# Meldonium



## Local Hero

Meldonium is an anti-ischemic drug used clinically to treat angina, myocardial infarction and chronic heart failure. It is manufactured in Latvia under the commercial name of Mildronate and is one of the countries largest exports, with turnover reaching EUR 65 million in 2013. It is not yet approved by the FDA for use in the USA.

Meldonium was added to the WADA list of banned substances on January 1st, 2016 because of “evidence of its use by athletes with the intention of enhancing performance.”

One review of the effects of Meldonium on exercise performance listed the following benefits:


Decreased levels of lactate and urea in blood
Improved economy of glycogen: level of glycogen increased in the cells during the long-lasting exercise
Increased endurance properties and aerobic capabilities of athletes
Improved functional parameters of heart activity
Increased physical work capabilities
Increased rate of recovery after maximal and sub-maximal loads
Activates CNS functions and protects against stress


WADA analysis of 8000+ B samples produced nearly 200 positives for this substance. 

Blog Sauce. 



Katusha Rider, Eduard Vorganov, was banned for Meldonium. 


Any others?


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## deviousalex

So, if no one on this forum cares that Sharapova was also taking it it's clearly a witch hunt against Lance?


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## Local Hero

deviousalex said:


> So, if no one on this forum cares that Sharapova was also taking it it's clearly a witch hunt against Lance?


That falls under :whoops:

_Sharapova insisted that she had been taking a medicine prescribed by her doctor for the past decade that was not included on the World Anti-Doping Agency's list of performance-enhancing substances._

Maria Sharapova fails drugs test - Sports Mole


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## DaveG

deviousalex said:


> So, if no one on this forum cares that Sharapova was also taking it it's clearly a witch hunt against Lance?


Who know what kind of stuff they are saying over at TennisReview.com.


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## deviousalex

DaveG said:


> Who know what kind of stuff they are saying over at TennisReview.com.


Probably not much, they may still be too busy drooling over her modeling pictures.


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## Marc

Local Hero said:


> That falls under :whoops:
> 
> _Sharapova insisted that she had been taking a medicine prescribed by her doctor for the past decade that was not included on the World Anti-Doping Agency's list of performance-enhancing substances._
> 
> Maria Sharapova fails drugs test - Sports Mole


TBH, I can understand her statement.

The mountain of banned drugs under WADA etc is huge....and trying to keep track of what is banned effective when has become pretty ridiculous. Most people on the streets are probably taking drugs or substances banned under WADA, as the list is that huge.


Considering how long the drug has been around, it is odd that it was just added to the banned list in January


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## asgelle

Marc said:


> The mountain of banned drugs under WADA etc is huge....and trying to keep track of what is banned effective when has become pretty ridiculous. Most people on the streets are probably taking drugs or substances banned under WADA, as the list is that huge.


Of all the excuses apologists make, this is the most baffling. Since the average person isn't subject to WADA restrictions, why should their compliance or lack thereof have any bearing on athletes subject to the code?

And given the amount of money Sharapova pays to coaches, hitting partners, doctors, nutritionists, lawyers, personal assistants, etc., she couldn't be bothered to have one of them check the prohibited items list in December when the notice of changes came out? Don't be ridiculous.


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## Marc

asgelle said:


> Of all the excuses apologists make, this is the most baffling. Since the average person isn't subject to WADA restrictions, why should their compliance or lack thereof have any bearing on athletes subject to the code?
> 
> And given the amount of money Sharapova pays to coaches, hitting partners, doctors, nutritionists, lawyers, personal assistants, etc., she couldn't be bothered to have one of them check the prohibited items list in December when the notice of changes came out? Don't be ridiculous.


And what other viable explanation do you have as to why suddenly 200+ athletes would all get popped the same day for the same PED that has only been banned a bit over 2 months? Did they all think WADA was bluffing? Or was it that they thought WADA was too incompetent? Or perhaps they thought they had a line and WADA was too corrupt to actually check their samples for the PEDs they themselves ban?

I mean it isn't like they were caught with a masking agent implying a PED that can escape detection...they were caught red-handed using PEDs.

I'm not apologizing for anyone. Just looking at it from the armchair fan POV, and find "I didn't know" the most rational excuse for why a bunch of pro athletes all popped blatantly for using the same drug all suddenly had positive B samples at once.


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## deviousalex

Marc said:


> TBH, I can understand her statement.
> 
> The mountain of banned drugs under WADA etc is huge....and trying to keep track of what is banned effective when has become pretty ridiculous. Most people on the streets are probably taking drugs or substances banned under WADA, as the list is that huge.
> 
> 
> Considering how long the drug has been around, it is odd that it was just added to the banned list in January


You would think that any drug you are taking you would inform WADA about and get a TUE if it was really needed.


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## troutmd

A Russian athlete taking performance enhancing drugs.

Shocking.


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## wgscott

I thought she was Serbian, or, as they say over there, Srbn.


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## Local Hero

Why was she taking this drug for a decade? 




deviousalex said:


> You would think that any drug you are taking you would inform WADA about and get a TUE if it was really needed.


But you only need a TUE if the drug is banned. 

Are you saying run everything past WADA and get the TUE if it is on the list? Well, that goes back to it just showing up on the list in January.


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## love4himies

Why did WADA wait so long to include it on their banned list???? If it's proven to enhance performance, it should be added automatically, not wait to see if athletes are using it. Of course some athletes are going to try anything to get the upper hand, it's their goal to win.


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## den bakker

asgelle said:


> Of all the excuses apologists make, this is the most baffling. Since the average person isn't subject to WADA restrictions, why should their compliance or lack thereof have any bearing on athletes subject to the code?
> 
> And given the amount of money Sharapova pays to coaches, hitting partners, doctors, nutritionists, lawyers, personal assistants, etc., she couldn't be bothered to have one of them check the prohibited items list in December when the notice of changes came out? Don't be ridiculous.


"Sharapova said she did not open a Dec. 22 email from WADA that would have notified her of the change." 
surely you cannot expect a pro athlete to lower themselves to open mail.


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## bikerjulio

The sheer stupidity of this is breathtaking.

She was close to retiring in any case. She could have done so with no blemish to her reputation.

Was the highest paid female athlete, mainly down to endorsement deals which are now quickly collapsing.

She received a letter in December warning that this drug was now banned. She didn't bother to pay attention to it.


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## Local Hero

love4himies said:


> If it's proven to enhance performance, it should be added automatically, not wait to see if athletes are using it.


Two things there. 

First, there are plenty of things that can enhance performance which are *not* banned, from inhalers to caffeine to beet juice. 

Next, some athletes were using it. 2% of the 8000 B samples they tested *prior* to the ban were positive for it.




I think that if someone was a Sharapova fan before this they will continue to be a Sharapova fan after this.


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## BlazingPedals

How many people believe she was being treated for angina?


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## bikerjulio

BlazingPedals said:


> How many people believe she was being treated for angina?


and "potential" diabetes, as well


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## mpre53

bikerjulio said:


> and "potential" diabetes, as well


If she's talking about Type 1, I don't think that there's any way to prevent it. It's starting to show up in people in their 30s and 40s, not just kids.

Even if she's genetically pre-disposed to Type 2, with her age and fitness level, she's probably 20-30 years away.


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## DaveG

BlazingPedals said:


> How many people believe she was being treated for angina?


Pro athletes sure seem to have a lot of medical issues for which they need meds that coincidentally have performance enhancing benefits. An awful lot of pro apparently have asthma


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## troutmd

wgscott said:


> I thought she was Serbian, or, as they say over there, Srbn.


