Over the last ten years, more than twenty footballers playing in the top divisions of German football have failed doping tests which has led to four players being banned.

In further cases, more footballers were suspected of undergoing prohibited intravenous infusions, which is a prohibited recovery technique once prevalent in professional football before it was banned in 2005.

German football’s anti-doping programme, which covers the country’s major leagues including the Bundesliga, is implemented by the German anti-doping agency, known as NADA Deutschland. The Telegraph had reported previously that the agency receives €840,000 annually from the German Football Federation (DFB) which commands over hundreds of millions of euros in revenue each year. These funds are used to conduct in and out-of-competition doping controls and partially manage the results of any consequent cases that arise.

In 2024, NADA Deutschland collected 1,960 doping samples from German footballers compared with 3,302 collected by UK Anti-Doping in the British game, and 288 in Spain home to some of the world’s best players in La Liga.

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This is part 2 of Faultlines - a series on Doping in Tennis. Here, you can find part 1 (link) as well as the introduction to the series (link).

When Gareth Southgate missed the crucial penalty against Germany at Wembley Stadium in the semi-finals of Euro 1996, the England national team and the wider country was in devastation; football was most certainly not ‘Coming Home’.

Germany, on the other hand, were euphoric in victory but they too were suffering in devastation – albeit of a different sort.

After 120 minutes of intense battle, and an agonising Paul Gascgoine miss on the English side, Die Mannschaft were on the verge of physical collapse. The television presenter Waldemar Hartmann informed the nation of such on terrestrial television.

“The team is like a field hospital. The doctors are working overtime. Kohler, Basler, Bobic, Klinsmann, Ziege, Kuntz, Helmer, Freund, Bode: None of them will be training tomorrow,” said the presenter.

The squad’s team of doctors and physios were working into extra-time, just as their players had hours earlier, with the final against the Czech Republic only three days away. But their workload intensified when the German tennis icon Boris Becker, who was also in London for Wimbledon, came calling.

Becker, who was suffering from serious wrist problems, was in need of assistance from the team doctor, Hans-Wilhelm Müller-Wohlfahrt, in advance of his third round Wimbledon match.

One of the purported recovery methods of choice for both the football team, and the tennis star’s various ailments were intravenous (IV) infusions, according to the striker Stefan Kuntz. The team also used this technique to recover from matches played in intense heat at the 2002 World Cup, according to the goalkeeper Oliver Kahn.

“So, Boris was right in the middle of it all,” said Dr. Müller-Wohlfahrt in an NDR documentary

“There was even a phase where we were together in the treatment bed,” Kuntz added. “They were just normal double beds. He was lying on the right and I on the left, both with an IV drip”.

At the time, and prior to the creation of the World Anti-Doping Agency (WADA), intravenous infusions were legal and were a common part of both footballers’ and tennis players’ recovery programmes. So widespread was their use in tennis that the two-time grand slam champion Jim Courier reportedly lambasted the Wimbledon organisers for not having IV facilities on-site like other tournaments. They were also said to be used by Becker’s rival Pete Sampras, and Justine Henin, according to newspaper reports.

It was a different era, and there was no wrongdoing involved, but it serves as a reminder that both sports were ‘medicalised’ long ago – even the ‘Gentleman’s Game’.

In 2005, infusions were banned although those regulations were later loosened to allow for administered volumes under 100ml. Regardless, their use in tennis has continued.

Last year, the Wimbledon 2022 Doubles Champion Max Purcell was suspended for eighteen months after ‘feigning illness’ to receive a prohibited infusion during a December training block.

In 2014 and 2020, two German tennis players were also suspected of undergoing IVs. They ultimately escaped suspension, and their identities were not disclosed.

These two German tennis cases comprise a string of cases in the sport, processed by the German anti-doping agency, which Honest Sport now reports on.

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In late October 2024, the Long Jump World Champion Jianan Wang was captured on CCTV footage accompanying a family member to a hospital in China a little after seven in the evening. The events over the following ten minutes would lead to the athlete being charged with an alleged doping violation.

During a short medical appointment, Wang’s relative was treated with an asthma medication called terbutaline using a nebuliser - a small device which turns liquid medicine into a mist that is then inhaled by the patient. Unfortunately for Wang, his relative was not the only member of his family to ingest the drug.

The following day, Wang tested positive for terbutaline, a prohibited doping substance which can increase muscle mass and an athlete’s oxygen-carrying capacity and endurance.

It was not confirmed if there was any footage of the relative undergoing the treatment but the Chinese anti-doping agency (CHINADA) and the Athletics Integrity Unit (AIU), upon review, were able to corroborate that Wang sat next to his family member in the waiting area and that patient files recorded the treatment.

Wang was found to have been at ‘no fault’. His case was concluded on 20^th March 2025 and no suspension would be served.

The case comes at a time when CHINADA and the World Anti-Doping Agency (WADA) are currently under intense scrutiny from the US federal government for closing, without charge, 23 doping cases involving Chinese swimmers who all tested positive for the heart medication trimetazidine before the Tokyo 2020 Olympics. WADA has advised its own officials not to travel to the USA in fear that they are sequestered by a US Grand Jury to explain their actions.

In relation to the 23 cases, the court of public opinion, in my view, ruled against the conclusions of an investigation conducted by CHINADA and the Chinese police force. The anti-doping agency claimed that the spice box and air conditioning unit in the athlete’s hotel kitchen had become contaminated with trimetazidine heart medication pills. The cases were laid to rest, behind closed doors, until they were finally exposed by the media three years later.

I, now, wonder myself how severely the increasing acceptance of unlikely, yet plausible, contamination scenarios are damaging the global anti-doping system. While Wang’s case was well supported with evidence, to trust that plausibility always aligns with innocence requires faith in both anti-doping agencies and their regulator WADA. Travis Tygart, the CEO of the US Anti-Doping Agency, has questioned this credibility citing that WADA’s reputation is “crumbling before the world’s eyes”.

There is an increasingly perpetuated narrative that the anti-doping system is catching more and more innocent athletes, as espoused by the WADA Director General Olivier Niggli, but if that premise is wrong then the system is in grave danger.

“Today, there is a problem of contamination,” said Niggli. “There are no more [doping cases] than before, but laboratories are more efficient in detecting infinitesimal quantities of doping substances.”

As I explain here, WADA’s own official testing statistics cast doubt on this premise and from 2027 onwards the agency will adapt its own regulations to allow for more lenient punishment in cases of unlikely, yet plausible, contamination scenarios - such as those involving contaminated air vents in China.

From contaminated supplements to the contaminated environment

Prior to the 2016 Indian Wells Masters, the future Wimbledon champion Simona Halep and a small group of journalists huddled together in the press room of the California tournament.

Weeks earlier, the 2004 Wimbledon champion Maria Sharapova had tested positive for the ‘metabolic cousin’ of the infamous heart medication trimetazidine – called meldonium.

Halep was asked if she was aware of the dangers of contaminated supplements which are blamed by so many athletes who are found with doping substances in their system.

“In your situation, do you or your team check everything that you take?” asked a journalist.

“Yes, we do,” replied Halep.

“And do you play an active part in that, or do you rely on your team to check for you?”

“No, I do myself,” the player answered definitively. “If you take something, you have to check very seriously before.”

Then, prior to the 2022 US Open, Halep’s Athlete Biological Passport showed signs of possible blood doping – and she also tested positive for the blood doping agent Roxadustat which increases an athlete’s endurance.

Halep, who was evidently vigilant in ensuring she did not inadvertently consume contaminated supplements, was now charged with two anti-doping rule violations. She then blamed contaminated supplements, and the Court of Arbitration for Sport accepted her defence. The player was banned for nine months and was cleared of intent to cheat.

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“We are still only catching the dopey dopers, and they are getting dopier. Most sophisticated dopers still evade detection,” said the former World Anti-Doping Agency (WADA) Director General David Howman.

During a self-coined ‘provocative’ speech at a recent US Anti-Doping Agency symposium on ‘Closing the Gap Between Doping Prevalence and Detection’, Howman constructively analysed the effectiveness of the global anti-doping system; a system which he helped build during his thirteen-year tenure at WADA.

Howman, who is now the chairman of the much-respected Athletics Integrity Unit, explained how many other anti-doping agencies are only familiar with how to enforce their regulations, rather than how cheats are circumventing them.

Agencies are failing to test athletes at a time when doping substances are still detectable in their systems, and the same athletes are missing drug tests they know they will not pass. Organisations should focus on the quality of testing, not the quantity.

If a sports man or woman is caught, they are escaping maximum sanctions by using bogus contamination defences. They are, in effect, contaminating products themselves, after the fact, to explain away failed drug tests.

“Currently manipulation of supposed contaminated products is a problem. Proving product contamination might usefully require independent sourcing of product, independent testing,” said Howman.

According to Howman, there are a myriad of ways to beat this system which is designed to act as a deterrent and therefore lower the prevalence of doping over time.

But in a society where testosterone and anabolic steroids are now easily accessible online or in your local gym, can we really believe that doping is trending in the opposite direction?

And so today, I’d like to take the opportunity to explain in-depth the results of several recent prevalence surveys conducted by UK Anti-Doping, the Spanish anti-doping agency and the organisers of the Commonwealth Games which I recently published in The Telegraph.

I will also explain how I spent a year trying to confirm the results of the studies while anti-doping agencies refrained from disclosing them.

I will also share the results of new prevalence surveys answered by US and Spanish Olympians, and the evidence which shows just how serious the problem is.

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This is Part 1 of ‘Faultlines’ - a long-running series on Doping in Tennis. You can find the introduction to the series here (link).

