Diuretics and Masking Agents

Diuretics are products which help to remove body fluids. They cause a lost of water due to partial paralysis of water reabsorption. Powerful diuretics can increase orine flow about 6 liters per day.

Masking agents are compounds which are taken with the purpose of hide or mask the presence of others ilegal drugs during the antidoping tests. Masking agents have the potential of ruin or hide the prohibited substance in orine. For that reason, diuretics can be considered as masking agents due to orine dilution that give rise to smaller levels of the prohibited substance when is excrete by the body.

Diuretics and others masking agents has the 5º position among the most used drugs of all adverse analyzed results in the world. They are prohibited both inside and outside the competition. In the following image we can see specifically which are prohibited by WADA:

Kidney is the main organ trough these drugs are excreted.  Chemically, diuretics are a group of compunds which stimulate or inhibit several hormones that are naturally present in the body for regulate the orine production by kidneys.

Athletes use diuretics with the purpose of lose weigth quickly, specillay in that sports classified by weigth categories, and/or to cover the presence of other prohibited substances. However, the fluid losses through orine causes by this kind of drugs can lead to the depletion of intravascular volume. For that reason, an overage diuretics use generally drive to dehydration and hypovolemia, which is one of the main causes of hypokalemia. This situation may produce effecst as hypotension, muscular weakness, muscle cramps, irregular neurological functioning, cardiac arrhythmias or even heart attacks.

Knowing the Gene Doping.

The gene is the biologic unit of the heredity and they are simplified codes for the protein synthesis. In some cases, these genes are defective and have wrong information that entail a lack or viceverse in the protein synthesis. In this join, the genetic therapy will try to repair the defective gene. But in the same way, it will be possible modify the genes with the purpose of achieve a biological advantange that can enhance the sport performance.

That fact cause that the WADA considered the gene doping as a ilegal method in the prohibid list. The following procedures are consider by the WADA as prohibited, since they have the potential to enhance performance:

1. The use of polymers of nucleic acids or nucleic acid analogues.

 2. The use of gene editing agents designed to alter genome sequences and/or the transcriptional or epigenetic regulation of gene expression.

3. The use of normal or genetically modified cells

However, is not easy to detec that genes have been modified. In the physical activity context there are several genes that carry the information of enhance endurance (EPO) or proteins which increase the muscle mass (Growth hormone).

Nowadays, the genetic therapy is not aprobed medically since could deliver in nocive effect. In a short term, this method can produce hard inmune-respone that could cause the death or the development of diseases as leukemia. In the long term, due to the lack of control of the gene expression, the integrates genes could produce substances althoug they are not required, which could increase the risk of tumours or lead to cardiovascular problems.

Cannabidiol stop to be a ilegal susbtance

Welcome everyone again, today we are going continue talking about the Cannabinoids, concretely about the Cannabidiol (CBD). 

As we talked in previous posts, Cannabidiol is one of the most important compounds of Cannabis Sativa. This substance was considered as a ilegal substance until the previous January, 1st 2018, when the new prohibited substances list was announced. This new was announced by the WADA on September, 29th 2017, and was the most important change on the 2018 official prohibited list.

According to the WADA, "Cannabidiol is no longer prohibited. Synthetic cannabidiol is not a cannabimimetic; however, cannabidiol extracted from cannabis plants may also contain varying concentrations of THC, which remains a prohibited substance."

It is truth that antiinflamatory properties of Cannabidiol have been known for a long time (Nagarkatte, P, 2010). Thank to these properties, CBD is becoming a popular alternative to the opiates for elite athletes. Is the chase of the fighter Nate Diaz, who use CBD because not produce secondary effects and it is not adictive although it is taken for long periods of time. Moreover, CBD could reduce substantially the recovery time of athletes due to his antiinflamatory properties.

On the other hand, the fact of this cannabinoid is a great analgesic involve that help with imsomnia and even can help with apetite. That is so important for elite athletes since a better sleep time means a better recovery, and in most chases they have to eat large amounts of food.

This change of CBD in the prohibited list supposed that any athlete could use freely CBD as a palliative or antiinflamatory without worrying about be expelled of competitions or suffer hard secondary effects. 

