On August 27th I had some exposure to poison ivy when mowing my overgrown lawn.
I had cleaned up with Tecnu which usually keeps it from getting to bad but apparently this year I’m back to being super sensitive to it. I broke out with in a few hours and being well over a week it’s only gotten worse and consulted a Dr this AM.
They immediately gave me a shot since the blisters were already rupturing and the swelling was getting beyond a comfortable level.
They also prescribed me an antibiotic, triamcinolone Acetonide, and a Prednisone taper staring tomorrow.
I don’t know what the shot was other than a steroid but I know the Prednisone is on the Anti-doping list as banned during competition.
My question is I have 70.3 race this weekend and I’m honestly unsure what I can/should do (or shouldn’t do for that matter). I am far from competitive and I’m only competing against myself.
I’m trying to figure out what the shot was but obviously it was a single dose more than 24 hours prior to competition so it should not be an issue. Should I start the TUE exemption application so I can start the Prednisone? Should I start it and just stop it come Friday?
Am I overthinking this and it doesn’t really apply of I’m not attempting to even qualify for WC? I wouldn’t take a slot if even it rolled down all the way to me even before this quandey let alone now. I’m just at a loss of thinking my season is already over as this was to be my final big race of the year.
I have yet to start the Prednisone and triamcinolone Acetonide but obviously was given a shot in the but before I could even think about what it meant so if I can avoid issues by not taking the Prednisone I might just wait to take it after the race on Sunday and deal until then (I was more worried about the blisters getting infected since they had ruptured).
Technically a corticosteroid that’s banned in-competition needs to be cleared of your system before the race, so it’s not enough to just stop the day before the race. Getting an answer on how long that takes is not easy at all, and you should probably figure our what the shot was
so you can investigate how long it remains in the system. I’d either wait on the steroid until after the race or call USADA and see what they have to say about an emergency TUE but from all I’ve heard, that’s not a quick process.
It depends on your personal ethics and morality standards. “In-Competition” means that you cannot take it after 11:59 PM on the day before competition until the end of the competition.
So, your shot is fine.
If you take your pills before 11:59 PM and then hold off taking the next dose until the event is done, you are within the standards.
If you take your dose the morning of competition, then you are in violation of Ironman’s rules.
Yeah I already did the pre-check with the USADA but they even say if it’s in the next 7 days start a TUE exemption. So I’m going that route. I’ll be calling the drs office to find out what exactly was the shot other than “poison ivy shot” as they said as they jabbed it in me.
It depends on your personal ethics and morality standards. “In-Competition” means that you cannot take it after 11:59 PM on the day before competition until the end of the competition.
So, your shot is fine.
If you take your pills before 11:59 PM and then hold off taking the next dose until the event is done, you are within the standards.
If you take your dose the morning of competition, then you are in violation of Ironman’s rules.
Do not alter the dosing schedule based on competition.
An inappropriate taper from a steroid can upset the HPA axis which suppresses your adrenal output from the first dose. This is a potentially dangerous situation, even without the exceedingly difficult challenge of the race.
Whether you choose to compete or not, continue on the schedule provided or consult your doctor before altering your dosing.
It depends on your personal ethics and morality standards. “In-Competition” means that you cannot take it after 11:59 PM on the day before competition until the end of the competition.
So, your shot is fine.
If you take your pills before 11:59 PM and then hold off taking the next dose until the event is done, you are within the standards.
If you take your dose the morning of competition, then you are in violation of Ironman’s rules.
Honestly my morals are really only about me. If I received an WC shot (hahaha snowballs in hell have a better shot) I would turn it down even BEFORE this.
I agree the “during competition” is questionable at best. I’m just trying to avoid being the random that gets flagged for drug testing at packet pick up and wacked with a multi-year ban because.
I’m going to find out what the shot was, submit a TUE for that and probably hold off on the Prednisone until after the race unless I hear between now and then.
Like I said I went to the Dr because the blisters were rupturing and I was more worried about an infection than anything else.
Do not alter the dosing schedule based on competition.
.
Would a shot of any kind be apart of the dosing schedule of an oral medication? I called and they said it was Solu-Medrol. That isn’t showing up when I search the banned substances so I presume it’s the brand name not the generic name.
If I don’t START the Prednisone would that constitute as altering the dosage?
It depends on your personal ethics and morality standards. “In-Competition” means that you cannot take it after 11:59 PM on the day before competition until the end of the competition.
So, your shot is fine.
If you take your pills before 11:59 PM and then hold off taking the next dose until the event is done, you are within the standards.
If you take your dose the morning of competition, then you are in violation of Ironman’s rules.
That’s not what I’ve been told. I contacted USADA about this very question about 3 years ago.
The answer was that, for drugs that are legal out of competition but banned in competition, you must have the drug out of your system 12 hours before the start of the competition.
That means that if your race starts at 8 am, you need to have the pred out of your system by 8 pm the evening before. That does not mean you can take pred at 8 pm the night before.
OP - fwiw, when I’ve been in the same situation, I’ve chosen to sit out the competition. It sucks, but it is what it is.
That’s not what I’ve been told. I contacted USADA about this very question about 3 years ago.
