Nothing official. Just speculation from press reports -'Close friend of LCW said..', a BAM official who declined to be named', 'expert from NSI who declined to be named'. The ones who are named refused to say more than wait for sample B results The closest would the article which quotes Sports Minister saying NSI tested all the traditional meds/herbs, no dexamethasone Mainly cos officially they cannot announce it's LCW until sample B results are out. After that, during the BWF hearing(if B tests positive), then we will know
thanks. may i have the link of the "Close friend" article again? I like to read it one more time.. thanks.
It's in malay : Kelmarin salah seorang rakan terdekat Chong Wei menyatakan, ikon negara itu memberitahunya dia tidak mengambil sebarang ubatan lain kecuali suntikan sel induk di salah sebuah hospital swasta Julai lalu kerana bergelut untuk sembuh daripada kecederaan paha. Rakannya itu mengesyaki mungkin doktor yang melakukan suntikan itu mencampur bahan lain hingga menyebabkan Chong Wei gagal ujian doping. Pemain berusia 32 tahun itu gagal dihubungi dan difahamkan bercuti di luar negara sebelum kembali ke tanah air minggu depan http://www.hmetro.com.my/node/3947?m=1 Another article : http://eberita.org/chong-wei-tak-ambil-dadah/
thanks. Based on reading of the above, which of the following is correct? (1) LCW thinks it's the cell injection (2) Friends of LCW thinks it's the cell injection
May not be related to LCW's case which involves dexamethasone. However, I came across this article dated 2012 http://www.wemjournal.org/article/S1080-6032(12)00194-9/pdf which stated this (line 14 of Editor's Introduction) - Both acetazolamide and dexamethasone are currently classified as performance-enhancing drugs (PED) by the World Anti-Doping Agency (WADA). (Note:It's mainly use by mountaineers). Another article relating to the sport of cycling http://www.isteroids.com/blog/tag/dexamethasone/ :- ... Dexamethasone is classified as a glucocorticosteroid on the World Anti-Doping Prohibited List and is prohibited under the USADA Protocol for Olympic and Paralympic Movement Testing and the International Cycling Union (“UCI”) anti-doping rules, both of which have adopted the World Anti-Doping Code (“Code”) and the World Anti-Doping Agency Prohibited List.... A potent synthetic member of the glucocorticoid class of steroid drugs, Dexamethasone can suppress the natural pituitary-adrenal axis and acts as an anti-inflammatory and immunosuppressant and is medically prescribed to treat inflammatory conditions such as allergies, skin conditions, ulcerative colitis, arthritis, and breathing disorders. When taken orally, Dexamethasone is 26.6 times more potent than the naturally occurring hormone cortisol and 6.6 times more potent than prednisone. The CYP2D6 enzyme inducer is commonly used by sportsmen to develop fat easily and may increase the effects of many prodrugs and protoxins which are metabolized via CYP2D6 (like tramadol or codeine) by directly increasing the amount of the active metabolite produced. And this article on arthritis (perhaps not very relevant) http://arthritis.answers.com/tradit...sone-drug-information-dosage-and-side-effects :- ... How Dexamethasone is Abused: Dexamethasone is a favorite for individuals looking for a drug that enhances athletic performance.... There are other articles from various medical fields,including veterinary, that also claim dexamethasone is sometimes used systemically as a "performance-enhancing” drug. The WADA 2015 Prohibited List is out, effective 1 January 2015 http://www.usada.org/wp-content/uploads/wada-2015-prohibited-list-en.pdf :- ... S9. GLUCOCORTICOIDS All glucocorticoids are prohibited when administered by oral, intravenous, intramuscular or rectal routes.
Looks like the consumption of dexamethasone has to do with LCW's stem cell therapy. The question is how could the doctor not know it's a banned substance for a professional athlete ? I'm sure he would at least consult with the sports medicine doctor (of BAM) before administering the treatment or obtain permission to do so. No doctor in his right mind will risk his career and reputation, ignorance is no excuse, recklessness is worse (it's tantamount to malpractice) - not when it also involves the nation's top athlete, a world famous one. You may argue it is accidental,negligent or inadvertent on the doctor's part but would WADA buy that ? Mind you, we are talking about a medical doctor, a stem cell therapist at that dealing in an advanced form of medical treatment. How about LCW's personal responsibility as he has been undergoing stem cell therapy even before the London Olympics 2012? Why did it happen now and not before? Even if LCW claims ignorance and/or innocence , I'm not sure how far WADA and BWF are willing to go to absolve or lessen his blame. At most they might consider it as an attenuating circumstance and also take into account it's LCW's first offence (not to mention his contributions to the sport as many top sportspersons can claim the same).