Nope --- Sharapova is just another Russian athlete taking performance enhancing drugs.

World Tennis organization is a tough spot as a likely two year ban will be costly for tournaments, but a slap on the wrist of the 74" blond will do little to encourage a "drug free" sport already under a bit of a black cloud over match fixing allegations.


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## jetdog9

troutmd said:


> A Russian athlete taking performance enhancing drugs.
> 
> Shocking.


Dude. Rocky IV was fake.


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## DrSmile

This and the Essendon thymosin beta-4 case should serve as ample evidence that the doping problems never did and aren't ever going away and that there is a never diminishing supply of new performance enhancing drugs available. Professional sports as a whole is screwed, and the only current practical solution is continued denial that it's happening on a large scale.


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## mulkdog45

troutmd said:


> A Russian athlete taking performance enhancing drugs.
> 
> Shocking.


Now that's funny.....


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## jaggrin

Will this drug help me go faster? If so how do I get it?


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## troutmd

jaggrin said:


> Will this drug help me go faster? If so how do I get it?


Make friends with some Russian.


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## spade2you

jetdog9 said:


> Dude. Rocky IV was fake.


If he dies, he dies.


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## MMsRepBike

I have some in the mail. We'll see how good it is.


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## crankout

bikerjulio said:


> and "potential" diabetes, as well


I believe it's 'diabeetus'.


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## mpre53

crankout said:


> I believe it's 'diabeetus'.


"The diabeetus" to be exact. I haz the diabeetus.


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## Local Hero

We need an "I can haz the diabeetus?" memepic with Sharapova's picture.


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## jmorgan

WADA tells AP: #Meldonium has produced 99 positive cases so far since Jan.1.

Seems like there is an abnormal amount of world class athletes with heart issues.


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## troutmd

jmorgan said:


> WADA tells AP: #Meldonium has produced 99 positive cases so far since Jan.1.
> 
> Seems like there is an abnormal amount of world class athletes with heart issues.


_A person that places their privileges before their principles soon lose both.

_


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## tom_h

den bakker said:


> "Sharapova said she did not open a Dec. 22 email from WADA that would have notified her of the change."
> surely you cannot expect a pro athlete to lower themselves to open mail.


Well, I've seen her doing her own grocery shopping in the local market!


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## TmB123

Why in the world was she taking a drug prescribed by a "family doctor". Surely any professional athlete let alone an elite level one (other than those trying to cheat) would run _everything _through their own sports doc and surely that sports doc would be checking the banned list every year. She's an idiot and her management "team" need a smack.


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## ddave12000

TmB123 said:


> Why in the world was she taking a drug prescribed by a "family doctor". Surely any professional athlete let alone an elite level one (other than those trying to cheat) would run _everything _through their own sports doc and surely that sports doc would be checking the banned list every year. She's an idiot and her management "team" need a smack.


She was obviously taking it for it's performance enhancements. I read somewhere yesterday a quote from a doctor saying that meldonium isn't the type of drug that you would take on a continuous cycle, as in for "a decade". You would only take it here and there to treat symptoms.


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## TmB123

ddave12000 said:


> She was obviously taking it for it's performance enhancements. I read somewhere yesterday a quote from a doctor saying that meldonium isn't the type of drug that you would take on a continuous cycle, as in for "a decade". You would only take it here and there to treat symptoms.


Exactly - I think that even the manufacturer came out and said it was only something that would normally be taken for a short period of time.


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## DaveG

ddave12000 said:


> She was obviously taking it for it's performance enhancements. I read somewhere yesterday a quote from a doctor saying that meldonium isn't the type of drug that you would take on a continuous cycle, as in for "a decade". You would only take it here and there to treat symptoms.


Maybe her "medical condition" was more serious than we thought? How brave of her to fight thought the illness


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## DrSmile

DaveG said:


> Maybe her "medical condition" was more serious than we thought? How brave of her to fight thought the illness


Is she missing a ball too?


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## wgscott

What is the evidence that this drug enhances performance?


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## den bakker

wgscott said:


> What is the evidence that this drug enhances performance?


does it matter?


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## wgscott

Yes. Facts matter.


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## den bakker

wgscott said:


> Yes. Facts matter.


never said they don't. 
It's on the banned list. they took a drug on the banned list. what other facts matter?


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## wgscott

Why is it on the banned list? (It was added only recently, and under a different name.)

If chemicals or drugs are placed on the banned list simply because of anecdotal evidence that they are performance-enhancing, then I think prayer should be banned too, for consistency.


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## DaveG

wgscott said:


> Why is it on the banned list? (It was added only recently, and under a different name.)
> 
> If chemicals or drugs are placed on the banned list simply because of anecdotal evidence that they are performance-enhancing, then I think prayer should be banned too, for consistency.


If you take it to that extreme, training should be banned too. To me the dividing line is preventing athletes from taking drugs that give them an unfair advanatge and may cause them medical harm. Sharapova clearly thought this drug would help her; that is why she took for for so long as well as many other athletes. Her story is the same kind of lame lie that we heard from Landis, Lance, Contador, etc.


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## wgscott

DaveG said:


> If you take it to that extreme, training should be banned too. To me the dividing line is preventing athletes from taking drugs that give them an unfair advanatge and may cause them medical harm. Sharapova clearly thought this drug would help her; that is why she took for for so long as well as many other athletes. Her story is the same kind of lame lie that we heard from Landis, Lance, Contador, etc.


People who believe in imaginary deities think prayer will enhance their performance. Since there is no empirical evidence that suggests that prayer has anything more than a placebo effect, no one bothers banning religious appeals. Hence my question: where is the evidence that this drug enhances performance? (What she or what other people believe or expect isn't relevant, for the same reason prayer isn't relevant.)


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## DaveG

wgscott said:


> People who believe in imaginary deities think prayer will enhance their performance. Since there is no empirical evidence that suggests that prayer has anything more than a placebo effect, no one bothers banning religious appeals. Hence my question: where is the evidence that this drug enhances performance? (What she or what other people believe or expect isn't relevant, for the same reason prayer isn't relevant.)


 Actually I think there is lots of reason to think prayer or visualization techniques work. Whether God exists or not if it gave the athlete more confidence or the ability to push harder then it worked.

I am not sure what your argument is here. Are you saying its OK that Maria cheated because the drug wasn't all that effective? If that were the case why didn't she just stop taking it after the 5th warning?


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## wgscott

No, I am asking what empirical evidence exists that suggests the drug should be banned? From what I have read, they banned it simply because athletes were taking it and testing positive for it, not because there is any compelling evidence in existence that the drug enhances performance. 

If this is wrong, where is the evidence? Where are the peer-reviewed publications?