Every Monday and Thursday, I send paid subscribers a press-round up of all the doping stories in the media from the past seven days. You can find an example post here (link).

If you are a member of the media who wants to report on this investigation, it would be greatly appreciated if you could provide a clickable link in your article.

The top Polish tennis player Kamil Majchrzak, who reached the fourth round of Wimbledon, was working with a Polish nutritionist who had openly spoken about his ‘experiences’ with the prohibited drug meldonium online when he failed four different doping tests for three different drugs, Honest Sport can reveal.

“Those of you who know Jacek Feldman know that he likes Russian medicines, especially Meldonium (mildronate),” read a post on the nutritionist Jacek Feldman’s Facebook account.

Meldonium is a heart medication which has been used by Russian athletes, alongside its ‘metabolic cousin’ trimetazidine, to enhance performance according to the former Moscow anti-doping laboratory director Grigory Rodchenkov. Five tennis players have tested positive for the drug, including the former Wimbledon champion Maria Sharapova who was cleared of intent to cheat.

In a now-deleted Facebook post, the nutritionist Jacek Feldman posted a photograph of 60 meldonium capsules which was taken against a similar table mat to one pictured in his ‘home’, as well as four other social media posts. The nutritionist did not respond when asked whether he was in possession, or in the presence, of the drug at the time, but he says he has never engaged in doping.

In 2023, the International Tennis Integrity Agency (ITIA) dealt Majchrzak a reduced thirteen-month suspension after the organisation accepted that the player had consumed contaminated supplements recommended by Feldman during a meeting in Warsaw; the ITIA placed weight on a witness statement from Feldman in its decision.

Majchrzak, who is now the world number 81, was coached at the time by the ex-Polish Tennis Federation coach Marcel du Coudray who has described the player’s ordeal as the most ‘black and white case ever’ of unintentional doping.

In a series of unearthed social media posts, Feldman also previously spoke about his ‘positive experiences’ in relation to the banned peptide BPC-157, which is used to treat injury.

Jacek Feldman told Honest Sport that the posts were not a recommendation and that his knowledge of the drugs came solely from the opinions of other individuals and scientific articles. In 2023, Majchrzak said he performed extensive research in order to take the ‘safest possible’ nutritional supplements prior to his positive drug tests.

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Every Monday and Thursday, I send a newsletter to paid subscriber’s inboxes with the URLs to all the major doping stories in the press over the past seven days.

Part 1: Top Polish tennis player's nutritionist spoke of 'experiences' with banned drug meldonium

During a press conference at the 2016 Laureus Sports Awards, the 24-time grand slam winner Novak Djokovic was asked about a topic that the professional tennis world had always been happy to ignore.

Just months earlier, the Wimbledon champion Maria Sharapova had tested positive for the heart medication meldonium and the topic of doping was now front and centre.

Djokovic was duly put on the spot and shared an opinion, also similarly espoused by Rafael Nadal and the US Open champion Dominic Thiem, that did not agree with the World Anti-Doping Agency Founding President Dick Pound.

“As long as there is no proof that somebody is doping, the sport is clean,” said Djokovic. “I think it all comes down to anti-doping agencies, governing bodies - they need to come out with proof, if they don’t it’s only rumours. I am actually proud to be part of a sport that is clean, pure, that is keeping its integrity.”

Nadal said that same year. “I have total confidence that all my rivals are totally clean…I believe in people until they show you otherwise.”

For Pound, the logic was flawed and, also, predictably in keeping with the ‘Gentleman’s Game’, and other sports’, unwillingness to uncover the true extent of the problem.

“That's a Lance Armstrong approach. 'I never tested positive therefore I am clean.' Wrong,” said Pound. “I think it goes deeper than most people expect, and certainly deeper than they are prepared to acknowledge.”

While the players were of course entitled to their opinions, it was of more concern that the International Tennis Federation’s (ITF) official charged with tackling doping, Stuart Miller, had previously suggested the sport was not susceptible to drug taking.

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In 2009, Miller said that blood doping agents, such as EPO, were potentially of little use in a sport based on skill rather than endurance; three of the four grand slam finals that year lasted over four hours.

“It may be that tennis is not conducive to EPO,” said Miller. “Maybe tennis is not a sport that is driven by a need to maximize stamina, which is what EPO essentially does.”

In the same year as those comments, the ITF failed to conduct a single out-of-competition EPO test and in 2012, the year Roger Federer, Rafael Nadal, Andy Murray and Novak Djokovic shared the four grand slams, that number rose to only 38.

Given Miller’s outlook and the blunt anti-doping programme he operated, albeit on behalf of his superiors, blood doping in the sport was near impossible to uncover.

So, finally, it was at this moment that I decided to start investigating the issue myself, first as a sports fan, and then as a journalist for British newspapers and international television stations.

With Jannik Sinner and Iga Swiatek, who have both served doping bans in the past year, winning the Wimbledon singles titles a fortnight ago, I think the time is ripe to start publishing more of this research.

I, therefore, present ‘Faultlines’ – a series on doping in tennis which will run and run.

Over the course of the next year, and even beyond, I will publish exclusive investigations on doping in tennis – a topic that can no longer be ignored.

Part 1: Top Polish tennis player's nutritionist spoke of 'experiences' with banned drug meldonium

Part 2: German tennis’ anti-doping cases

I have undertaken major doping investigations for British newspapers (link) and international broadcasters such as ITV and ARD. For discussions regarding potential doping investigations at your news organisation, please contact honestsport@substack.com.

I publish Long Read investigations on doping in sport. Every Monday and Thursday, I send a newsletter to your inbox with the URLs to all the major doping stories in the press over the past seven days. You can find an example post here (link).

You can read a recent investigation into the use of weight loss drugs in professional swimming here (link).

If you are a journalist who would like to report on this story, please provide a clickable link in your article. Thank you.

Elite athletes have continued to use controversial ‘weight loss’ hormones, which are used to treat thyroid cancer, at the past three Olympic games a new study has found.

Honest Sport can reveal that Olympic runners, cyclists and skiers self-declared their use of legal thyroid medications more frequently than athletes from other sports across Tokyo 2020, Beijing 2022 and Paris 2024.

Italy has the highest number of athletes who reported their use of the drugs during doping controls while the USA exhibited the second largest figure; Germany is third on the list. 25% of all Olympic athletes who used thyroid hormones were from these three countries.

At the Beijing Winter Olympics, the use of these drugs was nearly 3% but researchers have raised concerns that the number could be higher if all athletes were forced to answer more transparently.

“Some athletes may not declare everything they consume, particularly if a substance is not prohibited,” reads the paper co-published by officials from the International Testing Agency.

“Therefore, underreporting of TH [thyroid hormone] use is possible, and the true prevalence may be higher than recorded here”.

In 2008, the former athlete and whistle-blower Danny Mackey claimed that he was encouraged to take thyroid drugs, as well as prohibited testosterone therapy, by the former director of the Nike Lab in Oregon, USA. Nearly one decade later, the head coach at the Nike Oregon Project Alberto Salazar, who distributed thyroid drugs to his athletes without a prescription, was banned for doping offences.

“This is what Alberto Salazar’s athletes do, and they haven’t gotten caught. You’ll be okay,” read the decision in Salazar’s case.

Last month, the British 1500m world champion Josh Kerr, who is now coached by Mackey, renewed calls for the World Anti-Doping Agency finally to ban thyroid medications which are abused by athletes to improve their ‘power-to-weight ratio’.

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Prescription thyroid medications, such as thyroxine, are primarily used to treat disorders of the thyroid gland, situated in the neck, which produces hormones essential for metabolism and energy regulation. They are also used to treat cancer patients, as a form of hormone therapy, after their thyroid gland has been removed.

However, in professional sport these hormones have been abused by athletes claiming to suffer from a condition known as hypothyroidism. Hypothyroidism is an endocrine disease in which the thyroid gland does not produce enough thyroid hormones which can lead to extreme fatigue, muscle aches and weight gain. When an athlete who does not suffer from hypothyroidism takes the drugs during training, it is thought to aid weight loss and enhance performance.

In 2019, British athletes raised concern that UK Athletics, who employed Alberto Salazar as a consultant, was allegedly screening athletes for hypothyroidism to justify using the drug several years earlier. The governing body denied these claims.

The four-time Olympic champion Sir Mo Farah’s coach Alberto Salazar, who was a UK Athletics consultant over the same period, also provided thyroid hormones to the American runner Kara Goucher, as well as several other members of his training group, without a prescription to aid weight loss and boost testosterone levels.

The former British indoor gold medallist Matthew Yates said, “My deep concern is the long-term danger to the health and well-being of the athletes. I have a huge concern that this isn't being discussed and disclosed with athletes and coaches in depth, about the ramifications of using this medication on a punt for short-term performance.”

Officials at the International Testing Agency (ITA), who conduct the International Olympic Committee’s anti-doping programme, have now found that 2% of tested athletes competing in the last three Olympics have declared their use of the controversial, yet still legal, hormones.

When an athlete is selected for a doping control, they are required to disclose all legal medications, such as thyroid drugs, and supplements which they have consumed in the last seven days. By reviewing these forms, the academics were able to create a statistical report on the prevalence of thyroid medication use at the Olympics.

However, the athletes were not required to disclose their reason for using the drugs and therefore whether they were used therapeutically or to enhance sports performance.

The study reports that a total of 170 athletes declared their use of thyroid hormones during drug tests. 10% of these athletes came from Italy even though nearly 200 nations competed at the Olympics. The USA exhibited the second highest number (9%) followed by Germany (7%) and the Netherlands (6%). Great Britain, despite its past scandals involving thyroid hormones, does not appear on the list.