Dexamethasone combined with stem cell therapy to increase it's effectiveness is something new, discovered only in the past yr. In the past, his treatment likely didn't include that med. My deduction (and Cheung's) is that the medical team miscalculated the pharmacokinetics of it, ie how long it'll stay in his system. If ingested or given iv, it'll clear in likely a week. But intramuscularly as he had, it takes longer to clear. And so micro amounts was found in his urine, even several weeks after.
And please, a reminder to all... dexamethasone is not banned out of competition, only in competition. So when he used it, at the time he was recovering from his thigh injury and not playing, it was allowable.
Channel News Asia http://www.channelnewsasia.com/mobile/asiapacific/badminton-lee-chong-wei-s/1453104.html Badminton: Lee Chong Wei's B sample drug test result on Thursday POSTED: 04 Nov 2014 20:33 UPDATED: 04 Nov 2014 21:03 KUALA LUMPUR: The badminton world awaits anxiously the second dope test of Malaysia's ace shuttler Lee Chong Wei, after his A sample was tested positive of a banned substance. The world number one badminton player will be in Norway to witness the opening of his B sample for testing on Thursday (Nov 6). If the B sample is positive, not only could the 32-year-old be disqualified from the World Championships for violation of anti-doping rule but he could also face suspension for up to two years. Malaysians were shocked and saddened when news broke two weeks ago that Lee had failed an initial doping test during the World Championships in Denmark late August. Traces of banned substance Dexamathesone, a type of Corticosteroid used in anti-inflammatory treatment, were found in his urine sample. Lee was said to be struggling with a thigh injury and reportedly received stem cell injections in July. While Lee's B sample will be tested later this week, experts have warned the public not to get their hopes high. Dr M Jegathesan, head of Olympic Council for Asia's medical and anti-doping committee, said: "What people have to understand is that both A and B are actually two separate bottles containing portion of the same sample. It's quite a rare event for the B sample not to match the A sample result." Malaysian authorities were informed of the result on Oct 1. They said they would investigate the matter, including whether the drug was inadvertently taken as part of Lee's medical treatment. But experts said that is no excuse. Dr Jegathesan said: "Generally speaking, if athletes require a medication, they will apply for therapeutic exemption which could be attained. One may not be aware of the need to do this. It's the responsibility of organisation and athletes to be conversant of the rules and to be able to take care of themselves." Under a strict liability rule, athletes are disqualified from the competition and are stripped of their titles or medals if they are tested positive, regardless of whether the banned substance enhances the athletes' performances or not. Ignorance is no defence, but it can be a mitigating factor when the sport governing body is meting out sanctions. Dr Jegathesan said: "It's up to him to try to prove during the hearing he was not attempting to cheat, that he has inadvertently taken it. And if it's found that it's no fault of his own, there is a good chance to have the usual two-year suspension reduced." Lee was said to have taken the news badly, according to sources close to him. Any suspension of more than six months could affect his world ranking and rob him a chance to compete at the 2016 Olympic Games. Lee commands a great deal of respect among Malaysians. He has been and is still the country's pride. Regardless of the outcome on the second doping test, his fans have this to say: "Whether the result is good or bad, please don't get discouraged. You have already done so much for the country." "He can come back after two years, we will still support him." "He is my idol. I will always fight for him." "He is many people's hero. Well, mistake happens. If he is honest about it, I think Malaysians will welcome him back with open arms." - CNA/ir
