Cardiologists Question the Utility of the Drugs Found in Valieva’s Blood – The New York Times

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The Russian figure skater said she took the substances to treat a heart ailment.

The test that detected three drugs in the blood of the 15-year-old Russian figure skater Kamila Valieva raises questions of why she or any athlete would take the substances.
Valieva said she took the drugs to treat a heart ailment, but cardiologists said that two of those drugs are not regularly used in cardiology, and the third, the banned drug trimetazidine, is used in Europe only for patients whose coronary arteries are narrowed and who have no other options. Even then, it is weakly effective at best.
Trimetazidine, a metabolic enhancer, encourages the heart to use glucose rather than fatty acids for fuel. The hearts of healthy people have plenty of fuel, even during intense and prolonged exercise, said Dr. Benjamin Levine, a heart and exercise researcher at the University of Texas Southwestern Medical Center.
The other drugs, also metabolic enhancers, are the supplement L-carnitine and the drug Hypoxen. Both are sold online without a prescription, though Hypoxen does not appear to be sold in the United States in health stores. Neither substance is on the World Anti-Doping Agency’s prohibited substance list.
L-carnitine is easily available everywhere as a supplement and is supposed to enable the body to use fat as a fuel. It is unlikely to have any effect on an athlete’s performance, said Dr. Steven Nissen, a heart expert, at the Cleveland Clinic.
It has been used to treat patients with damaged hearts, but there is no “strong scientific evidence” that it helps them, Dr. Nissen said.
Dr. Levine added that “it is certainly not something we use in cardiology.”
Eddie Coyle, an exercise physiologist at the University of Texas in Austin, said L-carnitine “has no positive effects on muscle.”
Hypoxen is sold online by Russian companies. One company selling it claims it was developed in Russia in 1976 and is sold without a prescription. The companies make extravagant claims for the drug, saying it can improve athletic performance and also help with severe injuries, burns, major surgery, blood loss, as well as asthma.
“I don’t know whether it works or doesn’t work,” Dr. Nissen said.
The danger for athletes, medical experts said, goes beyond the risk of being caught using drugs improperly. The substances might be worse than useless — they could harm performance. And combinations of drugs that could interact add to the unknown consequences. As the history of medicine shows all too clearly, drugs that for every logical reason should have a beneficial effect can actually cause harm.
“Don’t mess around with Mother Nature,” Dr. Levine said.
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