Joining VeloClub not only supports the work we do, there are some fantastic benefits:
by Shane Stokes
October 29, 2014
Commenting five days after the UCI and WADA confirmed that they plan to appeal Roman Kreuziger’s clearing of biological passport infringements to the Court of Arbitration for Sport (CAS), the rider’s legal counsel has issued a statement reiterating the rider’s innocence.
According to that counsel Dr. Jan Stovicek, over half of Kreuziger’s samples were not transported correctly. He also claims that a long-running hypothyroidism issue may have contributed to some of the highlighted blood readings.
“We are convinced, and during discussions before the Czech Olympic Committee’s Arbitration Panel is was clearly demonstrated, that the Expert Panel of the Cycling Anti-Doping Foundation (CADF) decided on the alleged guilt of Roman Kreuziger on the basis of incomplete and insufficient information,” he argues.
“This relates, in particular, to the fact that two-thirds of the blood samples used as a basis for the decision making process were not, during transportation to the laboratory, demonstrably kept in conditions conforming to WADA regulations and may therefore have deteriorated. In addition, Roman Kreuziger has since 2003 suffered from hypothyroidism (insufficient function of the thyroid gland), and a worsening of this condition required the use of high doses of a substitute hormone L-Thyroxine precisely in the years in which the suspicion of misconduct arose (2011 and 2012), which was unknown to the panel.”
He continues by saying that while the CADF panel contains haematologists, it doesn’t include endocrinologists and that this area was ‘very important’ for the case. He referred to an open letter also issued addressing these areas and called on the CADF to reassess its position.
According to that open letter, Kreuziger submitted a medical report from his endocrinologist Dr. Fiala which it says confirms, ‘the rider suffers from severe overt hypothyroidism, and his thyroid insufficiency is compensated by a high dosage of L-Thyroxine, which increased significantly just in the period of his reticulocytes count increase as noted in his biological passport in 2011.’
It refers to a CADF report which mentioned Kreuziger’s hypothyroidism of being only of ‘minor severity.’
“We understand you reached this conclusion from the TSH level in the rider’s blood, but did not take into consideration the fact (probably unknown to you) that the rider was already taking a high dosage of L-Thyroxine medication, which balanced the TSH levels to almost normal. Also Prof. d’Onofrio [UCI expert – ed.] confirmed during the COC [Czech Olympic Committee] Arbitration Board hearing that it was unknown to your panel that the rider suffers from severe overt hypothyroidism.”
The letter does not explain why it was not originally made clear to the CADF panel that Kreuziger was taking high levels of L-Thyroxine.
It goes on to state that Kreuziger presented a paper by Kim et al, demonstrating the effects of L-Thyroxine on patients with severe hypothyroidism, specifically in relation to reticulocyte [young red blood cells] level.
It added that according to Prof d’Onofrio the paper had not been taken into consideration by the panel while preparing the original opinion.
“With regards to the above we believe that you lacked a number of vital elements when arriving at your original opinion, and that these elements are crucial to explain to increase in reticulocytes count of the rider which you address in your report,” today’s open letter states.
CyclingTips note: according to the summary of the original COC hearing mentioned here, the UCI experts stated that their concerns over the blood values were based not on the measured values themselves, but rather that the haemoglobin values rose under physical stress instead of than falling.
It also states that Kreuziger’s expert made at that hearing that Kreuziger had been using L-Thyroxine and that the rider had presented several written statements from experts backing his claims of hypothyroidism. It also states that Dr. Kim’s paper was presented to the COC. Consequently it is unclear why today’s open letter claims this information was not known.
The second major point raised in the open letter is claims that the blood samples taken from Kreuziger were not handled in accordance with WADA regulations.
“We carefully analysed the treatment of the rider’s blood samples serving as the basis for his biological passport records. To our surprise, we found 2/3! of the blood samples were not stored and transported in accordance with WADA instructions. In the case of some samples the temperature limits had been demonstrably exceeded. In the case of many of the samples a data logger had not been used at all (!), which makes these samples unreliable for any scientific use, as nobody can estimate what the conditions during transportation actually were. This is precisely why the WADA instructions clearly prescribe data logger use.
“We are sure you would agree with us that such unreliable samples cannot be used to establish any scientific result, and it would be in clear contravention of generally accepted standards of good clinical practice to base any scientific result on such unreliable samples.
“Apparently this information was also unavailable to you previously so you could not have taken it into consideration.”
Note: the same summary of the COC decision states that the transportation of the samples had been questioned in the original hearing but that the point had not been accepted as it could not be clearly proven.
The open letter concludes by stating that additional expert opinion from Dr. Cristobal Belda Iniesta, Director of the National School of Health in Madrid, had been included in the new correspondence to the CADF.
It also calls on the CADF to reconsider its original opinion on Kreuziger’s biological passport in light of the information raised.
Stovicek’s statement also claims Kreuziger is ‘innocent and should be treated accordingly.’
“Anti-doping regulations serve to protect decent athletes,” it asserts, “and should not be a tool for bullying them. I understand that the UCI wants to demonstrate an uncompromising stance in the fight against doping in cycling. You cannot measure everyone by a different scale. It’s the same as accusing someone of murder because they have kitchen knives at home.”
It adds that it believes that CAS will quickly decide on the case and “will not permit an honest man to be prevented from carrying on his profession. We should not allow the fight against doping to become a witch hunt.“
Also see: UCI wants ban of between two to four years for Kreuziger, loss of results from March 2011