Valieva Banned for Four Years, Effective December 25, 2021

[kwanfan1818]

I clicked the photo in the Twitter post and got straight to the article. I'm not a subscriber.

 

[Yazmeen]

Accessible version from Yahoo: https://www.yahoo.com/sports/kamila-valieva-russian-figure-skater-184615260.html

 

[MacMadame]

I thought at first that I couldn't get in to see the article, but go by the twitter link and just close the box that says you have to pay.

That worked!

Accessible version from Yahoo: https://www.yahoo.com/sports/kamila-valieva-russian-figure-skater-184615260.html

Different article with less detail. I recommend the first one and use @Alilou's trick.

ETA neither article listed all the substances. I wanted to see that.

 

[kwanfan1818]

The Times article listed them all at the bottom.

 

[Sylvia]

I can read the full article in The Times that's linked in the journalist's post: https://twitter.com/martynziegler/status/1767963798671921221

I edited this into my original post, ICYMI:

"The Court of Arbitration for Sport findings detail 55 other non-prohibited medications and supplements she was given by Russian team doctors between the ages of 13 and 15. A 56th non-prohibited substance, Ecdysterone, was also found in her urine sample."

The full list is published at the end of the article and is based on the January 29, 2024 CAS Arbitral Award document (129 pages): https://www.tas-cas.org/fileadmin/user_upload/9451-9455-9456_Arbitral_Award__publ._.pdf

 

[bardtoob]

Those responsible ruined her life.

 

[Vagabond]

I wish that there were some way of requiring an explanation as to why all of those substances, including the legal ones, were administered. For example, she took medications against both nausea and diarrhea. Really? Why was that considered appropriate?

 

[vireo]

The full list is published at the end of the article and is based on the January 29, 2024 CAS Arbitral Award document (129 pages): https://www.tas-cas.org/fileadmin/user_upload/9451-9455-9456_Arbitral_Award__publ._.pdf

That list is really something. There are several painkillers and anti-virals. One of the medications is banned in the US and EU because of its impact on the liver; while another of the meds is used to treat liver ailments. Just stunning.

 

[MacMadame]

I wish that there were some way of requiring an explanation as to why all of those substances, including the legal ones, were administered. For example, she took medications against both nausea and diarrhea. Really? Why was that considered appropriate?

Those were given over several years, not all at once. I am going to assume that at one point she was nauseous and at another she had diarrhea. There was also some cold medicine and flu in there. So those were probably only taken when she had a cold/flu. The question the list doesn't answer is if she was given all those meds every time she had the flu or did they give her different ones over time as they found ones they liked better. I hope it was the latter as that's a lot of different cold/flu meds.

Some of the others, like L-Carnitine were probably used during periods of active training as they don't really do anything if you are on vacation and not training. But the vitamins were probably taken every day even when on a break. They are just for general health.

It's quite a list and contains completely innocuous supplements all the way up to very suspicious ones. Plus some that probably didn't do anything because the evidence of their effectiveness is marginal.

 

[Vagabond]

Those were given over several years, not all at once. I am going to assume that at one point she was nauseous and at another she had diarrhea.

Why was she nauseous, and why did she have diarrhea, if in fact she was and did? Was it in reaction to performance-enhancing drugs (not that I expect anyone in Valieva’s situation to admit to that)? And why was medication even deemed necessary? She was an apparently healthy girl, aged thirteen to fifteen, and yet in three or so years, she took fifty-six different pharmaceutical substances.

 

[kwanfan1818]

I was a pretty healthy person at that age, but in junior high and high school I regularly took an anti-nausea medicine for car-sickness, took cold medicine when i had colds, and very, very reluctantly took Kaopectate a couple of times. Valieva didn't necessarily take these medications or multivitamins for a different reason than i did.

 

[MacMadame]

Don't you know... 13-year-olds can't get colds.

Look, we don't know when she took these things, how many she was taking at a time, or why each one was considered necessary to take. All we have is a list of everything her team ever gave her in that time period. You can believe that Sambo 70 is a horrible place that abused its young skaters without demonizing everything on that list and attributing it to bad motives.

 

[Vagabond]

You can believe that Sambo 70 is a horrible place that abused its young skaters without demonizing everything on that list and attributing it to bad motives.

Which is why I wish she were required to explain why she took so many things. I know that there is ni such requirement.

