Contador tests positive

Alberto Contador tests positive for clenbuterol - thoughts and conjecture

By now, most of you will have heard the news that greeted me as I woke this morning, that multiple Grand Tour champion Alberto Contador has tested positive for Clenbuterol during this year's Tour de France victory.  The reaction has been swift - Contador apparently heard of the result on the 24th of August, so one can assume the wheels have been turning furiously for both him and the anti-doping lab that detected the substance, and so it's no surprise that there are already many theories, discussions and possibilities around what has happened.

I haven't the time to delve too deeply into it right now, and besides, it would only repeat what is already out there.  So to save you some time in searches and your own reading, here are some of the more interesting pieces, that explain what might, or might not be going on:

Contador suspended and UCI statement

A report which contains the UCI's statement on the case, in which Contador is suspended pending further scientific investigation.  They release the level of clenbuterol in the sample as well, which is interesting only because it does give weight to the defence that is being put forward by Contador.

Food contamination: valid reason or overused excuse?

That defense, that the positive test is the result of contaminated food, is discussed in more detail in this article, which includes some quotes from Prof Don Catlin, one of the eminent anti-doping experts.  The interview with Catlin clearly took place before the UCI announced the level of clenbuterol in Contador's sample, because Catlin says "Without knowing what the level [of clenbuterol] in his sample is, it's impossible to say [whether or not food contamination is a viable explanation]".

I'd be interested to hear Catlin's views now that the level of 50pg/ml has been announced. 

Medical opinion on the concentration

There are other expert views on the level, however.  This report, prepared by Dr Douwe de Boer, contains a fairly systematic explanation of clenbuterol, what it does, how contamination might occur, gives a handful of examples of previous cases or reports of food contamination, and it mentions the specifics of Contador's case.

The report focuses very heavily on the concentration of clenbuterol in the urine in various cases.  For example, it is mentioned that cases of food poisoning which produce symptoms usually occur with a concentration of around 9 ng/ml, or 200 times greater than Contador's level.  The article also explains that WADA requires that its accredited-laboratories must be able to detect Clenbuterol at a level of 2ng/ml - this is referred to as the Minimum Required Performance Level (MRPL).

Contador's level was significantly lower than this, but before there's confusion, it's important to point out that clenbuterol is not a drug for which there is a detection level (or an LOD, Limit of Detection).  In other words, a "adverse analytical finding" (or positive test) is not declared only when the level reaches a value of say X.  If there is clenbuterol in the sample, then it's an adverse finding.

However, it's also mentioned that for some drugs - stimulants, narcotics and B-blockers - it is recommended that WADA labs do not report values below 10% of the MRPL.  Clenbuterol does not fall into those classes, and that's why the finding was reported despite falling well below that 10% level.

The implications of Contador's concentration, which is 40 times lower than the MRPL (not 400 as the UCI report is saying) are two-fold:  First, another laboratory might NOT have detected it, depending on how that laboratory compared to WADA's requirements for it to detect a given level of the drug.  And second, there's a question over whether any concentration should in fact constitute an adverse finding, or whether clenbuterol should be treated like those other drugs.  That would require the policies to be revisited, but would have resulted in Contador's test going unreported.  This says a great deal about the "grey areas" of doping control, but it's important in this particular case.

Contador's specific case details

The report by Dr de Boer goes on to describe when the positive tests occurred (on page 7 of the report).  Basically, Contador is tested on six consecutive days - July 19th to July 24th.  The tests on the 19th and 20th find no trace of clenbuterol.  On the 21st, the level is 50 pg/ml, it falls to 20 pg/ml on the 22nd, and then none is found on either the 23rd or 24th.  Based on these findings, and the half-life of clenbuterol, it is concluded that the clenbuterol was administered (either deliberately or via food) after the 20th.

