Football Sport

Testing positive to banned diuretics in football doping

Doctor’s Corner
DR JOSEPH KABUNGO
BRAZIL national soccer team player failed a dope test at the Copa America in Chile.
Fred, who features for Ukraine side Shakhtar Donetsk, tested positive to a banned diuretic known as hydrochlorothiazide. This is a sad development and the player faces a possible four year ban from all sporting activities.
At the FIFA medical conference in Zurich recently, new updates where given on doping control and one of the new penalties is the revision of the suspension period, from two years to four years for all players who test positive for any banned or prohibited substance.
As football is becoming highly technical, also other important components relating to fair play outside the game are following suit.
One important issue I want to share with players, coaches’ and football administrators is the role of diuretics in football.
It must be understood that diuretics are drugs that promote fluid loss from the body.
It is common reasoning that a soccer player will normally strive to keep as much fluid as he or she can to avoid dehydration and the associated problems that come with it.
Diuretics in sport and football in particular are not allowed and are referred to as masking agents.
Masking agents are products that have the potential to impair the excretion or removal from the body of a prohibited substance or they conceal the presence of a prohibited substance in the urine sample.
The other attribute of other masking agents is that of changing the hematological or blood parameters.
This is all targeted at concealing the presence of a prohibited substance.
A masking agent is taken so that it can help in hiding the presence of another prohibited agent or drug that has been used.
Diuretics promote fluid loss via increased urine output and individuals taking these drugs have increased frequency of passing urine.
Diuretics in a normal medical sense are used to help in the treatment of conditions such as hypertension and other cardiovascular conditions.
It is almost certain that when an athlete uses any form of diuretic such as hydrochlorothiazide, it is mainly for masking reasons.
This will probably be meant to mask the presence of a prohibited substance that is likely to be detected in urine.
This is the reason the World Anti-Doping Agency (WADA), has included diuretics on the list of prohibited substances in sport.
Apart from hydochlorothizide, one other commonly used diuretic in hospitals is Lasix or frusemide for the treatment of high blood pressure and other medical conditions characterised with fluid retention.
Any individual taking Lasix will attest to the fact that it can really be a bother because of the increased frequency of passing urine.
Other diuretics include spironolactone, amiloride and traimterene, just but to mention a few.
The primary site where diuretics act is at the kidney level. When diuretics are given they promote loss of water and other solutes through urine.
It is worth noting that diuretics can cause significant loss of elements such as sodium and potassium.
The rate at which these important elements will be lost will differ depending on the dosage and the type of diuretic used. The increase in urine output will tend to mask the presence of the prohibited substance.
In a football player, who is subjected t o sweating which implies loss of more water from the body together with some of the elements mentioned, the use of diuretics can prove to be dangerous.
The circulating blood volume will be reduced and this reduction will have an effect on the amount of blood that is ejected from the heart per contraction (Cardiac output).
The reduction in cardiac output will not support the demands of the body in terms of delivery of nutrients and also removal of waste products from the body tissues.
Diuretics can result in significant losses of sodium and potassium.
In some cases there is potential for suffering a cardiac arrest as a result depletion of some of the important elements that are needed for the normal functioning of he heart.
The main fundamental principles of doping control are to maintain the spirit of fair play i.e. no player should have an undue advantage over the other because of doping.
The other reasons are to safe guard the physical health and mental integrity of the players because of the potential which some of the drugs can have on them.
It is also important that the ethics of sport is preserved.
It is important to know that diuretics can result in someone failing a dope test.
Failing a dope test because of diuretics is rather an unfortunate thing because it clearly indicates that someone was trying to cheat.
Fair play and preservation of the player’s health is the way to go and doping of any kind has no place in football.
It is important that players take full responsibility for what they consume and also the drugs which they take in.
If there is a justifiable reason to the use of a prohibited substance, then the steps to obtain a therapeutic use exemption (TUE), has to be followed.
Without a TUE then the player found doping will face the full sanctions the worst of them all is suspension from football for four years.
It is therefore important that we all strive to keep sport clean and safe from any form of doping.
Remember that diuretics can cause abnormal heart rhythm, kidney stones, headache, extreme tiredness, dehydration, dizziness, muscle cramps or weakness and frequent urination.
For questions and comments write to Dr Kabungo Joseph
Email: zengajk@yahoo.com or kateulejk@gmail.com




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