“Austria, Canada, and the Czech Republic show lower, but similar levels of use, with only one or two athletes from other nations reporting usage at each event,” reads the study.

Perhaps to no surprise, the highest prevalence was seen in athletics, followed by cycling and cross-country skiing.

Footballers and tennis players also feature.

In 2022, lawyers of the 2019 Wimbledon champion Simona Halep argued before the Court of Arbitration for Sport that abnormal fluctuations in her Athlete Biological Passport, a tool used to detect blood doping, could have been caused in part by her hypothyroidism. Halep was eventually cleared of the charge.

Read the full study here

1.37MB ∙ PDF file

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In total, there was a prevalence of thyroid hormone use of 1.8% at Tokyo 2020 and 1.3% at the Paris 2024 Summer Olympics.

However, this number markedly increased to 2.7% at the Beijing 2022 Winter Olympics. The researchers suggested that athletes in sports, such as skiing, could be more susceptible to thyroid hormone abuse.

In sports which are sensitive to weight, thyroid drugs can be used to cut weight without losing power and increase an athlete’s ‘power-to-weight ratio’ which is a crucial indicator of performance in cycling particularly, as well as athletics.

The statistics also show that athletes competing in cross-country skiing and the athletics sprint events, between the 100m and 400m, declared their use of thyroid medications more often than athletes in any other disciplines from any other sports.

The former chemist Victor Conte, who provided doping substances to the sprinter Marion Jones before the Sydney Olympics, has previously revealed that his sprinters used the thyroid hormone liothyronine before races.

“Liothyronine was used to help accelerate the basic metabolic rate before competitions. The purpose was to reduce sluggishness and increase quickness. Two 25mg tablets were taken one hour before competition. There is no test available for liothyronine,” wrote Conte in a letter to UK Sport in 2008.

In the discussion section of the paper, the researchers considered that the prevalence of thyroid hormone use at the Olympic Games could indeed be higher given the statistics generated relied on athletes self-reporting themselves.

By making such disclosures, athletes could be subjected to suspicion and targeted drug testing because thyroid drugs have in the past been used as part of wider, systematic doping protocols by doctors such as Eufemiano Fuentes.

“Additionally, the 7-day reporting window provides a snapshot of recent use and may not represent longer-term usage or capture athletes that have used TH outside of the competition period, nor does it distinguish between therapeutic and non-medical use,” the researchers wrote.

According to the authors of the study, the prevalence of medically indicated thyroid hormone use in young adults within the normal population is estimated between 0.5 and 1.0%.

Last month, the British 1500m world champion Josh Kerr told The Times that the World Anti-Doping agency must now ban the use of thyroid medications by athletes nearly ten years after the US Anti-Doping Agency and UK Anti-Doping called for their prohibition.

“They should be illegal,” said Kerr.

If you are a journalist who would like to report on this story, please provide a clickable link in your article. Thank you.

You can read another recent investigation into the use of weight loss drugs in professional swimming here (link).

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I publish Long Read investigations on doping in sport. Every Monday and Thursday, I send a newsletter to your inbox with the URLs to all the major doping stories in the press over the past seven days.

If you are a journalist who would like to report on this story, please provide a clickable link in your article. Thank you.

When the former Olympic Australian swimmer James Magnussen was in training for a 50m Freestyle world record attempt, filmed during an hour-long Enhanced Games documentary, one moment was particularly poignant.

Magnussen, who won an individual silver medal at London 2012, was in the midst of a systematic 20-week doping programme when he realised his performance was suffering.

This protocol centred around the administration of synthetic testosterone to build up his muscle mass while a cocktail of unapproved, unregulated, but albeit prescribed growth hormone stimulating peptides were used for recovery.

In one scene, Magnussen is captured engaging in a blood doping technique, perhaps ozone therapy, to boost his red blood cell count and consequently endurance.

“We tried a few different things,” said the swimmer. “The base of it was testosterone and then peptides. We used BPC-157, CJC-1295, Ipamorelin and Thymosin.”

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However, the drugs which gave Magnussen new strength, and speed of recovery, also slowed him down.

At 252lbs, the 6ft5 Magnussen was now too heavy for any credible attempt at the record held by the Brazilian Cesar Cielo since 2009, who inadvertently failed a drug test during his career.

The oversized Magnussen, who retired in 2018, fell two seconds short of Cielo’s record which stands at 20.91s.

Magnussen was literally sinking in the water.

“In all honesty, I got too big. It didn't translate well into the water that last probably two months, because I was just too big for a swimmer," said Magnussen.

Contrary to the marketing message of the Enhanced Games, which promises unparalleled performances achieved through doping, the Australian learnt the hard way that elite sport is already near perfectly optimised for high performance - irrespective of the use of prohibited substances.

The outdated muscular physiques of both Magnussen and the East German swimmers of the past, once plied with anabolic steroids from childhood, have now been surpassed in their effectiveness by those with leaner, less muscular frames.

Magnussen, who employed several desperate ‘tricks’ to improve his buoyancy, now promises to showcase a ‘leaner’, ‘meaner’, ‘faster’ physique at the Enhanced Games which will be held in Las Vegas next year. The leaner Enhanced Games swimmer Kristian Gkolomeev was indeed able to ‘break’ the world record in training.

Magnussen’s coach Brett Hawke described the problems faced by his added weight.

“I have been frustrated that we have been down here and, I am trying to elevate him [in the water]. So, we have tried a number of different tricks. We have had to make some adjustments,” said Hawke.

While the Australian swimmer did not disclose the secrets of the adopted ‘tricks’, weight management in swimming has long been a serious issue in the sport, as demonstrated by the traumatic experiences of many young swimmers.

Honest Sport now reports that there is a significant body of evidence that weight loss drugs, known as ‘water pills’, are being abused in professional swimming as they have been in weight-focussed sports such as gymnastics and boxing.

“This is unfortunately the most common use of diuretics; gymnasts trying to lose weight through water elimination, primarily in the thighs and buttocks,” the International Gymnastics Federation has warned previously.

‘Water pills’, otherwise known as diuretics, are a class of medications that increase both the production and excretion of urine. The drugs, such as furosemide and hydrochlorothiazide, help the body shed excess water and salts.

The medications are legitimately used to treat blood pressure and have consequently been at the centre of many inadvertent doping scandals at the highest level of swimming.

At the 2012 London Olympics, James Magnussen’s 4x100m medley relay mate Brenton Rickard, who was an alternate, tested positive for the diuretic furosemide.

A year later, another of Magnussen’s countrymates on the same London 2012 swim team, Kylie Palmer, also tested positive for the drug. And in 2011, the 50m freestyle world record holder Cesar Cielo, who was trained by Magnussen’s coach Brett Hawke prior to 2008, along with three of his Brazilian teammates, tested positive for furosemide at the same event.

In America, on the other hand, diuretics cases have tended to involve another diuretic - hydrochlorothiazide.

Twelve days after Michael Phelps won a record 8 gold medals at the Beijing 2008 Olympics, his training partner at the University of Michigan Emily Brunemann tested positive for hydrochlorothiazide. Between 2017 and 2018, two members of the same Team USA junior swim squad, Grace Ariola and Matthew Willenbring, also tested positive for the same drug.

More recently, the Tokyo 2020 Olympic champion Bella Sims failed a drug test for hydrochlorothiazide while training under Anthony Nesty, the Team USA head coach at Paris 2024. Nesty’s swim group at the University of Florida also includes the swimming superstars Katie Ledecky and Caeleb Dressel, who holds the fastest 50m Freestyle time in recent years.

All of the swimmers were cleared of any intent to cheat with defences ranging from contaminated supplements to mistakenly confusing a relative’s medication for laxatives, as was the case for Brunemann.

However, diuretics use in professional sport, and specifically swimming, has a dark side.

At the time of the East German state doping regime, Olympic athletes worldwide used diuretics prior to international competitions, when they knew they would be tested, to flush the traces of anabolic steroids from their system.

The technique was effective, and athletes were able to take anabolic steroids just two weeks prior to competition.

When three Chinese swimmers tested positive for hydrochlorothiazide in 2016 an anonymous source told The Times that they were concerned the swimmers were using ‘water pills’ as a masking agent.

“That all these swimmers test positive for the same masking agent, which cleans out their system ahead of testing, indicates a systematic network of doping athletes. There is a deep problem and there are rogues working in the sport,” said the source.

However, in modern day swimming, diuretics are unlikely used for this purpose.

A current official at a World Anti-Doping Agency-accredited laboratory has told Honest Sport, in confidence, that diuretics are instead used for their weight-loss properties.

“Most diuretics are readily detectable and, hence, nowadays not very useful anymore as masking agents,” said the official. “But they certainly still are effective in quickly reducing body weight.”

It is an opinion also shared by the former doping chemist Victor Conte who worked with the American Olympic swimmer Amy Van Dyken in his career.

“[It’s] not a real smart strategy,” said Conte.

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In the past, diuretics would increase the speed at which the detectable by-products of anabolic steroids, known as metabolites, were excreted from the body by increasing the rate of urine flow. In 2012, however, a new long-term steroid metabolite test was developed which could detect anabolic steroids in urine months after administration irrespective of the use of diuretics.

Doping techniques have since changed and athletes take smaller doses of synthetic versions of natural compounds, such as testosterone and human growth hormone, which cannot be detected using standard steroid analysis. Human growth hormone, for example, can only be detected in blood samples.

