You may not need a TUE for that "prohibited only in competition" medication

Triathlon Forum
1

TLDR: If you are a “Non-National Athlete” in the U.S., have a prescription for a drug that is prohibited only in competition, and are not competing in an “International Event”, you may not need (or even be able to get) a TUE. But there could still be consequences if you are tested.

I was recently prescribed a short course of a medication that is “prohibited in-competition only”, and wanted to see what it would take to be cleared to race before the course was over. Here is what I learned:
If you are a Non-National Athlete, and have a first “Adverse Analytical Finding” for a substance that is prohibited only in competition, you “will not have committed an anti-doping rule violation” if you can prove that you had a prescription and it was appropriate to treat a documented medical condition, and you go through any additional testing required by USADAIf those circumstances would apply to you, USADA will discourage you from even applying for a TUE. For example, after I submitted the USADA pre-check form they sent me an email saying "Non-National Athletes are NOT required to obtain a TUE prior to using a prohibited substance or method within specific categories of prohibited substances or methods as per Article 5a of the USADA TUE Policy. XXXX is one of those substances."Even if you apply for a TUE, they will not act on it. "As a Non-National Athlete, you are welcome to submit a TUE application proactively. However, if a TUE is not required at the time of submission, USADA will keep your TUE application and medical documentation on file if needed for future evaluation."However, a positive test could still have consequences. You and your doctor would bear the burden of proof to show that the medication was necessary and appropriate, and if USADA did not agree, you would receive a doping sanction. Also, the exemption is a one-shot deal, and in the future you would need a TUE for any prohibited substance. And even if USADA agrees you qualify for the exemption, you may be disqualified from your event and receive a public warning (that case was for a diuretic / blood pressure medication that is “prohibited at all times”, but falls under the same exemption)
If you have any doubts as to your situation, I would read the USADA TUE policy and submit the pre-check form for confirmation.

2

The common sentiment on here is that a banned drug is a banned drug. And that if you plan on participating in this sport then you shouldn’t be taking banned drugs. Also, once you take a banned drug you may experience gains that you normally wouldn’t have had. So you should respectfully excuse yourself from ever competing in this sport again.

It’s ridiculous, but that’s the conventional wisdom on this forum.

3

I think this is a great “common sense” approach to the process.

4

That is super interesting. This winter in totally unrelated circumstances, a friend of mine and I were both prescribed the same steroid for cold congestion. Both of us ran significantly faster during training runs while on the drugs. And, we both finished the drugs 7 & 10 days before a 10 mile race. We both ran significantly faster in that race.

This is a big can of worms.

5

That is super interesting. This winter in totally unrelated circumstances, a friend of mine and I were both prescribed the same steroid for cold congestion. Both of us ran significantly faster during training runs while on the drugs. And, we both finished the drugs 7 & 10 days before a 10 mile race. We both ran significantly faster in that race. This is a big can of worms.

you were prescribed a big can of worms? :wink:

smarter people than me please correct me if i’m wrong. but the steroid this gentleman and his friend would’ve been prescribed is a corticosteroid, yes? catabolic? you felt great. but, did you feel great because it was a steroid? or because the steroid did its job? and you could breathe much better? my sense is that if you stayed on that steroid, it would be hard for you to build or retain lean body mass.

now i’ll shut up and get myself educated by folks who’ll set me straight.

6

I believe you are are probably correct that they were prescribed corticosteroids, and I believe they are only banned in-competition. I have heard that cyclists and runners use them to cut weight without losing strength and fitness, and it kind of blows my mind that that is allowed. I do not know about them making you stronger or improving aerobic fitness, but I could be wrong.

7

The common sentiment on here is that a banned drug is a banned drug. And that if you plan on participating in this sport then you shouldn’t be taking banned drugs. Also, once you take a banned drug you may experience gains that you normally wouldn’t have had. So you should respectfully excuse yourself from ever competing in this sport again.

It’s ridiculous, but that’s the conventional wisdom on this forum.

No, the common sentiment here is that people should follow the rules and not following the rules is cheating. Since this is part of the rules, I think you would find most people OK with it. Testosterone is not banned only in-competition, therefore this exception does not apply.

8

smarter people than me please correct me if i’m wrong. but the steroid this gentleman and his friend would’ve been prescribed is a corticosteroid, yes? catabolic? you felt great. but, did you feel great because it was a steroid? or because the steroid did its job? and you could breathe much better? my sense is that if you stayed on that steroid, it would be hard for you to build or retain lean body mass.

now i’ll shut up and get myself educated by folks who’ll set me straight.
It was Prednisone. I was not that sick, but I went to a doc-in-a-box and asked him to keep me as well as possible. He prescribed the Prednisone and an antibiotic. The weekend at the end of the prednisone prescription, I did a hard run and two very hard bike workouts that felt like nothing. Then, I did my fastest swim workout ever. After that, I looked it up and saw it was WADA-banned during competition. My quote to my friend was “The prednisone effect is very real.”

