NADO Flanders 2013 Disciplinary Commission 2013096 T

7 Nov 2013

After the findings of a judicial inquiry in April 2013 NADO Flanders reported an anti-doping rule violation against the Dutch cyclist for using ozone therapy in 2011 as Physical Manipulation of his blood. After notification the Athlete filed a statement in his defence and he was heard for the NADO Flanders Disciplinary Commission. 

The Athlete admitted the violation and denied that the ozone therapy was used for sport performance enhancement. He stated that when recommened he underwent 10 ozone therapy treatments in 2011 in order to recover from Infectious mononucleosis (glandular fever) he suffered. For this purpose the doctor in question treated his tapped blood in a machine and reintroduced it into his system. The Athlete acknowledged that he was advised against using this unprescribed ozone therapy by his general practitioner. 

NADO Flanders contended that the Athlete clearly underwent physical manipulation through tapping, manipulation and reintroduction of his blood into his system. He also underwent unprescribed ozone therapy against the advise of his general practitioner while this therapy is not a valid medical treatment for his diagnosed glandular fever. 

Consequently NADO Flanders deemed that the Athlete had committed an anti-doping rule violation and had acted with Significant Fault and Negligence. Futher it regarded that this is the Athlete’s second anti-doping rule violation since he previously was fined and sanctioned for 2 years in October 2005 for evading Doping Control. 

Considering the evidence in this case the Disciplinary Commission establish that the Athlete through ozone therapy underwent physical manipulation of his blood on multiple occasions and accordingly intentionally committed a second anti-doping rule violation without grounds for a reduced sanction. 

Therefore under the applicable UCI Rules the Disciplinary Commission decides on 7 November 2013 to impose a 10.000 euro fine and an 8 year period of ineligibility on the Athlete starting on the date of the decision.  

Fees and expenses for this Commission shall be borne by the Athlete.

iNADO Update #2021-04

1 Apr 2021

iNADO Update (2021) 04 (1 April)
Institute of National Anti-Doping Organisations (iNADO)


Message from our Chair

  • What did we learn in Anti-Doping from COVID-19?

iNADO Community

  • NADA Germany publishes Research into the Use of Analgesics in German Football Leagues
  • International Paralympic Committee launches Tokyo 2020 Anti-Doping Webpage
  • World Rowing Partners with the International Testing Agency
  • IADA Secretariat Handover

Bulletin Board

  • Enhanced Independence and a stricter Separation of Powers: iNADO´s Suggestions for WADA Governance
  • iNADO Annual General Assembly 2021
  • Bye Bye Facebook
  • Webinar Invitation by UK Anti-Doping
  • Governance in anti-doping: How to meet the challenges
  • Job Vacancy at AFLD

Athlete's Voice

  • "Be a Person first, an Athlete second"


  • Farewell to Jonas Hebchen


  • Helsinki Laboratory resumes its Anti-Doping Activities following Relocation

Practical Development in Anti-Doping

  • The Anti-Doping Knowledge Centre adds a dedicated Category for CAS Anti-Doping Division Awards

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iNADO Partners & Sponsors

  • New at the Anti-Doping Knowledge Center

Promoting functional foods as acceptable alternatives to doping: potential for information-based social marketing approach

10 Nov 2010

Promoting functional foods as acceptable alternatives to doping : potential for information-based social marketing approach / Ricky James, Declan P. Naughton, Andrea Petróczi. - (Journal of the International Society of Sports Nutrition 7 (2010) 37 (10 November); p. 1-11)

  • PMID: 21067611
  • PMCID: PMC2994790
  • DOI: 10.1186/1550-2783-7-37


Background: Substances with performance enhancing properties appear on a continuum, ranging from prohibited performance enhancing drugs (PED) through dietary supplements to functional foods (FF). Anti-doping messages designed to dissuade athletes from using PEDs have been typically based on moralising sport competition and/or employing scare campaigns with focus on the negative consequences. Campaigns offering comparable and acceptable alternatives are nonexistent, nor are athletes helped in finding these for themselves. It is timely that social marketing strategies for anti-doping prevention and intervention incorporate media messages that complement the existing approaches by promoting comparable and acceptable alternatives to doping. To facilitate this process, the aim of this study was to ascertain whether a single exposure knowledge-based information intervention led to increased knowledge and subsequently result in changes in beliefs and automatic associations regarding performance enhancements.

Methods: In a repeated measure design, 115 male recreational gym users were recruited and provided with a brief information pamphlet on nitrite/nitrate and erythropoietin as a comparison. Measures of knowledge, beliefs and automatic associations were taken before and after the intervention with at least 24 hours between the two assessments. The psychological tests included explicit measures of beliefs and cognitive attitudes toward FF and PED using a self-reported questionnaire and computerised assessments of automatic associations using the modified and shortened version of the Implicit Association Test.

