the degree of recent Kenyan... & now Ethiopian runners being caught with various banned stuff in their systems... http://www.theguardian.com/sport/20...pian-runners-suspended-on-suspicion-of-doping
     
  12. BEN-HUR

    BEN-HUR Well-Known Member

    That's interesting... boy!... could I have done with that stuff (Mildronate) in the past! I bet there were quite a few annoyed athletes on the 1-1-16 (when Mildronate was put on the banned list). With the performance enhancing traits of Mildronate - why did it take so long to be added to the list?
     
  13. Paul Bowles

    Paul Bowles Well-Known Member

    Drugs get put on the list after extensive monitoring from WASADA and other anti doping agencies. When they start to see "trends" in its use the substance is banned.

    Makes me wonder why Running Shoes haven't been banned either!!!!!

    Remember Mildronate is NOT available in Aus or the US and is not approved by the TGA orUS food and Drug Administration. It is NOT easy to get, it is only intended to be used for short periods of 4-6 weeks at a time. I'm not casting aspersions on Ms Sharipova but to say you have been using it for 10yrs is a little bit of a stretch. It has no known evidence to support its use in preventing diabetes as she has claimed.

    Do the math. At least she came out and admitted it.
     
  14. Craig Payne

    Craig Payne Moderator

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    They can under some circumstances
     
  15. BEN-HUR

    BEN-HUR Well-Known Member

    Well, Maria had no choice... she was caught with it in her system. She couldn't deny using it... that would make her predicament look more suspicious. Now she is very open about it... albeit, with what seems vague & irrational reasoning to back up her apparent "10 year" use of Meldonium/Mildronate... & for the conditions she's stating.
     
  16. Paul Bowles

    Paul Bowles Well-Known Member

    ...add to that: Diets, foods, vitamins, sleeping pods, certain types of clothing and possibly breathing...... :)
     
  17. Paul Bowles

    Paul Bowles Well-Known Member

    Tell that to Lance Armstrong LOL

    She took it on the chin. Not a good way to retire, but hey when you are the highest paid female athlete on the planet you can have your ups and downs!!!!
     
  18. BEN-HUR

    BEN-HUR Well-Known Member

    Well... Lance set a precedent (i.e. lie, bribe, intimidate... perjury)... to try & worm his way out of it. The world saw how that turned out :butcher: (good bye respect, sponsors, endorsements, friends & fans). I would think Maria & Team Sharapova (i.e. managers, lawyers) have learnt a lot from Lance's lesson... as should all athletes who are taking drugs (thanks Lance :rolleyes:).

    I think Maria is being (or trying to be) extremely careful... to avoid :butcher:.

    I remember shortly after the Lance ordeal... I was on a training run & ran past a pile of Lance Armstrong memorabilia (pictures, books) on the side of the road. Lance disappointed a lot of people... which is sad (for the fans, particularly young fans)... but Lance deserved what he got & some would say he deserved more punishment.
     
  19. Craig Payne

    Craig Payne Moderator

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    this is pretty telling:
     

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  20. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Meldonium use by athletes at the Baku 2015 European Games
    Mark Stuart, Christian Schneider, Klaus Steinbach
    Br J Sports Med doi:10.1136/bjsports-2015-095906
     
  21. BEN-HUR

    BEN-HUR Well-Known Member

    The following from Medscape...
    Meldonium -- The Drug That Brought Down Sharapova (http://www.medscape.com/viewarticle...ir&uac=156241CR&spon=17&impID=1042363&faf=1):

     
  22. NewsBot

    NewsBot The Admin that posts the news.

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    Novak Djokovic isn?t accused of doping, but he sounds eerily like Lance Armstrong
     
  24. BEN-HUR

    BEN-HUR Well-Known Member

    The following point caught my attention...

    I was curious... then that was soon answered...

    Wow... it wouldn't have taken long before the sports world got hold of that news. I'm willing to bet that athletes have been taken Meldonium since the 80's.

