UK Athletics are facing serious questions over their alleged willingness to use thyroid medication on distance runners after several elite athletes raised concerns to Sportsmail.
The beleaguered governing body — who are at risk of cuts to their £27million public funding following the embarrassing removal of Zara Hyde Peters before she could take up the chief executive role — have alarmed athletes by encouraging them to be screened for thyroid problems.
Medication for hypothyroidism, such as L-thyroxine and Cynomel, has been shown to aid weight loss and recovery between sessions, enabling athletes to train harder.
Alberto Salazar was banned for four years by the US Anti-Doping Agency (USADA) in October
‘Thyroid medication should be banned in athletics unless you have a genuine medical need,’ says Jo Pavey, seen in action during the womens 5000 metres final in Birmingham, 2010
That has led to suspicions in the sport that it is being used as a legal performance enhancer and provoked renewed pleas for it to be banned.
KEY PLAYERS: DR NOEL POLLOCK
Dr Noel Pollock with British hurdler Perri Shakes Drayton
Appointed chief medical officer for UK Athletics in 2016, having worked at UKA as a doctor since 2006. He also provides consultancy work at numerous hospitals and clinics. Pollock, pictured with 400m hurdler Perri Shakes-Drayton, was a successful amateur athlete, competing in the 1500m and 5,000m and winning international honours for Northern Ireland. There is no suggestion Shakes-Drayton has ever been advised to take thyroid medication.
Neither drug appears on the World Anti-Doping Agency’s banned list, despite calls in 2015 from UK Anti-Doping and United States Anti-Doping for it to be included, and athletes are permitted to take it without applying for Therapeutic Use Exemption (TUE) certificates.
But Great Britain athletes past and present have shared concerns with Sportsmail about UK Athletics’ attitude to thyroid medication going back years.
They expressed the suspicion that thyroid treatments have been targeted by UK Athletics and possibly used by current British athletes as a way of obtaining a marginal gain.
UKA denied any wrongdoing last night and insisted they only ever screen for thyroid issues, among a host of other medical tests, as a health precaution or recommended treatment when medically necessary.
One GB star and the coach of another have told Sportsmail that UKA’s senior medical staff specifically suggested within the past five years that they undertake screening for thyroid problems, which they declined.
A third was tested shortly after a race but dismissed the suggestion of a team doctor to visit their GP to discuss an apparent anomaly related to their thyroid level. In that case the athlete said they were so ‘disappointed and angered’ by the doctor apparently promoting thyroid medication that they arranged another screening, the results of which indicated that drugs were not required.
Barry Fudge of the Great Britain & Northern Ireland Athletics team poses in September
Head of endurance at UKA, after previous roles as the body’s head of science and senior physiologist. Mo Farah described him as his ‘right-hand man’ but the pair stopped working together in 2017 after a fall-out. Until then Fudge had been increasing his level of control over Farah’s training. Position called into question due to involvement with Salazar.
In another episode relayed to Sportsmail, an athlete is understood to have tested negative for thyroid problems and then been told to do another training session before taking a second test. Fatigue can influence thyroid levels, leading to the suspicion among athletes that UK Athletics were hoping for positive results.
When this was put to UKA, they said they attempt to do all blood tests when athletes are rested but cited it isn’t ‘always possible’, and that if there is a doubt about the reliability of a test, they repeat it. They added they ‘rarely if ever’ test after competition, though that is contradicted by the claim of one of the athletes who spoke to Sportsmail.
UKA, who say they developed guidelines in this area in 2014, would not disclose how many British athletes have competed while taking thyroid medication, nor if any current Great Britain athletes are, but said the numbers requiring medication are in line with the general population. Speaking to Sportsmail, Dr Adrian Heald, a consultant endocrinologist, estimated the prevalence of hypothyroidism at one in 20 for women and one in 100 for men.
Questions are now being asked once more over whether thyroid medication should be added to WADA’s banned list. Multiple international medallist Jo Pavey told Sportsmail: ‘Thyroid medica-tion should be banned in athletics unless you have a genuine medical need for which you have a Therapeutic Use Exemption.
Team GB Team Leader Neil Black poses during Rio Olympics announcement
Performance director of UKA from 2012 to 2019. He appointed Alberto Salazar to work as a consultant at UKA in 2013 and gave his full backing to Salazar in 2015, despite numerous allegations that the coach had violated anti-doping laws. Left his role last month following fierce criticism over his handling of the scandal and after Britain’s poor return at the World Championships.
‘It is really important that athletes are not tested when they have done a hard workout, which could possibly influence the results, and that it is done under proper conditions. It is a really un-fortunate situation because I believe many athletes out there are taking it unethically, purely for performance benefits rather than for their health.’
The athletes who have spoken to Sportsmail said suggestions about thyroid treatments were made by Dr Robert Chakraverty, who was the UKA chief medical officer between January 2013 and September 2016, and is currently the lead doctor for the England football team, as well as Dr Noel Pollock, who has been at UKA since 2008 and was appointed as Dr Chakraverty’s replacement in 2016.
Chakraverty admitted in 2017 that he had failed to properly record an injection of L-carnitine – a legal supplement – given to Sir Mo Farah to ‘help performance’ before the 2014 London Marathon. When asked via the FA about thyroid screening, Chakraverty de-clined to comment.
