Prof David GerrardProfessor of Sport and Exercise Medicine

Dunedin School of Medicine

10:45 - 11:10 Update on Doping in Sport: Life after Lance Armstrong

Professor David Gerrard

Otago Medical School

kudos

financial gain

power

national pride

mana

Biological variables over time

Indirect “doping” detection

“non-physiological variance”

Blood and steroid modules

Fundamental principle of profiling (ABP)

A marker of blood doping – Haemoglobin

The athlete is their own reference point

Subsequent values compared with normal physiological response

p.14

Abnormal blood passport

p.15

Atypical Profile (HGB)

Athlete targeted: Positive for EPO

p.16

unusual fluctuations

tagged to specific event?

relevant medical history?

rule out pathology…

Legitimises use of banned substance

Prioritises health of patient

Requires physician compliance

Diagnostic criteria

Chronic inflammatory bowel disease

Peri/post-operative management

Hypogonadism

ADD/ADHD

Acute asthma

Type-1 diabetes

Doping infractionsAdverse analytical findingsAnti-doping rule violations

Maria Sharapova

Australian Open 2016

Meldonium

• Inhibitor of fatty acid oxidation

• 1970 Latvia

• Indicated for “anti-ischaemia” effects

• Uses: angina, myocardial infarction

• Not approved by FDA

• 2010 clinical trial “…significant increase in exercise tolerance…”

• Monitored by WADA throughout 2015

• Considered to be misused for performance-enhancing effects

• Shushapova

anti-”grunting”

• Saccharinopova low cal

• Supernovapova

multivitamin supplement/electrolyte replacement

GDR – “sports medicine alchemy” 1960s-80s

Clandestine programme of experimentation using androgenic substances in female athletes…

Changing faces: clinical

consequences…

Andreas (formerly Heidi) Kreiger

Knud Jensen

1960 Rome

Team time trial

amphetamines

Ben Johnson

Seoul 1988

Stanozalol

Nadzeya Ostapchuk

London 2012

Stanozolol

“…our professional obligations to patients who also happen to be elite athletes, are subject to the provisions of the WADA Code.”