Results: The information based intervention significantly increased knowledge (p < 0.001), changed explicit beliefs in specific FF (p < 0.001) and shifted the automatic association of FF with health to performance (p < 0.001). Explicitly expressed beliefs and automatic associations appear to be independent.

Conclusion: Evidence was found that even a single exposure to a persuasive positive message can lead to belief change and can create new or alter existing associations - but only in the specific domain. Interventions to change outcome expectations in a positive way could be a rewarding avenue for anti-doping. Effective social marketing campaigns for drug free sport should follow appropriate market segmentation and use targeted messages via promoting the natural form as opposed to the purified form of the main active ingredient.

Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies

20 Mar 2021

Anabolic-androgenic steroid administration increases self-reported aggression in healthy males : a systematic review and meta-analysis of experimental studies / Razieh Chegeni, Ståle Pallesen, Jim McVeigh, Dominic Sagoe. - (Psychopharmacology (2021, 20 March); p. 1-12)

  • PMID: 33745011
  • DOI: 10.1007/s00213-021-05818-7


Rationale: Aggression and irritability are notable psychiatric side effects of anabolic-androgenic steroid (AAS) use. However, no previous study has systematically reviewed and quantitatively synthesized effects reported by experimental studies on this topic.

Objective: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effect of AAS administration on self-reported and observer-reported aggression.

Methods: Twelve RCTs comprising a total of 562 healthy males were identified through systematic searches of MEDLINE, PsycInfo, ISI Web of Science, ProQuest, Google Scholar, and the Cochrane Library.

Results: After excluding one outlier, AAS administration was associated with an increase in self-reported aggression under a random-effects model, albeit small (Hedges' g = 0.171, 95% CI: 0.029-0.312, k = 11, p = .018), and when restricting the analysis to the effect of acute AAS administration on self-reported aggression under a fixed-effect model (g = 0.291, 95% CI: 0.014-0.524, p = .014). However, the above effects were neither replicated in the analysis of observer-reported aggression nor after restricting the analysis to the effects of the administration of higher (over 500 mg) and long-term (3 days to 14 weeks) doses.

Conclusions: The present meta-analysis provides evidence of an increase, although small, in self-reported aggression in healthy males following AAS administration in RCTs. Ecologically rational RCTs are warranted to better explore the effect of AAS administration on aggression in humans.

Concerns about serum androgens monitoring during testosterone replacement treatments in hypogonadal male athletes: a pilot study

9 Feb 2012

Concerns about serum androgens monitoring during testosterone replacement treatments in hypogonadal male athletes : a pilot study / Luigi Di Luigi, Paolo Sgrò, Antonio Aversa, Silvia Migliaccio, Serena Bianchini, Francesco Botrè, Francesco Romanelli, Andrea Lenzi. - (The Journal of Sexual Medicine 9 (2012) 3 (1 March); p. 873-886)

  • PMID: 22321254
  • DOI: 10.1111/j.1743-6109.2011.02600.x


Introduction: A well-tailored testosterone replacement treatment (TRT) in male hypogonadal athletes plays a pivotal role to restore physiological performances, to reduce health risks, and to guarantee the ethic of competition. Few studies evaluated individual androgens profiles during TRT in trained individuals.

Aim: The aim of this article was to verify the efficacy in restoring eugonadal serum and urinary androgens profiles after testosterone enanthate (TE) and gel (TG) administration.

Methods: Ten male Caucasian-trained volunteers affected by severe hypotestosteronemia (<8 nmol/L) were included. Serum androgens and urinary testosterone metabolites were evaluated, in the same subjects, before and weekly for 5 weeks after both a single intramuscular TE injection (250 mg) and during a daily administration of TG (50 mg/die of testosterone), respectively.

Main outcome measures: The main outcome measures of this article were serum total testosterone (TT), dihydrotestosterone (DHT), calculated free and bioavailable testosterone (cFT, cBioT), 17-β-estradiol, and urinary glucuronide testosterone metabolites.

Results: Supraphysiological TT concentrations were observed in 50% of our volunteers until 7 days after TE and in the 4% of total samples after TG. Serum DHT was high both after TE (all volunteers on day 7 and 50% on day 14) and during TG (32% of total samples). A relatively low number of samples showed normal cFT and cBioT both after TE and TG (20-44%, respectively). Urinary metabolites were related to the type of treatment and to serum androgens profile and resulted in the normal ranges from 15% to 60% of total samples.