The Kenyan 1500m runner Asbel Kiprop, another doping confirmed

Last week, the Kenyan newspaper ''The Standard'' revealed that a Kenyan athlete had a positive result in a test, but they did not reveal the name. Yesterday, we knew the name, Asbel Kiprop.

Asbel Kiprop, a Kenyan star who had won the gold medal in the Olympic Games of 2008, was accused of doping with EPO on 27 november 2017. Nevertheless, he said to the Britain newspaper ''The Guardian'' that he had not used this type of methods, and also, he had fought against doping in Kenya.

You can find information about EPO here: EPO review. Collected from https://www.msssi.gob.es/.

In a statement, the AIU (Athletics Integrity Unit) have said this: “The AIU is satisfied that there has been no mix-up or tampering with the sample and that the sample collected from the athlete on 27 November 2017 was the same sample analysed by the laboratory and reported as an adverse analytical finding.”. Moreover, they added: “The AIU has confirmed that the doping control assistant involved in testing Mr Kiprop on 27 November 2017 [who is known to Mr Kiprop] admitted that he provided Mr Kiprop with advanced notice of the testing that was to take place on that date. This is extremely disappointing.”

If you do not know who is Kiprop, you can watch this video:

The Kenyan star refused the results, and recognise that the test assistant had asked him for money, and as he did not give him the money, the assistant had changed the sample.

Now, Kiprop have to wait until the AIU, IAAF and WADA decision. Which do you think wouldbe the correct penalty for Kiprop? Do you think that assistants test can change the results of a doping test?

Thanks for reading us,
Sergio Torreblanca.

Bibliography:
http://ecodiario.eleconomista.es/internacional/noticias/9111434/05/18/Estrella-del-atletismo-keniano-da-positivo-por-dopaje-medios.html
https://www.lavozdegalicia.es/noticia/deportes/2018/05/04/confirmado-doping-epo-campeon-olimpico-1500-pekin/00031525455227130573131.htm
https://www.theguardian.com/sport/2018/may/04/epo-suspect-asbel-kiprop-athletics-integrity-unit
http://www.marca.com/atletismo/2018/05/04/5aec969a268e3e12648b459f.html
García L., Antorán B. & López A. (2009). Eritropoyetina: revisión de sus indicaciones. Sistema Nacional de Salud, 33(1): 3-9.

Why are cannabinoids prohibited? Functioning and effects.

The Cannabinoids are a group of natural substances present in the plant Cannabis Sativa. Chemically they are derivated of dibenzopyrene or monoterpenoids. The Cannabis Sativa contanis about 420 chemical compounds of which the more important are THC, cannabinol (CBN) y cannabidiol (CBD). You can see the molecular form of these substances below.

As happen with the opiates, that they join directly to the endorphine receptors, the cannabinoids receptors join to his specific molecule: the anandamide. The anadamide is involved in the regulation of the mood, memory, appetite, pain, cognition and feelings.

Cannabis is widely use to have the characteristics of mood alteration and relaxation. The lack of scientific evidence about how cannabis could increase the performance is associated with the obvius evidence of their harmful effects over psychomotor skills and the cognosctive function, what could be dangerous in certain sport modalities (sky, motor sports).

The prohibition of the use of cannabinoids in sports is based in the safety concern during training and competition. According to the WADA, cannabinoids samples not are analysed in out competition tests.

The primary effects of cannabinoids are exercised over the central nervous system and cause lack of physical effort motivation and a weakening of the psychomotor system, memory and perception in the short term. Regarding to the physiological effects, cannabinoids cause tachycardia, bronchodilation and a greater blood flow to the limbs. The chronic consumption of cannabinoids could produce the destruction of CB1 brain receptors, giving as a result a blood flow shortening and a decrease in the glucose and oxygen supply to the brain what could produce attention déficit, memory lose and a deteriorated learning capacity.

Finally, it should be noted that since the beginning of 2018 Cannabidiol(CBD) stopped being considered as a ilegal substance by the WADA. We will talk deeper about it in following posts.

What are the TUEs? – A controversal topic

Welcome everyone again, in this new post, we are going to talk in depth about the Therapeutic Use Exemptions (TUEs).

In previous posts we talked about a recent new, the assumption doping of Bradley Wiggins in 2012 and others irregularities in the Team Sky. This topic is controversal due to the supposed doping was produced for an excessive use of a substance considered as a TUE.