And, I gained 2 lbs. over the weekend of all those workouts despite a pretty significant calorie deficit.

9

smarter people than me please correct me if i’m wrong. but the steroid this gentleman and his friend would’ve been prescribed is a corticosteroid, yes? catabolic? you felt great. but, did you feel great because it was a steroid? or because the steroid did its job? and you could breathe much better? my sense is that if you stayed on that steroid, it would be hard for you to build or retain lean body mass.

now i’ll shut up and get myself educated by folks who’ll set me straight.
It was Prednisone. I was not that sick, but I went to a doc-in-a-box and asked him to keep me as well as possible. He prescribed the Prednisone and an antibiotic. The weekend at the end of the prednisone prescription, I did a hard run and two very hard bike workouts that felt like nothing. Then, I did my fastest swim workout ever. After that, I looked it up and saw it was WADA-banned during competition. My quote to my friend was “The prednisone effect is very real.”

And, I gained 2 lbs. over the weekend of all those workouts despite a pretty significant calorie deficit.

Long Term Side Effects of Prednisone Can Be Severe

Long-term use of prednisone may lead to bone loss and osteoporosis. It can cause changes in the distribution of body fat which together with fluid retention and weight gain may give your face a moon-like appearance.

Stretch marks, skin thinning, and excessive facial hair growth are also not uncommon. Women who are pregnant or planning a pregnancy should let their doctor know before they take prednisone. Prednisone is not recommended in women who are breastfeeding a baby.

Children are particularly susceptible to prednisone’s side effects. Prednisone may suppress growth and development, an unfortunate effect that may be helped by alternate day treatment or growth hormone therapy. Prednisone may also cause sleeplessness and affect your moods. People with diabetes may find their blood glucose control is not as good as it usually is while they are taking prednisone.

It is a good idea to wear a medical alert tag or carry a Steroid Card if you need to take prednisone long-term.

Weight Gain is Common

Prednisone makes you hungry and weight gain is a common side effect. Fat deposits may occur around your abdomen, face or back of your neck. Fluid retention can also occur and may manifest as leg swelling and a sudden jump in your weight on the scales.****

The higher the dose and the longer the treatment, the more likely you are to put on weight. You can control fluid retention by eating a diet low in sodium and eating more foods that contain potassium such as bananas, apricots, and dates. A diet high in protein and low in carbohydrates may make you feel fuller for longer, making you less likely to overeat.

10

Holy crap, that is horrifying. And I thought Prednisone was not even a serious drug.

Several years ago I was on a round of Levaquin for a bone infection. That stuff is like toxic waste and can cause a spontaneous rupture of your achilles tendon. I actually got a spontaneous severe sprained ankle while on it and had to cease all exercise for several weeks after the drug was done. I would not want to outlaw that drug, because it kills the unkillable. But, those things are pretty scary.

As a general life hack, I avoid all drugs as much as possible.

11

Actually… I take back my statement about corticosteroids not making you faster - I have heard people say pred makes them feel like “superman”. But it sure sounds like it would be a pretty bad idea to be on it long enough to get real long-term training effects…

12

I have heard people say pred makes them feel like “superman”. But it sure sounds like it would be a pretty bad idea to be on it long enough to get real long-term training effects…
I looked back through my text exchange, and I actually said “I felt like Superman.” It probably did not have a material long-term effect, because my swimming pace regressed back to normal within a couple weeks. But while I was on it, I was definitely faster and recovered faster.

13

I think somebody’s been slipping me prednisone. I have all the side effects.

14

I think somebody’s been slipping me prednisone. I have all the side effects.

Not at that swim we did a couple days ago…

15

But it sure sounds like it would be a pretty bad idea to be on it long enough to get real long-term training effects…

So take it like exxxviii did. Dose before a race… but long enough before so you won’t get busted if you are tested at the race. It surely wouldn’t be too hard to get a prescription.

Does anybody have a problem with this?

Besides me…

16

How long does it take to not test positive?

17

How long does it take to not test positive?

Less than 24 hrs.

18

man , the 2 times I have been on prednisone I was barely able to workout.

Maybe I was too sick when I started it :slight_smile: but I hate being on it

19

How long does it take to not test positive?

Less than 24 hrs.

Wow, so every time we hear of an athlete being sick with a chest thing then coming out and smashing a race we know why, even if the testers don’t. There is a particular ITU athlete who commentators, and he himself, state was sick before quite a few races, they are always his good ones. Oh yeah he allegedly did have a positive for this actual drug but it was let go.

20

**There is a particular ITU athlete **

Did you not read the very first sentence of the OP??