Dr de Boer's ultimate conclusion is that the level is so low as to offer no performance enhancement, and fits with the explanation that contamination by the ingestion of meat is "extremely likely".  At this point, it's worth nothing that the report was commissioned by Andy Ramos, acting as Alberto Contador's attorney.  That doesn't discredit the argument, of course, but it's not entirely independent either - you can detect the bias as you read the report (we've had this debate over expert testimony before on this site!).  Ultimately, though, if the science is accurate, then the bias in how it is interpreted is largely irrelevant, and I don't know enough of the pharmacology to really dig into that aspect, unfortunately.

Some other thoughts - what is natural variation in clenbuterol?

The first thing that jumps out at me, as has been the case for most of the people spoken to, is the incredibly low concentration.  Another lab might have missed it altogether, while policy for some drugs is to not report if it's as low as this particular concentration.  Also, the positive test on the two middle days of a streak of six consecutive days supports the contamination explanation, though it wouldn't be the first time an athlete has tested positive once only.

Then there's the impact it would have on performance - almost none, and given how advanced doping practices are, it seems a foolish risk to take this particular substance (it wouldn't be the first time of course).  Also, there are better drugs for the same theoretical effect.

I think what would be most instructive in resolving this particular case is a massive research study (I'm thinking hypothetically here) in which hundreds of people (who eat meat) are tracked over many weeks, and their clenbuterol levels are monitored daily.

Obviously, clenbuterol is not supposed to be the urine - that's why the presence of even tiny amounts is marked as an adverse analytical finding.  It's not like other hormones that are produced endogenously and therefore are present.  But the point here is that if food contamination is a viable excuse (and based on the report, it has happened before, to the point of poisoning), then one would need to establish a safe baseline.  Perhaps every single person's clenbuterol levels do 'spike' by 0.05 to 0.5 pg/nl when they eat meat from certain areas, because of farming practices?  That's only really possible to know if you measure it and obtain some kind of "benchmark". 

The reverse approach, of course, is to ask what kind of concentration would be expected if an athlete does ingest a tablet?  Let's say Contador did take a tablet after the July 20th test.  What would have to happen in order to return a concentration of 50 pg/nl?  How much clenbuterol would that tablet contain?  Is it possible to 'hide' the ingestion of a larger amount through dilution/diuretics?  Would the level fall away to zero in only two days if a tablet was the source?

The transfusion possibility

The final possibility, which I'm adding to this post based on discussion below, is that the clenbuterol was taken many months ago (for either weight loss or to increase lean mass), then Contador's blood was drawn, frozen, and the clenbuterol found its way into Contador's body during the Tour as a result of the re-infusion of that stored blood.  This is what many alleged happened in the case of Landis and the testosterone.  It's certainly possible.  There are some questions, however.  One is whether clenbuterol 'survives' in stored, frozen blood for months.  Let's say Contador takes a significantly larger dose in the build-up to the Tour, and then extracts that blood.  What fraction of the drug would be expected to remain before it is re-infused, presumably on July 20th or July 21st?

And related to this, how much blood would be re-infused - Landis' allegations confirmed the notion of micro-doping, and so it's possible that very small infusion volumes to avoid detection would also produce a very small increase in clenbuterol detected in the urine.  Of course, if clenbuterol does NOT last in frozen blood, this argument is irrelevant - that's something for pharmacology to answer.  If it does persist, then what concentration of clenbuterol and what volume of infused blood would be required in order to produce this positive test at the concentration measured? 

The transfusion explanation is certainly looking more and more likely, at least as the main counter-argument to the contaminated food theory.  It will be interesting to know whether biological passport data was collected, and whether there is any indication of 'altered' profile on the dates in question - I am sure many will remember that Lance Armstrong's blood data from the 2009 inspired much debate because there was evidence (not proof) of unusual changes.  The same kind of change in Contador's samples would tilt the argument heavily towards the transfusion explanation.

What happens next is the "further scientific investigations" by the UCI.  I'm not sure what that entails either - perhaps they obtain their own expert counsel to produce a report similar to that written by Dr de Boer.  If those reports agree, then Contador's excuse looks valid and cycling's ability to enforce positive tests is again undermined.  If the reports differ, then cycling's current champion joins the army of previous champions consigned to the "doper" pile, which would drive another stake through the sport.  I'm not sure how either party can offer "proof" of anything in a case like this, but perhaps pharmacology holds the answer.   Time will tell...your thoughts are welcome!

