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Meldonium residues in milk: A possible scenario for inadvertent doping in sports?

10 Aug 2021

Meldonium residues in milk : A possible scenario for inadvertent doping in sports? / Sven Guddat, Christian Görgens, Tim Sobolevsky, Mario Thevis. - (Drug Testing and Analysis (2021) 26 August)

  • PMID: 34448364
  • DOI: 10.1002/dta.3145


Lately, the veterinary drug Emidonol® has been discussed as a possible scenario for inadvertent doping in sports. Emidonol® is approved for use in livestock breeding, exhibiting antihypoxic and weak sedative effects. The veterinary drug rapidly dissociates into meldonium, a substance prohibited in sports, and is excreted largely in its unchanged form into urine. To investigate if residues of meldonium in edible produce may result in adverse analytical findings in sports drug testing, a pilot study was conducted with three volunteers consuming a single dose of 100 ml meldonium-spiked milk at a concentration of 500 ng/ml (Study 1), and multiple doses of 100 ml of meldonium-spiked milk (500 ng/ml) on five consecutive days (Study 2). In the single dose study, urinary meldonium concentrations peaked between 2 and 6 h post-administration with maximum values of 7.5 ng/ml, whereas maximum meldonium concentrations of 18.6 ng/ml were determined after multiple doses 4 h post-administration. All samples were analyzed using an established and validated protocol based on HILIC-HRMS/MS.

NADO Flanders 2016 Disciplinary Commission 20167429

6 Dec 2016

In September 2016 NADO Flanders reported an anti-doping rule violation against the Georgian boxer after his sample tested positive for the prohibited substance Mildronaat (Meldonium).

After notification the Athlete failed to attend the hearing of the NADO Flanders Disciplinary Commission and a Decision was rendered in absentia of the Athlete.

The Disciplinary Commission finds that the presence of the prohibited substance had been established in the Athlete's sample and accordingly that he had committed an anti-doping rule violation. Further the Commission deems that the Athlete intentionally had used the substance since he failed to demonstrate how the substance had entered his system.

Therefore the NADO Flanders Disciplinary Commission decides on 6 December 2016 to impose a fine and a 4 year period of ineligibility on the Athlete, starting on the date of the Decision.

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

WADA - 2019 Anti-Doping Testing Figures Report

18 Dec 2020

2019 Anti-Doping Testing Figures / World Anti-Doping Agency (WADA). - Montreal : WADA, 2020


  • Executive Summary - pp. 2-8 (7 pages)
  • Laboratory Report -– pp. 9-37 (28 pages)
  • Sport Report - pp. 38-174 (137 pages)
  • Testing Authority Report - pp. 175-313 (139 pages)
  • ABP Report-Blood Analysis - pp. 314-355 (42 pages)

Report Highlights

  • A 5.5% increase in the overall number of samples analyzed: 263,519 in 2018 to 278,047 in 2019.
  • A slight decrease in the total percentage of Adverse Analytical Findings (AAFs): 1.05% in 2018 (2,774 AAFs from 263,519 samples) to 0.97% in 2019 (2,702 AAFs from 278,047 samples).
  • About 60% of WADA-accredited Laboratories saw an increase in the total number of samples recorded.
  • An almost similar total number and percentage of non-Athlete Biological Passport (ABP) blood samples analyzed: 9.3% in 2018 (24,495 of 263,519) and 9.1% in 2019 (25,339 of 278,047).
  • An increase of 16% in the number of ABP blood samples tested: 31,265 in 2018 to 36,401 in 2019.
  • An increase in AAFs reported for Erythropoiesis Stimulating Agents (ESAs), Growth Hormone (GH) and Growth Hormone Releasing Factors (GHRFs).

The World Anti-Doping Agency (WADA) has published its 2019 Testing Figures Report (2019 Report), which summarizes the results of all the samples WADA-accredited Laboratories analyzed and reported in WADA’s Anti-Doping Administration and Management System (ADAMS) in 2019.

This is the fifth set of global testing figures under the version of the World Anti-Doping Code (Code) that came into effect in January 2015. The 2019 Report – which includes an Executive Summary and sub-reports by Laboratory, Sport, Testing Authority and Athlete Biological Passport (ABP) Blood Analysis – includes in- and out-of-competition urine samples; blood and ABP blood data; and, the resulting AAFs and Atypical Findings (ATFs).

