Photo: Petra Kvitova of the Czech Republic hits a forehand on day seven of the 2016 U.S. Open . She is among several athletes who say they have asthma. Credit: Reuters
The suspected Russian hack of the medical records of several dozen Olympic athletes this week revealed no wrong-doing or illegal doping activity, but it did reveal one controversial fact: a lot of athletes say they have asthma.
That's because this claim of exercise-induced asthma allows athletes to obtain a special "therapeutic use exemption" or TUE from international sporting agencies, such as the International Olympic Committee.
Some athletes do have asthma and are taking medications to return to normal. For others, it's a case of taking a legal advantage to obtain drugs that others are already using.
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The release of information held by the World Anti-Doping Agency by hackers this week showed that Olympic and Tour de France cyclists like Bradley Wiggins and Chris Froome have TUEs for asthma, as well as Czech tennis player Petra Kvitova and German discus champ Robert Harting. They were among the 29 athletes' medical records released in the data dump.
Asthma drugs, such as albuterol, when taken in a mist through an inhaler, open the lung's airways and allow a greater amount of oxygen into the body.
"At some point in time, the notion took hold that asthma medicines could increase oxygen uptake, although the research shows that's not always the case," said Mark Johnson, a San Diego-based journalist and author of the recent book " Spitting in the Soup: Inside the Dirty Game of Doping In Sports ."
"So a lot of athletes started asking for use exemptions. That is what Russia is trying to indicate that they are not alone," Johnson said. "That other countries are using other methods to get away with doping."
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The idea that asthma inhalers could boost performance skyrocketed to the point that the starting lines of some amateur triathlons became littered with empty inhaler bottles.
Still, research shows that the medication doesn't always give the athlete a measurable performance edge. That's one reason why WADA took some asthma drugs off the prohibited list in 2012 and allowed athletes simply to declare that they needed them, rather than asking for a TUE.
Don McKenzie, an exercise physiologist at the University of British Columbia and expert in the field, says that inhalers give you a slight increased in lung function. "Does it influence performance? Probably not," McKenzie said. "The respiratory system is not the limiting feature. It's the oxygen transport."
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The blood stream may not be able to make use of that extra oxygen, McKenzie said.
It could be that athletes are using them receive the so-called "placebo effect" or increase in performance because they believe they are getting some kind of medical advantage, even if they are not.
There's another twist to the asthma-in-athletes story, McKenzie said. Some forms of oral albuterol, if taken in a large enough doses, do increase muscle performance and have side effects that include death. That's why anti-doping authorities still test for the drug.
"The issue is can you take enough in your inhaler to make a difference," McKenzie said. "If you go above 100 micrograms per liter, than you will get a sanction."