Image 1. Salbutamol (Ventolín) one of the TUE drugs more used nowadays. 

The TUEs are prohibited substances for WADA that can be used in exceptional chases for some athletes claiming theraupetic reasons previously. With the purpose of regulate this issue the WADA developed The International Standard for Use of Therapeutic Exemptions. In this mandatory International Standard is established the main conditions for achieve a TUE:

If an athlete have all these conditions and finally request a TUE, this application have to be assseded for the Therapeutic Use Exemption Committee (TUEC). As a last resort, is the WADA TUEC the panel in charge for review the TUE decisions of other Anti-Doping Organizations. You can download the template of TUE application form clikcing here.

According to the established in The International Standard for Use of Therapeutic Exemptions:

An Athlete who needs a TUE should apply as soon as possible. For substances prohibited In-Competition only, the Athlete should apply for a TUE at least 30 days before his/her next Competition, unless it is an emergency or exceptional situation. The Athlete should apply to his/her National Anti-Doping Organization, International Federation and/or a Major Event Organization (as applicable), using the TUE application form provided.

The form must be accompanied by:

a. a statement by an appropriately qualified physician, attesting to the need for the Athlete to Use the Prohibited Substance or Prohibited Method in question for Therapeutic reasons; and

b. a comprehensive medical history, including documentation from the original diagnosing physician(s) (where possible) and the results of all examinations, laboratory investigations and imaging studies relevant to the application.

Each TUE will have a specified duration, as decided by the TUEC, at the end of which the TUE will expire automatically. If the Athlete needs to continue to Use the Prohibited Substance or Prohibited Method after the expiry date, he/she must submit an application for a new TUE well in advance of that expiry date, so that there is sufficient time for a decision to be made on the application before the expiry date.

In the next drawing, we can see the process necessary for an non-international-level athlete for achieve a TUE.

Image 2. Process to get a TUE for an Non-International-Level Athlete.

In the chase, of international-level athlete or major events the process is longer and complicated, if

you are interested in know more about it you can read the whole information here.

Is possible the doping in the E-Sports players?

e-Sports

The e-Sports (Electronic Sports) are the new trend in the ‘gamers’ world. In the 21th century this market has grown amazingly. Nowadays, much children dream to become a famous e-Sports player such as to be LeBron James or Lionel Messi.

In October 2017, the IOC (International Olympic Committee) considered the e-Sports as a sport, like football, basketball or handball, with this text about it:

‘’The Summit discussed the rapid development of what are called "eSports", and the current involvement of various Olympic Movement stakeholders. The Summit agreed that:
·         "eSports" are showing strong growth, especially within the youth demographic across different countries, and can provide a platform for engagement with the Olympic Movement.
·         Competitive "eSports" could be considered as a sporting activity, and the players involved prepare and train with an intensity which may be comparable to athletes in traditional sports.
·         In order to be recognised by the IOC as a sport, the content of "eSports" must not infringe on the Olympic values.
·         A further requirement for recognition by the IOC must be the existence of an organisation guaranteeing compliance with the rules and regulations of the Olympic Movement (anti-doping, betting, manipulation, etc.).
The Summit asked the IOC together with GAISF in a dialogue with the gaming industry and players to explore this area further and to come back to the Olympic Movement stakeholders in due course.’’

(picked up from https://www.olympic.org/news/communique-of-the-olympic-summit)

Before this new, only two Spanish football clubs had an e-Sports team: Valencia C.F. and Alcorcón C.F. Nevertheless, so many clubs have created a new e-Sports team in their ranks after that.

In this aspect, anyone suspected that the doping could affect this sport. That was until a e-Sports player called Kory ‘Semphis’ Friesen, who played for Cloud 9 team, admitted that his colleagues and him had consume some substances to improve their performance in the competitions. The substance that they usually consumed was ‘Adderall’, which they bought in USA. Adderal is used as an athletic performance enhancer and cognitive enhancer, and recreationally as an aphrodisiac and euphoriant. It can do that people can improve and keep their concentration.

Cloud 9 team

But, there is a big problem in this aspect. There is not any agency or comittee mandated of the anti doping plan in the e-Sports. Also, you can not find any doctor in these competitions, so anypeople can do an antidoping test.