Fifty-six is an enormous number. Maybe almost everything she took is what a typical healthy Russian girl would take; that would say a lot about Russia.

 

[kwanfan1818]

I don’t see anyone arguing that she took a lot of things on that list as a civilian: many athletes are given and/or take a lot on the list only because they are athletes. I don’t think anyone has to explain the ones that could be in an average person’s, including teenaged person’s, system, like cold, anti-nausea, anti-diarrhea, or vitamins, unless they were the source of an illegal substance, like Berzhnaia’s cold medicine did, through no knowledge of her own.

 

[screech]

Even an average person can take multiple medications at one time. For example, I recently had a minor illness that just could not be beat, even with prescriptions. In addition to my regular medications (birth control, chronic minor condition) over the course of a 6 month period I was given about 10 different prescriptions to try, as well as trying probably another 10 or so over the counter medications. I'm a relatively healthy non-athlete and all-in-all I ended up taking a total of about 25 different medications over the course of 6 months. Plus my daily vitamin supplement.
So thinking of any elite athlete, who may be on birth control, or have chronic conditions, or encounter an illness and be given prescriptions, plus anything to ease aches and pains, or any injuries, plus supplements... just thinking of how many different things I took over just 6 months, twice that amount over quadruple the length of time doesn't seem THAT unreasonable. (Of course, I'm middle aged and not 13...)

 

[Wyliefan]

Russian Skater's Doping Case Leaves WADA Uneasy and Targeting New Rules Before Next Winter Olympics​

“It is clear that the taste of this case is very unpleasant when you see that there was a choice made to sacrifice an athlete rather than indicating who actually helped her dope,” WADA director general Olivier Niggli said.

Valieva was given a four-year ban by the Court of Arbitration for Sport in January following an appeal by WADA. She was 15 when her positive test for a banned heart medication was revealed at the 2022 Beijing Winter Games, and later blamed on a strawberry dessert prepared by her grandfather. She has been the only person punished despite the World Anti-Doping Code mandating that the people working with underage athletes implicated in doping cases should also be investigated.

The responsibility to conduct those investigations falls on national authorities and there is no sign that Valieva’s renowned coach Eteri Tutberidze and medical support staff will be held to account in Russia.

Instead, Tutberidze was last year awarded one of Russia’s highest honors authorized by President Vladimir Putin.

https://www.usnews.com/news/sports/articles/2024-03-12/russian-skaters-doping-case-leaves-wada-uneasy-and-targeting-new-rules-before-next-winter-olympics

 

[MacMadame]

I take 10 pills every day. I take 3 iron pills (on the list), 1 calcium (on the list), 1 Omega 3 (on the list), 1 multivitamin (on the list), 1 magnesium (on the list), and 3 prescription meds. And on Monday I have another prescription pill that I take weekly.

IMO people are overly focused on the 56 number and not on what they are. Here is my take on the whole list:

Over-the-counter painkillers. Athletes often have aches and pains around training and take stuff like this all the time:
Nimesulid - yes it can be hard on the liver but so can Tylenol (acetaminophen/paracetamol) and Advil (ibuprofen) is hard on the kidneys and stomach. Nimesuild was found to be similar to naproxen (Aleve) in effectiveness and possible harm in one study
Ibuclin - Combo drug of acetaminophen and ibuprofen
Versatis - a lidocaine patch
Traumeel S - an analgesic that reduces inflammation (don't know why it's listed as a heel ointment - maybe they meant heal ointment?)
Voltaren - painkiller gel (as mentioned before a lot of us use this)
Aspirin C - mild painkiller

Prescription?? painkiller
Ketrolac - the Mayo Clinic says it's an NSAID, not a narcotic and is not habit-forming. It is used to treat moderate to severe pain around a procedure. I don't remember Valieva having a severe injury or a procedure in this timeframe but maybe she did.

