Analysis: Cortisol conflict grows, illustrates MPCC strengths, weaknesses

Low cortisol levels are at the center of a yet another face-off between a team and the Movement for Credible Cycling (MPCC).

In the the hours after Astana was notified that Lars Boom had shown low cortisol levels in a pre-Tour medical check, the team faced a dilemma: it could stay within the MPCC and start the Tour de France without Boom, or it could ignore the organization and race with him.

It chose the latter. Boom, who won last year’s Tour stage over the French pavé, will take the start in Utrecht on Saturday, in defiance of MPCC rules which require a rider who returns low cortisol levels to not race for eight days.

Boom’s low cortisol levels re-opened a conflict between teams and the MPCC regarding its cortisol rules, which extend beyond those of the World Anti-Doping Agency (WADA) and the UCI. In the UCI’s eyes, Boom was always free to race; his removal would have been entirely voluntary on the part of Astana.

The MPCC’s cortisol rules are designed as a rider safety measure. The MPCC believes that if a rider’s cortisol levels fall too low, that rider is unhealthy. Teams, at least those that have run afoul of the rule, disagree.

Who’s right?

Cortisol conflict
Astana is the third WorldTour team to leave the MPCC in less than a year, following the exit of Lampre over the winter and LottoNL-Jumbo shortly after the Giro d’Italia. Both teams had riders excluded from major races by the cortisol rule — Chris Horner from the Vuelta a España and George Bennet from the Giro, respectively — but neither pulled itself out of the MPCC quickly enough to keep its rider in the race.

LottoNL contended at the time that MPCC’s cortisol rules were, “not 100 per cent accurate,” and that “a low cortisol level is not always the result of substance abuse, and a low cortisol level certainly does not always mean an unhealthy situation.”

The MPCC responded, noting that LottoNL was aware of the rules when it signed on, and that it shouldn’t have put pen to paper if it did not agree. The organization said it will not reconsider its cortisol rules until its congress in October.

Low cortisol levels can, and most often do, indicate the use of corticosteroids — medication that can be prescribed for anything from asthma to skin diseases, but can also be used as a powerful performance-enhancing drug, improving breathing, aiding recovery, and helping riders lose weight.

According to the CIRC report, an investigation into doping and governance in cycling, corticosteroid abuse does occur in the modern professional peloton. “Corticoids are widely used today both to reduce pain and therefore improve endurance capability and to achieve weight loss to improve power/weight ratio,” the CIRC report said.

Riders may be legally prescribed medication that lowers their cortisol levels and still race under UCI rules; all they need is a therapeutic use exemption (TUE). TUEs are subject to medical privacy law, so it is impossible to know who has one, and for what, unless such information is voluntarily disclosed.

The CIRC report also noted that TUEs are often used to cover up illicit or exaggerated use of certain drugs, including corticoids.

Toothless MPCC
The two WorldTour teams’ abandonment of the MPCC, and Astana’s flouting of its rules, illustrates a unique strength as well as a substantial weakness borne of the group’s status as a voluntary body.

The MPCC is the only body that can outright ban a team without suffering a protracted legal battle, because its bans are as voluntary as its membership. Any team found in violation of the group’s rules must ban itself; any rider found in violation is banned by his own team. The MPCC is not subject to the legal framework that constrains an international governing body.

“There are known limitations to the arsenal of legal repression available to the international associations,” said Roger Legeay, president of the MPCC. “The pitfall encountered by UCI regarding the Astana case (license commission case, not Boom case – ed.) is probably the same as the one who had forced UCI to step back in the Katusha case two years ago. These recent events show that MPCC rules are an inescapable, vital complement to those of UCI, even though they may in no event replace them.”

Of course, Astana proved Saturday that the rules are far from inescapable. As a voluntary organization, the MPCC is ultimately toothless against a team that simply ignores it.

In 2013, Ag2r La Mondiale and Rusvelo self-suspended following a string of doping positives, and Theo Bos missed the Vuelta a España due to low cortisol. In 2014, Chris Horner was prevented from defending his Vuelta title for the same reason. Just weeks ago, Bennett was knocked off LottoNL-Jumbo’s Giro d’Italia start list at the eleventh hour, again for cortisol.

All were victories, if they can be called that, for the MPCC. All were blows for the riders and teams involved, and all were contested and protested. But the punishments were levied, nonetheless, even if both Lampre and LottoNL would later remove themselves from the MPCC.

The MPCC has inflicted short but costly self-bans on Astana, which pulled itself from the Tour of Beijing in 2013, Ag2r, and Rusvelo successfully. The UCI, in contrast, has attempted twice in the last two seasons to remove a team from the WorldTour — Katusha in 2014 and Astana last winter — and failed both times.

The other side of that coin is the fact that any team can quit the MPCC at any time, as Lampre, Bardiani-CSF, and LottoNL have done, and Astana could do soon. There is nothing to prevent teams from signing on for the positive public image the relationship imbues, then simply ditching the MPCC when there is a conflict over the group’s rules.

Several WorldTour teams never signed on to the MPCC, including Sky, BMC, Movistar, Tinkoff-Saxo and Trek, due to these types of inconsistencies and ambiguities. If Astana leaves the group, or is kicked out, only eight WorldTour teams will remain.

With two WorldTour teams gone in less than a year, and another possibly on the way out, the MPCC’s efficacy and legitimacy have been dented. The cortisol rule, and how the group handles conflicts going forward, could be the determinant of its long-term fate.