This guy seems to make the same point: Sharapova suspension: Doping agency's unfair game of 'gotcha'? - CNN.com



> As for why meldonium ended up on the banned list, anti-doping agencies found meldonium in about 2% of control samples they tested randomly, and they've noticed chatter on websites touting the drug as a performance enhancer. In fact, dozens of other athletes besides Sharapova have now tested positive, and I imagine a sizeable percentage will prove to have no plausible medical rational for taking meldonium, and instead purchased the drug hoping to gain an edge. The uptick in activity prompted them to put the drug on a monitoring list, step up their testing, and ultimately decide to place it on a banned list, beginning in January 2016.
> 
> Outside of the hype you see about the drug online, there's not much scientific support for its use as an athletic enhancer. A major academic paper published last year recommended that WADA add meldonium to the banned list and described various methods for detecting it in urine samples.
> 
> But I looked into the only two studies that paper cited for athletic performance enhancement. One, focusing on judo, appeared in 2002 in a short-lived and now defunct journal based at Tbilisi State Medical University in the Republic of Georgia. I've been unable to locate a copy so I can't assess its methodology and data. The other paper is only a brief abstract published as part of conference. It contains no original data and cites the Tbilisi judo study.
> 
> The fact is, if meldonium did improve Sharapova's athletic ability over the past decade as she won numerous major titles, we can't know by how much. Beyond that, Sharapova is very open about her history taking meldonium, and she's offered a reasonable explanation for taking it.


So when you say 



DaveG said:


> Actually I think there is lots of reason to think prayer or visualization techniques work. Whether God exists or not if it gave the athlete more confidence or the ability to push harder then it worked.


I agree. 

Similarly, maybe taking this drug gave the athlete more confidence or the ability to push harder, based on a placebo effect. So why is it any different from the athlete using prayer or visualization techniques? One is thought of as devout or idiosyncratic, but harmless. The other is thought to be career-ruining.


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## DaveG

wgscott said:


> No, I am asking what empirical evidence exists that suggests the drug should be banned? From what I have read, they banned it simply because athletes were taking it and testing positive for it, not because there is any compelling evidence in existence that the drug enhances performance.
> 
> If this is wrong, where is the evidence? Where are the peer-reviewed publications?


Doing studies of athletes with and without performance enhancing drugs would seem to have dire ethical issues. I am not sure that published studies exist for things like EPO which clearly have performance benefits. Maybe Dr. Conconi has done these studies but I'd doubt any respectable journal would publish them. If someone has seen such a study published in a medical journal I'd be interested to see it.

WADA says they banned it because they found “evidence of its use by athletes with the intention of enhancing performance” by virtue of carrying more oxygen to muscle tissue


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## wgscott

I can make a similar argument for EPO. (I think it is a weaker argument, because what is known is EPO will increase the red cell count, and therefore the amount of hemoglobin available to harvest oxygen from the lungs. However, there is also evidence that in a healthy, non-anemic individual it could cause more harm to performance (and health) than good. Although I think the case against EPO is stronger than with this newly banned drug, I still think it is fairly weak. I'm only interested in this as a biochemist, by the way. I don't race or play tennis, nor would I even consider myself an athlete. I am a purely recreational cyclist.)



DaveG said:


> WADA says they banned [EPO] because they found “evidence of its use by athletes *with the intention of enhancing performance*” by virtue of carrying more oxygen to muscle tissue


Again, they don't have compelling evidence that it in fact _does_ enhance performance. So what WADA is saying is they banned EPO based on athletes _intending_ to enhance performance, just like someone who prays before an event intends it to enhance their performance. So why is once acceptable, and the other is a thought-crime that results in a ruined career?


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## den bakker

wgscott said:


> I can make a similar argument for EPO. (I think it is a weaker argument, because what is known is EPO will increase the red cell count, and therefore the amount of hemoglobin available to harvest oxygen from the lungs. However, there is also evidence that in a healthy, non-anemic individual it could cause more harm to performance (and health) than good. Although I think the case against EPO is stronger than with this newly banned drug, I still think it is fairly weak. I'm only interested in this as a biochemist, by the way. I don't race or play tennis, nor would I even consider myself an athlete. I am a purely recreational cyclist.)
> 
> 
> 
> Again, they don't have compelling evidence that it in fact _does_ enhance performance. So what WADA is saying is they banned EPO based on athletes _intending_ to enhance performance, just like someone who prays before an event intends it to enhance their performance. So why is once acceptable, and the other is a thought-crime that results in a ruined career?


sounds like you want these people to retract their paper based on the basis being wrong. 

Mildronate (Meldonium) in professional sports - monitoring doping control urine samples using hydrophilic interaction liquid chromatography - high ... - PubMed - NCBI


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## bikerjulio

> Similarly, maybe taking this drug gave the athlete more confidence or the ability to push harder, based on a placebo effect. So why is it any different from the athlete using prayer or visualization techniques? One is thought of as devout or idiosyncratic, but harmless. The other is thought to be career-ruining.



A drug does not need to be performance enhancing to be banned. Nor should it be. Or even though to be. The aim is a drug-free sport.


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## wgscott

den bakker said:


> sounds like you want these people to retract their paper based on the basis being wrong.
> 
> Mildronate (Meldonium) in professional sports - monitoring doping control urine samples using hydrophilic interaction liquid chromatography - high ... - PubMed - NCBI


The paper reports on a detection methodology using mass spec. It doesn't address anything about whether or not the compound is performance-enhancing.


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## wgscott

bikerjulio said:


> A drug does not need to be performance enhancing to be banned. Nor should it be. Or even though to be. The aim is a drug-free sport.


So by what criteria do we decide that ibuprofen is ok but Mildronate is not? (Ibuprofen even enhances my performance.) Ibuprofen is definitely a drug. Is it banned? If not, why not, if the aim is to have a drug-free sport. Or do we mean non-socially-acceptable drugs?


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## asgelle

wgscott said:


> So by what criteria do we decide that ibuprofen is ok but Mildronate is not? Ibuprofen enhances my performance.


We don't decide. These guys do. http://www.usada.org/wp-content/uploads/wada-2016-prohibited-list-en.pdf It really isn't complicated.


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## wgscott

Are you comfortable with someone being labeled a cheater and having their career terminated for ingesting a substance for which there does not appear to be much if any empirical evidence that it is performance-enhancing?


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## asgelle

wgscott said:


> Are you comfortable with someone being labeled a cheater and having their career terminated for ingesting a substance for which there does not appear to be much if any empirical evidence that it is performance-enhancing?


If someone violates the WADA code, they are a cheater.

Sports doesn't really work very well if every competitor gets to make up her own rules.


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## wgscott

I understand the rule. I am questioning the basis of the rule.


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## asgelle

wgscott said:


> I understand the rule. I am questioning the basis of the rule.


http://www.nytimes.com/2016/03/14/s...column-region&region=top-news&WT.nav=top-news


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## wgscott

Lots of people test positive for ibuprofen too. It enhances performance. Taking too much of it is bad for your kidneys. Why isn't that taken as evidence to add it on to the list?

Why not just give everyone a blood test, and apply handicaps to their scores for each suspect drug taken in proportion to the quantity detected?


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## asgelle

wgscott said:


> Lots of people test positive for ibuprofen too.


Name one.


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## wgscott

asgelle said:


> Name one.


It is not on the list. So why would anyone avoid taking it? I take it, even for headaches induced by compulsive arbitrary unthinking, uncritical and slavish rule-following. Or how about vitiamin B (if vitamin I bothers you)?


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## ddave12000

Really, the argument has come down to meldonium is no worse than prayer? Uh, other than the fact that one is a banned substance made from chemicals that get ingested into the body and the other isn't. 

wgscott, I'm having a hard time understanding why you're so hung up on this one. With so many athletes testing positive for this drug, it seems even more obvious to me that they're using it because they intend to receive some sort of benefit from doing so. It was fine to do so until until WADA decided it wasn't allowed to be taken. Now that it's banned, you can't take it. It's really simple.


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## asgelle

wgscott said:


> It is not on the list. So why would anyone avoid taking it? I take it, even for headaches induced by compulsive arbitrary unthinking, uncritical and slavish rule-following.


