Do Asthma Inhalers Make You Faster?

As most of you may - or may not? - know, I race with asthma, and am also part of "Team Asthma" here in Toronto: TEAM ASTHMA BLOG.

I admit I am not very diligent at using my inhalers properly, but lately, especially with the epic cold spell ["f u, polar vortex"], I have been had to use them in order to stay healthy. I actually need the bloody thing - just last week, in the middle of a heinously difficult swim set at the pool, I ended up on the side of the pool barely able to get a breath down, and without the puffer I carry with me, that could have been ugly..

Anyway, last week before my 3000m race on the indoor track, I took a couple of puffs as per my doctor's directions - only to have a guy beside comment "hey - isn't that cheating...?".

My first reaction was:

 But, all I said was "Ya, 'cause I really feel the need to suck back meds in order to take the massive - MASSIVE! - cash prize at the end of the race". Oh, wait - there is NOTHING awarded at these races (and for what it is worth, regardless of what is on the line at each race, aside from hoping to race my best...I WOULD NEVER USE A PED!! Maybe a little blue pill when I am old and grey but that is a different blog - haha).  

But his comment did get me thinking about whether people actually understand what an "asthma puffer" does, or, does not do. So, to that end, I write this blog for the guy whose snarky aside left me, pardon the pun, huffing and puffing:

Q: Will using an asthma inhaler make you a better athlete? Some athletes believe the answer is yes — but science says no.

The asthma medications of interest in terms of performance are the bronchodilators (such as salbutamol, albuterol and formoterol), which open closed airways and relieve the symptoms of asthma, including shortness of breath and wheezing. However, some athletes obtain bronchodilators for off-label use, believing the medications will further relax the muscle linings of their healthy lungs and provide an advantage over other competitors.Such logic is fallible, says Dr. Michael Koehle, a sports medicine researcher with the University of British Columbia. In a 2012 study performed by Koehle’s team, cyclists were given either salbutamol or a placebo inhaler before performing two 10-kilometer time trials. Though lung function did improve in the salbutamol group, it did not have any effect on time trial performance.“Numerous studies from a variety of research groups (including ours) can show no definite advantage for these medications,” says Koehle. A 2011 review of 26 studies on asthma inhalers found that the medications did not improve “endurance, strength or sprint performance in healthy athletes.”

sucking air after the Binbrook triathlon 2013

What’s more, the off-label use of bronchodilators can come as a cost — side effects such as tremor, palpitations, and jitteriness can derail an athlete’s training or racing efforts. Overuse of these medications in asthmatics may also, under certain circumstances, render them less effective when they are needed. As inhalers are a delivery system that can be used for the administration of a variety of drugs, it is important for asthmatics utilizing an inhaler to check the status of their medication on the WADA Prohibited List. Some medications administered by inhaler are prohibited, some are not, and some are considered threshold medications on the WADA Prohibited list, which means they are allowed in certain quantities, but prohibited in excess of that quantity. If an athlete has a legitimate medical need to take a prohibited medication, a Therapeutic Use Exemption (TUE) may be requested, which, if granted, allows them to take the medication in a therapeutic dose.“A substance or method will be considered for the WADA Prohibited list if it meets at least two of three criteria: It has the potential to enhance or enhances sport performance, it represents an actual or potential health risk to the athlete, and/or it violates the spirit of sport,” according to the U.S. Anti-Doping Agency (USADA). The independent organization is responsible for managing the anti-doping program including testing, results management, education and scientific initiatives, for all U.S. athletes in Olympic, Paralympic, Pan American and ParaPan American sports, including USA Triathlon.

So - bottom line? If an athlete has asthma, see your doctor and don't worry about a puffer giving you an unfair advantage; in fact, to the contrary, it may even save your life. And to the fellow athlete who questions your use of meds (and thus, implicitly, your integrity)? Just take them down hard at the line.

see ya on the track

Mellow Johnny