The weight loss properties of diuretics, on the other hand, have preserved the drugs’ place as a doping agent in sport. Previously, the prevalence of diuretic use was largely confined, at least publicly, to weight sensitive sports such as boxing and gymnastics.

A recent doping case involving a swimming doctor and the story of a brave young American athlete, whose experiences have some parallels to those of young swimmers at the world’s best swim clubs, suggest that is no longer the case.

In 2019, the American runner Mary Cain revealed to the New York Times that she had been subjected to ‘emotional’ and ‘physical’ abuse in relation to her weight by the Nike coach Alberto Salazar, who was banned for doping for four years. Cain was subjected to ‘weigh-ins’ in front of her teammates as Salazar allegedly kept a maniacal focus on her weight.

“Alberto was constantly trying to get me to lose weight. He created an arbitrary number of 114lbs and he would usually weigh me in front of my teammates and publicly shame me if I wasn't hitting weight,” said Cain.

That same year, the Australian swim coach Dean Boxall was accused of ‘fat shaming’ and subjecting swimmers to public weigh-ins at St Peters Western Club (SPW). SPW is home to the Australian Olympic champion Ariarne Titmus and Shayna Jack, who inadvertently failed a drug test for the anabolic agent ligandrol in 2019.

“Dad, I can’t please this guy (Boxall). Every time I walk in, it’s about my weight”, said one young swimmer.

SPW and Boxall denied the allegations, but similar claims were made against a former SPW coach, Michael Palfrey, by the Australian Olympic swimmer Maddie Groves.

"I would basically go and hide in the bathrooms, or go and hide, like, in another part of the pool area so that I wouldn't have to do it [weigh-ins] or they wouldn't be able to find me," said Groves.

Earlier this year, the top British coach Jon Rudd was also accused of similar conduct at the Plymouth Leander Swimming Club, which was home to Ruta Meilutyte when she won the 100m breaststroke at London 2012 as a 15-year-old.

Where these stories differ drastically is Cain’s weight loss pressures ended with Salazar, who coached Sir Mo Farah to four Olympic gold medals, allegedly encouraging her to use prohibited diuretics to lose weight. There is no evidence of diuretic use at the two aforementioned swim clubs.

“He wanted to give me birth control pills and diuretics to lose weight, many of which are banned in athletics,” said Cain who did not succumb to Salazar’s purported demands.

Another of the group’s runners, Kara Goucher, was also given a legal thyroid drug by Salazar, without prescription, for weight loss purposes rather than to treat any legitimate thyroid condition.

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Cain is now a council member at the Sport & Rights Alliance safeguarding centre which safeguards athletes against such welfare issues.

In 2006, 44% of sampled young swimmers, between the ages of 11 and 19 years old, demonstrated abnormal eating behaviours which can include the use of diuretics, according to academics at the University of Rio de Janeiro.

“Disordered eating (DE), a component of the female athlete triad, refers to a group of abnormal eating behaviors such as restrictive eating, fasting, frequently skipping meals, the use of diet pills, laxatives, diuretics, or enemas, overeating, binge eating, and purging,” read the study.

Cain’s story, in relation to diuretics, and the experiences of many young swimmers remain a brutal reminder of the toxic pressures of elite sport.

Next year, when James Magnussen subjects himself to self-enforced weight loss during an attempt to break the freestyle world record at the Enhanced Games, he will have the benefit of competing in an unregulated ‘sport’ free of drug testing.

For many young swimmers who are subjected to forced weight loss, unlike Magnussen, they must rely on the regulated sports world to stop bad actors from operating freely.

Last month, the International Testing Agency announced that it has suspended the Bolivian doctor Dr Matheus Das Neves Borgo for six years for administering the Olympic swimmer María José Ribera with furosemide, the same diuretic she tested positive for at the Paris 2024 Olympics.

“The doctor asked a supplement manufacturing laboratory to include the prohibited substance furosemide to made-to order supplements used by swimmer María José Ribera, who then tested positive for furosemide,” reads the ITA’s press release about the case.

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Jannik Sinner’s former physio Giacomo Naldi, whose actions led to the world number one twice testing positive for the anabolic steroid clostebol, was obligated to prevent athletes from inadvertently consuming doping substances during his time working for one of Italy’s most successful basketball clubs, Honest Sport can reveal.

In 2022, at least one basketballer at the club Virtus Bologna, which employed Naldi at the time, was aware of a case involving a rival team’s player who had tested positive for clostebol after inadvertently coming into contact with a third party who was using a ‘Trofodermin’ spray containing the steroid.

The player who tested positive has described Sinner’s case as ‘identical’ to his own.

Naldi is yet to respond to inquiries from this outlet. Sinner said, during his case, that his ‘attention has never been drawn specifically’ to the risks of clostebol contamination.

An Honest Sport investigation has also found that the Italian Olympic doctor at the Paris 2024 Olympics recommended another Italian basketballer to use a Trofodermin spray which caused him to consequently test positive for clostebol, in what was the second doping case of the player’s career.

Shortly after disclosure of Sinner’s case last year, Giacomo Naldi told the Italian media outlet Leggo that he hoped to shed further light on the case which he believed portrayed him as the ‘only culprit’.

Tomorrow, Sinner returns from a three-month suspension to play in the first round of the Rome Masters 1000 tournament.

On 10^th March and 18^th March 2024, the world number one tennis player Jannik Sinner twice tested positive for clostebol at the Indian Wells and Miami Masters 1000 tournaments in the USA. An independent tribunal accepted that Sinner had absorbed the drug during massages performed by Naldi who had been using a clostebol spray, called ‘Trofodermin’, to treat a cut on his finger.

Naldi was recommended the product by Sinner’s ex-physical trainer Umberto Ferrara, who now works with the Wimbledon finalist Matteo Berrettini. It is established that Ferrara bought the spray at the Trinità Pharmacy in Bologna, Italy, before travelling to the United States. He says he purchased the drug to treat a chronic condition.

“There is no question that Jannik is innocent in this case. The ITIA [International Tennis Integrity Agency] did not challenge that key principle. However, under strict liability rules Jannik is responsible for whatever is in his system, even when entirely unaware of it, as in this exceptional case,” read a statement released by Sinner.

In 2020, scientists from Rome’s WADA-accredited laboratory conducted a series of controlled experiments which showed that athletes can test positive for clostebol by shaking hands with another individual who has recently used Trofodermin.

The laboratory was also able to detect clostebol in the participants’ urine samples for between 2 and 11 days following absorption, or administration.

After Sinner’s two failed tests, the Polish Olympic canoeist Dorota Borowska, who was training in Italy at the time, tested positive for clostebol after treating a wound her dog had sustained with Trofodermin. The Italian tennis player Marco Bortolotti also inadvertently tested positive for the drug in 2023.

In the vast majority of clostebol cases in Italy, the athletes have been cleared of any intent to cheat. Therefore, there is no suggestion of wrongdoing on behalf of these individuals, including Jannik Sinner.

“An apparent doping steroid, a fake doping. And the first to know that it is a harmless substance if in small and irrelevant quantities as in the case of Sinner, and easily transmissible, are those responsible for anti-doping,” said the respected anti-doping campaigner Sandro Donati about clostebol.

On the other hand, Luis Horta, the former director of the WADA-accredited laboratory in Lisbon, has previously raised concerns that Trofodermin may be used as a doping agent.

“I suspect that they use creams. Because creams as clostebol, or testosterone by cream or by gel. The detection window it's very, very short. It's sometimes some hours, then it's a good way to dope,” Horta told Honest Sport.

In May 2024, the International Cycling Union suspended the Team Banco Guayaquil-Bianchi team for twenty days after two of its riders failed doping tests, one for erythropoietin (EPO), the other clostebol, within 80 days of each other. The team’s general manager Víctor Hugo Peña rode for the US Postal cycling team and worked with Lance Armstrong’s doping doctor Michele Ferrari, from Italy, during his career.

Last August, an Italian cyclist tested positive for both clostebol, which is largely only available in cream and spray form, and EPO.

In Italy, Trofodermin is sold over the counter in pharmacies for as little as twelve euros, and as such the packaging of the product is emblazoned with a red warning sign that the spray contains a doping substance prohibited for use by the World Anti-Doping Agency (WADA).

Naldi claims that the clostebol product, recommended to him by Umberto Ferrara, had been removed from its packaging and he was therefore unaware the spray contained an anabolic steroid. Naldi also testified that he did not read the label which clearly states Trofodermin contains ‘clostebol acetate’ – a prohibited substance.

“The canister of Spray had previously been removed from its packaging. Mr Naldi admits that he did not check the contents of the Spray or see that present on the label of the canister was ‘Clostebol’. Mr Naldi states that he had no knowledge that the Spray contained Clostebol,” reads the decision.

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Sinner himself told the tribunal that he ensured ‘his entourage was educated about anti-doping, including not to Use Prohibited Substances when treating him’.

Honest Sport can now reveal that Naldi acted in such a manner even though he was required to ensure athletes did not inadvertently fail doping tests while working in Italian basketball.

From July 2017 to January 2023, Naldi was employed as a physio at the Virtus Bologna professional basketball club. Virtus Bologna have won 16 Italian league championships, second only to Olimpia Milano, and two EuroLeague titles, the most prestigious club basketball tournament in Europe.

As a member of the club’s ‘medical staff’ and a contracted ‘employee’, Naldi was obliged to follow the Virtus Bologna ‘Code of Ethics’ and in doing so prevent the club’s players from involuntarily using prohibited substances.