Diarrhea meds. Most people get diarrhea at some point in their lives. My only concern for Valieva is that we know Sambo 70 promotes unhealthy eating that could possibly lead to a cycle of diarrhea and constipation. However, there is nothing on the list to treat constipation so she probably just had diarrhea once in a while as people do.
litrum–STI
Alfa Normix
Flitrum–STI
Diara

Flu/cold meds. Yes, even athletes get the flu.
Polyoxidonium - Anti-flu medication (needs a prescription??)
ACC - Cough medicine
Xylometazoline - Nasal decongestant - nose spray
Agisept - a cough drop? (the article calls it an antiseptic agent used for upper respiratory tract infections but it seems to be something like a cough drop or possibly a spray like Chloraseptic)
Grippferon - antiviral medication to treat colds and flu - another nasal spray. (Needs a prescription??)
Carmolis lolly - cough drops
Coldrex Maksgrip - it's listed as a cold and flu remedy but it's a mild painkiller that can be used to reduce fever
Gorpils - throat lozenges
Tilaxine - anti-viral drug that seems to only be available in Russia - not clear if it needs a prescription

Other OTT meds:
Imudon - used to treat and prevent mouth and throat infections - contains vitamin C and zinc (so like Airborne?)

Vitamins & Minerals:
Panangin Forte - potassium and magnesium (the article said it's used to treat heart attack and stroke but normal people who have no heart conditions take these supplements) - in the US, potassium supplements require a prescription because you can overdo them but this particular pill is available OTT elsewhere
Magnelis B6 - Magnesium
Vitrum Superstress - multivitamin with iron
Supadryn - Multivitamins
Orthomol Sport - Magnesium
Doppelhertz aktiv - another multivitamin as a supplement you add to food
CoQ10 - an anti-oxidant aimed at improving energy and boosting the immune system
Omega 3 - fish oil
Berocca Plus - another multivitamin
Junior Active Complex - another multivitamin but it also contains l-carnitine (listed below)
Calcimine Advance - another calcium and magnesium supplement
Maxilac - the article says it's a "Biologically active food supplement used to treat stomach disorders caused by medications" It's a pro-biotic, lyophilisate in particular (IOW, the description is overly dramatic)

Typical supplements athletes use:
L-Carnitine - it's a fat burner. WADA does prohibit taking it high doses but not taking it at all
SportExpert L-Carnitine
Creatine Ox - Amino acid supplement - good for the muscles and also helps burn fat
Stimol - Amino acid-based supplement that's supposed to reduce fatigue and also limit the accumulation of lactic acid in the muscles
Amino Vital, Amino Vital Multi Energy & Amino Vital Gold - Energy drinks/powders containing amino acids. (I used to use this on long bike rides until it got hard to find in my area)
Glycine - Amino acid supplement.
Geladrink - collagen, a protein
Sustamin - it's listed as 'A supplement of “bioactive milk proteins” aimed at improving joint function' but I think it's just something like collagen and that's the fancy marketing description
Isodrinx - electrolyte drink
BCAA+ Branch chain amino acids are recommended after hard exercise as a recovery aid
Guarana 300 - High caffeine energy booster - caffeine is a performance enhancer and lots of athletes of all stripes use caffeine during events. (In fact, WADA toys with banning it off and on but it's in food naturally so how could athletes control how much they get well enough to not be considered doping?)

So that leaves the following that I found concerning, not all because of doping, sometimes for other reasons.

Possibly Performance-Enhancing, some are on WADA's radar:
Ecdysterone - a steroid hormone that studies have shown enhances physical performance
Hypoxen capsules - an antioxidant that reduces oxygen consumption, improves lung capacity, and is used to treat heart conditions
Riboxin - an anabolic drug that stimulates metabolic processes and is used to treat coronary heart disease.
Cytovlavin - this seems to be Cytoflavin. In a published paper about the impact of taking this on hockey players, it says:

Cytoflavin is an ergogenic drug whose action is based on the combined effects of its active ingredients (succinic acid, inosine, nicotinamide and riboflavin), which are naturally occurring metabolites that stimulate tissue respiration.

The paper concludes that the drug improves body composition in athletes and enhances performance. Since it's ingredients are naturally occurring, it's probably fine and might be hard for WADA to set limits.

Bilactin - the article says:

The State Committee of the Russian Federation on Physical Training And Sports has stated Bilactin is one of its recommended medications to stimulate physical working capacity and rehabilitation.

It is apparently recommended for mountain climbers to help with the effects of altitude as well. It's probably fine but it's not easy to find and I'm not familiar with it so it made me suspicious. I would keep an eye on it, if I were WADA.