Conclusion: Besides well-known variations of mean serum TT, we showed a high percentage of serum and urinary samples with abnormal androgens, being TG safer than TE. We conclude that monitoring TRT with TT only may be inaccurate because of abnormal fluctuations of other circulating androgens. Further studies to identify the appropriate markers of eugonadism during TRT are highly warranted both in athletes and in non-athletes.

DMAA as a dietary supplement ingredient

9 Jul 2012

DMAA as a dietary supplement ingredient / Pieter A. Cohen. - (Archives of internal medicine 172 (2012) 13 (9 July); 1038-1039)

  • PMID: 22566490
  • DOI: 10.1001/archinternmed.2012.1677


The stimulant higenamine in weight loss and sports supplements

6 Sep 2018

The stimulant higenamine in weight loss and sports supplements / Pieter A. Cohen, John C. Travis, Peter H.J. Keizers, Frederick E. Boyer, Bastiaan J. Venhuis. - (Clinical Toxicology 57 (2019) 2 (February); 125-130)

  • PMID: 30188222
  • DOI: 10.1080/15563650.2018.1497171


Background: Higenamine is a stimulant with cardiovascular properties recently prohibited in sport by the World Anti-Doping Agency (WADA). Higenamine is also a natural constituent of several traditional botanical remedies and is listed as an ingredient in weight loss and sports supplements sold over-the-counter in the United States.

Objectives: We analyzed dietary supplements available for sale in the United States prior to WADA's prohibition of higenamine in sport for the presence and quantity of higenamine.

Methods: All supplements labeled as containing higenamine or a synonym (i.e., norcoclaurine or demethylcoclaurine) available for sale in the United States were identified. For each brand, one sample was analyzed by NSF International (Ann Arbor, MI) and one sample by the Netherland's National Institute for Public Health and the Environment (RIVM). NSF International carried out qualitative and quantitative analyses using ultra high performance liquid chromatography (UHPLC) with tandem mass spectrometry. RIVM carried out qualitative analysis using UHPLC quadrupole time of flight mass spectrometry for an independent confirmation of identity.

Results: Twenty-four products were analyzed. The majority of supplements were marketed as either weight loss (11/24; 46%) or sports/energy supplements (11/24; 46%); two brands did not list a labeled indication. The quantity of higenamine (±95% CI) ranged from trace amounts to 62 ± 6.0 mg per serving. Consumers could be exposed to up to 110 ± 11 mg of higenamine per day when following recommended serving sizes provided on the label. Five products (5/24; 21%) listed an amount of higenamine, but none were accurately labeled; the quantity in these supplements ranged from <0.01% to 200% of the quantity listed on the label.

Conclusion: Dosages of up to 62 ± 6.0 mg per serving of the stimulant higenamine were found in dietary supplements sold in the United States.

Identification and quantification of 1,3-dimethylbutylamine (DMBA) from Camellia sinensis tea leaves and dietary supplements

8 Jul 2015

Identification and quantification of 1,3-dimethylbutylamine (DMBA) from Camellia sinensis tea leaves and dietary supplements / Bharathi Avula, Mei Wang, Satyanarayanaraju Sagi, Pieter A. Cohen, Yan-Hong Wang, Pradeep Lasonkar, Amar G. Chittiboyina, Wei Feng, Ikhlas A. Khan. - (Journal of Pharmaceutical and Biomedical Analysis 115 (2015, 10 November); p. 159-168)

  • PMID: 26209774
  • DOI: 10.1016/j.jpba.2015.07.004


1,3-dimethylbutylamine (DMBA), is a CNS stimulant, which has recently been identified in multiple dietary supplements and sometimes labeled as a natural constituent of Pouchung tea. DMBA is an homologue of 1,3-dimethylamylamine (DMAA) which the US Food and Drug Administration has attempted to remove from all dietary supplements after DMAA consumption was linked to strokes, heart disease, and sudden death. To address questions concerning the natural origin of DMBA, three independent analytical methods were developed for analyzing authentic tea samples and dietary supplements. A high performance thin layer chromatography (HPTLC) method was developed for the fast screening and chemical fingerprint analysis. Chiral Gas Chromatography-Mass Spectrometry (GC-MS) was used to determine the enantiopurity and a validated Ultra-High Performance Liquid Chromatography-Quadrupole Time of Flight Mass Spectrometry (UHPLC-QToF-MS) method was developed for the quantification of DMBA. Using these techniques the presence of DMBA was confirmed using a reference standard and was not detected in any of 25 authentic or commercial samples of Camellia sinensis tea leaves (green tea, black tea, Oolong tea, and Pouchung tea). Of 13 dietary supplements tested, 11 contained DMBA in racemic form and ranged from 0.1 to 214mg per daily dose.