Ross

Live now - 5th Avenue Mile coverage

Fifth Avenue mile live coverage - Live Now!

As mentioned by Jonathan in yesterday's post, we're carrying a live feed from the Fifth Avenue Mile in New York City.  The men's race in particular should be a great race, with some big names including Bernard Lagat, Leo Manzano, Amine Laalou and a returning Nick Willis and Alan Webb featuring.

The race is live below - coverage is well underway, but the elite races get going at 18h50 SA Time, in just on 90 minutes from now.  If you are getting this message in your inbox, you've got literally 5 minutes until the men's race gets going, so check out the footage, courtesy the NYRR.

nyrr on livestream.com. Broadcast Live Free

Ross

Berlin Marathon splits live

Makau wins Berlin over Mutai, Kebede dominates

The 2010 Real Berlin Marathon produced a great men's race, and a dominant women's performance to kick off the fall marathon season.

Men's race - Makau over Mutai...again

On the men's side, it was a repeat of the Rotterdam Marathon, as Patrick Makau dueled with Geoffrey Mutai over the final 10km, and edged him by 2 seconds (it was 7 seconds in Rotterdam).  The winning time of 2:05:08 was just outside the Rotterdam performance, but it was hampered by very wet conditions on the streets of Berlin, and some erratic pace-making from one kilometer to the next - that may have been gusty conditions, it may have been puddles on the roads...

Nevertheless, it produced an enthralling race, which settled at about 15km, when it became clear that the world record was not going to fall.  The race opened up at 30km, and it was Ethiopia's Bizu Worku who did much of the early work.  He was rewarded for his efforts with a third placed finish and a PB, and at just 20, he's a name to look out for in the future.

However, today it was the two established names of Makau and Mutai.  Makau made the big decisive move at 40km, pushing through a 2:51 kilometer to shake Worku's resistance.  Then it was down to two, and in the end, with 200m to go, Makau had enough to see off Mutai.  There was no Martin Lel-like kick for the line, just a high sustained pace which Mutai was unable to follow.  Makau then, has run and won two major marathons, both in around 2:05, and he is now right up there as one of the great marathon racers.

As is typical, a lot of talk after the race about what might have been in better conditions.  It's a pity there is such a pre-occupation about time, though given Berlin's history, that's to be expected.  It was great to see a race in Berlin this year.

The race splits are below

 

Women's race - Kebede dominant 

On the women's side, it was Aberu Kebede who dominated the race.  After a very slow opening 5km (18:03), she threw down the gauntlet with a suicidal 3:08 kilometer (I must admit some skepticism about the accuracy of that time).  Only Bekele and Getaneh were able to to follow the pace, which soon settled at around 3:25 per kilometer.  That pace eventually saw Bekele and Getaneh dropped, and Kebede ran most of the final 15km all by herself.

Having been locked together with her country-women at 25km, her lead grew enormously from that point.  At 30km, her lead was 32 seconds.  At 35km, it was 1:03.  40km, she had 1:13, and that increase in the lead was testament to her dominance on the day.  And it wasn't as though she shifted into a higher speed - she kept producing 16:40-something 5km, the others dropped below 17 minute/5km pace.

Her winning time of 2:23:58 is a PB, just outside the best in the world this year, but given the slow first 5km, and the conditions, it's a great performance.  Bezunesh Bekele held on for second, while Ganet Getaneh fell backwards progressively and dropped out before 40km.  Third was eventually taken by Tomo Morimoto, just ahead of local favourite Sabrina Mockenhaupt, giving the locals something to cheer at the end.

Next up in the marathon season, Chicago, which should be a terrific (and fast) race!

But, before that, don't forget the 5th Avenue Mile later today.  The elite race starts at 12h50 ET, or 6h50 if you're in South Africa (CAT).  And we'll have a live feed of that race here on the site, so check in later and be sure to catch what should be a great spectacle from the streets of New York!

Thanks for joining our Berlin coverage!