Used to treat iron deficiency and anemia:
Tot’hema
Sorbifer Durules
These are probably not concerning but they bug me. Generally, what used to be called "Female Athlete Triad" included iron deficiency and anemia and it's a sign that the athlete is working too hard. (FAT has been renamed because men get it too, btw.) OTOH, these are probably just more iron supplements as listed above (but requiring a prescription??)

Valmedin - according to the article, this is used to promote sleep and reduce anxiety. I could not find a listing for it anywhere but I think it might be an herbal supplement possibly containing valerian. Or maybe it's a brand name for melatonin?

The only reason I consider this concerning is that teenagers shouldn't have issues with sleep and anxiety. OTOH, I'm probably being a pill about this because skaters travel all over crossing different time zones and probably do need to take stuff to sleep when their bodies think it's 7pm but the clock says it's 1am.

Kreon - I think this is actually Creon which is a prescription medicine that is used to improve digestion in people who cannot digest food properly. I don't see any reason why a healthy athlete would need this but maybe she had a really bad stomach ache at one point? Or, again, this could be a product of an unhealthy diet.

Esslial Forte - this one I'm on the fence about. The entry says "Used to treat diseases of the liver including chronic hepatitis cirrhosis and fatty liver disease" but it's an OTT herbal supplement you can buy on Amazon. Here is what the manufacturer says:

Essentiale forte N (I assume Esslial Forte is the name in Russia) is an herbal preparation for the supportive care of liver diseases for adults from 18 years of age. Essentiale forte N capsules are used as a means of supportive care in case of chronic hepatitis and toxic nutritional liver damage (e.g. damage caused by alcohol, etc.).

I do not see any reason why a healthy athlete would take this. Combined with the Kreon/Creon, I find it concerning.

Metoclopramide - anti-nausea medication. This is probably fine but it stuck out because of the Kreon and Esslial Forte entries.

To conclude:
We know that the Russians believe that elite athletes put a strain on their hearts and so should be treated with stuff that helps the heart. There is scientific evidence that high-level training does put a strain on the heart and very fit healthy athletes do suffer heart attacks when there are no other indicators that they are at risk for them. What is not proven is whether giving this stuff "as a precaution" actually does anything to stop the impact on the heart. Many doctors and scientists think that the way to approach this is to back off on the training when there are indications that the heart is suffering.

So what I see concerning is that she's taking stuff that will probably get banned in the near future but it's not banned now and she seems to have some severe digestive issues as well as anemia.

 

[Kateri]

IMO people are overly focused on the 56 number and not on what they are. Here is my take on the whole list:

Thank you so much for this in-depth breakdown!

 

[MacMadame]

Thank you so much for this in-depth breakdown!

You're welcome.

I encourage people who may know more about individual meds to chime in too.

 

[Debbie S]

FWIW, Vincent Zhou was interviewed a few weeks ago on the This Week in Skating podcast and commented that the list of meds was excessive (not in those exact words). He said he took a few vitamin supplements when training but nothing close to the number and type of meds on Valieva's list.

 

[MacMadame]

FWIW, Vincent Zhou was interviewed a few weeks ago on the This Week in Skating podcast and commented that the list of meds was excessive (not in those exact words). He said he took a few vitamin supplements when training but nothing close to the number and type of meds on Valieva's list.

So he never takes cold medicine, sucks on a cough drop or takes an Advil when he hurts after falling on a lot of jumps in pratice? I find that hard to believe. I suspect he skimmed the list or just heard "It's 56 items!" and didn't look at what was exactly on it.

Part of the reason there are 56 items, btw, is that they changed brands of OTT stuff over the years. And this really does consist of every single thing. Like cough drops!

 

[myhoneyhoney]

Per my weight lifter hubby: this doesn’t mean she’s swallowing 56 pills. Pre workout, post workouts, and other powders mixed into water or juice usually contain multiple ingredients.

ETA: Hubby cringed and shook his head that a 15 year old ingested all this. He wouldn’t give our boys pre workouts until they turned 18.

 

[Tesla]

So he never takes cold medicine, sucks on a cough drop or takes an Advil when he hurts after falling on a lot of jumps in pratice? I find that hard to believe. I suspect he skimmed the list or just heard "It's 56 items!" and didn't look at what was exactly on it.

Part of the reason there are 56 items, btw, is that they changed brands of OTT stuff over the years. And this really does consist of every single thing. Like cough drops!

With the strictness of USADA and WADA, I wouldn’t be surprised if he didn’t take cold medicine or use cough drops.

