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Why are we caught with Mildronate

photo: Natalia Gubernatorova

Vladimir Preobrazhensky, beyond doubt, one of the leading experts in the field of sports medicine in the country with experience more than 30 years. Why Mildronate is in the black list of WADA? Why our athletes continued to use it, although it should have known about the ban? Who’s to blame, what to do, and most importantly — how to correctly build a system of interaction between athletes and doctors, to at least minimize the doping scandals?

— Probably all know — began Vladimir Yurievich, that Mildronate — a drug that was invented in the USSR, in Riga. It was very cheap and available, remember, 20 years ago it was recommended literally everywhere, at all levels: in hospitals, clinics — anywhere…

What is this drug and how effective is it in sports?

— It is believed that he effectively treats patients with coronary heart disease. But at the same time in the coronary care, for example, where I’ve worked, this drug was not used. It is recommended to assign Mildronat in myocardial infarction with the aim of combating the effects of hypoxia, acidosis, leading to death of cardiomyocytes. The question immediately arises: how so? Do healthy athletes hypoxia in the heart muscle? It is known that the human heart contains the maximum number of mitochondria, therefore hypoxia in healthy myocardium when there is no power supply to the heart, no vasoconstriction, no violation of oxygen supply to the heart muscle, can not arise. But only when such violations lactic acid, which causes acidification of the medium and cell death, to necrosis and infarction.

In healthy athletes it happens? No. And suddenly I heard at a press conference that doctors who carried out profound medical examination of sportsmen, recommended the adoption of Mildronate athletes with heart problems. What are you talking about? Who it’s for? Those doctors who work in the FMBA (they were links)? Don’t do it! If the doctor sees coronary heart problems in the heart that occur during profound medical examination of sportsmen, is certain changes on the electrocardiogram, such an athlete no doctor will admit to the competition. We will examine, we will find out the cause of ischemia.

And not to be confused with ischemia, electrolyte disorders, which occur on the background of the training process. It’s a completely different question, to which Meldonium, or Mildronate, has nothing.

Why do athletes took the drug ineffective and especially why he made the list of banned substances?

— In the 80-ies and 90‑ies we were not able to buy a large number of expensive drugs, and to take what they need. Believed that Mildronate helps, believed that effectively. In fact this drug does not give the athlete the benefits in improved fitness and functionality. But let’s see how Wade operates. Before the drug is forbidden to admit that they sample during the year or some other period of time. First, someone estimated in the form of reports that the drug gives athletes an advantage in one direction or another. To confirm this, needs to conduct research is usually reference them.

I haven’t seen these studies, conducted by WADA, but I’m not a member of Wade, so to say that they weren’t, can’t. It would certainly be interesting to know what specialists and what medical and sports institutions vada refers in his allegations. I think that such research should be more open and to be carried out by several institutions from different countries. I found only one article in which the author claimed that 10 athletes have increased physical training. Very abstract, without specifics, what indicators have improved: endurance, strength, or coordination.

Wade on Meldonium was limited to ascertaining of the fact of how often this drug appears in the urine in athletes in high concentrations. Paying attention to those athletes who have been busted for doping. If this drug is found often in athletes undergoing a doping test, WADA concludes that it is used by athletes to increase performance. But we get something, I would say, of the fallacy of judgments. For example, let’s imagine, for some reason, in my opinion Wade becomes significant. I reported that, according to the Institute, Zelenka is a drug that improves the functional state of the athletes. Wade will begin to determine the concentration of brilliant green in the urine. But brilliant green is used a lot in the territory of the former USSR. I think in 30 percent of cases the concentration will be increased, and that then: Zelenka disable? But we understand that this is absurd.

Then who offered to check the Mildronate?

— Such experts need to be aware that this drug is taken in large quantities and only in our country. Know our inertia, and to understand that if this drug is prohibited to enter in, while all will get the picture and stop going to catch a lot of athletes. And you can say that our whole country is mired in doping that we can’t represent anything. Because now no one delves into how this product is effective or not effective. All just say: «Russians Again! Again on the dope!».

Then the following question arises: why don’t we have such people in WADA who offered to conduct research and study Mildronate until the moment when it will make the list of prohibited substances? All was still? Or Mildronate no one took seriously, because he’s inefficient? Yes, it is inefficient, but it made the list, and our athletes got on it, because I continued to take. Many doctors, I assure you, nothing was heard of its prohibition. It is a system of incompetence, of inertia, sometimes stupidity, the system a wrong «doing» of athletes, the system malfunctions in sports. And this system, someone took advantage of… We were supposed to stand up for herself and to attend to my interests — so do all. I am often on the coaches meetings at the international level, where every coach of a national team fighting for the interests of their athletes! Why don’t we do? Why not use the knowledge of those physicians, those specialists who are able to fight for them? Why we went away from this struggle and give up?

— How would you comment on the speech of the President of Federation of skating sports of Russia Alexey Kravtsov on this subject, saying that Mildronate Kulizhnikov and other athletes poured their own?

I watched in amazement all of this. Such a statement puts us in a worse position. Turns out, not only that we take illegal drugs, so we have some dishonest people, we’re all each other something we pour to eliminate a competitor! Kravtsov assured that conducting the investigation: athletes and doctors pass through the lie detector. I was horrified when I heard it. Immediately remembered the story, 53rd year, the case of doctors-saboteurs who allegedly treated properly and poisoned Zhdanov. Now something very similar when he said that someone slipped a drug. That is, each team found a poisoner?