“Virtus condemns the practice of doping and is committed to preventing the involuntary use of doping substances, acting in full compliance with international sports regulations and applicable nationals,” reads section 4.5 of the Code of Ethics. “No tolerance will be allowed in the matter of doping.”

The regulations were approved by the Virtus Bologna board of directors in September 2020. The document also states that it would ensure that ‘the Code’ was disseminated to all the club’s staff with corresponding confirmation of receipt.

"With respect to the Recipients, the Company's top management undertakes to: implement adequate training and awareness programs on the contents of the Code," states section 2.

Nevertheless, fourteen months after Naldi left Virtus Bologna, Jannik Sinner inadvertently failed two doping tests.

Sinner, who initially avoided a suspension from the International Tennis Integrity Agency (ITIA), was suspended for three months after WADA appealed the decision. Both parties reached a ‘case resolution’ agreement several weeks before the case was due to be re-heard at the Court of Arbitration for Sport.

WADA considered Sinner to be responsible for the actions of his entourage, which in this case included Giacomo Naldi and Umberto Ferrara, who were said to have acted negligently.

“WADA has confirmed and agreed that the athlete's scenario is scientifically plausible and well-supported by facts. Given his specific facts, a twelve-month sanction would have been disproportionately severe,” stated WADA’s press department. “WADA accepts that Mr. Sinner did not intend to cheat, and that his exposure to clostebol did not provide any performance-enhancing benefit.”

Lars Mortsiefer, a board member of the German anti-doping agency, told the Frankfurter Allgemeine Zeitung that he struggled to understand how WADA’s regulations allow for an athlete, in this case Sinner, to test positive for anabolic steroid and avoid a sanction of less than one year.

“Under current regulations, a reduction of less than one year of suspension is generally not permissible,” said Mortsiefer.

Indeed in 2022, the Italian national team basketballer Riccardo Moraschini was suspended for one year after testing positive for clostebol under what the player describes as ‘identical’ circumstances to Sinner.

In October the previous year, Moraschini inadvertently absorbed clostebol after coming into contact with a third party, his partner, who had applied Trofodermin spray to a cut on their finger after being recommended the drug by a pharmacist.

In Sinner’s case, the player inadvertently absorbed clostebol after coming into contact with a third party, his physio, who had applied Trofodermin spray to a cut on their finger after being recommended the drug by his physical trainer, a self-described ‘chemist pharmaceutical’.

“There is not even a thin thread between my story and this one of Sinner. It is exactly the same identical situation. But evidently managed in a totally different way in every way. Here is the world and the objectivity of the doping and anti-doping system,” wrote the Italian basketballer on the social media platform X.

The negligence demonstrated by Sinner’s ex-physio Giacomo Naldi, whose actions Sinner was responsible for as per WADA regulations, is harder to understand given his experience working in Italian basketball, which is well familiar with clostebol cases.

In 1998, La Stampa reported that the Italian Olympic doctor at the Paris 2024 Olympics Andrea Billi ‘prescribed’ Trofodermin spray to the Italian basketballer Mario Boni to treat an infection on his big toe.

Boni, who used the spray twice a day for four days, tested positive for clostebol. Despite testing positive for another anabolic steroid, nandrolone, four years earlier, Bini was cleared of intent to cheat. There is therefore no suggestion of wrongdoing on behalf of Dr. Andrea Billi.

“The analysis has shown that the quantity of anabolic is compatible with the use of the spray, excluding that the Clorebol [sic] was taken in another form,” reads the article.

According to his Curriculum Vitae, Andrea Billi was the team doctor of the Italian Men’s Italian National team from 1998 to 2015. He was also the Italian Olympic Committee doctor at the Tokyo 2020 and more recently at Paris 2024.

Moraschini, who overlapped with Dr. Billi in the national team in 2014 and at the Tokyo Olympics, later tested positive for clostebol as did his teammate at Olimpia Milano Christian Burns, who also played for Italy. Burns was cleared of wrongdoing.

Giacomo Naldi is yet to respond to inquiries asking whether he was aware of the Olimpia Milano cases prior to Sinner testing positive, and therefore why he did not take an extra precaution concerning the drug.

However, Honest Sport has now found that at least one basketballer on the Virtus Bologna team, who employed Naldi at the time, was aware of Moraschini’s case.

On 3^rd January 2022, Moraschini announced on Instagram that he had been suspended by the Italian anti-doping agency.

“It all comes from indirect contamination, that is, from contact with a person who was using, without my knowledge, a healing spray containing the substance (purchased in a pharmacy on the advice of the pharmacist himself...),” read the Instagram caption.

Under the post, the Virtus Bologna player Marco Ceron posted three heart ‘emojis’ which Moraschini duly replied to. Moraschini played for Virtus Bologna from 2007 to 2013 before later playing for Olimpia Milano.

Two days after the post, on 5^th January, Virtus Bologna played Olimpia Milano at the Mediolanum Forum arena. Several months later in the championship finals, the pair played a further six times. Both clubs’ players and staff were obviously well-known to each other.

While Naldi may have been unaware of Moraschini’s case - and its intricacies, Sinner’s former physio Umberto Ferrara reiterated to Gazetta dello Sport last month that he still warned Naldi that Trofodermin contained a prohibited substance.

“I was very clear in communicating to Naldi the nature of the product and the need for it not to come into contact with Jannik for any reason,” said Ferrara.

In October last year, Giacomo Naldi told the media outlet Leggo that he was not the only party responsible for Sinner’s failed drug tests.

“I hope that, sooner or later, I can tell what happened to shed some light because the current interpretations make me look like the only culprit, but that's not the case," said Naldi.

In August, Sinner parted ways with both Naldi and Ferrara shortly after the ITIA disclosed the conclusion of his case.

In previous cases, the ITIA has fought for more harsh sanctions when players, and by extension their entourage, are aware of a recognised contamination problem.

In 2023, the Brazilian player Gilbert Klier was banned after testing positive for the anabolic agent ostarine after consuming contaminated supplements produced in a compound pharmacy. In Klier’s case, the ITIA served the player with a one-year suspension because the agency, and the International Tennis Federation, had specifically warned Brazilian players about these supplements.

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“The Player could not assume that he was avoiding that risk in January 2022 in using what he thought was a reputable compound pharmacy based on cursory checks. To the contrary, he voluntarily assumed that risk,” read the decision.

Jannik Sinner said, as per the decision in his case, that his ‘attention has never been drawn specifically’ to the risks of clostebol contamination.

The ITIA confirmed to Honest Sport that it has never sent a formal warning to players that Italy has a recognised clostebol contamination problem. The agency also does not email players every time a player is suspended for doping.

Nevertheless, four months prior to Sinner’s case, the ITIA publicly announced, on its website and Twitter account, that the Italian player Stefano Battaglino had been suspended for four years after testing positive for clostebol. Battaglino says he overlapped with Sinner at the Piatti Tennis Academy. He was photographed at the centre in 2018, as per a post on Instagram.

In 2021, the Italian teenage tennis players Mariano Tammaro and Matilde Paoletti also inadvertently tested positive for clostebol. The Italian Tennis Federation (FITP) announced the conclusion to Paoletti’s case, who trained at an Olympic training centre, on its own Facebook page.

The FITP, nor the Italian anti-doping agency, is yet to clarify whether they took proactive measures to stop players from testing positive for clostebol prior to Sinner’s case. The German anti-doping agency has since actively warned athletes about the dangers of clostebol sprays.

Tomorrow, the world number one plays in the first round of the Rome Masters 1000 tournament in his homeland Italy, where he has been welcomed by the FITP President Andrea Binaghi.

Binaghi said last week, “The world is populated by idiots and envious people, and Sinner has noticed this in recent months.”

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Every Monday and Thursday, I publish a press-round up of all the doping and sports medicine stories in the media from the past seven days.

This Long Read is the final article in a three-part series on doping, and drug trafficking, in Jamaican sprinting.

It is the product of several years of research.

You can read Part 1 (here) and Part 2 (here).

A certain Anthony Brown was an assistant track and field coach at St. Jago High School, which is one of Jamaica’s oldest educational establishments.

The school boasts one of the best junior track and field teams in the country and its former alumni includes the Olympic gold medallists Yohan Blake, Melaine Walker and Nickel Ashmeade. During Brown’s time coaching at the school in the late 1990s, the girls’ track team won four consecutive titles at the Boys and Girls Athletics Championships, better known as ‘Champs’ as you now know.

Brown, however, was using his coaching position on the boy’s track team for his own motives.

In 2012, Brown testified before a US grand jury that both he and two school friends had trafficked cocaine into the US when the team competed internationally at the Penn Relays held in Philadelphia in the late nineties.

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Every Monday and Thursday, I publish a press-round up of all the doping and sports medicine stories in the media from the past seven days.

This is the second article in a three-part series on doping, and drug trafficking, in Jamaican track and field. You can read Part 1 (here).

In part 3 (link), I explain in-depth exactly how a close relationship between sprinting circles in Jamaica and the US has provided the foundation for elite sprinters to cheat the system.

Kingston, the capital of Jamaica, is just a two-hour flight away from the sunshine state of Florida. But for many young Jamaican athletes on board over the years, this short journey across the Gulf of Mexico has represented an entirely new beginning in a land of opportunity.

Every year, many of Jamaica’s best young sprinters win prestigious US college scholarships for their spectacular performances at the high school track and field championships known as ‘Champs’ held in Kingston. Over 3000 Jamaican athletes gather at the National Stadium for the four-day event hoping to follow in the footsteps of Olympic champions, such as Usain Bolt, Yohan Blake and Veronica Campbell-Brown who first made their name at Champs.