 

[Vagabond]

Much of the period in question was during the first two years of the pandemic. I would expect that many of the people who post here didn't use cough medicine much if at all during that period, since they were less likely to be exposed to cold viruses then than they normally would be.

 

[Willin]

Don't you know... 13-year-olds can't get colds.

Look, we don't know when she took these things, how many she was taking at a time, or why each one was considered necessary to take. All we have is a list of everything her team ever gave her in that time period. You can believe that Sambo 70 is a horrible place that abused its young skaters without demonizing everything on that list and attributing it to bad motives.

Sure, but some of the stuff on the list is very inappropriate and others make me think they were trying to mask symptoms for some things so she could return to skating faster and others are known to be bad for you quite easily.

To break it down:

Nimesulid - yes it can be hard on the liver but so can Tylenol (acetaminophen/paracetamol) and Advil (ibuprofen) is hard on the kidneys and stomach. Nimesuild was found to be similar to naproxen (Aleve) in effectiveness and possible harm in one study
Ibuclin - Combo drug of acetaminophen and ibuprofen
Versatis - a lidocaine patch
Traumeel S - an analgesic that reduces inflammation (don't know why it's listed as a heel ointment - maybe they meant heal ointment?)
Voltaren - painkiller gel (as mentioned before a lot of us use this)
Aspirin C - mild painkiller

Prescription?? painkiller
Ketrolac - the Mayo Clinic says it's an NSAID, not a narcotic and is not habit-forming. It is used to treat moderate to severe pain around a procedure. I don't remember Valieva having a severe injury or a procedure in this timeframe but maybe she did.

This is an enormous amount of painkillers. NSAIDs like nimesulid and ibuclin are known to cause stomach ulcers, especially on an empty stomach and with chronic use. Considering what we know about Eteri's dietary plans, that part concerns me.

As for ketorolac/toradol, that's another NSAID. It's very powerful and works excellently. The problem being it fries your kidneys very, very easily. Even for young people with no kidney issues you need to limit it to 5-7 days of use at a time so you don't hurt their kidneys. The risk of kidney failure only increases given we know Eteri promotes dehydration. It's only given IV or via a shot (usually in the butt).

That being said, these are all things or similar to things we give US athletes. I've even seen football teams criticized for using toradol too often to push athletes with aches/pains through practices and games. Because of its risk profile it's usually only given with more severe injuries/pain/surgeries. So my criticism of this would vary depending on the details. I would err on the side of this cocktail being used to get her to push through injuries in an unhealthy manner. Again, done in the US, but that doesn't make it correct. We've seen Eteri skaters expected to compete and train through both chronic and acute injuries - and this is likely the answer to how that happens.

Diarrhea meds. Most people get diarrhea at some point in their lives. My only concern for Valieva is that we know Sambo 70 promotes unhealthy eating that could possibly lead to a cycle of diarrhea and constipation. However, there is nothing on the list to treat constipation so she probably just had diarrhea once in a while as people do.
litrum–STI
Alfa Normix
Flitrum–STI
Diara


Flu/cold meds. Yes, even athletes get the flu.
Polyoxidonium - Anti-flu medication (needs a prescription??)
ACC - Cough medicine
Xylometazoline - Nasal decongestant - nose spray
Agisept - a cough drop? (the article calls it an antiseptic agent used for upper respiratory tract infections but it seems to be something like a cough drop or possibly a spray like Chloraseptic)
Grippferon - antiviral medication to treat colds and flu - another nasal spray. (Needs a prescription??)
Carmolis lolly - cough drops
Coldrex Maksgrip - it's listed as a cold and flu remedy but it's a mild painkiller that can be used to reduce fever
Gorpils - throat lozenges
Tilaxine - anti-viral drug that seems to only be available in Russia - not clear if it needs a prescription
Other OTT meds:
Imudon - used to treat and prevent mouth and throat infections - contains vitamin C and zinc (so like Airborne?)

These don't concern me on any individual level - even a couple of the cold/flu meds together are nothing to sneeze at. What concerns me is the sheer amount. Sure, people get diarrhea. People get colds/the flu often and especially when travelling as much as skaters do in the winter. That being said, most US athletes cannot take common cold/flu medicines without a doctor's note due to USADA/WADA restrictions, which makes it more strange she took this many.