    Meldonium looks to be what I would call a "wonder drug" & from memory (from previous research) has little in the way of adverse side effects.


    Speaking of performance enhancing drugs... use by 'soldiers' (in the following case - brainwashed morons following a vile, debasing, intolerant cult!)... & use in the Middle East... there is another drug that has interested me - Captagon.

    Captagon - The Smart Drug Fuelling Syria's Civil War: (http://www.smarternootropics.com/2014/01/captagon-the-smart-drug-fuelling-syrias-civil-war/)

    The tiny pill fuelling Syria's war and turning fighters into superhuman soldiers: (http://www.msn.com/en-au/news/world...ldiers/ar-BBndg1C?li=AAabC8j&ocid=mailsignout)

    Fenethylline (Captagon): (https://en.wikipedia.org/wiki/Fenethylline)
     
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  26. BEN-HUR

    BEN-HUR Well-Known Member

    I decided to form the following offshoot thread... "Use of proven (albeit *illegal*) therapies in elite athletes" (http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=106422). I inadvertently directed this thread down a path which isn't really related to the subject matter of the thread ("unproven therapies in elite athletes") when I cited the case of Maria Sharapova & her use of the illegal substance of Meldonium (which is a proven/effective substance - albeit, illegal). Interesting... but not really related to this topic.

    Hence the following thread - "Use of proven (albeit *illegal*) therapies in elite athletes". This is potentially a fascinating (& disturbing) topic (well, I think so)... particularly in light of breaking news in the world of athletics... like the following...

    Everything You Need to Know About The Jama Aden Doping Raid That Took Place With Three Dibaba Sisters Being Present (http://www.letsrun.com/news/2016/06...raid-took-place-three-dibaba-sisters-present/)... http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=106422
     
  27. NewsBot

    NewsBot The Admin that posts the news.

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    Story behind meldonium?from pharmacology to performance enhancement: a narrative review
    Wolfgang Schobersberger et al
    Br J Sports Med doi:10.1136/bjsports-2016-096357
     
  28. BEN-HUR

    BEN-HUR Well-Known Member

    - Controversy at World Swimming Championships (athletes refuse to acknowledge Sun Yang):
    Sun Yang (Olympic champion distance swimmer) has tested positive (in the past) to Trimetazidine (an anti-ischemic [anti-anginal] metabolic agent)… to treat a (apparent) "heart condition". I say bulls@#t! Just medically test for the supposed "heart condition" of this young fit/conditioned world-class athlete!

    - Similar to:
    Maria Sharapova tested positive to Meldonium (another anti-ischemia medication)… to treat a (apparent) "heart condition". I say bulls@#t! Just medically test for the supposed "heart condition" of this young (she started taking it at age 18-19) fit/conditioned world-class athlete!

    Interesting how both drugs have been associated with i.e. improved exercise capacity ("significantly improves exercise tolerance")… & improved oxygen uptake. Crikey - how convenient.


    The dark secret that ruined Sun Yang, Chinese swimming megastar turned pariah: (https://wwos.nine.com.au/swimming/s...uncement/46311a70-47b7-46cf-a47c-97646dc608d9)
    "
    ...Trimetazidine is usually prescribed for angina, though it is considered performance-enhancing in athletes because it improves the body's use of oxygen. When Sun took the drug, it was only banned in-competition; it was allowed for use under medical supervision out of competition, but Sun tested positive via an in-competition sample..."

    The prevalence of trimetazidine use in athletes in Poland: excretion study after oral drug administration:
    (https://www.ncbi.nlm.nih.gov/pubmed/25421604)
    "... Trimetazidine (TMZ) is used as a well-known cardiologic drug with confirmed biochemical and clinical activity. According to knowledge of the pharmacology and mechanism of TMZ action, TMZ can be used by athletes to improve physical efficiency, especially in the case of endurance sports..."
     
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