Update: British Cycling’s medical mysteries

Evidence of medical misconduct at Team Sky and British Cycling continues to trickle out via U.K. Anti-Doping’s (UKAD) ongoing inquiry, testimony before parliament, and good old fashioned reporting. Last weekend we learned of a package of testosterone patches shipped to British Cycling and that more than 50 vials of a powerful corticosteroid remain unaccounted for.

The last week in particular has been enlightening, largely thanks to the testimony of UKAD chief Nicole Sapstead and the reporting of the The Sunday Times and The Telegraph newspapers, among others.

For those without the time or inclination to seek out the dozens of stories written on this subject in the last few weeks, here’s a handy update:

A box of testosterone patches? Really?
Yes. The Sunday Times reported over the weekend that a box containing testosterone patches was shipped to Dr. Richard Freeman at the National Cycling Center (NCC) in 2011. Freeman was responsible for ordering medical supplies at the NCC at the time.

Testosterone is banned in- and out-of-competition. An elite athlete cannot receive a TUE for testosterone under any circumstance.

Were the patches used?
We do not know. The box was opened by a British Cycling employee, Dr. Steve Peters, who then confronted Freeman. Freeman said that the patches were not for any riders, and that they had been shipped in error. Peters said the box was then returned to sender.

Who is Freeman?
He was the head of medicine at British Cycling and is a former Team Sky doctor.

Has he been questioned before parliament?
No, the day before he was to appear before the hearing, he called in sick.

That feels like the set-up for a joke.
Alas, no.

Was Freeman the only one calling the shots?
No. According to The Sunday Times, doctors within Team Sky teamed up to stop Dr. Freeman from administering Wiggins with a fourth dose of triamcinolone. One of the doctors changed the password needed to apply for a TUE via the World Anti-Doping Agency’s online portal. When Freeman asked for the password three days before the Tour of Britain in 2013, it was not given to him.

Are we still talking about the jiffy bag?
Yes. Sky general manager Dave Brailsford testified that Freeman told him the jiffy bag delivered by Simon Cope to the 2011 Criterium du Dauphine contained decongestant Fluimucil. Brailsford has been unable to back that claim up with medical records. U.K. Anti-Doping (UKAD) is investigating reports that the jiffy bag contained triamcinolone, a corticosteroid, under the brand name Kenalog.

Remind me what triamcinolone does.
Triamcinolone is a corticosteroid that can be used in a localized manner to treat inflammation and joint issues or systemically as to treat respiratory problems. Within cycling, the drug is commonly considered to be beneficial to weight loss. Multiple current and former professionals have professed to its strength as a performance enhancer.

Bradley Wiggins received three Therapeutic Use Exemptions (TUEs) for triamcinolone, each in the lead up to a grand tour, to treat respiratory problems.

So those three doses are the issue here?
Nope. They were until last week, but we have since learned that British Cycling ordered 60 to 70 vials of triamcinolone in 2011, according to a Sunday Times source. Of those, fewer than ten have been accounted for.

Sapstead testified that this quantity of triamcinolone, which was ordered by Team GB and former Team Sky doctor Richard Freeman, was “far more” than would be expected for a single individual.

Where did the rest of the vials go?
Five vials of triamcinolone have been accounted for thus far. Wiggins received three TUEs for triamcinolone, each of which accounts for a single vial.

Two coaches now say the triamcinolone was actually for them. Brailsford said that at least one of the vials was for him, administered by Freeman to reduce inflammation in Brailsford’s knee. Keith Lambert, a coach with the Great Britain Cycling Academy, says he received a dose from Freeman for an arthritic hand.

Reports have indicated that Freeman treated additional staff, friends, and family with the drug, but no records have been produced to back up this claim.

Where did the medical records go?
It remains unclear whether they’ve gone missing or never existed.

I heard something about a stolen laptop?
Dr. Freeman’s laptop, which allegedly contained medical records pertaining to the jiffy bag delivery, was allegedly stolen in Greece. Freeman was supposed to upload the records to a Dropbox but failed to do so prior to the theft.

The laptop was stolen in 2014. So Freeman had three years from the Jiffy Bag incident to upload.

Doesn’t Dropbox sync automatically?
Perhaps UKAD should question Freeman’s IT guy next.

What’s next?
Daniel Benson of CyclingNews.com reported on Monday that members of Team Sky are considering asking Brailsford to step down.

UKAD’s investigation into triamcinolone, testosterone, and more is ongoing, as is the investigation of a parliamentary select committee.