What is unusual is that any normal human being - especially an otherwise healthy teen - would need this many different meds for this sort of thing over the span of a few years. Usually you just do OTC cough drops, decongestants, and cough syrup/drops. Antivirals are very, very toxic and should only be given for severe infections or infections in those who are immunocompromised.

The only thing this would make sense with is them trying to get her healthy enough to train/compete while sick - and we've seen Eteri skaters have miraculous skates despite illness. Again, pushing them past healthy limits.

Vitamins & Minerals:
Panangin Forte - potassium and magnesium (the article said it's used to treat heart attack and stroke but normal people who have no heart conditions take these supplements) - in the US, potassium supplements require a prescription because you can overdo them but this particular pill is available OTT elsewhere
Magnelis B6 - Magnesium
Vitrum Superstress - multivitamin with iron
Supadryn - Multivitamins
Orthomol Sport - Magnesium
Doppelhertz aktiv - another multivitamin as a supplement you add to food
CoQ10 - an anti-oxidant aimed at improving energy and boosting the immune system
Omega 3 - fish oil
Berocca Plus - another multivitamin
Junior Active Complex - another multivitamin but it also contains l-carnitine (listed below)
Calcimine Advance - another calcium and magnesium supplement
Maxilac - the article says it's a "Biologically active food supplement used to treat stomach disorders caused by medications" It's a pro-biotic, lyophilisate in particular (IOW, the description is overly dramatic)

Typical supplements athletes use:
L-Carnitine - it's a fat burner. WADA does prohibit taking it high doses but not taking it at all
SportExpert L-Carnitine
Creatine Ox - Amino acid supplement - good for the muscles and also helps burn fat
Stimol - Amino acid-based supplement that's supposed to reduce fatigue and also limit the accumulation of lactic acid in the muscles
Amino Vital, Amino Vital Multi Energy & Amino Vital Gold - Energy drinks/powders containing amino acids. (I used to use this on long bike rides until it got hard to find in my area)
Glycine - Amino acid supplement.
Geladrink - collagen, a protein
Sustamin - it's listed as 'A supplement of “bioactive milk proteins” aimed at improving joint function' but I think it's just something like collagen and that's the fancy marketing description
Isodrinx - electrolyte drink
BCAA+ Branch chain amino acids are recommended after hard exercise as a recovery aid
Guarana 300 - High caffeine energy booster - caffeine is a performance enhancer and lots of athletes of all stripes use caffeine during events. (In fact, WADA toys with banning it off and on but it's in food naturally so how could athletes control how much they get well enough to not be considered doping?)

Vitamins aren't concerning, however supplements are not good for you. Aside from being unregulated (and therefore containing sketchy stuff that's gotten US athletes doping bans), there are some that are outright dangerous. For instance, I've seen L-Carnitine kill a grown man from liver failure. So while some are safe, not all are.

As an aside - high caffeine drinks are dangerous for people with heart problems. Shows they know they can't use the "she has a heart condition" excuse without further scrutiny - unless they really just care so little they'll clam that she does have a heart condition and they don't care if her heart stops from the caffeine.

Kreon - I think this is actually Creon which is a prescription medicine that is used to improve digestion in people who cannot digest food properly. I don't see any reason why a healthy athlete would need this but maybe she had a really bad stomach ache at one point? Or, again, this could be a product of an unhealthy diet.

Esslial Forte - this one I'm on the fence about. The entry says "Used to treat diseases of the liver including chronic hepatitis cirrhosis and fatty liver disease" but it's an OTT herbal supplement you can buy on Amazon. Here is what the manufacturer says:

Essentiale forte N (I assume Esslial Forte is the name in Russia) is an herbal preparation for the supportive care of liver diseases for adults from 18 years of age. Essentiale forte N capsules are used as a means of supportive care in case of chronic hepatitis and toxic nutritional liver damage (e.g. damage caused by alcohol, etc.).

I do not see any reason why a healthy athlete would take this. Combined with the Kreon/Creon, I find it concerning.

Metoclopramide - anti-nausea medication. This is probably fine but it stuck out because of the Kreon and Esslial Forte entries.

Kreon is used for people with pancreatitis, pancreatectomies, exocrine pancreatic insufficiency, or other issues preventing the pancreas from releasing it's digestive enzymes into the intestines. Without it these patients have severe cramping, abdominal pain, and diarrhea. It must be taken with food. This is one that's puzzling to me because AFAIK she has none of these issues - and if she did she's probably be too sick to train or compete. It also has no clear benefit for her training. Unless they were trying to get the food to digest faster so she'd absorb less to maintain her weight?

