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Discussion Starter · #1 · (Edited)
Sorry about the long backstory here. 2013-2015 I would consider myself to be a semi competitive athlete. I was regularly racing Cat 2 mountain bike races and even placed 7th in an endurance race with over 100 entrants in 2014. I also placed 2nd in a local multi-sport adventure race for solo male class. I'm not sure how else to measure my performance in cat 3 I could podium pretty regularly cat 2 I was a mid pack finisher. I also ran a bit competitively, low 7 minute pace per mile, a few 5k's here and there and also adventure racing. I was no where near pro, but I wasn't out of shape or what I'd consider slow.

Near the end of last year I began to notice that recovery times between workouts were getting longer and longer. I also noticed that knee and feet pain were too extreme for me to run any longer. I also would wake up every morning with burning pains in my joints and feet and it took forever to get going. I completely quit mountain biking and running in October 2015 as the pain was too great. I did get on the cross bike and ride around the neighborhood some. I knew something was very wrong as I was quickly getting worse and worse. Anyway, I googled my symptoms and decided I need to see a rheumatologist. After several tests, it was confirmed in December that I indeed had Severe Rheumatoid Arthritis. I was prescribed a chemotherapy treatment consisting of 18mg of Methotrexate and of course no drinking. 5 months later I wasn't seeing any improvement, the disease might have slowed slightly, but I definitely wasn't getting better. Oh and an occasional prednissone for when things got really painful.

Last month I was selected for an experimental drug program by Abbvie and placed on a new untested non-approved drug called ABT-494. I've been on this drug now for 3 weeks. I was told I would see results within 2 weeks. I saw results within 2 days. My results thus far, to put it bluntly are outstanding, borderline unbelievable. Up until this month I've been lethargic and not riding much, and certainly not training. In the last 10 days I've done 3 semi long rides and the 1st I hadn't gotten my blood tests in so I just rode how I felt. I was able to keep up with the fast group quite easily for the 1st 19 miles and only broke off because I was riding the 42 mile route. Again I haven't consistently trained, or ridden much and haven't felt like it at all. I'm not sure how I could ride as well as I was.

Later that week my recent blood test came in and my AST levels were too high which indicated problems with my liver. My doctor advised to not exercise or not exercise excessively, not to push it. So when a buddy of mine who is also out of shape asked me to go on a ride I informed him I have to take it easy and I'm going to try to keep my HR under 130. He agreed. Anyway, I'm fairly certain he was pushing it and I wasn't winded or challenged in anyway, and I easily kept my HR under 130 for most of the ride. It was almost as if I hadn't skipped a beat, like 6 months of lethargy and sickness haven't slowed me down. Admittedly I'm not sure what drugs I'm taking, but how could it be possible if it weren't for drugs of some kind? Oh and I just turned 40 in April and I'm about 175lbs about 10 over what I was when I was most competitive.

Sorry about this long story, this is as much as me looking for an outlet to talk to people about this as it is for answers. I'm posting the recent ride here, you're welcome to take a look. The day before I did a similar ride as well.

Whoops forgot the link.
https://www.strava.com/activities/593121201
 

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Interesting.. and yes.. in the strictest sense, you went from being in one condition, to almost the polar opposite, after taking a drug. That would be considered an unfair advantage, even if you were not taking it for performance reasons.
 

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Probably.

It isn't too surprising, most drugs have PED side effects either major or minor.
 

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First I thought you were getting a new generation SARM, most of them have alpha numeric names. I looked it up (it's not) and looks like it could be one of the best options for RA.

Are you doping?

No, you fall under "Therapeutic exemption". Your apparent gains in performance come from pain relief, and chronic pain from inflammatory conditions like RA can be debilitating. You were probably in excellent shape in early stage RA but you certainly could have done much better at that stage. Your fitness suppressed the early effects but inflammation was starting to wear at your joints.

Good to hear you are getting some relief, some of these RA drugs are very costly and have serious side effects. Even people who can tolerate them eventually have issues related to suppressing the immune system. If ABT 494 is effective with low side effects you win big time
 

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Discussion Starter · #5 ·
First I thought you were getting a new generation SARM, most of them have alpha numeric names. I looked it up (it's not) and looks like it could be one of the best options for RA.

Are you doping?

No, you fall under "Therapeutic exemption". Your apparent gains in performance come from pain relief, and chronic pain from inflammatory conditions like RA can be debilitating. You were probably in excellent shape in early stage RA but you certainly could have done much better at that stage. Your fitness suppressed the early effects but inflammation was starting to wear at your joints.

Good to hear you are getting some relief, some of these RA drugs are very costly and have serious side effects. Even people who can tolerate them eventually have issues related to suppressing the immune system. If ABT 494 is effective with low side effects you win big time
That's good to hear. Yes early on they wanted to get me on Xeljanz, but at $3400 per month that was out of the question, unless I wanted to live in a cardboard box. So far it's been amazing, I hope it stays that way.
 

