Britscher Verbandsmediziner Leichtathletik und Fußball
Dr. Robin Chakraverty, von 2009 bis 2016 Chefmediziner des Britischen Leichtathletikverbands und anschließend führender Leistungssport-Mediziner beim Britischen Fußballverband FA, legte letztere Position im März 2020 nieder. Im Zuge der erneuten Diskussion um britische Verstrickungen in zweifelhafte Medikamentenbehandlungen in Verbindung mit dem Nike Oregon Project wurde frühere Vorwürfe erneuert. Er soll Mo Farah mit L-Carnitin-Infusionen versorgt und Sportlerinnen das Schilddrüsenhormon Thyroxin zum Abnehmen verabreicht haben. Die Vorwürfe reichen bis in das Jahr 2011 und speziell 2014 zurück.
Combatting doping in sportFourth Report of Session 2017–19, S. 34
Eine genauere Untersuchung seitens des General Medical Council (GMC), der britischen Ärztekammer, fand jedoch nicht statt. Es bestand angeblich hierzu keine Notwendigkeit. Es blieb unklar, in welchen Dosen die Substanz verabreicht wurde.
Die Sache wurde brisant, nachdem die BBC im Februar 2020 den Fall erneut ansprach und einige frühere Aussagen widerlegt wurden.
BBC: Alberto Salazar: Concerns over medications for Mo Farah ‚dated back to 2011‘
BBC: Rob Chakraverty leaves role as England team doctor
sportsintegrityinitiative.com: BBC Panorama: Farah changed his L-Carnitine story
Mit dem Schilddrüsenhormon Thyroxin werden Schilddrüsenunterfunktionen behandelt. Seit einigen Jahren genießt es den Ruf einer wirksamen Schlankheitspille und wird entsprechend im Leistungssport eingesetzt. Das in Deutschland verschreibungspflichtige Medikament steht nicht auf der Verbotsliste der WADA und kann daher von Sportler*innen ungehindert eingenommen werden, eine medizinische Ausnahmegenehmigung ist nicht nötig. Es hat allerdings eine Reihe möglicher sehr schwerer Nebenwirkungen und, eingesetzt zum Abnehmen ohne medizinische Indikation, birgt die Einnahme auch die Gefahr der Entwicklung von Essstörungen in sich. Damit kann eine lebenslangen Sucht verbunden sein, die meist schwere gesundheitliche Probleme mit sich bringt und im schlimmsten Fall zum Tod führt. Angesichts des Schlankheits- und Abnehmwahns im Hochleistungssport scheint dieses Medikament breit eingesetzt zu werden.
Im Nike Oregon Project fand es unter Leitung von Alberto Salazar und Dr. Jeffrey Brown häufige Anwendung. Beide wurden mittlerweile sportrechtlich gesperrt.
Am 29.2.2020 berichtete Mail on Sunday über die Mittelstreckenläuferin Emma Jackson, die 2011 aus gesundheitlichen Gründen von Rob Chakraverty das Hormon verschrieben bekommen hatte. Die verschriebene Dosis nahm sie bis zu ihrem Rücktritt ein. Danach stellte ein behandelnder Arzt fest, dass die Dosis viel zu hoch sei, sie müsse um die Hälfte reduziert werden. 2015 kam es zu einem von UKA organisiertem Gespräch zwischen Chakraverty und Jackson, bei der ihr versichert wurde, sie sei keine ‚Laborratte‘ gewesen, er habe nicht mit ihr experimentiert. Die Athletin führt eine Reihe gesundheitliche Probleme, die sie bis heute hat, auf die Behandlung zurück.
Dr. Chakraverty Rücktritt fand exakt an dem Tag statt, an dem von UKA ein interner Report einer unabhängigen Kommission aus dem Jahr 2015 nach mehrmaliger Aufforderung durch UKAD vorgelegt wurde, der sich mit den Verbindungen von UKA zu dem Nike Oregon Project befasst, siehe hier.
Zitate
Zitat aus The Times, vom 20.3.2020:
The Times and the BBC also revealed that Chakraverty had expressed reservations about giving the injections, while a BBC Panorama programme had further detail about how the doctor was flown into London especially for the procedure. It also emerged that Fudge had been flown to Switzerland, at UKA’s expense, to collect the vials of L-carnitine because they were not available in the UK. In email correspondence published by the BBC, Fudge and former performance director Neil Black also expressed reservations about a procedure given at the request of Salazar. The BBC revealed that the L-carnitine used had not been “batch-tested”, as is recommended by UK Anti-Doping. UKA said it was “pharma-grade”.
Chakraverty has had to deal with other negative press reports, in particular around the thyroxine treatment given to former British middle-distance runner Emma Jackson. While Jackson needed thyroxine medication because of the absence of a thyroid gland, she told the Mail on Sunday last month that Chakraverty prescribed her dangerously high doses.
While it is not a banned substance, thyroxine is a drug some claim is being abused in endurance sport because it can assist with weight loss.
In a recent statement in response to BBC Panorama, Chakraverty said: “The evidence I provided to the DCMS Select Committee Inquiry in April 2017 was a detailed and honest account.
“Following appropriate discussions and checks on the L-carnitine supplement, including around safety and the Wada [World Anti-Doping Agency] dosage rules, 2.7grams of L-carnitine was given intravenously — administered via four injections totalling 13.5ml [1 x 4.5ml and 3 x 3ml injections].
“This volume, as planned, was well below the 50ml permitted during a six-hour period.
“I have not contravened any Wada or Ukad rules and I have always acted in the best interests of those I treat. My due diligence checks were thorough — this is standard process, and was necessary as it was the first time I had been asked to administer L-carnitine.