You were the one who wrote, 


wgscott said:


> Lots of people test positive for ibuprofen too.


So tell me at least one of these many people who tested positive.


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## wgscott

The argument comes down to there is no more empirical evidence that meldonium is performance-enhancing than prayer.

I'm not hung up on anything. I just think the rule is silly and arbitrary. I can understand why anobolic steroids are banned, for example.

Why are bicyclists allowed to compete with each other using different equipment? Doesn't that favor the independently wealthy or the person most capable of getting corporate sponsorship, rather than the best athlete _per se_?


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## asgelle

wgscott said:


> Why are bicyclists allowed to compete with each other using different equipment?


Equipment


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## wgscott

asgelle said:


> You were the one who wrote,
> 
> So tell me at least one of these many people who tested positive.


OK, so I should have said "many people would have tested positive for ibuprofen, had they bothered to check for ibuprofen." You are just playing games. You know exactly what I mean.


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## DaveG

ddave12000 said:


> Really, the argument has come down to meldonium is no worse than prayer? Uh, other than the fact that one is a banned substance made from chemicals that get ingested into the body and the other isn't.
> 
> wgscott, I'm having a hard time understanding why you're so hung up on this one. With so many athletes testing positive for this drug, it seems even more obvious to me that they're using it because they intend to receive some sort of benefit from doing so. It was fine to do so until until WADA decided it wasn't allowed to be taken. Now that it's banned, you can't take it. It's really simple.


I am not sure why wgscott is so hung up on this either. Maybe a huge crush on Maria? He keeps asking for something that doesn't exist for any drug: A scientific, peer reviewed study that demonstrates the benefits of a performance enhancing drug. No reputable organization is going to conduct a study like that. No one would want to publish a study that shows proof that a certain drug aids athletic performance. Taking a drug for other that the purposes it was intended has ethical implications. That is the basis for WADA's ban


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## ddave12000

wgscott said:


> The argument comes down to there is no more empirical evidence that meldonium is performance-enhancing than prayer.
> 
> I'm not hung up on anything. I just think the rule is silly and arbitrary. I can understand why anobolic steroids are banned, for example.
> 
> Why are bicyclists allowed to compete with each other using different equipment? Doesn't that favor the independently wealthy or the person most capable of getting corporate sponsorship, rather than the best athlete _per se_?


Everyone has to play by the same equipment rules or limitations. You cannot use whatever you want. Beyond that, life isn't fair? Why should joe bob be allowed to have more time to train than I do? 

I understand what you're saying, but there's lots of things on the banned substance list that doesn't provide the same benefit as anabolic steroids or EPO, but they're still on there. Why? I dunno, but if you're a professional competitor you shouldn't take those items unless you have no other option, in which case you should get an exemption or hang it up.


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## wgscott

So how do we know any of these substances (take your pick from their list) is performance-enhancing? And if we have no evidence that this is the case, why do we ban their use?


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## asgelle

wgscott said:


> And if we have no evidence that this is the case, why do we ban their use?


I said it before and I'll say it again; "we" don't ban substances. WADA, and in particular, The Prohibited List Group, does. There's been plenty published on how they reach their decisions.

By the way. I don't think it's fair that the rim in basketball is 10' off the floor. I see no peer-reviewed scientific proof that it's the optimum. I know I've played with a 7' rim and like much better.


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## wgscott

Fine. I will rephrase: If *they* have no evidence that these drugs are performance-enhancing, why do *they* ban their use?

Happy now? 

*They* reach the decision based on testing for the compound. Do *they* test for ibuprofen, or caffeine? *They* clearly have formed a presupposition based on anecdotal evidence such as people discussing its possible performance-enhancing benefits on the internet. That is a rather arbitrary criterion. If it is simply used to ban someone from participating in an event, I don't really care. If it is used to destroy someone's career, it starts to worry me that it is being done without some sort of empirical evidence. There are plenty of ethical ways to gather such evidence. All *they* need is a retrospective study with users vs. a control group. *They* don't even have that.


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## asgelle

wgscott said:


> Fine. I will rephrase: If they have no evidence that these drugs are performance-enhancing, why do they ban their use?


I believe the Times article answered this question. Did you read it, or do you prefer to just keep arguing the same points over and over?


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## wgscott

You can believe what you want, but the NYT article doesn't provide any empirical evidence that the drug enhances performance. I concede that it may well, but it is only based on indirect assumptions, any one of which could be wrong.


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## asgelle

wgscott said:


> You can believe what you want, but the NYT article doesn't provide any empirical evidence that the drug enhances performance.


Do you think no one sees through this? I will repeat your question since you seem to have forgotten it.


wgscott said:


> Fine. I will rephrase: If *they* have no evidence that these drugs are performance-enhancing, why do *they* ban their use?


You asked why, the article explained that for you.


----------



## wgscott

They ban them based on an assumption that may or may not be correct, rather than on empirical evidence.



NYT said:


> Dr. Thevis is a German biochemist who works at a laboratory in Cologne and is one of 13 experts who make up WADA’s prohibited-list group, an influential international panel that largely determines which substances are considered for the monitoring list and then for prohibition.
> 
> That group is widely known as the list committee.
> 
> “They meet every January to look at what might be on the horizon,” Mr. Howman said. “*And they use the results of research projects and the results of what’s come in from the labs from the previous year and all these sorts of things to start talking about whether there should be any alterations or amendments to the list*.”


The key thing here is what they mean by "research projects." My reading of the rest of the article is that it means analysing things like the frequency of positive tests, not determining whether or not a compound has performance-enhancing properties. Rather, they appear to start with the assumption that it does.


----------



## bikerjulio

wgscott said:


> They ban them based on an assumption that may or may not be correct, rather than on empirical evidence.


Exactly what part of "drug free sport" don't you understand?


----------



## wgscott

bikerjulio said:


> Exactly what part of "drug free sport" don't you understand?
> 
> Troll much?


The overwhelming evidence is that the sport is more of a drug scene than the average Grateful Dead concert.

I'm "trolling" only in the sense that I am questioning the original assumption, i.e., that substances thought to be performance-enhancing have been demonstrated to be performance-enhancing.


----------



## bikerjulio

wgscott said:


> The overwhelming evidence is that the sport is more of a drug scene than the average Grateful Dead concert.
> 
> I'm "trolling" only in the sense that I am questioning the original assumption, i.e., that substances thought to be performance-enhancing have been demonstrated to be performance-enhancing.


I don't agree that there is any need for a drug to be thought of as performance enhancing in order to be banned. You seem to be deliberately missing the point.


----------



## wgscott

So what is the criteria for banning a drug? Why not caffeine? It isn't that I am missing the point. I am missing the basis for the assumption that some drugs, even if they enhance performance, are ok (like caffeine, which is a better example than my earlier one of ibuprofen), but other drugs, even if it is not known that they are performance-enhancing, should be banned simply on the basis that a set of athletes believe they enhance performance and consume them.

More broadly, I think the drug ban list approach is failing. Perhaps a different approach would be more effective. (Maybe one that assigned handicaps based on the type and amount consumed, instead of destroying a career after the fact. So let's say a cyclist uses a standard dose (whatever that might be) of EPO. Add 20% to his time. This is a completely arbitrary example, so don't pin me down on the number).


