Wellbeing
Thyroid Medication Could Be Banned in Sports
http://www.wsj.com/articles/thyroid-medication-could-be-added-to-banned…
Amid suspicion of abuse, members of the U.S. Anti-Doping Agency and U.K. Anti-Doping ask the World Anti-Doping Agency to ban synthetic thyroid medication
Alberto Salazar, a Nike-sponsored distance-running coach, watches the men’s 10,000 meters at the U.S. outdoor track and field championships last month.
Alberto Salazar, a Nike-sponsored distance-running coach, watches the men’s 10,000 meters at the U.S. outdoor track and field championships last month.
Two national antidoping authorities are lobbying to add thyroid hormone medication to the list of substances banned in global sports, amid concerns it is being used to boost performance rather than treat disease.
Members of the U.S. Anti-Doping Agency and U.K. Anti-Doping have submitted appeals to ban synthetic thyroid medication to the World Anti-Doping Agency on the grounds that they could be misused. While critics have long complained that thyroid medication could be misused to boost performance, it wasn’t previously known that antidoping authorities shared those concerns. The positions of the U.S. and U.K. authorities could put more pressure on the hotly debated practice.
Elite athletes don’t openly use thyroid medication as a performance-enhancer, but rates of thyroid disorder claimed by coaches run much higher than its incidence in the general population. This has led authorities to suspect that coaches are trying to gain an edge for their athletes.
WADA establishes the list of banned substances in sports, which is now in the midst of its annual review. Though the WADA prohibited list is updated each year, the preceding consultation period with stakeholder agencies and the review of their recommendations tends to occur behind closed doors. The specific recommendations made by Usada, U.K. Anti-Doping and others typically aren’t made public.
For a substance or method to be prohibited by WADA, it must meet two of the following three criteria: that it is performance-enhancing, that it is harmful to an athlete’s health and that it goes against the “spirit of sport.”
Sophie Ashcroft, a spokeswoman for U.K. Anti-Doping, said the organization has twice appealed to WADA to add thyroid hormone to the prohibited list, particularly because it believes using thyroid hormone without a genuine medical need “can be extremely harmful to health.”
‘The use of thyroid medication for doping is a threat for all athletes, especially endurance athletes.’
—The U.S. Anti-Doping Agency in a letter to the World Anti-Doping Agency
WADA’s final list of prohibited substances, which will take effect for the calendar year beginning Jan. 1, is expected to be ratified in September. Spokesman Ben Nichols said that the agency is aware of the use of thyroid hormone among athletes and has discussed the issue as recently as April, but isn’t prepared to impose a ban.
“To date, however, there has not been enough scientific information available to suggest it should be added,” he said.
Critics say that some athletes are using thyroid medicine to speed recovery from tough workouts, which in turn could provide a competitive advantage. Meanwhile, some coaches, physicians and athletes say that world-class endurance training can suppress thyroid function, requiring use of synthetic thyroid hormone to restore normal levels.
In a letter submitted to WADA’s Prohibited Substance Committee last year and reviewed by The Wall Street Journal, Usada said taking thyroid hormones “could be abused by athletes for performance-enhancing effects” and that “intelligence collected by Usada suggests the use of thyroid medication for doping is a threat for all athletes, especially endurance athletes.”
It isn’t clear exactly how many world-class athletes are currently being treated for hypothyroidism, since use of synthetic thyroid hormone currently isn’t prohibited and requires no disclosure. Nike-sponsored distance-running coach Alberto Salazar wrote in an open letter on his website last month that five of 55 runners he has coached—or 9%—have been diagnosed with hypothyroidism after he began training them.
Nike said in a statement that the company doesn’t condone the use of performance enhancing drugs.
Salazar, whose athletes won three medals at the 2012 London Olympics, is well-known in distance-running circles for championing cutting-edge science, technology and medicine in his training, including the use of altitude-simulating tents in athletes’ homes—a legal practice—to help improve their endurance capacity.
In an interview with The Wall Street Journal in 2013, Salazar emphasized that taking thyroid hormone couldn’t enhance performance beyond what the body was naturally capable of achieving. He didn’t respond this week to a question regarding whether his views have changed given that some authorities are lobbying to regulate thyroid hormone use.
Use of thyroid medicine among elite runners extends beyond those who train under Salazar.
Jeffrey Garber, chairman of the Thyroid Scientific Committee of the American Association of Clinical Endocrinologists, said there is no clinical reason he is aware of for the apparent high incidence of hypothyroidism among elite athletes. Mainstream endocrinologists say that hypothyroidism affects about 5% of the U.S. population, though a small camp of so-called “alternative” endocrinologists have been known to diagnose the condition using more liberal thresholds.
Medical experts say there is little clinical research discussing use of thyroid hormone by elite athletes, let alone showing what performance-enhancing effect it may have. But if a person’s thyroid is performing at less than its optimal levels, synthetic thyroid hormone can be supplemented to bring a person back up to 100%, according to Garber. The risk in thyroid hormone usage is in taking too much, which can lead to jitters, insomnia, increased heart rate and other side effects, he said.
Athletes who demonstrate a clear medical need for substances on the prohibited list must apply for a therapeutic use exemption to continue treatment and remain competition-eligible, according to WADA code. It is unclear how or if antidoping authorities would be able to determine which athletes have a genuine medical need for thyroid hormone and would require a therapeutic-use exemption, and which athletes may be abusing the substance.