As for these herbal liver supplements, they're junk. I care for a lot of patients with liver failure and not once have I seen any take any herbal supplements. In fact we discourage them because many herbal supplements are actually toxic to the liver.

Those two together do make me wonder if the combos of pain meds + exercise supplements (that can be hepatotoxic) + occasional antivirals + other medications were causing concerns for them about her liver/pancreas. Probably just lab value changes since she never looked sick, but concerns nonetheless.

Reglan is a commonly used anti-nausea medication. It's pretty strong and is typically indicated only for use in cancer patients. It also has a Black Box warning (a serious side effect warning) for causing a movement disorder that can cause swallowing/chewing difficulties with chronic use. The more common option for both in and outpatient use would be zofran, which is safer for almost everyone. Again, my criticism of this would be dependent on the availability of zofran, how often she used it, and why she was using it.

To conclude:
We know that the Russians believe that elite athletes put a strain on their hearts and so should be treated with stuff that helps the heart. There is scientific evidence that high-level training does put a strain on the heart and very fit healthy athletes do suffer heart attacks when there are no other indicators that they are at risk for them. What is not proven is whether giving this stuff "as a precaution" actually does anything to stop the impact on the heart. Many doctors and scientists think that the way to approach this is to back off on the training when there are indications that the heart is suffering.

So what I see concerning is that she's taking stuff that will probably get banned in the near future but it's not banned now and she seems to have some severe digestive issues as well as anemia.

It seems like they don't know when backing off is good.

As I've pointed out, a lot of things could've been helped by backing off temporarily and rest. They obviously preferred pain meds to the careful rest and return to training that many US athletes use. The diarrhea/anti-infectious meds could've not been used if they just let her heal like a normal teen instead of pushing her to get through the illnesses to train. They used supplements that are dangerous normally, but at least one that is dangerous if she has a heart condition as they so seem to think considering the other meds.

(Side note: anemia isn't concerning per se - it could be; who knows. But it's somewhat common in young women, so again my criticism of that depends on details we don't have)

 

[VGThuy]

With the strictness of USADA and WADA, I wouldn’t be surprised if he didn’t take cold medicine or use cough drops.

Yeah, Vincent isn’t an idiot and knows more about this whole process than most of us here since he’s lived it.

 

[Sylvia]

Re-posting from earlier in the thread for those interested:

You can listen to more from Vincent in the latest "This Week in Skating" podcast episode as well:

This Week in Skating / Vincent Zhou talks about the CAS decision, Olympic medals

Listen to This Week in Skating Podcast on RedCircle

redcircle.com

 

[PRlady]

Sure, but some of the stuff on the list is very inappropriate and others make me think they were trying to mask symptoms for some things so she could return to skating faster and others are known to be bad for you quite easily.

To break it down:

This is an enormous amount of painkillers. NSAIDs like nimesulid and ibuclin are known to cause stomach ulcers, especially on an empty stomach and with chronic use. Considering what we know about Eteri's dietary plans, that part concerns me.

As for ketorolac/toradol, that's another NSAID. It's very powerful and works excellently. The problem being it fries your kidneys very, very easily. Even for young people with no kidney issues you need to limit it to 5-7 days of use at a time so you don't hurt their kidneys. The risk of kidney failure only increases given we know Eteri promotes dehydration. It's only given IV or via a shot (usually in the butt).

That being said, these are all things or similar to things we give US athletes. I've even seen football teams criticized for using toradol too often to push athletes with aches/pains through practices and games. Because of its risk profile it's usually only given with more severe injuries/pain/surgeries. So my criticism of this would vary depending on the details. I would err on the side of this cocktail being used to get her to push through injuries in an unhealthy manner. Again, done in the US, but that doesn't make it correct. We've seen Eteri skaters expected to compete and train through both chronic and acute injuries - and this is likely the answer to how that happens.


These don't concern me on any individual level - even a couple of the cold/flu meds together are nothing to sneeze at. What concerns me is the sheer amount. Sure, people get diarrhea. People get colds/the flu often and especially when travelling as much as skaters do in the winter. That being said, most US athletes cannot take common cold/flu medicines without a doctor's note due to USADA/WADA restrictions, which makes it more strange she took this many.

