David Millar says that triamcinolone, a drug that was used by Sir Bradley Wiggins under a therapeutic use exemption (TUE), should be banned during races. The ex-pro, who has been a high profile anti-doping campaigner since being banned from the sport in 2004, also believes there should be full public disclosure of all TUEs.
Wiggins’ use of triamcinolone was revealed when the Fancy Bears hackers published medical data stored by the World Anti-Doping Agency (Wada) on their site last week.
The rider received several intramuscular injections of the substance as a treatment for asthma shortly before the Tour de France in 2011 and 2012 and before the Giro d’Italia in 2013. Following the publication of the details, he felt it necessary to issue a clarification relating to comments he had made in his autobiography regarding the use of needles.
Millar also used Kenacort – a trade name for triamcinolone – during his career. He told The Telegraph that he didn’t understand how a doctor could prescribe the drug to a rider about to compete in a race.
“As I said in my book, I took EPO and testosterone patches, and they obviously produce huge differences in your blood and you felt at your top level … Kenacort, though, was the only one you took and three days later you looked different.”
Millar also said Kenacort was a factor in his taking sleeping pills because it put him “on this weird high.”
Speaking about the effects, he described the drug as ‘scary’.
“You would do all the training but my weight would stick. But if I took Kenacort, 1.5-2kgs would drop off in like a week. And not only would the weight drop off I would feel stronger.
“If you are non-asthmatic and you take Ventolin it’s not going to give you any advantage. But if you take Kenacort it’s not only going to make a sick person better, it’s going to make a sick person better than a healthy person. That’s a very grey area.”
Millar suggests that there are other forms of cortisone which could be used to treat allergies instead of triamcinolone. “We [athletes] shouldn’t have to face this. If it’s that strong we shouldn’t be allowed to take it unless there is a serious issue. And if we’re suffering from that serious an issue, we shouldn’t be racing. I don’t know how a doctor could prescribe it [before a race]. I can’t fathom it.”
Add new comment
50 comments
Yea, I got that the first time. Do you realize how common things like allergies and asthma are? Let alone other types of health conditions that are managable with medication. People with health problems aren't a subspecies of lesser people.
Whether this particular case was an abuse or not, that's certianly an issue. But you can't prohibit such a large portion of the public from being able to compete for reasons they have no control over. That's pretty much the definition of discrimination.
pretty much! Perhaps they could have different categories of entry, drugged and drug free, obviously not competing together as that wouldn't be fair, now would it.
At least it would give the competitor a choice of which side of the fence he/she is on. Making sport more transparent. No grey areas and possibly end the deceit of cheating.
I don't think you understand fair versus not-fair. Say I have a skin condition that's treated with a steroid that has a very slight performance benefit for a small percentage of people that use it. You'd have me choose between risking skin infection or worse versus racing with Lance Armstrong? No, that's not even remotely fair.
'elite sport' is the definition of discrimination.
The issues here are playing the TUE system and the brutality of grand tours, not the fact that not very many people are born like Usain Bolt.
I'm a big fan of Wiggo but even I have to admit it looks fishy - not so much the drug used but the timing of each of the three TUEs. Before the big GC crack at the tour in 2011, before the the next big attempt at the tour in 2012 and finally before going for the giro the following year. Hate to say it, but I think he played the system. The obvious solution is to have a no-racing period after a TUE, depending on the effects of the drug.
It is more than fishy and precisely because of the timing and the drug used. But TUE means that he's broken no rule that any other athlete has been subjected to.
The Russians are right to point out the hypocrisy. You don't even have to look at TUEs to say that. What happened with Lizzie Armitstead was pure hypocrisy. Her case was seen to very speedily and was able to compete, despite breaking the rules. Other Russian athletes were given summary judgements based on third party evidence and banned from competing.
I don't dispute that the probability is that the Russian athletes were part of an organised doping program, but unlike Lizzie, they passed all the tests and didn't break any rules based on their requirement to produce samples. Lizzie was allowed off on a technicality with more than a hint that she consciously avoided tests.
The system is broke.
Millar is probably right about this... but I'd also say, Wiggins was right to get the TUE when he did...
This isn't utopia, this is professional sport, and if that TUE was avaulable to him, then all cool in my books.
if there are the effects highlighted by Millar, then it should not be allowed, or should dictate a period of non-racing after prescription. To me its not about lloking back and pointing fingers, its about learning the 'system' and changing things moving forward.
Written back in 2013.. Riis mentions it in his book as this post points out too.
http://www.biscuittinmedia.com/alejandro-marque-cortisone-confusion-tour...
I have time for Millar on this subject - he is someone who know exactly where the bones are buried.