The brilliant athlete Kulizhnikov it’s second case. And than he got last time? With methylhexanamine is a stimulant, which is essentially two cups of coffee. This is again complete nonsense, and who advised him to accept it, I don’t know. First hit with a stimulant, then with Mildronate, which also is no has no effect.

All of this suggests that the compromised system. There must be people who watch and are responsible for the athlete. The athlete needs help, he can not know all, he cannot learn all the drugs. And if we made a mistake, you have to admit, not to say that someone someone slipped something… I immediately raises the thought that maybe decided to find a man of mediocre level athletes, he will take the blame, I will say that everyone was drugged. No, I hope not! Even in favor of what you want to save the athlete! Yes, it’s a disaster for the champion, it is the collapse of all his hopes on someone’s stupidity, inadvertently, but such excuses the athlete is not to save, but for us, for our country even worse will be watching.

In this situation, Masha Sharapova admitted honestly, recognizing that she was taking Mildronate. Yes, because I thought that Mildronate is not Meldonium. Yes, she was advised to take it back in 2006. It probably was, advised Russian doctor, but then he was not banned. Only the efficiency is unknown, but Mary believed that it is effective. Apparently, it is constantly not lead sports physician. When she is having problems with his shoulder, with something else, then it is treated by the specialists in this field. But, apparently, there is no such doctor who’d guided her constantly and tracked all it takes. She was wrong and was able to say about it. I believe that disqualification Sharapova should be minimal, because she’s completely honest reaction. Of course, ignorance is no excuse. But I think this is fair game.

We know cases when our players were extremely honest, could say, for example, that incorrectly scored. Great ability to plead guilty or to admit that the goal was wrong. This distinguishes Igor Netto from another player, who said that the hand with which he scored that goal was the hand of God.

— What conclusions can be drawn from the situation?

— The situation can be divided into several main aspects. The first aspect: illegal drugs must not be taken; we did it. Second: why Mildronate was banned? And why we didn’t fight, lest he be banned? Not to be entered in the list, knowing its inefficiency? And the third aspect: why we are now trying to come up with anything and don’t want to admit our mistakes, to recognize the imbalance of our system in the sport? After all, it is absolutely clear that it is not operating correctly. Should have one responsible physician in the team or in the Federation. One sports medicine physician who is versed in all aspects of sports medicine and in rehabilitation facilities. And the team needs to be physical therapists, they should work with athletes to help them recover. But to prescribe drugs and to prescribe drugs not their prerogative. So work in the most countries of the world. And when every doctor, often trapped in a command by mistake, may appoint any drug — just it seems to him that he is a genius and can experiment as you like, then we have the terrible mistakes for athletes and our sport. To prevent this from happening, we need a system of construction which I have yet to see.

— In your opinion, how to work on the development of sports medicine in our country? What to do?

— Now is the time of the crisis finally began to count money, I realized that the mindless public spending should be cut now. It would seem that good? Here’s what: the reduction of public funding will greatly reduce the number of random individuals in sports medicine. Money will have to earn, not get. Every leader will have to think about how with minimum expenses to make the medicine more effective. All who are engaged in sports medicine, will more actively, I hope honestly, to compete in the struggle for athletes. To achieve good results, only by raising competition among sports medical centres. And to achieve quality in work with athletes only if you have good professionals, doctors, physiotherapists. Today, our sports medicine this far behind. For example, we purchased before the Olympics in Sochi a lot of sporting equipment but nobody to operate it, because there are no specialists.

Today money should not invest in the equipment that exists, and specialists. Equipment must be purchased for a doctor who will be able to work on it, but not so much that we bought a thousand of the devices, and to work for them nobody knows. You need to understand that it is important to prepare good specialists. No need to build a lot of health centers — they are expensive, as there are no specialists, the centre will not be in demand.

On the other hand, I am very afraid that if we admit such setoperationname, you can participate in major competitions and the Olympics. And where will this lead? We then just lower all. With us this has happened after 1917, but forgot. It scares me that we will squeeze out from the world sports community. It’s awful. So the situation is very scary for me, I am very afraid that we will obuobisa that we begin to throw from the Olympic movement for our stupidity. We don’t admit what is happening, don’t want to change or change very slowly and poorly, I don’t want to admit their mistakes, which is largely our fault and our own mess. I’m afraid of the consequences of this all, I’m scared from what is happening.

Suddenly we decide that we are unjustly offended? Offended at the whole world and will not compete with anyone? As a result, our sport will sink to the level of 1948, when our athletes for the winter Olympics for the first time came to perform abroad in Norway. Then we all lost, there was one 4th place. Lack of communication and competition leads only to the fact that the level of sporting achievements is reduced, and that scares me, it scares me that we can’t go there. This is absolutely the wrong way. We need to admit our mistakes and need to correct them. Nothing terrible has happened. Yes, for athletes it’s a disaster. I guess because someone has to answer, everyone should see their mistake and try to not repeat it. Do not look for those who put the powder. But if someone from the staff yet something slipped, we need to remember who it recruited and admitted that he poured this powder.

It is important to understand that the way of offense is a false path. You need not be offended, but you need to make to us all and turned us all admired. Remember the Olympics in Sochi — let’s hope she still remembers every.