What is unusual is that any normal human being - especially an otherwise healthy teen - would need this many different meds for this sort of thing over the span of a few years. Usually you just do OTC cough drops, decongestants, and cough syrup/drops. Antivirals are very, very toxic and should only be given for severe infections or infections in those who are immunocompromised.

The only thing this would make sense with is them trying to get her healthy enough to train/compete while sick - and we've seen Eteri skaters have miraculous skates despite illness. Again, pushing them past healthy limits.


Vitamins aren't concerning, however supplements are not good for you. Aside from being unregulated (and therefore containing sketchy stuff that's gotten US athletes doping bans), there are some that are outright dangerous. For instance, I've seen L-Carnitine kill a grown man from liver failure. So while some are safe, not all are.

As an aside - high caffeine drinks are dangerous for people with heart problems. Shows they know they can't use the "she has a heart condition" excuse without further scrutiny - unless they really just care so little they'll clam that she does have a heart condition and they don't care if her heart stops from the caffeine.

Kreon is used for people with pancreatitis, pancreatectomies, exocrine pancreatic insufficiency, or other issues preventing the pancreas from releasing it's digestive enzymes into the intestines. Without it these patients have severe cramping, abdominal pain, and diarrhea. It must be taken with food. This is one that's puzzling to me because AFAIK she has none of these issues - and if she did she's probably be too sick to train or compete. It also has no clear benefit for her training. Unless they were trying to get the food to digest faster so she'd absorb less to maintain her weight?

As for these herbal liver supplements, they're junk. I care for a lot of patients with liver failure and not once have I seen any take any herbal supplements. In fact we discourage them because many herbal supplements are actually toxic to the liver.

Those two together do make me wonder if the combos of pain meds + exercise supplements (that can be hepatotoxic) + occasional antivirals + other medications were causing concerns for them about her liver/pancreas. Probably just lab value changes since she never looked sick, but concerns nonetheless.

Reglan is a commonly used anti-nausea medication. It's pretty strong and is typically indicated only for use in cancer patients. It also has a Black Box warning (a serious side effect warning) for causing a movement disorder that can cause swallowing/chewing difficulties with chronic use. The more common option for both in and outpatient use would be zofran, which is safer for almost everyone. Again, my criticism of this would be dependent on the availability of zofran, how often she used it, and why she was using it.


It seems like they don't know when backing off is good.

As I've pointed out, a lot of things could've been helped by backing off temporarily and rest. They obviously preferred pain meds to the careful rest and return to training that many US athletes use. The diarrhea/anti-infectious meds could've not been used if they just let her heal like a normal teen instead of pushing her to get through the illnesses to train. They used supplements that are dangerous normally, but at least one that is dangerous if she has a heart condition as they so seem to think considering the other meds.

(Side note: anemia isn't concerning per se - it could be; who knows. But it's somewhat common in young women, so again my criticism of that depends on details we don't have)

My only layperson addition is that I have Zofran for occasional nausea that is a side-effect of previous surgeries. Taking it a few times a month is fine but I don’t know about drug intersections. Reglan, my gastro doc says, is for gastroparesis (delayed stomach emptying) and is a lot more powerful with more side effects.

 

[MacMadame]

With the strictness of USADA and WADA, I wouldn’t be surprised if he didn’t take cold medicine or use cough drops.

Cough drops are made of sugars and maybe some essential oils like menthol. You'd have to be pretty paranoid not to use them.

I am an amateur athlete who is subject to drug testing by USADA so I am quite familiar with the code and what is and is not allowed and the cough drops you get at the drug store are fine.

This is an enormous amount of painkillers.

It would be if they were taken all at once. This is not a list of what she gets every day. It's what she got over several years so we have no idea if she was one of those athletes who pops analgesics and NSAIDs like they are candy or if she only uses them when she's injured.

This is true of all the stuff on this list. There is a lot of repetition there. For example, there are 3 listings for Amino Vital because there are slightly different formulas just like there are for Gatorade which is what it is equivalent too. There are multiple entries for calcium and magnesium too. That just means that they changed brands over time not that she takes 3 different kinds every day.

 

[AJ Skatefan]

I was going to say that she takes a lot of magnesium! No wonder she has diarrhea!