One example of the importance of the anti doping measures is the NBA 2K League, that is represented by the NBA real teams, as Golden State Warriors or Denver Nuggets, for instance. As this is an oficial NBA competition, the players have to pass some drug tests, because they have to accomplish all the NBA rules. Here you can see a video about this league.

What is your opinion about this? In a future, do you think that more e-Sports players will consume substances to improve their performance? We are waiting your answers in the comments.

Thanks for reading us,

Sergio Torreblanca.

The Kings of Doping: Russia

The last years, Russia has been appeared as the country with the largest number of doped athletes: more than 1,000 athletes and 29 olympic medallists have been accused. ‘An unprecedented fraud’ according to the WADA.

Grigori Rodchenov, who had been worked for the RUSADA (Russian Antidoping Agency) between 2006 and 2011, used anabolic agents. He has the aim to get many medals in the Olympic Winter Games of Sochi 2014, because 4 years before Russia only was the 6th country in the medals classification.

Rodchenov decided to tell the truth to the WADA some years later and uncover this story. It was a systematic plan of many years, when, for example, two female urine were discovered as male urine.

The plan had two phases. The first one was to avoid the doping control: all the athletes knew how to avoid them and what they had to do. The second one was to avoid this controls during the competition, but it was more difficult because of the WADA, but the RUSADA constructed a building near the sport facilities where they can avoid this controls. There, they had two bottles: one where they should urine and other where there were the false urine.

Nevertheless, there was a problem. One of the Russian athletes, Yuliya Stepanova, and his boyfriend, Vitaly Stepanov, picked up some tests about the plan. They sent to the AMA 200 mails that included all that Rodchenkov was doing. In 2014, all the world discovered the truth with a documentary film in the German television about the Russian doping, where Stepanova and another athlete, Liliya Shobukhova, confirmed the suspicion. They related that they had to pay 450.000 € to convert a positive test doping to negative. In 2015, Rodchenkov ran away to United States of America.

In the Olympic Games of 2016, 111 athletes were removed because of previous doping by the COI, and in 2017, they removed all the athletes for the Olympic Winter Games of 2018. Then, in 2018, before the Olympic Games, the penalty was changed and the Russian athletes could participated in this competition.

Here you can see a video that resume the Russian doping plan.

Thanks for coming,

Sergio Torreblanca.

Bibliography:

http://www.superdeporte.es/olimpiadas/2016/07/21/cronologia-escandalo-dopaje-deporte-rusia/304380.html

http://www.xlsemanal.com/conocer/20170124/dopaje-rusia-deportes-doping.html

https://es.wikipedia.org/wiki/Dopaje_en_Rusia

http://www.bbc.com/sport/winter-sports/42674331

https://www.vanityfair.com/hollywood/2018/02/icarus-documentary-nominee-doping

What are anabolic agents?

Anabolic steroids, also known more properly as anabolic androgenic steroids (AAS), are synthetic variations of the male sex hormone testosterone. The terms "Anabolic" refers to muscle building, and "androgenic" refers to increased male sex characteristics.

USES:

Anabolic steroids have many uses, classified into four groups mainly: Medical, anabolic, androgenic and other uses (like male contracepcion, treatment of breast cancer in women, etc).
One of the uses more know is to improve performance.

Studies in the United States have shown that AAS users tend to be mostly middle-class heterosexual men with a medianage of about 25 who are noncompetitive bodybuilders and non-athletes and use the drugs for cosmetic purposes.

Routes of administration:

The most commons forms of administration of AAS are by oral pills, injectable steroids and creams or gels.

Some athletes and other who abuse of these sustance, think that they can avoid unwanted side effects or maximize the drugs effects taking them by differents ways:

• Stacking: Combination of two or more types of steroids.
• Cycling: Taking doses for a period of time, stopping for a time.
• Pyramiding: Slowly increasing the dose or frecuency of abuse, reaching a peak amount, and then gradually tapering off.

ADVERSE EFFECTS:

The use of AAS have some side effects  that can seriously affect health.