First I didn't assume LCW only had two stem cell treatments, once before the LOG'12 and the second before this year's Copenhagen WC. What I'm implying is when the doctor started to introduce dexamethasone to him, LCW should be told beforehand as he has been undergoing such therapy since before the LOG'12 during which time dexamethasone presumably wasn't added but only recently a year or so ago perhaps. The question is when the doctor started using dexamethasone, whether LCW was told about it, permission sought from his sports medicine doctor, the dosage used, that it is only allowed out of competition, when traces of the substance would clear from the body system, that a TUE application to WADA is required to authorize its use for treatment, etc, etc. I mean dexamethasone is a not a rare substance where an ordinary doctor can claim insufficient knowledge of its properties, effects, uses, and abuses - that's a lame excuse, even for miscalculating the pharmacokinetics whether it is ingested orally, intravenously, or injected intramuscularly. Second, I thought the use of dexamehthasone to enhance the effects of stem cell therapy by increasing the cell expansion rate was discovered as early as Aug 2008, see http://www.nature.com/cr/journal/v18/n1s/full/cr2008206a.html; also reported here in a July 2010 article http://www.ncbi.nlm.nih.gov/pubmed/20058244; and Sep 2013 report http://stemcellres.com/content/4/5/117. Pardon me if I get it wrong as I'm just a layperson. Don't get me wrong, I'm not trying to be a wet blanket or anything but being realistic and objective about the whole matter. If you're a WADA official, the questioning, probing, suspicions, doubts and demands will be much more exacting, vigorous,stringent. Better to prepare for the worst while hoping for the best.
even Hong Kong "experts" are commenting on this. kinda rare, no? Lee Chong Wei innocent of drug taking, says Hong Kong expert HK sports medicine expert believes Malaysian star used dexamethasone to only treat an injury PUBLISHED : Tuesday, 04 November, 2014, 9:59pm UPDATED : Tuesday, 04 November, 2014, 10:00pm Chan Kin-wa kinwa.chan@scmp.com Lee Chong Wei will learn his fate on Wednesday in Oslo for using a banned substance. Photo: AP A sports medicine expert believes world number one Lee Chong Wei is innocent of drug taking and hopes the Malaysian is treated leniently when he learns of his fate on Wednesday. A dope test during the world championships in August tested positive for the banned substance dexamethasone and Lee's B sample will be opened in Oslo on Tuesday evening. Lee and his wife, Wong Mew Choo, also a former Malaysia team player, arrived in the Norwegian capital to witness the process, according to reports from Kuala Lumpur. If the 32-year-old is found guilty, Lee will face a two-year suspension in accordance with Badminton World Federation rules. But Dr Patrick Yung Shu-hang, executive director of the Hong Kong Jockey Club Sports Medicine and Health Sciences Centre, said using dexamethasone to enhance a badminton player's performance would have minimal impact and he had great sympathy for Lee. "My personal opinion is that Lee is innocent," said Yung, who is also a consultant in the Department of Orthopaedics & Traumatology of Prince Wales Hospital. "Dexamethasone is a kind of corticosteroids used therapeutically to treat inflammations, asthma and arthritis and it is different from anabolic steroids which are synthetic substances for promoting the growth of skeletal muscle for the purpose of enhancing sporting performance," Yung said. "Dexamethasone is very common in medical treatment and it is not banned during out-of-competition period. Indeed, there has long been debate on whether this substance should be removed from the doping list. "I hope in Lee's case it is because of some ignorant doctors giving injections for treating the player's thigh injury before the world championships." Lee Chong Wei could face a two-year ban for doping. Photo: Reuters But Yung admitted it would be difficult for Lee to escape any penalty as there had been cases of athletes from other sports suspended because of dexamethasone use. In 2012, American cyclist Yosmani Pol Rodriguez was banned for two years after an in-competition urine sample collected during the Delray Beach Twilight Criterium. "Dexamethasone can help cyclists relieve high-altitude training-related sicknesses such as acute mountain sickness, pulmonary edema and headaches, and hence indirectly enhance performance. But I can't see any significant help for a badminton player," said Yung. "If Lee's B sample remains the same, he may only be able to cut down the penalty if he has a very good reason of unintentional use. It will be difficult but, on the international scene, there are always political reasons behind final judgments." The former head of the Hong Kong Doping Committee, Dr Yvonne Yuan Wai-yi, also said corticosteroids were mainly used for treating inflammation and only systemic use during competition was prohibited. "If Lee could prove he has no significant fault in the case, a sanction may be reduced," said Yuan. "For example, if he said he had informed doctors he should not be prescribed with banned substances in sports, yet the doctors provided him with the medicine that caused the positive result, then he has a case." This article appeared in the South China Morning Post print edition as Lee's positive test 'could have been honest mistake' http://www.scmp.com/sport/other-spo...ei-innocent-drug-taking-says-hong-kong-expert
