Will using an asthma inhaler make you a better athlete? Some athletes believe the answer is yes — but science says no.
The asthma medications of interest in terms of performance are the bronchodilators (such as salbutamol, albuterol and formoterol), which open closed airways and relieve the symptoms of asthma, including shortness of breath and wheezing. However, some athletes obtain bronchodilators for off-label use, believing the medications will further relax the muscle linings of their healthy lungs and provide an advantage over other competitors.
Such logic is fallible, says Dr. Michael Koehle, a sports medicine researcher with the University of British Columbia. In a 2012 study performed by Koehle’s team, cyclists were given either salbutamol or a placebo inhaler before performing two 10-kilometer time trials. Though lung function did improve in the salbutamol group, it did not have any effect on time trial performance.
“Numerous studies from a variety of research groups (including ours) can show no definite advantage for these medications,” says Koehle. A 2011 review of 26 studies on asthma inhalers found that the medications did not improve “endurance, strength or sprint performance in healthy athletes.”
What’s more, the off-label use of bronchodilators can come as a cost — side effects such as tremor, palpitations, and jitteriness can derail an athlete’s training or racing efforts. Overuse of these medications in asthmatics may also, under certain circumstances, render them less effective when they are needed.
As inhalers are a delivery system that can be used for the administration of a variety of drugs, it is important for asthmatics utilizing an inhaler to check the status of their medication on the WADA Prohibited List. Some medications administered by inhaler are prohibited, some are not, and some are considered threshold medications on the WADA Prohibited list, which means they are allowed in certain quantities, but prohibited in excess of that quantity. If an athlete has a legitimate medical need to take a prohibited medication, a Therapeutic Use Exemption (TUE) may be requested, which, if granted, allows them to take the medication in a therapeutic dose.
“A substance or method will be considered for the WADA Prohibited list if it meets at least two of three criteria: It has the potential to enhance or enhances sport performance, it represents an actual or potential health risk to the athlete, and/or it violates the spirit of sport,” says Annie Skinner of the U.S. Anti-Doping Agency (USADA). The independent organization is responsible for managing the anti-doping program including testing, results management, education and scientific initiatives, for all U.S. athletes in Olympic, Paralympic, Pan American and ParaPan American sports, including USA Triathlon.
If an athlete has questions regarding the status of their medication they can check online at globaldro.com or call the USADA Drug Reference Line at (800) 233-0393.
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