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TUEs and their use in sport

Dr Leon Creaney, a consultant in sport & exercise medicine, gives us his opinion on TUEs and their use in sport


A post shared by bradley wiggins (@bradley_wiggins_official) on Mar 1, 2014 at 1:39pm PST

The news that athletes such as Bradley Wiggins have been given Therapeutic Use Exemptions (TUES) for prohibited drugs to treat conditions such as asthma has gone viral after the data was released by Fancy Bears, a Russian group of hackers.

Dr Leon Creaney, Consultant in Sport & Exercise Medicine, gives us his opinion: 

“The recent revelations by Fancy Bears are, in my opinion, an attempt to create a story, where no real story exists; sour grapes that Russian systematic cheating has been exposed.

 “Athletes are allowed to take medications if they have a diagnosed medical condition, and the only medication that works just happens to be on the prohibited list.

 “To get a TUE you have to be objectively diagnosed (usually by two separate specialists) that you have the condition. This will usually involve clinical opinion, and the results of various tests. This information has to be submitted to the governing body of the sport, and for international competition, the international body, and for the Olympics, the IOC. It is a separate application each time.

 “So a British athlete would have to apply to UKAD/British Athletics, IAAF and the IOC for example.

 “In terms of the medication, they would have to prove that other medications have been tried already, and aren’t controlling the condition, and that the only medication that works, happens to be on the prohibited list.

 “The kind of medications that sports people get TUEs for (i.e. Insulin, Thyroxine, Triamcinolone which is a corticosteroid) are not particularly performance enhancing anyway, so it’s all legitimate as far as I’m concerned.

 “In particular asthma is a chronic inflammatory condition, and it tends to be exacerbated by hard training. So if you told athletes that they could only compete when they are symptom-free and off all medications, they would never compete!

Exercise-induced asthma explained

"Should athletes go public with their TUE’s? Not really, it’s not in the general public interest what diseases an athlete has. It’s private medical information." 

Dr Leon Creaney


Consultant in Sport & Exercise Medicine


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How can you realistically and logically argue that they are not performance enhancing when the it is plainly being argued that without that drug being prescribed they would not be able to compete - it follows that the drug MUST have performance enhancing qualities!

I have serious and grave concerns about TUEs and the argument that they simply 'level the playing field' - sorry, but that doesn't wash with me. If that is the case, then why shouldn't the women running against Caster Semanya permitted to supplement with testosterone, for example?


Tricky this one.

I've struggled over the last 2 years to complete the couch to 5K program. Each summer as the pollen levels rose, my hayfever kicked in and I was unable to complete 10minutes of running without gasping for breathe. Following a diagnosis of allergy induced asthma I have an an inhaler and it allows me to actually run in the same way as I can in the winter when there is no pollen. Is this levelling the playing field or, because it allows me to train in the summer, is it performance enhancing?

Now, I'm a completer not a competer so it doesn't make a lot of difference to the authorities, but to me it makes a huge difference. I'd like to understand more about the timings and frequency of some of these TUEs. One off's are not likely to make much of a difference, but regular injections of steroids might.

Having said that - I'm not giving up my inhaler for anyone, until I can cope without it.

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