Pereiro and his TUE

Le Monde: Pereiro positive for salbutamol
This should come as no surprise to anyone that another professional cyclist would test positive, but at least Pereiro supposedly has paperwork exempting him due to a TUE. Remember those TUEs, as in Therapeutic Use Exemption?

If you recall I posted "Got your TUE" back in September 2006 after it was revealed 13 riders had tested positive during the 2006 Tour de France. Unfortunately for Floyd Landis he lacked a TUE for his positive result (which I'm sure doesn't exist for low testosterone for men), but 12 of those 13 riders did possess their TUE to stay out off Dick Pound's hatchet list.

What was more revealing back then was that of the 105 riders tested in the Tour over 60% possessed some type of TUE. One can only imagine why so many have a TUE and what the prescription is for, but my guess is it's a running joke in the peloton as to each rider's TUE exemptions.

So what does a rider have to do to get a TUE? I suggest checking out the official website of WADA to see the plethora of information available. See this Q&A about TUE exemptions and what criteria must be met to grant a TUE:

1. The athlete would experience significant health problems without taking the prohibited substance or method
2. The therapeutic use of the substance would not produce significant enhancement of performance.
3. There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method.

Here's a question for Oscar Pereiro and all the other pro cyclists taking asthma medication; do you maintain a regular prescription for those drugs and take the medication as prescribed, or are you only taking this medicine during peak periods of the racing season?

Here's another question; when you stop taking medication for asthma do you have significant health problems?

Oh wait, here's another; when you take that medicine does it not produce significant enhancement to your ability to breath and compete?

I am willing to put money down on my three answers, and I feel confident I'd walk away with more money than when I placed my bets.

Pereiro tested positive twice for salbutamol, in stages 14 and 16. According to Pereiro's personal allergist the dosage could not have prompted a positive test result. At least he has UCI President Pat McQuaid on his side saying this should never have become a news story, and blames Le Monde for going after the sport despite being fully aware of the TUE exemption and WADA's rules.

Where Pereiro is more to blame is that he has not responded to three requests by the French anti-doping agency. Evidently the agency is disputing his medical waiver for the asthma TUE along with six other riders who tested positive during the Tour. The French have always had an axe to grind when it comes to doping, but on this one I like their approach because they're saying, "prove it to us." A simple doctor's note won't cut it, of which anyone can easily obtain.

Is your head spinning yet? When I have questions about health topics I occasionally turn to WebMD, and about asthma they have this to say. Asthma affects 17 million people in the US, which is approximately 6% of the population if you figure we now have 301 million. I will guess again that a significantly larger percentage of professional cyclists have a TUE exemption for asthma medication, much greater than 6%. What say you? Read on.....

I know what you're thinking, yes, in fact it is hard to breathe when climbing up a 20k mountain at a 350+ watts average. A little help opening up the airway passages would help us all. However, salbutamol is a....."bronchodilator, which relieves the symptoms of asthmas by temporarily relaxing the muscle bands that tighten around the airways....." Salbutamol is deemed a short-acting inhaler specifically for improving breathing for four hours. If you're having difficulty breathing in a four to six hour bike race then salbutamol is the drug to use.

Like any drug on the market there are important disclaimers. From the WebMD site here is what they say about the bronchodilator drug salbutamol:

"WARNING: Bronchodilators are potent drugs. If overused, they can cause dangerous side effects such as high blood pressure and fast or irregular heart beats (arrhythmias). If you are using your short-acting rescue bronchodilator more than twice a week because of asthma symptoms, talk to your doctor. Your asthma needs to be controlled better."

Is Oscar Pereiro controlling his asthma properly? I mean, he did test positive twice in the span of three days. He is an athlete competing in a sport which demands an accelerated heart rate. Is anyone concerned about his general health here, or should we simply not be surprised when he or others drop dead because their heart rate became too rapid? Look back at the criteria to obtain a TUE.

When I first read that Pereiro had tested positive I remembered this Cyclingnews article about the prevalence of cyclists taking asthma drugs to improve performance. At the Olympic Games in Atlanta in 1996 a study of the athletes reported that 45% of the cyclists had asthma and were taking medication. So what it really says is that the fittest and most talented athletes on the planet, nearly half of them, are asthmatics and can only compete with the help of medication.

Draw your own conclusions, but this boils down to something that's not as black and white as Pat McQuaid would have us all to believe.