Ross

Race commentary

For those interested, below are comments from the race, as I watched live.

Welcome to the live splits from the Berlin Marathon.  The race is underway in a misty, wet Berlin, and the next two hours should throw up some fascinating racing, with the possibility of a world record for the men.

We'll bring you the 5km splits, projected times and updated reports as it unfolds, so join us for an evolving story/post!

Men's Race

After a "conservative" first 5km, the pace shifted up substantially from 5km to 10km, and by 10km the projected time was below Gebrselassie's world record.  However, the pace has been erratic - 2:54 followed by 3:05, followed by 2:55 again, and that may be attributable to the conditions with very wet roads.  It may also be down to mistakes on the course measurements - the 19th kilometer was reported to be a 2:34/km, which is almost inconceivable.  Hopefully the 5km times are accurate!

The pace for the 13th and 14th kilometers has slowed significantly - both were outside 3:05.  That may be the weather - the course is very wet and perhaps the puddles are affecting the pace.  In any event, the record pace has drifted below the current tempo, and another shift would be required to bring it back.

At halfway, the split is 62:36, which is quite considerably outside world record pace, and the requested pace for today (which was 62 minutes), and perhaps it's time to call of expectations of a world record and focus rather on the race.  There are currently eight elite men in the lead group, surrounded still by about four pace-makers.  All the big names are still there - Makau, Kiptanui, Mutai.

At 25km, the pace has now seemingly settled at around 3:00/km, which means a good race is on the cards from about 30km, when the last of the pacemakers should step aside.   The elite group is down to seven - Bernard Kipyego is now 8 seconds down from the leaders.  It's building towards a fascinating battle over the final 10km.

At 30km, the race has finally taken its shape - Bazu Worku of Ethiopia led at 30km, after a very quick last 5km - 14:42, 2:56/km.  That pace shook all but three other men - a pacemaker, and then Geoffrey Mutai and Patrick Makau, the big favourites from Kenya, who are in familiar territory after their race in Rotterdam earlier this year.  The rest of the elite field are almost 20 seconds behind, and include Eliud Kiptanui.

Unfortunately, the weather has affected more than just the pace, it's also preventing us from getting continued footage of the elites, and we're watching a lot of 3-hour runners at the moment.  So those of you who are struggling to get the internet footage, don't worry - you're not missing too much.  I'm watching the feed and the splits are still the most informative source of information, which doesn't say much!

The men's race is still in the balance at 35km.  The pace has remained strong - under 3:00/km, and it's Worku who is doing much of the work.  It would be a major surprise if he is able to beat BOTH of the favoured Kenyans, and Makau and Mutai are still looking comfortable in second and third.  Makau has awesome half-marathon credentials, and has won in Berlin over that distance, so he'll favour his local knowledge and is probably the favourite, based on Rotterdam this year.  Anything could still happen...

38km, and the Kenyans have gone to the front.  Makau moved past Worku and threw in a small surge, but it hasn't done any damage at all to Worku, and still the three are locked together.  It wasn't an aggressive move, more just a change in leadership.  With just over ten minutes to run, something must surely give within the next five minutes.  The pace isn't too quick - 3:01 for the 38th kilometer, so it's become a little cagey.

39km - and Worku is once again pushing on at the front.  The pace hasn't increased - another 3:01 for the 39th kilometer, so it's more attritional than explosive.

40km, and the last 5km have been run in 14:56, which is not that quick.  At exactly 40km, Makau made a big move, and that move did finally shake Worku in third.  Mutai has responded, and so it's down to the big two Kenyans, a rerun of Rotterdam.  With 2km to go, they're locked together and this could be a fabulous final few hundred meters!  And we get to watch the women's race, now, of all times...having not seen it for 45 minutes, they cut to what is actually a boring race, at the expense of a duel to the finish line...

41km, and no change, with Mutai leading Makau.  Worku is about ten seconds behind.  2:52 for the 41st kilomter, and that was Makau's decisive move as they hit the 40km timing mat.  They might come close to 2:05 here...

