Facts, Not Fiction

 
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    I saw the allegations that Salazar would weigh Cain in front of teammates to shame her.
    If that's so, then all that's been coming his way late this year couldn't have happened to a nicer guy. We cannot praise him too highly.
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    Quote Originally Posted by gh View Post
    i could well be wrong, but I don't believe there's a blanket proscription against all diuretics. There may well be shades of gray between prescription and over-the-counter versions and also between what might be legal in training but illegal in competition.

    any pharmacologists out there?
    Looks like all diuretics are banned, in and out of competition:
    https://www.wada-ama.org/en/content/...masking-agents

    Exception is for one class, carbonic anhydrase inhibitors, when used as an eyedrop for glaucoma (with very little systemic absorption). And, I suppose a TUE (therapeutic Use Exemption) might allow a diuretic to be used, but I can't think of a diagnosis that would fly....TFDR ("Too Fat for Distance Running")? TSNRF ("Too Slow Need to Run Faster")?
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    Quote Originally Posted by DrJay View Post
    Looks like all diuretics are banned, in and out of competition:
    https://www.wada-ama.org/en/content/...masking-agents

    Exception is for one class, carbonic anhydrase inhibitors, when used as an eyedrop for glaucoma (with very little systemic absorption). And, I suppose a TUE (therapeutic Use Exemption) might allow a diuretic to be used, but I can't think of a diagnosis that would fly....TFDR ("Too Fat for Distance Running")? TSNRF ("Too Slow Need to Run Faster")?
    Dawn Harper-Nelson got busted for a diuretic she was prescribed in the ER for high blood pressure. She tried looking it up, but did it wrong, so she thought she was ok when she wasn't. USADA made her go off of it and try other methods of lowering her blood pressure, which lead to some dramatic tweets on her end because whatever they were making her try wasn't working and was jeopardizing her health. She never said publicly how it was resolved, probably she finally got a TUE for something that worked.

    Young healthy African Americans are at risk for developing high blood pressure, especially during pregnancy which is what happened to Allyson Felix.

    So I mean yeah, there are legitimate reasons why an elite athlete could eventually end up with a TUE for a diuretic, but they aren't easy to get.
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    And there are plenty of other BP meds to try, but, yeah, some people's BP responds really well to hydrochlorothiazide (a weak diuretic) and not as well to others. Not unreasonable to require them to try three or four others before a TUE for HCTZ. People don't come to grief from a mildly to moderately elevated BP for a few weeks or even months. It's when it's high for years that the risk of stroke, heart attacks, etc goes up.
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    Quote Originally Posted by DrJay View Post
    Looks like all diuretics are banned, in and out of competition:
    https://www.wada-ama.org/en/content/...masking-agents

    Exception is for one class, carbonic anhydrase inhibitors, when used as an eyedrop for glaucoma (with very little systemic absorption). And, I suppose a TUE (therapeutic Use Exemption) might allow a diuretic to be used, but I can't think of a diagnosis that would fly....TFDR ("Too Fat for Distance Running")? TSNRF ("Too Slow Need to Run Faster")?
    Doesn’t this call into question her allegation about Salazar making her take diuretics?
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    Quote Originally Posted by Dave View Post
    Doesnít this call into question her allegation about Salazar making her take diuretics?
    She didn't say she actually took diuretics. She only said he wanted her to take them.
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    Quote Originally Posted by 18.99s View Post
    She didn't say she actually took diuretics. She only said he wanted her to take them.
    I’m having trouble with even that. Salazar would have been quite conversant on banned substances and known she could not take them for fear of triggering a positive.
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    Quote Originally Posted by Dave View Post
    I’m having trouble with even that. Salazar would have been quite conversant on banned substances and known she could not take them for fear of triggering a positive.
    If she had agreed to take them, presumably he would have told her what to do minimize her chances of getting caught. And/or the request to take them may have happened when her performances had declined to the point that she was no longer elite enough to be in the OOC testing pool.
    Last edited by 18.99s; 11-13-2019 at 12:23 PM.
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    Quote Originally Posted by DrJay View Post
    And there are plenty of other BP meds to try, but, yeah, some people's BP responds really well to hydrochlorothiazide (a weak diuretic) and not as well to others. Not unreasonable to require them to try three or four others before a TUE for HCTZ. People don't come to grief from a mildly to moderately elevated BP for a few weeks or even months. It's when it's high for years that the risk of stroke, heart attacks, etc goes up.
    I think most docs would start with a thiazide diuretic in a young african american woman with hypertension. The data supports that. I'm no expert on TUE's, but rules without evidence shouldn't get in way of evidence-based medicine. It's not like they are race horses taking a crap load of Lasix right before a race. I can't imaging a low dose thiazide having any effect on performance. And if the thiazide gives incomplete control, you don't increase the dose, you add a 2nd class of medicine or change the class.
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    Quote Originally Posted by Dave View Post
    Iím having trouble with even that. Salazar would have been quite conversant on banned substances and known she could not take them for fear of triggering a positive.
    Diuretics are primarily used by track athletes as a masking agent so that chap knew exactly what he was doing.

    Rapidly shedding of water weight would not have helped Mary Cain.
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