Write to Sara Germano at sara.germano@wsj.com
http://www.wsj.com/articles/thyroid-medication-could-be-added-to-banned…
Amid suspicion of abuse, members of the U.S. Anti-Doping Agency and U.K. Anti-Doping ask the World Anti-Doping Agency to ban synthetic thyroid medication
Alberto Salazar, a Nike-sponsored distance-running coach, watches the men’s 10,000 meters at the U.S. outdoor track and field championships last month.
Alberto Salazar, a Nike-sponsored distance-running coach, watches the men’s 10,000 meters at the U.S. outdoor track and field championships last month.
Two national antidoping authorities are lobbying to add thyroid hormone medication to the list of substances banned in global sports, amid concerns it is being used to boost performance rather than treat disease.
Members of the U.S. Anti-Doping Agency and U.K. Anti-Doping have submitted appeals to ban synthetic thyroid medication to the World Anti-Doping Agency on the grounds that they could be misused. While critics have long complained that thyroid medication could be misused to boost performance, it wasn’t previously known that antidoping authorities shared those concerns. The positions of the U.S. and U.K. authorities could put more pressure on the hotly debated practice.
Elite athletes don’t openly use thyroid medication as a performance-enhancer, but rates of thyroid disorder claimed by coaches run much higher than its incidence in the general population. This has led authorities to suspect that coaches are trying to gain an edge for their athletes.
WADA establishes the list of banned substances in sports, which is now in the midst of its annual review. Though the WADA prohibited list is updated each year, the preceding consultation period with stakeholder agencies and the review of their recommendations tends to occur behind closed doors. The specific recommendations made by Usada, U.K. Anti-Doping and others typically aren’t made public.
For a substance or method to be prohibited by WADA, it must meet two of the following three criteria: that it is performance-enhancing, that it is harmful to an athlete’s health and that it goes against the “spirit of sport.”
Sophie Ashcroft, a spokeswoman for U.K. Anti-Doping, said the organization has twice appealed to WADA to add thyroid hormone to the prohibited list, particularly because it believes using thyroid hormone without a genuine medical need “can be extremely harmful to health.”
‘The use of thyroid medication for doping is a threat for all athletes, especially endurance athletes.’
—The U.S. Anti-Doping Agency in a letter to the World Anti-Doping Agency
WADA’s final list of prohibited substances, which will take effect for the calendar year beginning Jan. 1, is expected to be ratified in September. Spokesman Ben Nichols said that the agency is aware of the use of thyroid hormone among athletes and has discussed the issue as recently as April, but isn’t prepared to impose a ban.
“To date, however, there has not been enough scientific information available to suggest it should be added,” he said.
Critics say that some athletes are using thyroid medicine to speed recovery from tough workouts, which in turn could provide a competitive advantage. Meanwhile, some coaches, physicians and athletes say that world-class endurance training can suppress thyroid function, requiring use of synthetic thyroid hormone to restore normal levels.
In a letter submitted to WADA’s Prohibited Substance Committee last year and reviewed by The Wall Street Journal, Usada said taking thyroid hormones “could be abused by athletes for performance-enhancing effects” and that “intelligence collected by Usada suggests the use of thyroid medication for doping is a threat for all athletes, especially endurance athletes.”
It isn’t clear exactly how many world-class athletes are currently being treated for hypothyroidism, since use of synthetic thyroid hormone currently isn’t prohibited and requires no disclosure. Nike-sponsored distance-running coach Alberto Salazar wrote in an open letter on his website last month that five of 55 runners he has coached—or 9%—have been diagnosed with hypothyroidism after he began training them.
Nike said in a statement that the company doesn’t condone the use of performance enhancing drugs.
Salazar, whose athletes won three medals at the 2012 London Olympics, is well-known in distance-running circles for championing cutting-edge science, technology and medicine in his training, including the use of altitude-simulating tents in athletes’ homes—a legal practice—to help improve their endurance capacity.
In an interview with The Wall Street Journal in 2013, Salazar emphasized that taking thyroid hormone couldn’t enhance performance beyond what the body was naturally capable of achieving. He didn’t respond this week to a question regarding whether his views have changed given that some authorities are lobbying to regulate thyroid hormone use.
Use of thyroid medicine among elite runners extends beyond those who train under Salazar.
Jeffrey Garber, chairman of the Thyroid Scientific Committee of the American Association of Clinical Endocrinologists, said there is no clinical reason he is aware of for the apparent high incidence of hypothyroidism among elite athletes. Mainstream endocrinologists say that hypothyroidism affects about 5% of the U.S. population, though a small camp of so-called “alternative” endocrinologists have been known to diagnose the condition using more liberal thresholds.
Medical experts say there is little clinical research discussing use of thyroid hormone by elite athletes, let alone showing what performance-enhancing effect it may have. But if a person’s thyroid is performing at less than its optimal levels, synthetic thyroid hormone can be supplemented to bring a person back up to 100%, according to Garber. The risk in thyroid hormone usage is in taking too much, which can lead to jitters, insomnia, increased heart rate and other side effects, he said.
Athletes who demonstrate a clear medical need for substances on the prohibited list must apply for a therapeutic use exemption to continue treatment and remain competition-eligible, according to WADA code. It is unclear how or if antidoping authorities would be able to determine which athletes have a genuine medical need for thyroid hormone and would require a therapeutic-use exemption, and which athletes may be abusing the substance.
Write to Sara Germano at sara.germano@wsj.com