----------



## TwiggyTN

As the NY TIMES article stated there is a committee that reviews and discusses all available information on a particular substance submitted for review. They do not share exactly what this information is but I guess they don't have to and there are probably very good reasons for them not to. I mean do people actually think this is some big conspiracy to ban athletes from Russia? Come on, look at the positive tests so far, why are all these athletes taking this medicine? Of course it boosts performance. Maria has been vague about this issue. What is the exact condition she has been treating for 10 years? She failed to say in her big press conference. Why the secrecy?


----------



## DrSmile

In this day of customized pharmacology, if we waited for every drug to be tested regarding it's performance enhancement we'd have even more cheaters than we already do, nevermind that the legal challenges teams and sponsors would throw at every major sports organization refuting the research would quickly bankrupt the organizations. It seems patently absurd to question a drug's place on the WADA list, the list is there to prohibit any POTENTIALLY beneficial drug, which is the way it has to be. Meldonium is on the list, which means don't take it or face the music.


----------



## DaveG

wgscott said:


> So what is the criteria for banning a drug? Why not caffeine? It isn't that I am missing the point. I am missing the basis for the assumption that some drugs, even if they enhance performance, are ok (like caffeine, which is a better example than my earlier one of ibuprofen), but other drugs, even if it is not known that they are performance-enhancing, should be banned simply on the basis that a set of athletes believe they enhance performance and consume them.
> 
> More broadly, I think the drug ban list approach is failing. Perhaps a different approach would be more effective. (Maybe one that assigned handicaps based on the type and amount consumed, instead of destroying a career after the fact. So let's say a cyclist uses a standard dose (whatever that might be) of EPO. Add 20% to his time. This is a completely arbitrary example, so don't pin me down on the number).


So are you saying Maria wasted 10 years faking angina to take this and the stuff doesn't even work?


----------



## Aadub

wgscott said:


> You can believe what you want, but the NYT article doesn't provide any empirical evidence that the drug enhances performance. I concede that it may well, but it is only based on indirect assumptions, any one of which could be wrong.


LOL! You think the list of athletes with meldonium in their systems was "just in case it works?"


----------



## wgscott

I think they were taking what they thought was a performance-enhancing drug that wasn't yet banned. My guess is they believe it works. It may work, for all I know. But if we don't have any controlled experiments, even retrospective experiments, that tell us that it works, then we don't know. Some athletes tend to be very superstitious.


----------



## den bakker

wgscott said:


> The paper reports on a detection methodology using mass spec. It doesn't address anything about whether or not the compound is performance-enhancing.


"To date, substances such as Mildronate (Meldonium) are not on the radar of anti-doping laboratories as the compound is not explicitly classified as prohibited. However, the anti-ischemic drug Mildronate demonstrates an increase in endurance performance of athletes, improved rehabilitation after exercise, protection against stress, and enhanced activations of central nervous system (CNS) functions." 
you might want to contact the journal. an erratum is surely in order.


----------



## DaveG

wgscott said:


> I think they were taking what they thought was a performance-enhancing drug that wasn't yet banned. My guess is they believe it works. It may work, for all I know. But if we don't have any controlled experiments, even retrospective experiments, that tell us that it works, then we don't know. Some athletes tend to be very superstitious.


Who would you expect to run these controlled experiments?


----------



## wgscott

den bakker said:


> "To date, substances such as Mildronate (Meldonium) are not on the radar of anti-doping laboratories as the compound is not explicitly classified as prohibited. However, the anti-ischemic drug Mildronate demonstrates an increase in endurance performance of athletes, improved rehabilitation after exercise, protection against stress, and enhanced activations of central nervous system (CNS) functions."
> you might want to contact the journal. an erratum is surely in order.


The paper itself reports on detection methodology. What you are quoting is the introductory part of the abstract, not the findings in the paper itself.

Did you bother to read beyond the abstract?

If you did, you would find the quoted assertions are referenced with this:

*15. Z. Kakhabrishvili, N. Chabashvili, V. Akhalkatsi, T. Skhirtladze, T. Chutkerashvili. Mildronate effect on physical working capacity among highly qualified judokas. Ann. Biomed. Res. Edu. 2002, 2, 551.

16 M. Dzintare, I. Kalvins. Mildronate increases aerobic capabilities of athletes through carnitine-lowering effect. Curr. Issues New Ideas Sport Sci. 2012, 5, 59.*

The first is a review, not even the primary literature, and the second is semi-popular press. It is hardly compelling. It is more like sloppy scholarship. Is it really enough to destroy someone's career based on a claim in an analytical chemistry paper's introduction that is in turn based on two non-primary references?

Glad your standards are so high. 

It is odd that those who preach morality the loudest usually do so with the flimsiest grasp of basic factual reality.


----------



## wgscott

DaveG said:


> Who would you expect to run these controlled experiments?


Scientists.


----------



## den bakker

wgscott said:


> The paper itself reports on detection methodology. What you are quoting is the introductory part of the abstract, not the findings in the paper itself.
> 
> Did you bother to read beyond the abstract?
> 
> If you did, you would find the quoted assertions are referenced with this:
> 
> *15. Z. Kakhabrishvili, N. Chabashvili, V. Akhalkatsi, T. Skhirtladze, T. Chutkerashvili. Mildronate effect on physical working capacity among highly qualified judokas. Ann. Biomed. Res. Edu. 2002, 2, 551.
> 
> 16 M. Dzintare, I. Kalvins. Mildronate increases aerobic capabilities of athletes through carnitine-lowering effect. Curr. Issues New Ideas Sport Sci. 2012, 5, 59.*
> 
> The first is a review, not even the primary literature, and the second is semi-popular press. It is hardly compelling. It is more like sloppy scholarship. Is it really enough to destroy someone's career based on a claim in an analytical chemistry paper's introduction that is in turn based on two non-primary references?
> 
> Glad your standards are so high.
> 
> It is odd that those who preach morality the loudest usually do so with the flimsiest grasp of basic factual reality.


You can keep your personal attacks and strawmen for yourself, I cannot be bothered.


----------



## wgscott

Good.

The main point is the paper you reference doesn't set out to demonstrate what you claim it demonstrates. It looks like a perfectly good paper describing a liquid chromotography/mass spec detection methodology. There is nothing wrong with the paper. But using the introductory comments from the paper to claim that the authors of that paper have themselves established that the drug is performance-enhancing is at the best an innocent mistake which could be easily made if you aren't familiar with how scientific research publications are written. (If however you are familiar with how they are structured, then it is more disingenuous for you to do this.)


----------



## den bakker

wgscott said:


> Good.
> 
> The main point is the paper you reference doesn't set out to demonstrate what you claim it demonstrates. It looks like a perfectly good paper describing a liquid chromotography/mass spec detection methodology. There is nothing wrong with the paper. But using the introductory comments from the paper to claim that the authors of that paper have themselves established that the drug is performance-enhancing is at the best an innocent mistake which could be easily made if you aren't familiar with how scientific research publications are written. (If however you are familiar with how they are structured, then it is more disingenuous for you to do this.)


another strawman.


----------



## wgscott

But you snottily (and falsely) suggesting I think the paper should be withdrawn or amended, simply because I pointed out the paper doesn't claim to establish what you wrongly think it establishes, is somehow perfectly reasonable?


----------



## den bakker

wgscott said:


> But you snottily (and falsely) suggesting I think the paper should be withdrawn or amended, simply because I pointed out the paper doesn't claim to establish what you wrongly think it establishes, is somehow perfectly reasonable?


getting more and more weird. have a good day.


----------



## wgscott

den bakker said:


> ...you might want to contact the journal. an erratum is surely in order.





den bakker said:


> sounds like you want these people to retract their paper based on the basis being [sic] wrong.