Overview of Prohibited Substances and Prohibited Methods from the IOC Lists & WADA Prohibited Lists (1968-2021)

30 Mar 2021

Complete Overview of Prohibited Substances and Prohibited Methods from the IOC Lists (1968-2003) & WADA Prohibited Lists (2004- ) / ed. M.C. Tuk, Olivier de Hon. - Doping Authority Netherlands (Dopingautoriteit); Anti-Doping Knowledge Center (ADKC), 2021

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Analytical progresses of the World Anti-Doping Agency Olympic laboratories: a 2016 update from London to Rio

26 Sep 2016

Analytical progresses of the World Anti-Doping Agency Olympic laboratories : a 2016 update from London to Rio / Ioanna Athanasiadou, Sven Voss, Emmanouil Lyris, Amina Aljaber, Mohammed Alsayrafi, Costas Georgakopoulos. - (Bioanalysis 8 (2016) 21 (November); p. 2265-2279)

  • PMID: 27665839
  • DOI: 10.4155/bio-2016-0185


The 2016 Olympic and Paralympic Games, the biggest event in human sports, was held in Rio de Janeiro with more than 10,500 athletes from 206 countries over the world competing for the highest of sports honors, an Olympic medal. With the hope that the Olympic ideal accompanies all aspects of the XXXI Olympiad, WADA accredited antidoping laboratories use the spearhead of analytical technology as a powerful tool in the fight against doping. This review summarizes the main analytical developments applied in antidoping testing methodology combined with the main amendments on the WADA regulations regarding analytical testing starting from the 2012 London Olympics until the 2016 Olympic Games in Rio de Janeiro.

SI 2020 SI Disciplinary Decision 20207130

8 Apr 2020

In March 2020 Sport Ireland has reported an anti-doping rule violation against the Gaelic football player IS-7130 after his sample tested positive for the prohibited substance Meldonium.

After notification the Athlete gave a prompt admission, waived his right for a hearing and accepted the sanction proposed by Sport Ireland.

Therefore Sport Ireland decides on 8 April 2020 to impose a 4 year period of ineligibility on the Athlete IS-7130 starting on the date of the sample collection.

CAS 2019_A_6587 BWF vs Kate Foo Kune

15 Dec 2020

CAS 2019/A/6587 Badminton World Federation v. Kate Jessica Foo Kune

In 2017 the Badminton World Federation (BWF) launched an investigation against the official of the Mauritius Badminton Association (MBA) Mr. Raj Gaya and established that he had diverted funds intended for the MBA into his personal bank account.

Consequently the BWF Ethics Hearing Panel decided on 21 November 2018 to impose a fine and a lifetime ban from performing any function in badminton. In this ethics case the Mauritian badminton player Kate Jessica Foo Kune and another key withness assisted the BWF in their investigation and testified against Mr. Gaya. 

In June 2019 the BWF reported an anti-doping rule violation against the Athlete Kate Foo Kune after her A and B samples tested positive for the prohibited substance 1-androstenedione. On 21 October 2019 the BWF Doping Hearing Panel deemed that the Athlete had committed an anti-doping rule violation but decided not to impose a period of ineligibility on the Athlete due to no fault or negligence.

Here the Doping Hearing Panel determined that the Athlete more likely than not had demonstrated that she had consumed water that was deliberately spiked with the prohibited substance and victim of malicious sabotage by the MBA. 

Hereafter in November 2019 the BWF appealed the decision of its Doping Hearing Panel with the Court of Arbitration for Sport. The BWF requested the Panel to set aside the Decision of 21 October 2019 and to impose a 2 year period of ineligibility on the Athlete. 

The BWF accepted that the Athlete’s violation was not intentional but contended that she failed to establish the origin of the prohibited substance. She didn’t demonstrate on the balance of probabilities how the prohibited substance had entered her system nor how an ill-intentioned individual could have deliberately spiked her food or drink with this prohibited substance. 

The BWF argued that it is willing to accept any new evidence, and that it is open to re-evaluate its position regarding such new evidence, that would allow the Athlete to demonstrate that sabotage took place, or any other mitigating circmumstances. 

The Athlete explained why an accidental contamination of her supplements or her food and water consumed during the Championships in Nigeria was not possible. Instead she submitted that the positive test resulted by way of the malicious sabotage by the MBA or Mr. Gaya, or an associate of either. In particular, she asserted that her team backpack had been left out-of-sight several times during the Championships in Nigeria and that the most likely explanation for the positive test is that her water was intentionally spiked without her knowing during this period. 

The Panel regards that the Parties in this case did not dispute that the Athlete’s anti-doping rule violation was unintentional. It also finds that it is not absolutely necessary for the Athlete to show the origin of the prohibited substance to establish absence of intent.

Nevertheless the Panel deems that the Athlete didn’t provide sufficient evidence that supports her assertion while the scientific analysis of an independent expert witness underminded the allegation of sabotage.

The Panel concludes that the Athlete failed to establish on a balance of probabilities how the prohibited substance entered her system. Consequently andy plea of no (significant) fault or negligence must be rejected. 

Therefore the Court of Arbitration for Sport decides on 15 December 2020 that:

1.) The appeal filed by the Badminton World Federation against the decision rendered by the BWF Doping Hearing Panel on 21 October 2019, is upheld.

2.) The decision issued by the Badminton World Federation Doping Hearing Panel on 21 October 2019, is partially set aside.