Campbell-Brown, the 2-time Olympic 200m champion who started her career at the University of Arkansas and has a house in Florida, believes the intense pressure at the event lay the foundation for her future success.

“It taught me how to run and win under pressure and I think my days at Champs actually helped me in my career because it was so competitive,” said Campbell-Brown.

Champs has become not only a Jamaican institution but the bedrock of the country’s athletics success.

But as with any professional sport, in any country, when the stakes are so high, and the competition is fierce bad actors are never far away.

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Every Monday and Thursday, I send a newsletter to your inbox with the URLs to all the major doping stories in the press over the past seven days. You can read a free example of these round-ups here (link). I publish Long Read investigations on doping in sport, you can find the archive here (link).

Senior World Anti-Doping Agency (WADA) officials believe the ‘court of public opinion’ has demonstrated that the agency correctly handled 23 doping cases involving Chinese swimmers who all tested positive for the heart medication trimetazidine prior to the Tokyo 2020 Olympics, according to internal communications obtained by Honest Sport.

The athlete-led group Global Athlete tells Honest Sport that WADA officials must be ‘living under a rock’ to hold such an opinion given concerns already raised by ‘clean’ athletes over WADA and the Chinese anti-doping agency’s handling of the cases.

In a letter addressed to the anti-doping regulator’s Executive Committee, the WADA President Witold Banka and Director General Olivier Niggli reveal that the agency has dropped its lawsuit against the US Anti-Doping Agency (USADA) CEO Travis Tygart who accused WADA of sweeping the Chinese swimming cases ‘under the carpet’.

“While we remain convinced that the lawsuit would be successful on its merits, we have determined that it is futile to argue with somebody who is unwilling to accept clear evidence, whose only goal is to damage WADA and the global anti-doping system,” reads the letter. “We will now put this behind us and move forward in collaboration with our stakeholders for the good of all athletes around the world.”

Last month, the US government withheld its annual payment of $3.6m to WADA after the agency initially refused to drop its libel case against Travis Tygart. US federal officials also asked WADA to submit to an external audit after losing some confidence in the agency’s ability to tackle doping worldwide following the China scandal. WADA is still yet to do so.

“It is to be noted that, although the U.S. Government representative on the ExCo stipulated withdrawal of the lawsuit as a condition to payment, he never espoused or defended the outrageous cover-up allegations made by Mr. Tygart,” wrote Niggli and Banka.

In January 2021, 23 Chinese swimmers tested positive for the heart medication trimetazidine but escaped sanction after the Chinese Anti-Doping Agency (CHINADA) attributed the cases to environmental contamination in their athlete hotel. WADA had the right to appeal CHINADA’s decision, as it does in every case involving athletes governed by the WADA code, but chose not to do so.

Shortly after ARD and the New York Times broke the story last year, the USADA CEO Travis Tygart accused WADA of a ‘cover up’ - claims which became the focus of the now-dropped libel case.

“It’s even more devastating to learn the World Anti-Doping Agency and the Chinese Anti-Doping Agency secretly, until now, swept these positives under the carpet by failing to fairly and evenly follow the global rules that apply to everyone else in the world,” said Tygart.

Indeed, a WADA-appointed prosecutor, Eric Cottier, wrote in his report that CHINADA deviated from recognised anti-doping practices by neither informing the swimmers they had tested positive nor provisionally suspending them.

“In short, the Chinese Anti-Doping Organisation, by refraining from notifying the positive athletes, completely ignored ISRM Article 5.1.2.1, which the expert describes as a fundamental violation of anti-doping rules. This violation gave rise to a whole series of consequences which, in the expert's view, are the results of many flaws in the proceedings conducted by CHINADA,” read the report.

However, Cottier ruled that WADA showed no bias towards China, that its decision not to appeal the cases to the Court of Arbitration for Sport was reasonable and that it acted in line with its own regulations. However, the Director General of the French anti-doping agency (AFLD) has criticised the narrow scope of the report which was set by WADA itself.

Nevertheless an internal letter from WADA’s two most senior officials to its Executive Committee now reveals that the officials still believe that the ‘Cottier Report’ has strengthened the agency’s reputation.

“We were willing to consider its one condition – withdrawal of the lawsuit – on the basis that the lawsuit’s purpose had largely been achieved through the court of public opinion. This is to say that the world (except for Mr. Tygart) has accepted the findings of the Cottier Report and has shown a desire to move on,” reads the letter.

This is however a view that it not shared by the entire anti-doping community.

The former WADA Vice-president Linda Helleland has called on the Norwegian government, to follow the US, and withhold its annual payment to the agency otherwise they risk “siding with WADA and China”.

“We have a global anti-doping organisation that is devoid of integrity and that is not doing its job. They are supposed to fight doping and ensure fair competition among athletes, but now appear most concerned with protecting the interests of the dark forces that want to destroy sports,” said Helleland.

Meanwhile, the head of the German anti-doping agency has called for an independent investigation.

A board member of the athlete-led group Global Athlete, which is directed by a former WADA official, told Honest Sport that WADA must be “living under a rock” and that Travis Tygart has the full backing of American athletes.

“Athletes in the U.S. have full faith in Travis Tygart to stand up for their interests, to fight for an equitable and effective global anti-doping system, and to call out injustices when he sees them. At the same time, athletes have lost all confidence in WADA,” said the board member Noah Hoffman, who is also a USA Olympian. “WADA must be living under a rock if they think they won the case involving 23 Chinese swimmers testing positive for TMZ [trimetazidine] in the court of public opinion. If any athlete outside of China tested positive for TMZ, they would immediately face a provisional suspension, and the positive test would be publicly disclosed.”

WADA maintains that it had no basis to challenge CHINADA’s explanation of environmental contamination given the available scientific evidence and intelligence.

Just months earlier, a Chinese whistle-blower reportedly informed WADA officials that Chinese athletes had, in the past, taken undetectable amounts of trimetazidine – the same drug the 23 swimmers tested positive for. Further in 2014, the 3-time Olympic champion Sun Yang, in the first of two doping cases during his career, also inadvertently tested positive for the same drug.

WADA also chose not to appeal in the case of the top-ranked tennis player Iga Swiatek who tested positive for trimetazidine after claiming to have taken contaminated melatonin pills.

The American tennis player Jessica Pegula is one of many athletes who has lost faith in the global anti-doping system.

“I can give a reason and explain in a million different ways to make it sound right and I feel that what's been happening the last few years. There is just always an explanation of all these extreme or weird circumstances in cases and I just don't understand how you can trust the process,” said Pegula.

The WADA Presidential elections will take place in May and the current President Witold Banka is widely expected to be re-elected for his third term.

Letter To Wada Executive Committee Feb 2025

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Twenty months before the start of the Beijing 2008 Olympics, a package was delivered to the doorstep of the Jamaican hurdler Adrian Findlay.

The shipment contained prohibited testosterone and the anabolic steroid oxandrolone, US investigators found. Over the same winter, two packages of HGH had arrived at the home address of another Jamaican hurdler, Deloreen Ennis-London.

Six months later, Ennis-London won a bronze medal in the 100m Hurdles at the 2007 World Athletics Championships. She then won bronze again in 2009.

Ennis-London still has those medals, and her results have never been annulled. Nor have those of the Jamaican 400m hurdler Adrian Findlay.

Both Ennis-London and Findlay, as an alternate, went on to form part of Jamaica’s track and field team at the Beijing 2008 Olympics. Jamaica won a record eleven Olympic medals led by its gold medal winners Shelly-Ann Fraser-Pryce, Melaine Walker, Usain Bolt, Veronica Campbell-Brown, Asafa Powell and Nesta Carter.

But years later, journalists uncovered that several male Jamaican sprinters had been caught with the anabolic agent clenbuterol in their systems at those very same Olympics. These failed drugs tests, detected through retesting, were never officially ‘reported’, and the athletes were never formally required to defend themselves.

The International Olympic Committee (IOC) maintained that pattern analysis had shown that the Jamaican positives had been likely caused by meat contamination during the Olympics in China. A pattern the IOC and WADA were willing to disregard was that banned hormones had been shipped to the homes of two members of Jamaica’s sprint team.

This is the story of the curious clenbuterol cases in male Jamaican sprinting at Beijing 2008.

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When Craig Dawson, a multiple sclerosis sufferer who could not walk, was ushered into a hyperbaric oxygen chamber at the OxyMed clinic in the Melbourne suburb of South Yarra, they were the last conscious moments of his life.

A short while later, an exhaust valve failed and the mask delivering him 100 percent pure oxygen suddenly sucked onto his face with 80 kilograms of force, emptying his lungs and triggering a heart attack.

He was soon found by the clinic’s owner, Malcolm Hooper, unconscious with blood inside his mask.

The chamber had not been fitted with an ‘emergency dump valve’ which allows a patient to be reached within 30 seconds in an emergency.

Instead, it took five minutes for Hooper to decompress the chamber and reach Dawson. Hooper also did not have a valid First Aid qualification, reported News.com.au.

The multiple sclerosis sufferer never regained consciousness and died five days later in hospital.

It was in this clinic, a six-minute drive from Melbourne Park, that Novak Djokovic reportedly entered one of OxyMed’s hyperbaric oxygen chambers just months earlier during the 2016 Australian Open. Hooper kept his clinic open until the early hours of the morning for tennis players competing at the tournament that year.