They are your words of weirdness, not mine.


----------



## DaveG

wgscott said:


> Scientists.


I don't think any respected organization would take on a study that
1. Provided drugs to participants for purposes other than which they were intended and with serious ethical implications
2. Would provide information of specific physiological benefits to athletes of taking such drugs. This would equate to being somewhat of a "how to" on doping


----------



## wgscott

DaveG said:


> I don't think any respected organization would take on a study that
> 1. Provided drugs to participants for purposes other than which they were intended and with serious ethical implications
> 2. Would provide information of specific physiological benefits to athletes of taking such drugs. This would equate to being somewhat of a "how to" on doping


I was thinking FDA scientists, or similar. I don't think it would have to be the kind of study you are suggesting. *The FDA evaluates the efficacy of the drug for its intended use, as well as side effects. * That should be more than adequate.


----------



## DaveG

wgscott said:


> I was thinking FDA scientists, or similar. I don't think it would have to be the kind of study you are suggesting. The FDA evaluates the efficacy of the drug for its intended use, as well as side effects. That should be more than adequate.


As a taxpayer I would be very concerned if tax money was being used to study how helpful certain drugs are for athletic cheating. The FDA is in the business of evaluating drugs for treating or curing medical conditions. Its interesting that the drug in question here, is not approved for use in the US and most of Europe. It must work though because Maria has not had any complications from her angina since taking it the last 10 years


----------



## wgscott

Did you bother to read what you quoted and responded to, by any chance? Or if reading comprehension isn't really your thing, I highlighted part of it in bold-face as an aid. Let me know if you need me to draw pictograms.


----------



## DaveG

wgscott said:


> Did you bother to read what you quoted and responded to, by any chance? Or if reading comprehension isn't really your thing, I highlighted part of it in bold-face as an aid. Let me know if you need me to draw pictograms.


Yes I did. Side effects means negative impacts, like vomiting, diarrhea, dry eye, and all the other stiff rattled off during a drug commercial and printed on the brochure that comes with the drug. I have never seen an FDA side effort be "13% improvement in athletic performance" or "20% faster recovery after tennis matches"

I have to admire that you are still fighting this after not a single person has agreed with your POV. The reality is all the banned drugs were banned without the kind of study you are requesting. It is based on expect opinions about the likelihood that the drug is being abused to enhance athletic performance. Again, the fact that so many athletes took this drug despite not having the medical condition it was intended for is clear indication that they expected performance benefits


----------



## wgscott

DaveG said:


> Again, the fact that so many athletes took this drug despite not having the medical condition it was intended for is clear indication that they expected performance benefits


I have no argument with your final sentence.

However, what I am trying to suggest is that it might not actually _be_ performance-enhancing. (Side-effects, btw, can be any range of unintended consequences. What I was trying to suggest is that you don't necessarily need the kind of experiments you were suggesting to make a reasonable case against the drug.)

I think if you go into one of those GNC shops and buy one of their bottles of supplements, there are all kinds of compounds in there that are alleged to be performance-enhancing. I would also be willing to wager most of them don't work as claimed, but it doesn't keep people from buying them. I'm not interested in defending Sharapova or any other athlete. What I am interested in is how these decisions get made, and how they are enforced. I also don't think truth is established by social consensus.


----------



## DaveG

well, I have to retract one statement. There is at least one person that agrees with you, the maker of the drug

Grindeks the maker of the drug told MedPage Today "As far as there have been no clinical studies providing scientific evidence that acute or chronic use of meldonium increases the athlete's physical ability, any suggestions to include meldonium in the prohibited list have no scientific basis and are not justified," 

One interesting note, according to the company website the drug "improves physical capacity and mental function" in healthy people. That sounds to me like Grindeks was marketing this to people that don't have heart disease


----------



## wgscott

Neither Hitler nor I ate meat. Therefore, by similar logic, I am a nazi.


----------



## Coolhand

Self Godwin, [Achievement Unlocked] :thumbsup:


----------



## tennisfreak

*Crappy Review of Literature*



wgscott said:


> I have no argument with your final sentence.
> 
> However, what I am trying to suggest is that it might not actually _be_ performance-enhancing. (Side-effects, btw, can be any range of unintended consequences. What I was trying to suggest is that you don't necessarily need the kind of experiments you were suggesting to make a reasonable case against the drug.)
> 
> I think if you go into one of those GNC shops and buy one of their bottles of supplements, there are all kinds of compounds in there that are alleged to be performance-enhancing. I would also be willing to wager most of them don't work as claimed, but it doesn't keep people from buying them. I'm not interested in defending Sharapova or any other athlete. What I am interested in is how these decisions get made, and how they are enforced. I also don't think truth is established by social consensus.


You stated in a previous post that the review of literature to support the Mildronate performance enhancement claims are weak......I'm very surprised that nobody else has actually taken the time to read the cited literature........it is weak and most of the research has been done around the testing aspect not the performance aspects. This is a sorry state of affairs if WADA can ban a drug based on this. Most of the cited literature including the Cologne study of 2015 cite the Judoka Study and the Latvian Sport Science meeting in 2012 which was only a literature review.


----------



## asgelle

Coolhand said:


> Self Godwin, [Achievement Unlocked] :thumbsup:


More like a self Buckley. Anyone professing membership in an undesirable group should be taken at their word since anyone would avoid the stigma attached to belonging unless undeniably true.


----------



## asgelle

tennisfreak said:


> iThis is a sorry state of affairs if WADA can ban a drug based on this.


You seem to have missed the previous posts and many articles explaining that performance enhancement is not required to be placed on the prohibited list. You're just propagating a straw man argument. It doesn't work.


----------



## tennisfreak

*Bad Research Supports Meldonium Ban*



Local Hero said:


> Meldonium is an anti-ischemic drug used clinically to treat angina, myocardial infarction and chronic heart failure. It is manufactured in Latvia under the commercial name of Mildronate and is one of the countries largest exports, with turnover reaching EUR 65 million in 2013. It is not yet approved by the FDA for use in the USA.
> 
> Meldonium was added to the WADA list of banned substances on January 1st, 2016 because of “evidence of its use by athletes with the intention of enhancing performance.”
> 
> One review of the effects of Meldonium on exercise performance listed the following benefits:
> 
> 
> Decreased levels of lactate and urea in blood
> Improved economy of glycogen: level of glycogen increased in the cells during the long-lasting exercise
> Increased endurance properties and aerobic capabilities of athletes
> Improved functional parameters of heart activity
> Increased physical work capabilities
> Increased rate of recovery after maximal and sub-maximal loads
> Activates CNS functions and protects against stress
> 
> 
> WADA analysis of 8000+ B samples produced nearly 200 positives for this substance.
> 
> Blog Sauce.
> 
> 
> 
> Katusha Rider, Eduard Vorganov, was banned for Meldonium.
> 
> 
> Any others?


If the other banned substances are there because they cited similar weak science........
The published research that I could find on Meldonium is pretty weak and some of the so called gold standard studies are citing the weak literature. It takes quite a bit of effort to actually read the studies and not just the abstracts but well worth it. She may have taken a banned substance for sure, this is not in dispute.....but is the substance banned because of hard scientific evidence......this is disputed


----------



## wgscott

Coolhand said:


> Self Godwin, [Achievement Unlocked] :thumbsup:


I knew if I did it the other way around, it would be misconstrued in the obvious way.