Known of possible side effects of Anabolics include:

• Dermatologycal: oily skin, acne vulgaris...
• Reproductive/endocrine: libido changes, reversible infertility, hypogonadotropic hypogonadism, erectile dysfunction, hirsutism...
• Psychiatric/neurological: mood swings, irritability, aggresion, euphoria, depression...
• Musculoskeletal: Muscle strains, tendon ruptures, muscle hypertrophy...
• Cardiovascular: atherosclerosis, hypertension, dyslipidemia, left ventricular hypertrophy...
• Hepatic: elevated liver function tests, hepatotoxicity, peliosis hepatis, hepatocellular...
• Renal: renal hypertrophy, acute renal failure, glomerulosclerosis...
• Others: insuline resistance, immune dysfunction, glucose intolerance.

Bibliography:

Anabolic steroid

Drugabuse.gov

A different type of doping for Samir Nasri

Ex-Arsenal F.C., Sevilla F. C., and Manchester City F. C. midfielder Samir Nasri has been accused last week because of doping by the WADA (World Anti-Doping Agency). 

Here you have a Youtube video of Nasri playing for Manchester City F. C: Samir Nasri
If you do not know what is the WADA, you can read our last post ;).

It seems that Samir Nasri, who is a famous football player, received a treatment when he was playing for Sevilla F. C.  A medical company called 'Drip Doctors' treats him with a drip intravenous vitamin treatment based on a high dose of vitamins B, C, Selenium and Zinc combined with others nutrients which help people to avoid viruses and other illnesses.

This is a metod that appear in the prohibited WADA list, so the CEDB (control, ethics and disciplinary body) decided to ban Nasri for 6 months. There is a limit of 50 millilitre for active athletes, but the footballer took 500 millilitres of this infusion.

In our opinion, athletes are not informed of this not usual doping methods They have to be careful because the penalties are harder than they think. In other way, it seems that this method do not improve the performance, but it could be a good option as recovery method between matches, for example.

Here you can see some slides with pictures about Nasri:

What do you think about this type of doping? Do you consider that it improves the performance as well as typical substances? 

We are waiting for your answers in the comments.

Thanks for reading us, see you soon,

Sergio Torreblanca.

Leading the fight against Doping: The World Anti-Doping Agency (WADA).

Welcome everyone to the first post of the page. In this post we are going to talk about the organization that leads the fight against doping worldwide: The WADA.

As we can find in his website:

"The World Anti-Doping Agency (WADA) was established in 1999 as an international independent agency composed and funded equally by the sport movement and governments of the world. Its key activities include scientific research, education, development of anti-doping capacities, and monitoring of the World Anti Doping Code (Code) – the document harmonizing anti-doping policies in all sports and all countries."

The WADA, was created after the events happened in cycling in the summer of 1998., when the International Olympic Committee (IOC) deciced to convene a World Conference on doping getting together all parts involved in the fight against doping. In this way ocurred the First World Conference on Doping in Sport held, in Lausanne, Switzerland, on 1999, producing the Lausanne Declaration on Doping in Sport. Pursuant the terms of this document, the WADA was founded in November 10, 1999, in Lausane (Switzerland). 

As we said previously, the WADA born trough the accordance between the sport movement and the international governments. This agreement have a important common point that is known as the "World Anti-Doping Code". The WADA define the Code in the following way:

"The Code is the fundamental and universal document upon which the World Anti-Doping Program is based. Its purpose is to advance the anti-doping effort through universal harmonization of core anti-doping elements. It is intended to be specific enough to achieve complete harmonization on issues where uniformity is required, yet general enough in other areas to permit flexibility on how agreed-upon anti-doping principles are implemented. The Code has been drafted giving consideration to the principles of proportionality and human rights".

On the other hand, the WADA,  every year make public "the list of prohibited substances and methods", which is valid for the whole year(from January 1 to December 31). This document classify the ilegal substances and methods in three categories:

- Prohibited at all times (in and out of competition)
- Prohibited in competition.
- Prohibited in particular sports.

Moreover, into these categories, the prohibited substances and methods are classified in groups according his roles. 

To sum up, it seems clear that with only 19 years is an agency relativalety young in comparison with the majority of sports and even nowadays some countries do not cooperate completely with this organization. Definitely appear that much work remains to be done to achieve a cleaner sport.

This is only a short summary about the main things which are important to know about the WADA. In following post we will talking deeper about the code and the prohibited list.