Here's a post, that you might find interesting about Jannik Sinner's clostebol case. This was written by an anesthesiologist, who brought up several points that I wasn't privy to about what would need to take place for this substance to have been detected in Sinner's system.
1. Billionths of a gram” is how almost all PEDs / metabolites are measured, in nanograms per deciliter. It’s a common measurement for many tests. It was smart of the PR team to include it in that language as laypeople will read it a certain way, but it’s not meaningful in context. What IS meaningful is that that amount, taken at that time, is not effective to enhance performance. We do not have further information to say if the levels were ever higher, and that’s why he was proven innocent. Whether or not the levels were ever higher is a question mark, and one could postulate that’s likely if they wanted to accuse him, but they were never *documented* to be higher.
2. For detectable systemic (bloodstream) absorption in the time frame described, the anabolic-androgenic steroid would have had to enter Sinner via cuts, not transdermally, which is why the open skin is mentioned so much.
3. As many of you have mentioned, it’s definitely icky / not within medical standards to not perform hand hygiene/wear gloves before something like a massage knowing both parties have open cuts. AND, it was a physiotherapist, not a physician, we don’t give massages, we wear gloves for everything and they perhaps don’t. And these physios have close, long term relationships to their athletes unlike a typical healthcare worker with a patient they know for less than a day. Like, it’s possible that some of them almost never wear gloves. [Edit: I removed a tongue in cheek stereotypical comment about Italians being touchy.]
4. Most people are familiar with topical corticosteroids like hydrocortisone or clobetasol (note very similar spelling to clostebol). Those are corticosteroids and commonly used worldwide for pretty much all skin conditions. Over time, corticosteroids generally lead to catabolism (molecule breakdown). Interestingly, used systemically, they are ALSO banned per doping regulations and only allowed topically. Clostebol in contrast is an anabolic (molecule building) steroid with vastly different effects. Any topical use would likely not be an issue if it had not absorbed through the bloodstream.
5. This is why I see so much grey zone. If topical corticosteroid use is allowed and it’s known to absorb systemically with high doses over time, why allow it? Corticosteroids are a perfect example of a life saving drug for people with asthma and are indicated for hundreds of other medical issues. Without a deep understanding of how these nuances are handled for athletes with medical conditions, seriously just put the phone down, your opinion doesn’t make sense.
6. I know nobody wants to think about this, because we all want cold hard scientific facts, but lab error when we’re talking about this minuscule level of a highly uncommonly tested metabolite is real. Even when you test a basic blood level like potassium, it can be off by a pretty significant margin of error depending on numerous location-dependent lab factors, and that test is drawn billions of times a day across the globe and I make medical decisions based on these imperfect data points as do all physicians.
The part in bold is very, very important for understanding this case. In order for detectable systemic absorption to have occurred, in the time frame mentioned, The substance would have had to enter Sinner's body via cuts. Not transdermally. Meaning that even if they had sprayed Sinner with that cream, directly sprayed him too by the way. Which they claimed that they didn't do! It STILL would not have been enough for him to have gotten flagged for clostebol, during the two drug tests. Like I said before, it had to be transmitted through cuts.
When is justice going to be done about this?