----------



## tennisfreak

asgelle said:


> You seem to have missed the previous posts and many articles explaining that performance enhancement is not required to be placed on the prohibited list. You're just propagating a straw man argument. It doesn't work.


Yes I do get your point but if the role of WADA is to creat a level playing field by ensuring that drugs which can enhance performance are not used......then it is critically important that they get their research right. One assumes that drug bans are not employed in an arbritrary or political manner and that the science is well documented. This is an important point which you seem to miss....or don't deem worthy of discussion?


----------



## asgelle

tennisfreak said:


> Yes I do get your point but if the role of WADA is to creat a level playing field by ensuring that drugs which can enhance performance are not used.....


That is not WADA's charter.


----------



## wgscott

asgelle said:


> You seem to have missed the previous posts and many articles explaining that *performance enhancement is not required to be placed on the prohibited list.* You're just propagating a straw man argument. It doesn't work.


Actually, he (she?) gets it. In fact, that is the point. Some of these compounds are added to the prohibition list simply because they are suspected, based on anecdotal evidence, to be performance-enhancing. Other compounds, such as caffeine and glucose, that are known to be performance-enhancing, but aren't listed. Why is caffeine not listed? Why not prayer? Is coffee too popular, or too main-steam? Is drinking coffee more acceptable than drinking some concoction purchased at GNC stores?


----------



## asgelle

wgscott said:


> Why is caffeine not listed? Why not prayer? Is coffee too popular, or too main-steam? Is drinking coffee more acceptable than drinking some concoction purchased at GNC stores?


Asked, and answered.


----------



## wgscott

WADA would experience a backlash and loss of credibility if they started ruining people's careers for ingesting caffeine.


----------



## asgelle

wgscott said:


> WADA would experience a backlash and loss of credibility if they started ruining people's careers for ingesting caffeine.


"We are not final because we are infallible, but we are infallible only because we are final."


----------



## tennisfreak

That is like saying that the role of the Federal Reserve is only to ensure full employment and to maintain the intergrity of the US dollar......if WADA is the only scientific watchdog entrusted with maintaining the integrity of sport with respect to drugs.....it must realize that its actions are more far reaching than its charter. The fact that some drugs are allowed and some not even if the scientific data to support inclusion or ban are weak.....speak to an inherent weakness in the system itself. Saying essentially that sorry not my problem......is not helpful.


----------



## asgelle

tennisfreak said:


> if WADA is the only scientific watchdog ...


Once again, you state as fact things that are not true.


----------



## DaveG

wgscott said:


> WADA would experience a backlash and loss of credibility if they started ruining people's careers for ingesting caffeine.


We are talking about a drug that is supposed to treat coronary disease being used because some athletes believed it increased their performance. There is no valid reason for any elite athlete to take Meldonium. WADA announced they were going to ban it. People kept taking it. You can't blame WADA for an athletes failure to comply when they knew the risks. 

FYI, WADA did ban caffeine prior to 2004 and then was removed from the list. WADA has been pressing to restore the ban recently


----------



## wgscott

They should, for consistency.

Again, I am not suggesting taking the drug is a good idea. I am questioning the basis for putting it on the list, which no one has been able to say is based on anything more than anecdotal evidence and that it is used by a bunch of Eastern Europeans and Russians.


----------



## asgelle

wgscott said:


> I am questioning the basis for putting it on the list, which no one has been able to say is based on anything more than anecdotal evidence and that it is used by a bunch of Eastern Europeans and Russians.


So if you understand the answer, why are you still asking the question?


----------



## wgscott

"I am questioning" = "I am calling into question"

Keep playing semantic games. They are infinitely entertaining. Not.


----------



## Local Hero

What are you guys arguing about?


----------



## wgscott

I forgot. It is no longer raining outside.


----------



## JohnStonebarger

tennisfreak said:


> ...The fact that some drugs are allowed and some not even if the scientific data to support inclusion or ban are weak.....speak to an inherent weakness in the system itself...


The makers of this drug didn't have enough faith in it to pay for clinical trials. That's their stated reason for never submitting it for FDA approval (or approval from anywhere outside of the former USSR, apparently).

You think WADA should somehow pay for those studies instead? Ha! Far cheaper and more effective simply to state: meldonium is either a PED or it's a scam; either way it has no valid place in sport.


----------



## JohnStonebarger

wgscott said:


> ...What I am interested in is how these decisions get made, and how they are enforced. I also don't think truth is established by social consensus.


There are plenty of articles -- some current to this doping scandal, some older -- that illustrate how this process works. Maybe look into some of those?

And as far as I can tell, none of this is about "truth" as you want to describe it. Sports have rules, some about PEDs, some not. You don't have to agree with a rule or see some deep "truth" in it -- just play by the rules or don't compete.


----------



## TricrossRich

JohnStonebarger said:


> And as far as I can tell, none of this is about "truth" as you want to describe it. Sports have rules, some about PEDs, some not. You don't have to agree with a rule or see some deep "truth" in it -- just play by the rules or don't compete.


^^^ This. I actually do get what WGSCOTT is suggesting and somewhat agree with him, but in the end it comes down to "playing by the rules." This discussion really amounts to nothing more than a discussion of "why is the rules 3 strikes and you're out in baseball? I think it should be 4 strikes or even 5 strikes that make you out. I'd like to see the evidence that proves 3 strikes makes you out."

Obviously, that's over-simplyfing things, but to a certain extent the rules in any sport are arbitrary and are established to make the playing field as even as they can... to eliminate advantages that might be gained by anything other than athletic ability, training and practice. To this end, WADA is acting as a rules organization.


----------



## DaveG

JohnStonebarger said:


> The makers of this drug didn't have enough faith in it to pay for clinical trials. That's their stated reason for never submitting it for FDA approval (or approval from anywhere outside of the former USSR, apparently).
> 
> You think WADA should somehow pay for those studies instead? Ha! Far cheaper and more effective simply to state: meldonium is either a PED or it's a scam; either way it has no valid place in sport.


I am sure those Latvian drug trials were very rigorous

I 100% agree. If WADA were required to provide proof that a drug was performance enhancing that would mean it could takes years (if ever) to put dangerous drugs on the list. The resources to carry out such tests would be substantial. I don't have an issue with WADA making decisions based on partial data if:
1. Many athletes are taking it believing that it has performance enhancing benefits
2. The drug has no legitimate use for a healthy athlete

In the case of Meldonium, both these conditions apply

FYI, I saw an article today that said the the Russians used to give this drug to their troops in Afghanistan to give them, more stamina


----------



## DaveG

TricrossRich said:


> This discussion really amounts to nothing more than a discussion of "why is the rules 3 strikes and you're out in baseball? I think it should be 4 strikes or even 5 strikes that make you out. I'd like to see the evidence that proves 3 strikes makes you out."


Please don't go there, baseball is boring enough without adding more strikes, but I digress


----------



## JohnStonebarger

DaveG said:


> FYI, I saw an article today that said the the Russians used to give this drug to their troops in Afghanistan to give them, more stamina


Yeah, I've seen things to that effect.

As far as I can tell, meldonium isn't a great medical treatment for anything, which is why it wasn't fully developed and marketed internationally. It has shown some (questionable) use as a PED, though, which has kept it in production for over 30 years now.


----------



## mpre53

Local Hero said:


> What are you guys arguing about?


I haven't been around since page 2---did Lance's name pop up somewhere around page 3? I mean 6 pages, can't be about some hot tennis chick unless someone got their hands on nude photos of her.