The following year, in 2017, Hooper was charged with failing to provide a safe workspace emanating from Craig Dawson’s death. And in late 2020, the Australian government’s Therapeutic Goods Association initiated proceedings in the Federal Court of Australia against Hooper for promoting hyperbaric oxygen therapy to treat incurable diseases such as Alzheimer's, cerebral palsy, dementia and HIV.

Despite these serious charges, several of which Hooper has since been found guilty, an Honest Sport open-source investigation has now found that Novak Djokovic has continued his association with Malcolm Hooper, who he referred to as a ‘dear friend’ in 2017.

The ten-time Australian Open champion was pictured with Hooper inside his OxyMed clinic during the 2019 Australian Open. Hooper also sat in the rows behind, or in, the 24-time Grand Slam champion’s player’s box at the 2015, 2016, 2019, 2020, 2021, 2023 and 2024 Australian Opens.

Hooper also wrote on social media that he ‘assisted’ Djokovic during the 2019 and 2021 editions of the event. Djokovic features in promotional material for the clinic advertising OxyMed’s services.

The player’s representatives have yet to respond to inquiries from Honest Sport as to whether Djokovic has received hyperbaric oxygen therapy from Hooper since the death of Hooper’s patient in 2016. Djokovic is therefore yet to detail why he has chosen to continue his association with Hooper.

Djokovic, however, has always been open about his use of hyperbaric oxygen therapy therefore is no suggestion of wrongdoing on his part.

“I think it really helps - not with muscle but more with recovery after an exhausting set,” Djokovic told the Wall Street Journal in 2011. “It's like a spaceship. It's very interesting technology”.

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurised chamber and mimics the effects of sleeping at high-altitude. This therapy is legal and beneficial to athletes because it boosts their red blood cell count and thus the oxygen carrying capacity of their body.

Djokovic has previously suggested that use of the therapy was a sensitive topic. A representative of Djokovic’s new coach Andy Murray told the Wall Street Journal that Murray tried the therapy but decided that it was not for him.

“It’s very sensitive, especially in the European part of the world,” Djokovic said. “I wish I can have this all over the place, I wish”.

Djokovic has since been pictured in hyperbaric oxygen therapy clinics in England and Spain, as the stigma around the treatment has eased. Elite footballers are now open about their use of the therapy on social media.

According to Hooper’s Facebook page, Hooper claims to have assisted Djokovic during the 2021 Australian Open. The post was captioned, “It is again a privilege to assist Novak with his AO 2021 campaign”, and Hooper uploaded two posters, signed by Djokovic himself, depicting a caricature Djokovic with a speech bubble coming from his mouth saying, “Hyperbaric oxygen, the power from within”.

Djokovic signed one of the posters, “To Mal and Kate (Hooper’s wife), much love to you and OxyMed”, and the second “Journey of a broken racquet not a broken spirit”, acknowledging the racquet he had broken against Alexander Zverev in his quarter-final match. Hooper was also pictured inside Djokovic’s box during his semi-final with Aslan Karatsev.

Honest Sport has also found a photograph of Djokovic with the artwork, posted on Instagram by the artist.

“Novak Djokovic received a copy of my Open Winner caricature at OxyMed Australia in Chapel Street today [the clinic’s address],” read the post. “Mal Hooper helped Novak overcome the tear on his tummy and commissioned me to draw a few Djokers”.

Hooper’s other clients have previously included the three-time Australian Open Doubles champion Bethany Mattek-Sands, Ana Ivanovic and Mike Bryan.

“It just helps recovery. I felt a little better doing it,” said Bryan.

According to the ‘Oxysports Integrative Medicine’ sections of older versions of Hooper’s clinic website, Hooper also offers optional legal amino acid supplements, and peptides to be taken in combination with hyperbaric oxygen therapy. There is no evidence that any tennis players have ever received any other types of treatment or therapy from Hooper. However, amino acid injections were given to Australian rules footballers by Hooper.

When tennis players reportedly underwent hyperbaric oxygen therapy at OxyMed prior to the death of Hooper’s patient, Hooper’s problems with the law were already well known.

In 2013, Hooper, a former chiropractor who used to be addressed as ‘doctor’, was disqualified from practising for two years after he charged a 30-year-old patient with cerebral palsy approximately $50,000 for hyperbaric oxygen therapy.

The patient called his treatments a ‘charlatan style’ sham, and the Victorian Civil and Administrative Tribunal said Hooper showed ‘disgraceful and dishonourable’ behaviour, misrepresenting his treatment’s effectiveness against the incurable condition.

The tribunal, which deals with medical treatments, found him guilty of five counts of unprofessional conduct and three of professional misconduct.

The husband of the American player Bethanie Mattek-Sands was unconcerned.

“He’s been nothing but an upstanding, good guy,” he told the Wall Street Journal in 2016.

The article stated that Hooper had been open about his past. In Australia, one also does not need to be a doctor to operate hyperbaric oxygen chambers.

There was however one athlete who was worried about the treatment he had received at Hooper’s OxyMed clinic.

In 2015, the former Essendon Australian footballer Hal Hunter sued the club and Australian Football League (AFL) in an attempt to find out, among other things, exactly what had been put into his body at Hooper’s clinic in the wake of the supplement scandal that rocked the league.

In 2016, the Court of Arbitration banned thirty-four Essendon players after they were injected with the prohibited peptide Thymosin-beta-4 by the club’s medical staff, not Hooper.

Mr Hunter alleged that in 2012 he attended the clinic, then called HyperMed, at the club’s request. He was sent by Stephen Dank, the sports scientist since banned for life from the AFL after he committed several anti-doping violations.

As part of an AFL investigation, the organisation said that Hooper had reportedly injected the players with amino acids that he had sourced from a patient. This patient, who suffered from muscular dystrophy, had allegedly obtained the supplements from a chemist abroad but both he and Hooper claimed to not know their contents.

Ultimately, the AFL concluded the injections did not contain prohibited substances, and the Supreme Court ruled that Essendon Football club had provided Hunter with all of the medical data that they possessed. Hooper has never been charged with any anti-doping breaches, and there is no suggestion of wrongdoing by any tennis players.

Instead, Hooper has faced other problems.

In July 2021, Malcolm Hooper convicted in the County Court of Victoria of three counts of failing to provide a safe workplace after Mr Dawson’s death. He was also fined $726,750.

The judge found Hooper, and OxyMed, guilty of failing to complete comprehensive risk assessments of patients, and of failing to have attendants with adequate first aid training. Hooper also pleaded guilty to failing to ensure appropriate supervision of patients. The judge also said that Hooper, who did not have a valid first aid qualification, did not place Craig Dawson on a hard flat surface and therefore the chest compressions he performed were largely if not completely ineffective.

However, Hooper was found not guilty of recklessly placing a person in danger of serious injury. The judge said it remained unknown whether effective chest compressions would have changed the outcome of events. The judge did note that Hooper cared about his patients and passionately believed in hyperbaric oxygen therapy, even if some of his belief lay outside the ‘mainstream’.

In December 2021, the Federal Court of Australia fined Hooper and his clinic OxyMed $3 million for wrongly advertising that hyperbaric chambers were effective in the treatment of serious diseases and medical conditions, including Alzheimer's disease, cerebral palsy, dementia, stroke, HIV/AIDS, cancer, depression and post-traumatic stress disorder.

Honest Sport asked Novak Djokovic’s representatives about his association with Malcolm Hooper post-2021 but is yet to receive a response.

Up until 2017, Djokovic, as per his own words, referred to Hooper as a ‘dear friend’ in a recorded video for the 11^th edition of the International Hyperbaric Medical Symposium.

“I would like to thank my dear friend Dr. Malcolm Hooper from Australia who has been greatly influencing my education and my awareness of HBO world in the last 7-8 years,” said Djokovic.

“I have witnessed and seen first-hand the drive and the passion that this generous man has and the good that he has done to so many of his patients over the last seven, eight years with the severe health conditions and diseases.”

It remains to be seen whether Malcolm Hooper, as he was in 2023 and 2024, will again be sat behind Djokovic’s player’s box at the upcoming Australian Open.

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The following is a chronological, photographic timeline of all of the occasions on which the alternative practitioner Malcolm Hooper was pictured either with Novak Djokovic at the OxyMed clinic, in his player’s box, or in the rows behind, starting with the 2015 Australian Open. The timeline also lists the dates that Hooper has faced charges and/or convictions, and includes all of the social media posts referred to in the main article. It is also includes all of the sources used to write this article.

2013: Malcolm Hooper is ‘struck off’

This detailed, sourced 1500 word timeline now continues.

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In the autumn of 2001, after a Serie A match versus Piacenza, a doping control officer shepherded the Brescia Calcio footballer Pep Guardiola through the corridors of the Stadio Leonardo Garilli to a designated drug testing room, and asked the player to submit a urine sample.

The results of the analysis performed on that sample, sent to Guardiola weeks later by Italian anti-doping authorities, marked the beginning of the future FC Barcelona manager’s eight-year, but ultimately successful battle to salvage both his and his beloved Catalan club’s reputation.

Six months earlier, the Barcelona defender Frank de Boer had tested positive for metabolites of the anabolic steroid nandrolone after a UEFA cup quarter-final tie versus Celta Vigo. Guardiola, in his eleventh first-team season with the club, also took to the field in that match and played in central midfield behind the Brazilian legend Rivaldo, who scored twice.

De Boer was initially banned for one year, until an appeal committee at UEFA, European football’s governing body, reduced the sanction to eleven weeks. But it was quotes from de Boer within the press release announcing that decision that forced FC Barcelona to defend themselves against even a whisper of wrongdoing.