Unfortunately, all these references have already been addressed before in this thread. a) altitude - yes, performance enhancing (cyclists and mountain climbers). sea level? different situation b) performance enhancing - at high doses yes. Your references do not address the effect at low levels or micro levels. As mentioned by myself before, references for low levels having a performance enhancing effect seem very sparse c) think about the isports blog paragraph - develop fat easily? err, does that sound logical for an athlete? CYP2D6 induction? That blog had better give better examples. Tramadol and codeine are painkillers. As a drug of abuse, yes. As a performance enhancing effect, no. Does the blog give peer reviewed references? d) your arthritis reference has given you a confused interpretation. First sentence it says performance enhancing - but doesn't clarify exactly what the performance enhancing effect is. The second sentence starts with "However" which is the key word. That refers to other effects which are not performance enhancing. Beware of cut and paste of facts. e) the 2015 WADA list again specifies dexamethasone banned in-competition. But not out of competition. It does not classify dexamethasone as an anabolic steroid.
Except your whole argument is about the dose being big prior to the urine sample (therefore giving some kind of edge), but as everyone and their grandma already mentionned, it's allowed out of competition so he could've had his body filled with it if he wanted.
Ahh, good! Translational research! Something I have more than a passing interest in! One of my side hobbies is peer reviewing scientific articles. (OK, strange hobby!) There are many laboratory findings which 'might work' to benefit a human but don't actually make it. Here is one extreme example. Regarding the doctor, I am not going to question his qualifications, but mistakes do happen in the medical system. nearly 30% of incidents were medication incidents in this paper. The information about the medical treatment LCW received is too sparse at present. Different doctors involved? Same doctor mixing up the medication? nurse mixup? Checking procedures not followed? And that is assuming dexamethasone wa given as part of the treatment.
I am not sure of the exact pharmacokinetics of dexamethasone. Suffice to say, I tried looking for a quick summary and the information that is relevant to this discussion doesn't seem easily available (not mentioned in drug information). It's got a lot of absorption in muscle and liver so the slow elution back into the blood stream will produce micro levels in the blood. Again, dose dependent.
Does anybody know when was the urine specimen for B test was taken? If it was taken at the same time as A test, the chance for B test to be negative is remote. We all know that LCW has injury prior to the tournament. Personally I believe he took this medication for its anti-inflammatory action. As far as I understand dexamethasone is metabolised by the liver. 10% is excreted by kidney. The half life is between 1 to 5 hours and it usually take about 4-5 half life to clear. Having said that I believe it would also depended on LCW liver and kidney function while he was taking the medication. I understand that dexamethasone can be used outside the tournament but I am not sure if the drug testing organisation has a protocol that state when dexamethasone should be stopped before the tournament. I suspected he had the medication right to one to two days to the commencement of the tournament with the hope that it was clear by the start of the tournament. I think if the B test is positive, LCW and his team have to defend and provide evidence that the use of the dexamethasone in this case is legitimate.
Glucocorticoids are class of steroid hormone that regulate our body metabolism of glucose. Its human product, Cortisol, is synthesis in the adrenal cortex gland while its synthetic product i.e Dexamethasone, is widely produce pharmacologically. Mineralocorticoids are a class of steroid hormones that regulate our body salt and water balances. Since Dexamethasone is a Glucocorticoid class steroid therefore it's glucocorticoid effect is far greater while having only minimal mineralocorticoid effect. Since Dexamethasone is a synthetic glucocoticoidsteroid product, its glucocorticoid effect has been pharmacologically increased for therapeutic and medical usage hence having a far greater potency as to compare to it's human product, Cortisol. ....OR..... they knew but did not apply the TUE due to the fact that whoever administered it is very confident that it will not be detected pharmacologically by the time Dato' compete.