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That's good to hear. Yes early on they wanted to get me on Xeljanz, but at $3400 per month that was out of the question, unless I wanted to live in a cardboard box. So far it's been amazing, I hope it stays that way.
$3400 a month for meds is f ing criminal

You have a TUE and I hope the meds continue to help
 

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That's good to hear. Yes early on they wanted to get me on Xeljanz, but at $3400 per month that was out of the question, unless I wanted to live in a cardboard box. So far it's been amazing, I hope it stays that way.
Part of my practice is patients diagnosed with inflammatory/auto immune conditions. In terms of pain and functional ability these conditions can be very debilitating as you have experienced. People without experience cannot understand the severity. The right drug regimen, exercise and nutrition will make the difference between being compromised and functional. As a group I've noticed that these patients are among the most courageous and compliant to treatment protocols. These drugs have no performance advantage to the average person and I'm sure the doping agencies would grant TUE for this class of medication.

Also, anybody with an inflammatory condition should consider Turmeric/Curcumin as a supplement, especially one with BCM-95. This will help with inflammation, usually compatible with most drug regimens and is not a banned substance. Do not take this if you are still in a clinical trial experiment as it might skew the result of the study. As always, consult with your M.D. to make sure this is compatible with your current treatment. I've had good clinical success with this supplement in clinical experience with patients and myself.
 

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Discussion Starter · #8 ·
I was using Turmeric in my food and took a daily supplement for a while, but I couldn't say I was seeing a measurable positive result from it. I actually tried just about every natural remedy under the sun. Thunder God Vine, Turmeric, Cinnamon, Vegetarian diet, juicing, and I wouldn't say I had any real gains. This drug is giving me results similar to Prednisonne, without the side affects.
 

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I was using Turmeric in my food and took a daily supplement for a while, but I couldn't say I was seeing a measurable positive result from it. I actually tried just about every natural remedy under the sun. Thunder God Vine, Turmeric, Cinnamon, Vegetarian diet, juicing, and I wouldn't say I had any real gains. This drug is giving me results similar to Prednisonne, without the side affects.
In your case Turmeric as a stand alone would not produce noticeable benefit but can help reduce inflammation at some level. With RA any help with inflammation can slow progression and possibly aid the meds you're taking. There is peer review research that Turmeric can help prevent and treat some types of cancer. If your Doc approves it would be worth considering.
 

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One of the effects of Rheumatoid Arthritis is/can be inflammation of the lining around the heart. It's certainly possible that you have/had this, and the medication improved that condition. This could certainly account, at least partially for how much better you are feeling.

I don't know how the anti-doping authorities view such things, but I certainly wouldn't consider you as 'doping' (in terms of sport performance) for taking medication to treat RA.
 

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This is one of those instances where I find it utterly absurd that amateur athletes have to even contemplate whether or not they're "doping" for the sake of amateur competition.

Health first, whatever that takes. If you want to compete, I don't know. Actually, I know I wouldn't care (not that that matters in the least) seeing the level you compete at. However, I don't know how I'd feel if someone did the same at an elite amateur level in national/regional races. I might feel differently. Not sure.

Gray area?

In any case, if these drugs aren't on the WADA list, even if they might be in the future, you're not "doping" and that's all good regardless.
 

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Are you doping?

No, you fall under "Therapeutic exemption".
You have a TUE and I hope the meds continue to help


To be clear, you have to apply for and receive a TUE. You aren't just "exempt". There's a process and if the proper paper work isn't filed and you popped positive you would have some serious issues. Just see Simon Yates.
 

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Discussion Starter · #14 ·
One of the effects of Rheumatoid Arthritis is/can be inflammation of the lining around the heart. It's certainly possible that you have/had this, and the medication improved that condition. This could certainly account, at least partially for how much better you are feeling.

I don't know how the anti-doping authorities view such things, but I certainly wouldn't consider you as 'doping' (in terms of sport performance) for taking medication to treat RA.
I hadn't heard of RA affecting the heart, this is new to me. That's really interesting/scary I wonder if that's why it seemed my threshold was so low last year, or if that's even a possibility.
 

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WADA disagrees with you.
Of course, you are correct. You must apply for a TUE and be granted it. If not then you are doping. One of those "devil is in the details" things.

Example. Just like me and probably most other working stiffs. I am not supposed to be at work under the influence of narcotic pain relievers. But, if a doctor prescribes it for a legitimate condition such as a tooth extraction or surgery then I must notify my supervisor that I am taking a narcotic while at work. If they agree that it is Ok, then no problem. They may make some restrictions to my work duties but I am in compliance with the companies drug policy. If I don't tell them and drive a car to a client's site and get in a wreck or am randomly tested. Too Bad, So Sad. You're fired!!

A pro racer who is required to have a Biological passport is "on the job" 24-7-365.

I pretty sure an amateur middle of the pack racer with arthritis is not who the dope police are after.
 
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