“I acknowledged to the inquiry that my usual standard of record-keeping slipped due to heavy work commitments and travel. I undertook a further update on good clinical record-keeping in response in May 2018.
“The GMC reviewed this issue in 2018, and concluded that the case required no further action.”
In response to claims relating to Jackson, Chakraverty said: “I have had the privilege of working with many world-class athletes and I take pride in the care I provide, which is always in their best interests. I refute any suggestion that I have been encouraging medical screening or the use of medication for any reason other than protecting athletes’ health.
Zitat aus dailymail.co.uk: Former Team GB rising star Emma Jackson says her career collapsed after current England football team doctor Rob Chakraverty advised her to take high doses of thyroid drugs, 29.2.2020:
Chakraverty took over Jackson’s supervision of thyroxine use in 2011 at a time where her levels were variable, which had led her GP to prescribe 250mcg of thyroxine per day, which was intended to be for a short period.
When Chakraverty took over, he lowered the levels to 225mcg per day and later to 200mcg per day – but for two years. Jackson then continued the dosage for an additional year because no one told her to stop.
Dr Nicky Keay, a sports endocrinologist at Durham University, said: ‚A high dose for a slim young person with accompanying report of significant symptoms is potentially suggestive of over replacement.‘
Over the next two years, Jackson’s health, mental state and training deteriorated to such an extent that Barry Fudge, now UKA Head of Endurance but then a sports scientist with the English Institute of Sport, asked her father if she had an eating disorder.
Her body fat was 9.5 per cent and skin folds were 35mm in March 2013, causing one nutritionist to comment she was ‚the leanest female 800m runner he has ever encountered.‘
She ran her personal best in early 2012 but failed to make the London Olympic team that year, after suffering a rib stress fracture and losing form.
During that period, Jackson says she was experiencing personality changes, becoming obsessive about food and training, constantly eating but always hungry. ‚I was just training all the time and I was always hungry.
You know when you have to eat because you’re so hungry? It was like that all the time. It wasn’t a nice feeling. I was obsessed with what I was eating.
‚I was looking at people around me thinking, why am I eating so much? You feel like your heart rate is always going and you can never switch off.
‚Everyone thought the obsessiveness and personality change was down to missing out at the Olympics. Because I was so disappointed, people thought I had become obsessive. But it was actually because of the high dose. And as soon as the dose was brought back down my personality was visibly different.‘
Keay said: ‚High levels of thyroxine can lead to the situation of metabolism speeding up, causing adverse physical and psychological effects such as fast pulse rate, excessive hunger and compulsion to over exercise due to anxiety.‘
Despite the warning signs and seeing her fat test results, Chakraverty continued to email her to say that she should ’stay on same dose of thyroxine.‘
…
Jackson initially spoke out in 2015 about what she felt had been inappropriate care and at that stage UKA organised a meeting with her and Chakraverty to reassure her, at which she accepted that she had not been used as a guinea pig to test how effective thyroxine was.
But Jackson feels that she wasn’t taken seriously by the endocrinologist at the meeting, Dr Kristien Boelaert, when suggesting that her stress fractures could have been caused by high doses of thyroxine
Jackson said: ‚I am concerned how quickly I was dismissed in the meeting. They didn’t seem to care about the fact that I was not able to eat enough to fuel my training. I explained why I felt let down but she [Boelaert] kept saying: „No, no, that’s not the case. That wouldn’t have caused stress fractures“.‘
‚Before the meeting I could tell Rob [Chakraverty] was worried. After it had finished, he seemed relieved. I felt like I was coerced into getting the reaction they wanted about the causes of my injuries.‘
After meeting with UKA, Jackson agreed to make a statement that she had accepted their reassurances ‚that there was no attempt to boost my performance.‘ Also, Chakraverty denied that the high levels of thyroxine prescribed were to enhance performance.
However, contemporaneous notes taken at the meeting, seen by The Mail on Sunday, record that he did say he should have handled the case differently and that he apologised to Jackson.
Despite feeling undermined by Boelaert at the meeting, Jackson took up an offer to be assessed by her, after which the athlete said the doctor’s attitude changed and she was ‚really nice‘ and helped her regulate her dose.
…
‚Running is repetitive so foot stress fractures are not unusual. Stress fractures in unusual areas would be clinically significant and further investigations warranted to identify the cause.‘
Jackson had a stress fracture of the rib in June 2012, a fracture of the foot in July 2012 and two femur stress fractures in 2014. Boelaert declined to comment, citing patient confidentiality.
Last month Jackson was contacted by UKA, for the first time in five years, in the run up to the Panorama documentary, to remind her of the statement she had made in 2015. ‚That was the first contact I’ve had in years and though it appeared friendly it felt like a threat not to speak out,‘ she said.
Keay said: ‚In keeping with official guidelines from The National Institute for Health and Care Excellence (NICE), over treatment with thyroxine is indicated in the clinical context of significant symptoms and by suppressed levels of TSH (thyroid-stimulating hormone).
…
After Jackson’s case, Chakraverty continued to suggest screening elite athletes for thyroid issues. The Daily Mail has documented how he raised the issue with Premier League doctors, discussing if it would be possible to screen England players for thyroid conditions, though they never did so due to the negative response he received.
He attended a summit with the English Institute of Sport in 2014 which discussed treatment of athletes for ’subclinical hypothyroidism‘ – essentially athletes on the borderline. Minutes from that meeting do, however, stress that it would not be administered as a performance-enhancing strategy.
Chakraverty said: ‚I have had the privilege of working with many world-class athletes and I take pride in the care I provide, which is always in their best interests. I refute any suggestion that I have been encouraging medical screening or the use of medication for any reason other than protecting athletes‘ health.