The Plot Thickens: As the blood thinners bring a double standard

I have zero interest in the olympics, and paid no attention to (actually did not hear about) Kamila Valieva’s positive drug test until discussion came up in a women’s group.

She took trimetazidine.  I heard about that drug around the time I was taking valsartan to lower my blood pressure.  For those with high blood pressure, it thins the blood and allows it to flow more easily in the body.  In athletes, that increased blood flow can increase how much oxygen enters the muscles, increasing athletic performance.  It’s a banned substance for that reason.

Valieva claims she “must have gotten it from a glass of water” that her grandfather was drinking from.  How much water was she drinking?  Five litres?  Or drinking a glass every day?  You don’t get a detectable amount in your system from a single passive drink.

According to the US’s NIH, the drug has a half life of six hours.  For it to be detectable in a drug test would mean she was taking it repeatedly over a long period of time or in a significant amount the day of the test.  From the link:

After oral administration, trimetazidine is rapidly absorbed from the intestinal tract, without significant effect of food on its bioavailability. The mean peak plasma concentration (Cmax) of the IR formulation was found to be 53.6 μg/L and was reached within 1.8 hours; the area under the plasma concentration–time curve (AUC0–∞) was 508.9 μg·L−1·h−1 after single and 831.4 μg·L−1·h−1 after multiple doses. Steady-state levels of trimetazidine are reached within 24 hours; it is biotransformed to a low extent into several metabolites only detectable in the urine. Trimetazidine is weakly bound to plasma proteins. Its elimination half-life is about 6 hours after single or repeated oral administration of IR tablets, with the majority of the drug excreted in the urine. In patients with renal impairment and in elderly people, the elimination half-life of trimetazidine increases, whereas the renal clearance decreases when compared with healthy young subjects.

Even if she didn’t know she was taking it, somebody was giving it to her.  That still makes her dirty and disqualified.

This, of course comes almost a year after Sha’Carri Richardson’s positive drug test for marijuana.  THC, the active substance in marijuana, is a depressant.  It decreases athletic performance and reaction times, something detrimental to sprinters which Richardson is.  So why was she disqualified?

Think back to the 1998 Nagano olympics.  Canadian snowboarder Ross Rebagliati (white) was first disqualified after testing positive for having THC in his system.  That disqualification was overturned because it was deemed “accidental inhalation” (are you kidding me?) and “did not improve performance”.  If it didn’t improve his, why did it improve Richardson’s?


  1. jenorafeuer says

    From what I recall of Rebagliati, he pretty much claimed that he hadn’t partaken personally, but some of his friends at a ‘good luck’ party thrown for him had, and he’d just been in the same room. Thing is, THC can stay in your bloodstream in detectable amounts for several days after exposure, and the amount seen in him was actually consistent with that claim, so he was given the benefit of the doubt.

    The double-standard is real, of course. Why are they even still testing for THC when it’s known to be so problematic at a detection level and has generally little effect on performance? Especially given it is now legal in many jurisdictions and thus accidental exposure is more likely? Heck, it would have been far more useful to Rebagliati than to Richardson; being relaxed (less likely to have a panic reaction) would be far better a thing in snowboarding than in sprinting.

    The answer to that is probably still some ‘Reefer Madness’ moral panic holdover.

  2. greenwing says

    That wasn’t the reason Rebagliati got to keep his medal.

    In February 1998, marijuana was banned by the International Ski Federation (FIS), but not by the IOC. Because Rebagliati violated the FIS’ drug ban, the IOC took his medal away from him. He appealed the decision to the Court of Arbitration for Sport, which ruled that because the competition was held by the IOC, and not the FIS, the IOC’s drug rules applied. Since marijuana was not on the IOC’s banned list, it couldn’t take away Rebagliati’s gold.

    The IOC put marijuana on its banned list within a year.