----------



## wgscott

mpre53 said:


> I haven't been around since page 2---did Lance's name pop up somewhere around page 3? I mean 6 pages, can't be about some hot tennis chick unless someone got their hands on nude photos of her.


Here is a quick summary:

01. There is little if any actual scientific evidence to back the claim that meldonium actually _is_ a performance-enhancing drug, so by what criteria are compounds banned?
02. (a) You are either with us, or you are a terrorist/in love with the [not so] hot tennis chick/a Russian or Eastern European/own stock in Meldonium-R-Us, Ltd, Latvia/a self-proclaimed nazi
(b) God said it, I believe it, that settles it.
(c) Rules are rules. Don't think critically or you will be tossed into a re-education camp.
(d) Athletes ingest the compound, therefore it must be performance-enhancing, or 2(a).
03. Go to 01.


----------



## Local Hero

3 minutes on pubmed.


_Mildronate demonstrates an increase in endurance performance of athletes, improved rehabilitation after exercise, protection against stress, and enhanced activations of central nervous system (CNS) functions. In the present study, the existing evidence of Mildronate's usage in sport, which is arguably not (exclusively) based on medicinal reasons, is corroborated by unequivocal analytical data allowing the estimation of the prevalence and extent of misuse in professional sports. _
Mildronate (Meldonium) in professional sports - monitoring doping control urine samples using hydrophilic interaction liquid chromatography - high ... - PubMed - NCBI

_Meldonium treated patients demonstrated marked reduction of systolic BP and heart rate during heat, increased sodium level at the 2nd visit, improved quality of life. These changes corresponded to adaptive responses of healthy men. _
[Using meldonium to improve the adaptation of patients with cardiovascular disease to the effects of heat and correction of associated oxidative st... - PubMed - NCBI


----------



## DrSmile

wgscott said:


> So how do we know any of these substances (take your pick from their list) is performance-enhancing? And if we have no evidence that this is the case, why do we ban their use?


This strikes me as a not so subtle attack on Wada and their competence. It reminds me of Jim Sensenbrenner's Lance financed attack on USADA. Wada does not put drugs on the banned list randomly. It has an "Expert Group" and a Health, Medical and Research Committee, which has a consultation period before preparing and publishing the List by 1 October. The list is based on a scientific consensus. This is the right and really the only reasonable way of creating such a list.


----------



## wgscott

DrSmile said:


> This strikes me as a not so subtle attack on Wada and their competence. It reminds me of Jim Sensenbrenner's Lance financed attack on USADA. Wada does not put drugs on the banned list randomly. It has an "Expert Group" and a Health, Medical and Research Committee, which has a consultation period before preparing and publishing the List by 1 October. The list is based on a scientific consensus. This is the right and really the only reasonable way of creating such a list.


Being a scientist myself, I am simply curious about how "scientific consensus" (whatever the hell that is) was established in the case of this drug.


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## wgscott

Local Hero said:


> 3 minutes on pubmed.
> 
> 
> _Mildronate demonstrates an increase in endurance performance of athletes, improved rehabilitation after exercise, protection against stress, and enhanced activations of central nervous system (CNS) functions. In the present study, the existing evidence of Mildronate's usage in sport, which is arguably not (exclusively) based on medicinal reasons, is corroborated by unequivocal analytical data allowing the estimation of the prevalence and extent of misuse in professional sports. _
> Mildronate (Meldonium) in professional sports - monitoring doping control urine samples using hydrophilic interaction liquid chromatography - high ... - PubMed - NCBI
> 
> _Meldonium treated patients demonstrated marked reduction of systolic BP and heart rate during heat, increased sodium level at the 2nd visit, improved quality of life. These changes corresponded to adaptive responses of healthy men. _
> [Using meldonium to improve the adaptation of patients with cardiovascular disease to the effects of heat and correction of associated oxidative st... - PubMed - NCBI


Maybe you need to do more than spend 3 minutes to quote introductory remarks in an abstract on pubmed. 

We've already discussed the first of these papers. It is available in its entirety, for free. Just click that button at the upper right-hand corner of the pub med abstract page. What you will see when you read the paper is that it describes a methodology for detecting the compound (using liquid chromatography with mass spec). The detection methodology is the finding that this paper reports, and the methodology presented appears to be completely sound. No one has brought that into question. If you look at the references (as I did, see previous posts above) for the introductory comments, you will see that the documentation is quite sparse. There is a total of one primary reference, and no one can get ahold of it because it is in a now defunct journal.


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## asgelle

wgscott said:


> Being a scientist myself, I am simply curious about how "scientific consensus" (whatever the hell that is) was established in the case of this drug.


Maybe as a scientist, you should check the primary sources. So far you show no evidence of having done that. Instead you ask the same questions over and over of a group that is unable or unwilling to give you the information.


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## duriel

You want to get involved? Go to WADA. What difference does it make, really?


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## jaggrin

Is this drug what made her absolutely gorgeous?


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## nate

wgscott said:


> Here is a quick summary:
> 
> 01. There is little if any actual scientific evidence to back the claim that meldonium actually _is_ a performance-enhancing drug, so by what criteria are compounds banned?


Off-label use seems to be the criteria in this case, which is fine with me. You have a bunch of athletes with no conditions that the drug is intended to treat taking the drug because they think it helps performance. I actually agree that lots of drugs are taken by athletes with the intention of improving performance even though there is no evidence the specific drug will do any such thing. However, they're still taking the drug for a reason other than actual medical need, so I have no problem putting it on the banned list.

And let's be real here. It's not actually a banned list. If an athlete has a true medical need, they can get a TUE. Sometimes they can get one even without a true medical need, as evidenced by the number of athletes that get TUEs for exercise-induced asthma.


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## Aadub

wgscott said:


> Being a scientist myself, I am simply curious about how "scientific consensus" (whatever the hell that is) was established in the case of this drug.


I would think the consensus is it works, hence the number of endurance athletes who take the stuff. You want someone to post up a double blind study or something?


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## .je

Have you seen this?
Report: Russian hockey hit by mass doping scandal - Article - TSN


> Russia’s entire roster will reportedly be replaced just one week prior to the IIHF World Under-18 Men’s World Championship in Grand Forks, N.D., marking the biggest mass doping scandal ever to hit hockey.
> A source told TSN more than half of the 30 players in Russia’s evaluation camp tested positive for meldonium, a performance-enhancing substance banned by the World Anti-Doping Agency (WADA) as of Jan. 1.


Ya know, looks like it's wide-spread agreed on by the people who matter (the athletes), not internet wankers arguing over basically punctuation and spelling, that it's a PED. The people whose careers and future careers are being built on any non-enhancements that this non-drug gives them. 

What an embarrassment to that team, and I guess to that nation's credibility as the veritable athletic empire we all know it is.


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## wgscott

Aadub said:


> I would think the consensus is it works, hence the number of endurance athletes who take the stuff. You want someone to post up a double blind study or something?


A double-blind study that came out positive would be far more compelling than the circular logic in your first sentence.



asgelle said:


> Maybe as a scientist, you should check the primary sources. So far you show no evidence of having done that. Instead you ask the same questions over and over of a group that is unable or unwilling to give you the information.


Maybe you missed it. The problem is there *aren't* any primary sources. See the link to the CNN opinion piece I posted earlier, if you don't believe me.


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## Aadub

wgscott said:


> A double-blind study that came out positive would be far more compelling than the circular logic in your first sentence.


Facepalm..


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