However, on this point:
You take a strong enouph dosage, and there certinally is a performance advantage from Ventolin. It only lasts 5 min or so, but during that time - whaaayyyyy.
(although of course, some who needs that strenght of medication, aint going to be racing pro at the same time)
There's a limit to how much you can dilate a bronchus. If you don't have asthma, your bronchi shouldn't be constricted. Salbutamol will also give you a raging tachycardia for a relatively short time if you take a lot of it. That can be quite uncomfortable.
I couldnt think of anyone else I'd rather have actiing as a mentor to our younger riders.
Is this really how TUEs work?:
"I'm feeling a bit poorly, can I have some of the good stuff?"
"But it's illegal to use that during a race"
"But I'm not racing right now, and I really need it; can I have a doctor's note?"
The whole TUE approach is a joke.
'The Russians': we're exposing the hypocrisy of the system - if you just plain dope and get caught, you're a cheat. If you're Western and play the system, you dope and get a TUE, and then you're not a cheat.
It's a bit more subtle than that, but this has got legs and it's undermining WADA and national anti-doping agencies.
As a medic I would never use triamcinolone for "asthma", as Millar says (and he does know this sh*t) there are many other steroids that could be used for asthma, and certainly there's no reason to use injectable steroids either.
And this is the point that none of the media want to discuss from the fancy bears hack. One of the criteria for a TUE is that there should be no legitimate alternative treatment available, but there are 12 non-banned asthma inhaler treatments.
There is no reason that a TUE should be granted for salbutamol or triamcinolone unless the athlete has an adverse reaction to all 12 of those, and since they work by several different means that is almost impossible. That so many athletes are taking one or other of these is clear abuse of the system.
TUEs have only been required for salbutamol when exceeding doses way in excess of normal usage since about 2010,and if you were taking I think its approx 16 inhaler doses a day to control your asthma, you wouldnt be getting on abike and riding in a race anyway, youd be in hospital. at which point the doctors would be saying well why are you using a reliever medicine as a preventer medicine, and then prescribe you something completely different. You go for the salbutamol inhaler only when its needed, its not a magic performance boost drug,in normal consumption, no matter how many times people keep smearing that it is.
The drug already is banned during races. The only way you're allowed to take it during races is through cynical manipulation of the TUE system.
Millar is exactly who should have a voice. He knows his shit. And wasn't some washed up nearly ran, the guy was a boss. Good times, bad times. He's seen pretty much all of it.
I listen to him. Who you want to listen to? Some rose-tinted Mr. Nice Guy putting out platitudes and sweeping everything under the carpet? Doped for years and knows he got away with it? Loads of riders doped and didn't get caught and play down fears I bet.
People think Millar isn't legit cos he got caught. On the contrary, I think it made him legit as soon as he threw his hands up.
I remember Millar being interviewed a few years ago and talking about how it was a clean new world and the young guys in his team didn't face the pressures to dope that he did. You didn't have to be following cycling news very closely at the time to realise that was he was either hopelessly naive, dishonest, or just sticking his head in the sand. It certainly didn't come across as "knowing your shit".
It's interesting that Millar regards this drug as the most potent thing he's ever used, because the Telegraph reported this yesterday:
Dr Brian Lipworth, of the Scottish Centre for Respiratory Research, said, however, that he believed there was “no scientific reason” why a drug like triamcinolone would be performance-enhancing.
“An anabolic steroid like testosterone puts on muscle mass but this is a catabolic steroid which breaks down muscle,” said Lipworth, who sits on the WHO guidelines committee ARIA. “The benefits to David Millar were probably the fact that he was taking EPO and testosterone at the same time as he was using triamcinolone. So the anaobolic effect of the testosterone probably counteracted the triamcinolone."
Ian Pavord, a Professor of Respiratory Medicine at the University of Oxford, said he too doubted injected triamcinolone could help athletic performance as it would “reduce proximal muscle mass”.
Stephen Durham, the Head of Section for Allergy and Clinical Immunology at NHLI, Imperial College and Professor of Allergy and Respiratory Medicine at Royal Brompton Hospital London, said that to the best of his knowledge it would not aid performance but that "it would require a biochemist/clinical pharmacologist to provide a definitive answer that it would not have minimal effects".
http://www.telegraph.co.uk/cycling/2016/09/20/sir-bradley-wigginss-last-...
I'd like to know why Wiggins was using this treatment if it was for performance enhancement, and not just a very heavy duty allergy treatment, because it doesn't sound very useful. Either way, I'm not sure I would rely on Millar's comments about its performance enhancing effects instead of the opinion of expert scientists!
Millar should not given a voice. Can't get over that this cheat was given a job with British cycling to look after young riders when there are 50 other, internationally experienced riders- who road with honour, who could fulfil this role with pride and honesty.
Pages