A spokesperson for UKA, where Dr Pollock is chief medical officer, said: ‘British Athletics always apply the highest standards to medical practice. Thyroxine is only ever prescribed when treating hypothyroidism and we have worked closely with the EIS (English Institute of Sport), UK Anti-Doping and the British Thyroid Association to ensure good clinical governance processes.
Alberto Salazar, athletics coach with Mo Farah in 2013
Mo Farah’s head coach between 2011 and 2017. He ran the Nike Oregon Project before its closure this year. Last month he was banned from athletics for four years over doping violations following a four-year investigation by US Anti-Doping. Three weeks ago one of his former athletes, Mary Cain, claimed his fixation with weight loss led to her body breaking down and suicidal thoughts. Salazar’s former assistant Steve Magness confirmed this account, saying: ‘I’ve witnessed the harm and damage that such a culture creates.’
‘British Athletics continues to discuss its approach in this area with other medical colleagues including within the EIS and with Endocrine specialists to ensure maintenance of these high standards.’
The concerns of the athletes about the ethics of marginal gains through legal drugs comes in a week when UKA have announced the commencement of their review into the 2015 decision to allow Sir Mo Farah to continue working with Alberto Salazar.
That controversial green light came despite the televised broadcast of serious anti-doping alle-gations against the now-disgraced coach, who for a time from 2013 worked as a consultant to UK Athletics, with current head of endurance Barry Fudge operating as his main point of contact.
There is no suggestion of wrongdoing by Fudge.
In the USADA investigation into Salazar and his endocrinologist Dr Jeffrey Brown – both of whom were banned for four years for anti- doping violations in October – it was alleged that the encouragement of thyroid treatments were a common part of the Nike Oregon Project operation.
The arbitration panel noted: ‘Usada also alleged that Respondent [Brown] was complicit with Salazar in prescribing excessive and dangerous levels of prescription vitamin D and thyroid medicines to NOP athletes, hoping these prescriptions would increase testosterone levels.’
DR ROB CHAKRAVERTY
UKA’s chief medical officer between 2013 and 2016, before leaving to take up his current role as the England football team’s doctor.
England team doctor Rob Chakraverty during a training session last year
He admitted not recording the dosage of L-carnitine which he gave to Mo Farah ahead of the 2014 London Marathon after being named in the DCMS select committee’s report on doping in sport.
Chakraverty also works as a lower-back injuries specialist at the Royal Orthopaedic Hospital in Birmingham.
Travis Tygart, who led the USADA investigation, revealed last month that one former NOP athlete has to stay on thyroxanol [a thyroid drug] for the rest of their life because they were put on it incorrectly and it altered their thyroid system.
The worry, articulated by numerous British athletes and coaches, is that some of Salazar’s legal yet questionable practices may have been adopted in this country. In October, when asked directly by Sportsmail if he was aware of thyroid medication being used by British athletes without medical necessity, former UKA performance director Neil Black insisted they had not.
Black, who had once backed Salazar as a ‘genius’ and left his post in October in the wake of the scandal, said at the time: ‘To the best of my knowledge no British athlete has ever taken thyroid medication when it wasn’t required.’
In warning of the potential health implications of an athlete taking unnecessary medication, former European indoor gold medallist Matthew Yates told Sportsmail: ‘My deep concern is the long-term danger to the health and well-being of the athletes. I have a huge concern that this isn’t being discussed and disclosed with athletes and coaches in depth, about the ramifications of using this medication on a punt for short-term performance.
‘Those being performances that ultimately keep people, who are not the athletes, in well-paid jobs. It is only a tiny minority of athletes who are using thyroid treatments to aid performance.
‘What I would say is this drug should have a TUE as a minimum and WADA and UKAD should push for that. I believe the protection of health and wellbeing of the athletes should be a priority over anything else in sport. It seems that it is being neglected in the pursuit of medals.’
European indoor gold medallist Matthew Yates, pictured in February 1992, told Sportsmail: ‘My deep concern is the long-term danger to the health nd well-being of the athletes’
Dr Adrian Heald consultant endocrinologist at Salford Royal Hospital: ‘Unnecessary treatment can lead to serious heart issues’
In the condition hypothyroidism, the thyroid gland does not make the necessary thyroid hormone for the body, which can lead to weight gain and other symptoms.
Hypothyroidism tends to impact women more than men. The figures suggest around one in 20 women are affected by it and one in 100 men. All of these people need hormone replacement.
The treatment of hypothyroidism is straightforward and we have safe medication, usually L-thyroxine in the UK.
Untreated, a person can become very unwell and die.
We all need thyroid hormones to maintain basic metabolic processes, to have enough energy to get through the day and maintain a normal sleep pattern.
Hypothyroidism is not as tricky to manage as other hormonal conditions. An athlete with hypothyroidism, for example, would be able to compete at the highest level if they had L-thyroxine treatment, because the medication would simply be replenishing what they need.
If hormone treatment was given when it was unnecessary, or if excess hormone was given to an athlete, the main concern would be the heart being over-driven.
In the short to medium term, that could lead to a rapid heartbeat and perhaps even an irregular heartbeat called a cardiac dysrhythmia. In the longer term, the person may develop cardiomyopathy, which is an enlargement of the heart muscle and is a very serious, potentially life-threatening condition.
No endocrinologist would recommend that someone takes more thyroid hormone than they need or that a person takes L-thryroxine if they don’t need it.