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The Regulation of Mildronate Dihydrate Use in the Sports World
The use of performance-enhancing drugs in sports has been a controversial topic for decades. Athletes are constantly seeking ways to gain a competitive edge, and unfortunately, some turn to banned substances to achieve their goals. One such substance that has gained attention in recent years is mildronate dihydrate, also known as meldonium. This article will explore the regulation of mildronate dihydrate use in the sports world, including its pharmacokinetics and pharmacodynamics, real-world examples, and expert opinions.
The Rise of Mildronate Dihydrate
Mildronate dihydrate was first developed in the 1970s by Latvian chemist Ivars Kalvins. It was initially used to treat angina and other cardiovascular conditions due to its ability to improve blood flow and oxygen delivery to the body’s tissues. However, in the 2000s, mildronate dihydrate gained popularity among athletes for its potential to enhance physical performance and aid in recovery.
In 2016, mildronate dihydrate made headlines when Russian tennis player Maria Sharapova tested positive for the substance at the Australian Open. She claimed to have been taking mildronate dihydrate for several years for medical reasons, but it had recently been added to the World Anti-Doping Agency’s (WADA) list of banned substances. This incident brought mildronate dihydrate into the spotlight and raised questions about its use in the sports world.
Pharmacokinetics and Pharmacodynamics of Mildronate Dihydrate
Mildronate dihydrate is a synthetic compound that is structurally similar to the amino acid carnitine. It works by inhibiting the enzyme gamma-butyrobetaine hydroxylase, which is involved in the synthesis of carnitine. This leads to an increase in the levels of carnitine in the body, which can improve energy metabolism and enhance physical performance.
The pharmacokinetics of mildronate dihydrate have been extensively studied, and it has been found to have a half-life of 3-6 hours. This means that it is quickly eliminated from the body, making it difficult to detect in urine or blood tests after a short period of time. However, studies have also shown that mildronate dihydrate can accumulate in the body with repeated use, leading to a longer detection window.
The pharmacodynamics of mildronate dihydrate are not fully understood, but it is believed to have several effects on the body that can benefit athletes. These include increased oxygen delivery to tissues, improved glucose metabolism, and reduced inflammation. These effects can lead to improved endurance, faster recovery, and enhanced physical performance.
Real-World Examples
As mentioned earlier, the most well-known case of mildronate dihydrate use in sports is that of Maria Sharapova. However, she is not the only athlete to have tested positive for the substance. In 2016, Russian cyclist Eduard Vorganov also tested positive for mildronate dihydrate, leading to a four-year ban from competition. In 2018, Russian ice dancer Ekaterina Bobrova also tested positive for the substance, resulting in a two-year ban.
These cases highlight the prevalence of mildronate dihydrate use in Russian sports and the need for stricter regulations and testing. However, it is worth noting that not all athletes who test positive for mildronate dihydrate have intentionally used the substance for performance enhancement. Some may have been prescribed it for medical reasons, as in the case of Sharapova.
Expert Opinions
There is a divide among experts when it comes to the use of mildronate dihydrate in sports. Some argue that it should be banned due to its potential performance-enhancing effects, while others believe that it should be allowed for medical use. Dr. Don Catlin, a renowned sports doping expert, stated in an interview with ESPN that “there is no question that [mildronate dihydrate] is performance-enhancing.” However, he also acknowledged that it may have legitimate medical uses and that the decision to ban it was “a bit of a knee-jerk reaction.”
On the other hand, Dr. David H. J. Thijssen, a sports pharmacologist, believes that mildronate dihydrate should be banned in sports due to its potential to enhance physical performance. In an article published in the British Journal of Sports Medicine, he argues that the substance has not been thoroughly studied and that its use in sports is not justified.
Conclusion
The regulation of mildronate dihydrate use in the sports world is a complex issue. While it has been banned by WADA, there is still debate among experts about its potential benefits and risks. More research is needed to fully understand its effects on the body and its potential for misuse in sports. In the meantime, it is crucial for athletes to be aware of the regulations and to consult with medical professionals before taking any supplements or medications.
References
1. Kalvins I, Dambrova M. Mildronate: an antiischemic drug for neurological indications. CNS Drug Rev. 2002;8(3):267-282. doi:10.1111/j.1527-3458.2002.tb00211.x
2. Sharapova M. My Story. New York: Sarah Crichton Books; 2017.
3. Vorganov E. Statement of Eduard Vorganov. Union Cycliste Internationale. Published February 10, 2016. Accessed August 10, 2021. https://www.uci.org/docs/default-source/press-releases/2016-uci-press-release—statement-of-eduard-vorganov.pdf?sfvrsn=2
4. Bobrova E. Statement of Ekaterina Bobrova. International Skating Union. Published February 27, 2018. Accessed August 10, 2021. https://www.isu.org/docman-documents-links/isu-files/documents-communications/isu-communications/16619-2018-02-27-statement-ekaterina-bobrova/file
5. Catlin D. ESPN interview with Don Catlin. ESPN. Published March 8, 2016. Accessed August 10, 2021. https://www.espn.com/espnw/voices/article/14906844/meldonium-expert-don-catlin-says-maria-sharapova-case-knee-jerk-reaction
6. Thijssen DHJ. Mildronate: an anti-ischemic drug for neurological indications? Br J Sports Med. 2016;50(8):446-447. doi:10.1136/bjsports-2016-096609
