Maria Sharapova Banned from Tennis for Two Years for Doping

Maria Sharapova, the richest female athlete for the past decade,  received a two-year suspension from the International Tennis Federation (ITF) for doping. Sharapova tested positive for banned drug meldonium. Sharapova, 29, failed a drug test at the Australian Open in January. She was given a provisional ban on March 12. The ITF banned meldonium as a performance enhancing drug at the start of this year.

Sharapova claims that she had been taking meldonium for the past 10 years for heart issues, a magnesium deficiency and because her family has a history of diabetes.  She started using meldonium under the care of a doctor in Russia, Anatoly Skalny. It was prescribed as part of a mix of 18 supplements and medications. Meldonium is not approved by the FDA (Food and Drug Administration) for use in the U.S. Sharapova has lived in the US since she was seven years old.

In a statement, Sharapova said:

“The ITF tribunal unanimously concluded that what I did was not intentional,” the 29-year-old Sharapova said. “The tribunal found that I did not seek treatment from my doctor for the purpose of obtaining a performance enhancing substance. The ITF spent tremendous amounts of time and resources trying to prove I intentionally violated the anti-doping rules and the tribunal concluded I did not.
“You need to know that the ITF asked the tribunal to suspend me for four years — the required suspension for an intentional violation — and the tribunal rejected the ITF’s position.
“While the tribunal concluded correctly that I did not intentionally violate the anti-doping rules, I cannot accept an unfairly harsh two-year suspension. The tribunal, whose members were selected by the ITF, agreed that I did not do anything intentionally wrong, yet they seek to keep me from playing tennis for two years.”
Sharapova has several big commercial sponsors: Nike, Head and Evian are standing by Sharapova, while Porsche and TAG Heuer have postponed promotional work.

What You Should Know about Meldonium

Meldonium, chemical name mildronate,  is used to treat ischemia: a lack of blood flow to parts of the body, especially in cases of angina (chest pain) or heart failure.

The drug is thought to expand the arteries, helping to increase the blood flow as well as increase the flow of oxygen throughout the body. Mildronate was designed to inhibit carnitine biosynthesis, a highly oxygen-consuming process. It also prevents the accumulation of toxic byproducts of fatty acid oxidation in oxygen-deprived tissues.

It was originally developed in Latvia for  use in animals (apparently, it increases the sexual performance and sperm motility of boars). It is only distributed in Baltic countries and Russia. It is not approved by the Food and Drug Administration for use in the United States nor authorized in the rest of Europe.

The drug was used extensively by Soviet troops in Afghanistan, to assist them carrying heavy packpacks through mountainous terrain.

A review of the scientific literature (through PubMed) on meldonium show that it has been used effectively in patient with heart problems such as cardiovascular disease, heart failure and stroke. It may also improve mood in some patients. There is no mention of the use of meldonium for magnesium deficiency. There have been some studies about the effects on sugar metabolism in diabetic rats, but no evidence for use in non-diabetic patients with a family history of diabetes.

The World Anti-Doping Agency (WADA) found “evidence of its use by athletes with the intention of enhancing performance” by virtue of its perceived ability to carry more oxygen to muscle tissue. It is classed as an S4 substance under the WADA code, which deals with hormone and metabolic modulators.

Meldonium was added to the World Anti-Doping Agency (WADA) list of banned substances effective January 1, 2016 because of evidence of its use by athletes with the intention of enhancing performance. The standard ban under the World Anti-Doping Code is four years.

A German investigative documentary on Russian doping reforms referred to a 2015 study in which 17% of Russian athletes (724 of 4,316) tested were found to have meldonium in their system. A global study found 2.2% of athletes had it in their system.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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