March 24, 2015
Sunday’s Sunday Times in the UK had two articles that detailed the extent that Nike Oregon Project coach Alberto Salazar and his team will go to to get their athletes an edge, focusing on the use of the legal supplement L-carnitine, including allegedly injecting assistant coach Steve Magness with L-carnitine and using him as a “guinea pig.” The articles, which are here and here, are behind a paywall (only cost £1 to read for the first month) but well worth the read. We summarize the key points and break them down below into good news and bad news for the Nike Oregon Project.
First, the facts alleged in the article.
- Alberto Salazar, in two shipments 14 months apart (January 2011 and March 2012), ordered 180 cartons at a cost of £3,600 ($5,380 at today’s exchange rate) of a perfectly legal supplement NutraMet Sport, a mixture of L-carnitine and carbohydrate, that “scientists found can boost performance by up to 11%.”
- Galen Rupp and Mo Farah admit to taking L-carnitine in the past but both said they stopped taking it, in Farah’s case because it wasn’t effective. Farah said, “I tried a legal energy drink containing L-carnitine but saw no benefit and actually gained weight so I stopped drinking it.”
- Studies show L-carnitine can be much more effective when injected than when taken orally. Orally, L-carnitine can improve performance in three to six months, but according to the Sunday Times it can improve performance in “as little as five hours when the substance is taken into the body via an intravenous drip.”
- Alberto Salazar wanted to try L-carnitine injections and emailed USADA in December 2011 saying, “I’d like to try this test on a few of my elite athletes.”
- Dr. Jeffrey Brown, an advisor to the Nike Oregon Project (most famous for being an expert on thyroid medication) “said he had carried out experiments involving L-carnitine injections with permission from the US Anti-Doping Agency (USADA).”
- USADA said, “USADA did not give anybody approval to conduct experiments on athletes. USADA’s response to any inquiry about injections would be to point the individual to the WADA rules.”
- Former Nike Oregon Project coach Steve Magness was used as a “guinea pig” for the L-carnitine injections and “was given three injections of L-carnitine over two hours to see whether a performance uplift could be secured within hours rather than months….After the injections, Magness is understood to have taken part in five days of treadmill tests. His performance had improved by 8-9%.”
The Good News for the Nike Oregon Project
L-carnitine is a perfectly legal supplement when ingested. If a perfectly legal supplement could boost performance 11%, then a coach would not be doing his duty if he did not make his athletes aware of it.
According to the Sunday Times, Alberto Salazar emailed USADA “seeking USADA advice” on having his athletes injecting it. Those actions are consistent with a coach trying to do everything possible to enhance his athletes’ performance while not violating anti-doping rules.
The contention that Galen Rupp and Mo Farah stopped taking L-carnitine — at least in the liquid form — is believable as well. According to the Sunday Times, Salazar ordered the L-carnitine supplement NutraMet Sport in two shipments 14 months apart (the founder of the company details his orders from Alberto Salazar), which does imply that they found it effective enough to reorder. But the fact NutraMet Sport is not made anymore gives credence that it is not that effective at boosting performance or there are better variations of L-carnitine elsewhere. If it boosted performance by 11%, athletes would be clamoring for it. If it could be proven to improve running performance by 1%, athletes would be clamoring for it. (A 1% improvement in the 10k world record would lower it nearly 16 seconds, and would lower the world record in the marathon by 1 minute and 13 seconds).
The Bad News for the Nike Oregon Project – Salazar has said, “None of our athletes are on any sports-specific supplement other than beta alanine, which is an amino acid. Other than that, it’s iron, vitamin D and that’s it. You don’t really need anything else.”
While no prohibited substances have been shown to be taken, injecting L-carnitine crosses many people’s ethical boundary of what should be acceptable in sport.
First, the rules. This WADA Document says, “Intravenous (IV) infusions have been included on the WADA List of Prohibited Substances…since 2005.” However that is a bit misleading, as the technical anti-doping rule says, “Intravenous infusions and/or injections of more than 50 mL per 6 hour period are prohibited except for those legitimately received in the course of hospital admissions or clinical investigations.”
Athletes can inject legal substances all they want as long as they keep it under 50ml per six-hour period. You could take 50ml (1.6 ounces) in six hours and take another 50ml the next six hours. Technically legal. Now it’s hard to figure out how much L-carnitine someone would inject per six-hour period but looking at bodybuilding/steroid forums and a horse site, we think it would be under 50ml if you injected nothing else (we’d like a doctor to email us because 1.6 ounces of anything seems very small).1
Coach Salazar appears to know that there seems to be nothing prima facie against the rules about injecting less than 50ml of L-carnitine. Thus, when according to the Sunday Times he wrote his athletes saying “When asked (by drug testers) about an [intravenous] infusion, you are to say no. L-carnitine and iron in the way we have it done is classified (technically) as an injection. So no TUEs [therapeutic use exemptions] and no declaration needed, not online and not when asked about infusions when getting drug tested in or out of competition,” he was not instructing them to lie as a message board headline said (that we linked to on our homepage). He was telling them to follow the letter of USADA rules. Under normal circumstances, our reading of the rules is that an infusion of something less than 50ml, even via a drip, is not technically an infusion that needs to be reported to USADA. (At the Olympics and other events, “there are specific no-needle policies requiring declarations of all injections/infusions”).