Very aggressive running by Mutai at the front now, he's pressing very hard with 400m to run.  Under the Brandenburg gate and locked together - a great race in Berlin.  Makau hits the front now and is this the winning kick?  They're still looking at each other...no Lel-like kick from these two!

200m to go, and now Makau sprints, and Mutai will NOT respond!  It's going to be Rotterdam again, Makau wins by 2 seconds and Mutai is second, just as in Holland earlier this year!  Great race!  The winning time 2:05:08, a great time in the conditions, with a superb finish!

Bazu Work is third, in a big PB, but it's Kenya's day.  The women's race will provide consolation for Ethiopia...

Women's race

The women's race only got going at 5km, after a very slow first 5km.  Then the pace exploded - a 3:08 kilometer, which is suicidal in the marathon, followed by a series of 3:30 kilometers.  The pace is now projecting a mid 2:20, which will be good going in the conditions. Three Ethiopians are in the lead - Kebede (who set the pace for that super-fast surge), Getaneh and pre-race favourite Bezunesh Bekele.

The pace has held for the third interval, and is now projecting a 2:25.  That projection is based on some very up and down pacing, with that very slow first 5km.  More likely, we're looking at a time in the range of 2:23.

At 20km, the time is 68:37, with a subsequent halfway split of 72:20.  The race is still being led by the three Ethiopians, and should develop into an intriguing battle over the final 15km.

A major development in the women's race at 30km - the consistent pace of high 16 per 5km has shed Bekele and Getaneh, and now Aberu Kebede is all alone at the front of the race.  Her lead is 30 seconds, and she's on course for a mid 2:23 time.  We've seen absolutely none of the race in the last 30 minutes, so if I could tell you where the gap was created, I would.  In any event, she has established what should be a decisive lead, because the others have slowed, rather than Kebede speeding up.  That suggests that she'll hold that lead to the finish.

2010 Real Berlin Marathon and 5th Ave Mile

Watch them live on the web

We are sorry to say we missed doing a preview for this year's Berlin Marathon, but personal and work commitments have silenced us recently.  Ross's work at the canoeing world champs in Poland left him in a hole back in Cape Town during his absence, out of which he has been digging himself.  On the other side of the pond the academic year has hit Jonathan with full force and coincided with the birth of their second child (another boy).  So just trying to find time for a post here or there has suddenly become a real issue!

But the preview for Berlin could have been summed up in short order---No Geb, and three (two of them young) Kenyans looking to show the running world they are not "one-hit" wonders.  All three contenders have run sub-2:05, and so on paper it has the potential to be a fast race (and not a time trial as we have seen the past four years).  The one with perhaps the most to prove is Sammy Korir, whom many of you might recognize as Paul Tergat's pacemaker in 2003 who nearly stole the show.  He lost to Tergat by one second but became the second runner to break 2:05 for the distance.  However before that race and since then he has managed to run "only" in the 2:08-2:10 range.

Of the other two, Patrick Makau ran 2:04:48 earlier this year in Rotterdam, where Geoffrey Mutai finished second to him only seven seconds back.  

The race starts at 8:30 AM in Berlin, so by the time many of you read this the results will already be up, but the good news is that no matter where you are in the world, you can catch it live on the web here.  It is a refreshing break from many other events that limit viewing to a specific locale.

And speaking of viewing races live on the web, the NYRR is permitting people like us and others to stream the event live on their site.  This is excellent forward thinking because it can only increase the exposure and help the sport.  The action starts early (9:00 AM Eastern time), but there is a full schedule of races in including age group races for the entire morning followed by the professionals toeing the line at 12:50 (Women) and 1:05 (Men) Eastern time.

So check the video for the 5th Avenue Mile below and the Berlin Marathon for a nice Sunday of racing action.  The mile race is filled with solid competitors, some of whom have much to prove (Alan Webb), with  others looking to maintain their notoriety (Bernard Lagat) while others trying to build on Beijing success (Nick Willis).  Don't forget to follow us on Twitter for live updates and for an alert on when we post our Berlin analysis!

5th Avenue Mile - LIVE stream starts at 9:00 AM Eastern

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Jonathan and Ross