  • Ms. Kate Jessica Foo Kune has violated Article 2.1 of the BWF Anti-Doping Regulations and committed an anti-doping rule violation.
  • Ms. Kate Jessica Foo Kune is suspended for two (2) years as from the date of this decision in accordance with Article 10.1 of the BWF Anti-Doping Regulations, with credit given for any period of ineligibility already served.
  • The results obtained by Ms. Foo Kune during the All African Championships on 28 April 2019 shall automatically be disqualified, pursuant to Article 9 of the BWF Anti-Doping Regulations.

3.) The present arbitration procedure shall be free of charge, except for the CAS Court Office Fee of CHF 1,000 (one thousand Swiss francs), which has already been paid by the Badminton World Federation and is retained by the CAS.

4.) Each party shall bear its own legal and other costs.

5.) All other motions or prayers for relief are dismissed.

Strong stuff: the size and seriousness of the doping trade in the Netherlands

13 Dec 2020

Strong stuff : the size and seriousness of the doping trade in the Netherlands / Ilse van Leiden, Marjan Olfers, Anton van Wijk, Rebecca Rijnink, Joey Wolsink, Juno van Esseveldt. - 2020

Sterk spul : aard, omvang en ernst van de dopinghandel in Nederland / Ilse van Leiden, Marjan Olfers, Anton van Wijk, Rebecca Rijnink, Joey Wolsink, Juno van Esseveldt. - Bureau Beke; Vrije Universiteit Amsterdam; i.o.v. Ministerie van Volksgezondheid, Welzijn en Sport. - Arnhem : Bureau Beke, 2020. - (Beke reeks)

  • ISBN 9789492255402


The use of image and performance enhancing drugs (IPEDs) for cosmetic reasons and in amateur sport has become accepted, a 224 page Report examining the size and seriousness of the doping trade in The Netherlands has highlighted. The Report found that this is in contrast to elite sport, where use of doping substances remains taboo.

The Report concludes that around 2% of the Dutch population uses or has used doping substances, and is fastest increasing amongst noncompetitive athletes who use doping substances to enhance their appearance. In addition, it found that doping is becoming accepted in recreational sport.

The Report found that elite athletes generally come into contact with doping substances through their entourage, which means that they are likely to receive guidance on usage. In contrast, cosmetic and recreational sport users do not receive guidance and gather most of their information from the internet, which puts their health at greater risk.

In elite sport, the Report found that the most common doping agents are anabolic steroids, stimulants, and hormonal and metabolic modulators. It found that there has been a decrease in the number of athletes who are prescribed substances without medical need in an attempt to boost performance since 2015. Micro doping (i.e. using substances in small amounts to avoid detection) is on the increase, as well as utilisation of experimental food (such as ketones).

More shipments of doping substances from outside the EU are being intercepted. From 2016 to 2018, customs seizures tripled with officers intercepting over 8,000 shipments involving medication, including 1,000 that contained doping substances. The most common substances intercepted were stimulants, glucocorticoids, and anabolic agents. Seizures of diuretics, masking agents, beta blockers, and hormonal and metabolic modulators are also increasing.

The Report points out that pharmaceutical companies in Eastern Europe are well known supply chains for the Dutch market. Also, it is impossible to know what substances are being imported into the country from other European Union countries, due to free trade rules. However, it did find that due to stricter regulation on doping substances in recent years, there has been a boost in Underground Laboratories (UGLs) in The Netherlands.

As well as the usual worries about the quality of substances produced in such labs being dangerous to health, the Report found that the increase in UGLs that compete with each other has led to a ‘hardening’ of the market. ‘In the Netherlands, a violent incident is already known where those involved in an UGL were extorted by new players on the market’, it reads.

Doping is not as lucrative as drug trafficking, but the Report did find that criminals are increasingly becoming involved in the doping market. This is because due to the increase in UGLs, the supply of doping substances is no longer dependant on foreign pharmacies. Products can now be produced for export where they can be sold in person or via the internet or dark web.

Doping in sport is not a criminal offence in The Netherlands. However, the Report concludes that the increased intertwining of doping with drug trafficking and the doping trade due to UGLs enabling an international market fo doping products represents a ‘serious problem’.



In de media duiken met enige regelmaat berichten op over het gebruik van doping in de sport. Niet alleen in de topsport, ook daarbuiten worden middelen gebruikt om de (sport)prestaties te vergroten. Maar wat gaat er achter het dopinggebruik en de -handel schuil?

In opdracht van het ministerie van VWS onderzochten wij samen met de Vrije Universiteit Amsterdam de aard, omvang en ernst van dopinghandel in Nederland. In ‘Sterk spul’ komen profielen van gebruikers van dopingmiddelen aan bod en welke risico’s er met het gebruik gepaard gaan. Daarnaast wordt ingegaan op de vraag hoe de handel in dopingmiddelen in elkaar steekt, hoe grootschalig deze handel is en in hoeverre er in Nederland ook dopingmiddelen worden geproduceerd. Een relevante vraag hierbij is wie er bij het produceren, verstrekken en verhandelen van dopingmiddelen betrokken zijn.

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