An amphetamine isomer whose efficacy and safety in humans has never been studied, β-methylphenylethylamine (BMPEA), is found in multiple dietary supplements

7 Apr 2015

An amphetamine isomer whose efficacy and safety in humans has never been studied, β-methylphenylethylamine (BMPEA), is found in multiple dietary supplements / Pieter A. Cohen, Clayton Bloszies, Caleb Yee, Roy Gerona. - (Drug Testing and Analysis 8 (2016) 3-4 (March-April); p. 328-333)

  • PMID: 25847603
  • DOI: 10.1002/dta.1793


The amphetamine isomer β-methylphenylethylamine (BMPEA) was first synthesized in the early 1930s, but its efficacy and safety in humans has not been studied. Recently, the United States Food and Drug Administration (FDA) detected BMPEA in dietary supplements labelled as containing Acacia rigidula. Over a year after the FDA reported its findings, we analyzed Acacia rigidula dietary supplements to determine if BMPEA had been removed. Supplements were analyzed using liquid chromatography-quadrupole time-of-flight mass spectrometry. Diluted methanolic extract from each supplement was run three times and each data set obtained was analyzed using Agilent MassHunter Qualitative Analysis. The presence of BMPEA was confirmed by accurate mass, retention time and mass spectra match against a reference standard. Quantification of BMPEA was determined using an eight-point calibration curve of spiked standard to a matrix blank. Twenty-one brands of Acacia rigidula supplements were analyzed. More than half (11/21; 52.4%) of the Acacia rigidula supplement brands contained BMPEA. The stimulant was present at quantities such that consumers following recommended maximum daily servings would consume a maximum of 93.7 mg of BMPEA per day. Consumers of Acacia rigidula supplements may be exposed to pharmacological dosages of an amphetamine isomer that lacks evidence of safety in humans. The FDA should immediately warn consumers about BMPEA and take aggressive enforcement action to eliminate BMPEA in dietary supplements

A synthetic stimulant never tested in humans, 1,3-dimethylbutylamine (DMBA), is identified in multiple dietary supplements

8 Oct 2014

A synthetic stimulant never tested in humans, 1,3-dimethylbutylamine (DMBA), is identified in multiple dietary supplements / Pieter A. Cohen, John C. Travis, Bastiaan J. Venhuis. - (Drug Testing and Analysis 7 (2015) 1 (January); p. 83-87)

  • PMID: 25293509
  • DOI: 10.1002/dta.1735

Erratum in

  • Drug Test Anal. 2015 Jan;7(1):88
  • DOI: 10.1002/dta.1762


A synthetic stimulant never before studied in humans, 1,3-dimethylbutylamine (DMBA), was suspected of being present in dietary supplements. DMBA is an analogue of the pharmaceutical stimulant, 1,3-dimethylamylamine (DMAA), which was recently banned by the US Food and Drug Administration. We obtained all dietary supplements sold by US distributors that listed an ingredient on the label, such as AMP Citrate, that might be a marketing name for DMBA. Supplements were analyzed for the presence and quantity of DMBA. Fourteen supplements met our inclusion criteria and were analyzed by two separate laboratories using ultra high performance liquid chromatography (UHPLC) - mass spectrometry and a reference standard. The identity of DMBA was confirmed in 12 supplements in the range of 13 to 120 mg DMBA per serving. Following recommendations on the supplement label for maximum daily intake, customers would consume from 26 to 320 mg of DMBA per day. Supplements containing DMBA were marketed to improve athletic performance, increase weight loss and enhance brain function. DMBA has never before been detected in supplements. The stimulant has never been studied in humans; its efficacy and safety are entirely unknown. Regulatory agencies should act expeditiously to warn consumers and remove DMBA from all dietary supplements.

This erratum corrects DOI:10.1002/dta.1735 published online 8 October 2014 in Wiley Online Library.

The Frenzy products we tested for our study were not purchased in the USA nor were they shipped from any retailer/distributor to the USA; rather, as we said in the Short Communication, the Frenzy products were purchased from an online retailer in the UK. While we are not aware of Driven Sports (the manufacturer of Frenzy) or any of its authorized US distributors selling Frenzy in the USA, as of the relevant time period of our study (April 2014), the USA Today was reporting that on April 9, 2014, Frenzy was available for sale on ebay's U.S. site. [A. Young. FDA warns maker of controversial sports supplement Craze. USA Today, April 15, 2014.] We have since confirmed that Frenzy is still offered for sale on ebay's U.S. site and can be purchased from sellers (including those sellers based in the US) on eBay's U.S. site. The inclusion criteria, therefore, include products containing DMBA available to U.S. consumers from various on‐line sources.

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