Where Salazar further gives his detractors ammunition is he has in the past tried to give the impression that very few supplements are needed to run well. At Worlds in 2013, he told The Telegaph, “We don’t take that much stuff and everything that Mo takes is from UK Athletics. None of our athletes are on any sports-specific supplement other than beta alanine, which is an amino acid. Other than that, it’s iron, vitamin D and that’s it. You don’t really need anything else.”
Salazar’s statement is in great conflict with his actions — a coach who orders £3,600 of a new supplement and wants to test it via injection on his assistant coach does not give the impression of “you don’t really need anything else.”
Another interesting point here is the timing of Salazar’s orders of L-carnitine. Salazar’s first order of L-carnitine was, according to the Sunday Times, in January 2011. The study that praised L-carnitine’s performance enhancing qualities was published a month later in the February 2011 Journal of Physiology and
was not published online until February 18, 2011. (update: a message board poster notes it was published online on January 4, 2011). That leaves three possibilities: a) The study was circulating around before it was officially published 2) The hard copy was released before February 2011 or 3) Alberto knew about L-carnitine from some other source.
All three scenarios do not support a coach who believes “you don’t really need anything else” to be the best. Salazar was very much on the cutting edge to the potential benefits of the supplement — placing a massive order before it was even published online.
As for Alberto possibly ordering L-carnitine before he read the Journal of Physiology study, there is the interesting comment in the Sunday Times from former NOP therapist Allan Kupczak, who “claims Salazar told him how he had been alerted to a legal L-carnitine supplement that was claimed to have significantly improved the performance of a prominent British cyclist.”
There has been speculation for a while now that Farah, Rupp, and British Tour de France winner Brad Wiggins took the same supplement as evidenced by these posts here and here on the LRC forums. Was L-carnitine this “super drug” people had heard about? If Salazar heard about L-carnitine from the Brits, that might support his contention that “everything that Mo takes is from UK Athletics.” (However, it’s worth noting that the Nike Oregon Project started taking L-carnitine a year before Wiggins won the 2012 Tour de France)
Dr. Brown Connection
Then there is the connection to thyroid doctor, Dr. Jeffrey Brown, who admits to the Sunday Times to carrying out experiments involving L-carnitine injections. Many of Salazar’s athletes have had thyroid problems and been put on thyroid medication by Dr. Brown. We personally know of a friend of LRC (a non-NOP member) who has visited Dr. Brown for thyroid problems. The Dr. Brown connection has generated a lot of attention in the mainstream press, including the Wall Street Journal, and Nike Oregon Project supporters usually claim Dr. Brown is just returning athletes to their natural thyroid levels. That may be the case, but here he clearly is looking for an advantage others may not have with L-carnitine. This message board poster also posts to a study showing a link between L-carnitine and thyroid production.
The actions outlined in the Sunday Times clearly show Salazar does not believe “You don’t really need anything else” besides iron, vitamin D and beta alanine. Alberto himself during his competitive days took Prozac to improve his performance and experimented “with the corticosteroid prednisone in an attempt to revive his deficient adrenal system.”
It would be best if Salazar went back to saying what he told the Independent in 2011, “It’s like in war. The soldier has to learn how to fight and do everything – be physically fit, be a one-man army. But you also try and equip him with every bit of top science – everything you can – to keep him alive. That’s what we do. We use science every bit that we can, on top of old-school training.”
Footnote: 1 USADA, in an FAQ on its website says, “Some reports suggest that administration of IV infusions, including supplement and vitamin cocktails, are being provided to athletes for recuperation. This practice is prohibited at all times without prior TUE approval” which the laymen would think would outlaw injections of L-carnitine. However, in our reading of the rules, something technically isn’t an IV infusion unless it is more than 50ml in six hours.
Extra note: Last year, former World XC Champ Craig Virgin called for more transparency on the supplements athletes take. He asked what Galen Rupp could be “taking (legal or illegal supplements) that could help his body metabolize the lactic acid so quickly.” It is interesting to note that more carnitine in the muscles according to the Sunday Times “reduces the build-up of lactic acid.” We at LRC don’t want sport to become who has the best doctors injecting their athletes with supplements others are not aware of. Virgin said it well when he said, “Do you know the Steak ‘N Shake slogan ‘If in sight it must be right.’ That’s the way I feel about supplements and medication. Complete transparency is probably the better route. I would have had no problem as a clean athlete doing that myself to prevent unfounded rumors from getting started.”