The answer was that, for drugs that are legal out of competition but banned in competition, you must have the drug out of your system 12 hours before the start of the competition.Good point; you are probably correct. WADA defines the in-competition period as 11:59PM - end of competition. But, I think it is implied that is the testing period and that the drug must not be present when they test during that period. So, to be valid, the Glucocorticoid must not be present in your system at any time during the in-competition period.
Solumedrol == methylprednisolone, an initial IV/IM dose followed by a brief course of prednisone would be a reasonable therapeutic approach for a number of allergic or immune-mediated disorders.
That’s not what I’ve been told. I contacted USADA about this very question about 3 years ago.
The answer was that, for drugs that are legal out of competition but banned in competition, you must have the drug out of your system 12 hours before the start of the competition.Good point; you are probably correct. WADA defines the in-competition period as 11:59PM - end of competition. But, I think it is implied that is the testing period and that the drug must not be present when they test during that period. So, to be valid, the Glucocorticoid must not be present in your system at any time during the in-competition period.
I just happened to be looking at the rules (for the UK and so under British Triathlon Federation governance not US) and the in-competition period was indeed from 23.59 the day before the race until after the race + the period after the race for doping control. Not just when you cross the line. (I guess that part ofbthe rule was to stop anyone claiming ‘ahh I stopped using it for few days then took one 30 secs after crossing the line’
(I was looking as some medical guidance in the UK to GPs has changed and they had contacted me about the asthma inhaler I was on and given an ‘emergency card’ for the inhaler that was classed as a steroid. And I’d also had Prednisolone previously when rather ill - albeit I could hardly get to the kitchen to make a brew without being out of breath when I was on them, not starting a race).
Do not alter the dosing schedule based on competition.
.
Would a shot of any kind be apart of the dosing schedule of an oral medication? I called and they said it was Solu-Medrol. That isn’t showing up when I search the banned substances so I presume it’s the brand name not the generic name.
If I don’t START the Prednisone would that constitute as altering the dosage?
If they gave you a shot of a steroid already, I’d assume the prednisone would just be a continuation of the taper so you’re already on the cycle. I’m not an expert in this, but last time I was on prednisone it was explained to me that steroids require a taper to prevent your immune reaction from ‘overreacting’ after the initial steroid suppressed it which could occur if you went off the steroids cold turkey. Assuming that initial steroid has already been administered, I’d assume that you are best off taking the prednisone as suggested.
This may not be a popular opinion here, but I’d go ahead and race assuming doc doesn’t have an issue. Yes, by the letter of the law you will be doping, but I’m more of a ‘spirit of the law’ kind of person, and you’re not in violation of the spirit of the rule IMO.
/not an MD, maybe should check with a real one
//Also not an ethicist
Thanks for the input everyone. I’m going to call tomorrow to see if not starting it after the steroidal
shot would be an issue.
With more snooping I COULD file an TUE retroactively if I am tested but do run the risk of denial. Since Im not going for a podium or WC slot I get the impression a retroactive approval would probably be higher since OTC medications and other means were attempted first but caused adverse reactions.
I’m going to leave it at this point of not taking it until after the race IF my doc says it’s fine. If not, I’ll file an TUE this week and drop off the form and hope it gets sent in fast enough. If not then I’m at least set up for a retroactive TUE application if I do get to be the lucky one who is tested - I have hit multiple slot machines before so that >1% is a threat to me.
When you do start taking it, you might feel pretty amped up after a dose. From my n=1 experience with that medication, taking it later in the day can really destroy a night’s sleep, so keep that in mind. Mornings worked out much better. Hope you feel better.
In the U.S., if you are not a National Athlete, are not competing in an International Event, and the substance is prohibited in competition only, you may not need a TUE in advance (and USADA may not even process the TUE application if you submit one). At least, that is the response I received when I tried to apply for a TUE a couple of years ago. If you did get selected for testing and test positive, then you would need to get a retroactive TUE.
Details are in the TUE Policy - it changed at the start of the year, but the part about being able to apply retroactively still is there (“Recreational Athletes are able to apply for a retroactive TUE in accordance with the ISTUE and this Policy” on page 6).
It depends on your personal ethics and morality standards. “In-Competition” means that you cannot take it after 11:59 PM on the day before competition until the end of the competition.
So, your shot is fine.
If you take your pills before 11:59 PM and then hold off taking the next dose until the event is done, you are within the standards.
If you take your dose the morning of competition, then you are in violation of Ironman’s rules.
Do not alter the dosing schedule based on competition.
An inappropriate taper from a steroid can upset the HPA axis which suppresses your adrenal output from the first dose. This is a potentially dangerous situation, even without the exceedingly difficult challenge of the race.
Whether you choose to compete or not, continue on the schedule provided or consult your doctor before altering your dosing.
Doctor here…
What is said above is good advice re tapering of your prednisone/prednisolone, but it is generally accepted you need at least three weeks of doses above 20mg before you see significant HPA suppression. The taper in question here is likely more for the allergy side of things.
We have this situation routinely in theatre and yes it is dangerous if someone is on long term steroids and stops then suddenly, your body cannot mount its own stress response and this can be very serious, hence why we supplement with IV hydrocortisone until oral intake is resumed.
Well done on going down the TUE route, I do think you are over thinking things personally, you have needed it for a legitimate medical reason and your chances of getting popped at a 70.3 with what you have said are incredibly low.