The UEFA Appeal Body ruled that it was ‘more than likely’ that de Boer had been the victim of contaminated supplements despite the fact the contaminated products in question had not been located. De Boer suspected the club’s doctors may have accidently given him contaminated tablets when he had a low white blood cell count, although he made it clear he had absolute trust in the club’s medical staff.

“In February, Barcelona gave me two or three yellow tablets because my level of white blood cells was low,” de Boer said, “I am not blaming Barcelona, but this has to be investigated further. It is possible that these tablets were responsible for the positive test. I do, however, trust the doctors from the Dutch federation and from Barcelona”.

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In response, the head of Barcelona’s medical services, Dr. Josep Borrell, insisted that the club had never provided substances to any player that “could be considered to be a banned substance”. The club had never had a positive drug test, and there was no evidence they had engaged in wrongdoing, but this saga caused great embarrassment.

Given the severity of the scandal, it came as a great surprise therefore when Guardiola, who was still being diligently supervised by an FC Barcelona doctor, tested positive for the same anabolic steroid as de Boer while playing in Italy several months later.

At the start of Guardiola’s ordeal, de Boer gave his former teammate one piece of advice via the Spanish newspaper Marca, “If he wants to go to the World Cup, he should go looking for a good lawyer”.

Guardiola’s two failed doping tests

On 21^st October, and on the 4^th November 2001 after a match against Lazio in Rome, Pep Guardiola tested positive for the anabolic steroid nandrolone. The matches were some of Guardiola’s first appearances for Brescia Calcio after his move from FC Barcelona that summer.

Nandrolone is a potent anabolic steroid that can drastically increase muscle mass at the expense of unwanted side effects such as acne, hair growth and voice changes. However, at lower dosages it has also been used by professional sportsmen and women to improve their strength and speed, and to increase their training load.

The steroid can be detected during doping analysis by the presence of its metabolites 19-norandrosterone. One of Guardiola’s two urine sample showed the presence of 9ng/ml of 19-norandrosterone, which was four times over the legal limit (2ng/ml). However, the amount of nandrolone found in Guardiola’s samples was still far less than the amount found in the samples of some other athletes such as the British 100m Olympic champion Linford Christie (200ng/ml).

In the days following the news of his positive drug tests, Guardiola hosted a press conference, accompanied by the Brescia doctor Ernest Alicicco, to protest his innocence. Guardiola was emphatic that he had never knowingly taken anabolic steroids.

“A machine says I have taken nandrolone, but I know I did not,” he said, “Before Piacenza I only took the multivitamins that Dr. Ramón Segura, my trusted physiologist, has prepared for me for six or seven years. They consist of only specific vitamins, as evidenced by the more than 60 doping tests that I have undertaken over the many years of my career, all came back negative. I am innocent and I’m going to prove it.”

Despite leaving Barcelona several months earlier, Guardiola’s supplementation regime was still overseen by the FC Barcelona consultant doctor Ramón Segura. Segura had been at Barcelona, as had Guardiola, at the time of de Boer’s positive.

Dr. Segura soon told the press that he was shocked at news of Guardiola’s failed drug test. “I cannot believe it. I have spoken with Guardiola and he cannot find an explanation, he is not aware of having taken anything that could cause him to test positive. Neither is it possible it was the vitamin supplements he takes,” said Dr. Segura in November 2001.

Given the timing of both de Boer and Guardiola’s positive nandrolone tests, Barcelona sent the supplements they had provided to the club’s players for testing to demonstrate no wrongdoing on their part. The results came back negative for nandrolone.

It did emerge however, during disciplinary proceedings brought forward by the Italian Olympic Committee (CONI) against Guardiola, that Segura provided supplements to Guardiola which he could not have been sure were free of contaminants.

“Taking the supplements prescribed, supplied and guaranteed by the Prof. Ramon Segura, doctor of FC Barcelona for which the player previously played, constituted risky behaviour, also because said supplements were prepared with ‘raw materials purchased from different suppliers according to market availability’, outside of suitable ‘certification of the manufacturing companies (which was neither requested nor verified)’,” read the decision.

Nonetheless, the professional relationship between Dr. Segura and Guardiola was not impacted. Indeed, Barcelona re-hired Segura after Guardiola became the club’s manager in the 2008/2009 treble-winning season.

According to Segura, Guardiola took a keen interest in the aids his former physician provided to his players, perhaps in order that the pair could ensure that the Barcelona players did not accidently ingest banned products. “Guardiola took this program of daily supplementation very seriously and insisted to the players on the need for it and made sure they followed it,” Dr. Segura explained.

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At the conclusion of the first instance of Guardiola’s doping case in 2001, the future manager was fined €50,000 by the Italian league, the Lega Nazionale Professionisti, and he was suspended from football for four months. When Guardiola appealed the CONI’s decision, he was unsuccessful.

It had been found that the supplements Guardiola had taken did not contain nandrolone and were therefore not the source of his positive tests. It was noted however that Guardiola had taken a risk by taking the supplements.

“Guardiola is not a beginner, but a profound connoisseur of the world of football who knows how products intended to enhance performance of athletes (for their own or others' interests) can easily contain prohibited substances, he should not have accepted the risk of taking products recommended to him, yes, by the company doctor, but of an inadequately safe origin,” stated the appeal decision in Guardiola’ case.

The nandrolone metabolites found in his samples had also not been endogenously produced by his body, which was an argument that Guardiola would adopt at later appeals.

However, the panel did reduce Guardiola’s ban below the minimum standard sanction of two years. This was an acknowledgement that Guardiola, while he may have been at fault, did not act with intent to cheat.

“I have never understood the four-month suspension, because either it is doping, or it is not doping. If I was guilty, they should have disqualified me for two years," said Guardiola after his failed appeal at the Court of Brescia.

The spate of nandrolone positives across professional sport

In 2001, Pep Guardiola and Frank de Boer were just two of the many footballers, and athletes, who tested positive for nandrolone. At the time a spate of nandrolone positives had engulfed professional sport.

In fact, two of Frank de Boer’s teammates from the Dutch national team, Jaap Stam and Edgar Davids, also tested positive for nandrolone that same year. Davids was playing for Juventus, who were under investigation as a club for doping, and Stam had recently joined Lazio from Manchester United.

Initially, it was proposed that de Boer, Stam and Davids may have been victims of supplement contamination while away together on international duty, even though their positives were spaced several months apart. However, the supplement manufacturer for the Dutch national team, Ortho Company, had already released test results showing their products were free from doping substances. The theory was then firmly laid to rest when Ortho Company went further and sent de Boer a legal letter demanding confirmation he would never mention the company again in relation to his doping case. The three players were however all cleared of any intent to cheat.

When eight professional tennis players tested positive for nandrolone over the same period, seven of which were never publicly named, a World Anti-Doping Agency report also concluded that the failed tests could not have been caused by a mass contamination event. The tennis authorities never reopened the cases.

This large spate of positives, in general, did however have a legitimate explanation.

“The reason for all these cases were undoubtedly, the presence on the market of dietary supplements containing what the industry referred to as ‘prohormones’, precursors of nandrolone such as norandrostenedione, norandrostenediol and isomers between 1995 - 2005,” the former WADA lab director Professor Christine Ayotte told Sporting Intelligence in 2017.

Prohormones are precursors to anabolic steroids, which means that they are not steroids in their original form, but after liver filtration they are converted into steroid hormones by the body.

Prohormones were introduced into the fitness supplement market by the US chemist Patrick Arnold in 1996. Arnold developed the designer steroid THG, also known as ‘the clear’, that lay at the centre of the BALCO doping scandal involving the chemist Victor Conte and the disgraced sprint queen Marion Jones. Jones was stripped of her five Olympics medals from Sydney 2000 after Conte was found to have provided her ‘the clear’ and erythropoietin (EPO) in the lead up to the Games.

By changing the formulation of some steroids, Arnold realised that prohormones, unlike anabolic steroids, could be sold legally. As these products were predicated on the fact that they were not active hormones, and that your body had to convert them into anabolic steroids, they were not considered controlled substances.

From then on anabolic steroids, in the form of prohormones, could be bought over the counter and online legally. When ‘19-nor’ prohormones were introduced onto the market –which were converted by the body into nandrolone – the flow of nandrolone positives began.

“So, many athletes tested positive for having consumed commercially available legal (but still considered doping) supplements correctly labelled or not,” says Ayotte.

The ease of access to anabolic steroids, through prohormones, was obviously a point of concern for doping authorities but the lack of regulation around these ‘dietary supplements’ was also causing problems for clean athletes.

Anabolic steroids are controlled substances, and pharmaceutical grade steroids must be manufactured under strict conditions. Prohormones, on the other hand, were unregulated and the manufacturing process lacked quality control. As such prohormone manufacturers often produced other legal products that were often incorrectly labelled or contaminated with prohormones.

In doping cases involving nandrolone, it soon became difficult to ascertain whether an athlete had knowingly cheated or not.

There were three scenarios in which an athlete could have ingested nandrolone in relation to prohormones; an athlete had knowingly doped by taking correctly labelled prohormones, or an athlete had knowingly taken prohormones, but it contained another anabolic steroid which was not on the label and thus the athlete was unaware it would appear during doping controls, or an athlete had taken an entirely legal supplement that was contaminated with prohormones.

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And there are known examples of all three.

In 1999, the British sprinter Linford Christie, who won 100m gold at Barcelona 1992 tested positive for nandrolone. The amount of nandrolone found in Christie’s urine samples was one hundred times above the legal limit and it was therefore clear he was not a victim of low-level contamination but had indeed knowingly doped. In fact, Christine’s nandrolone levels were so elevated that it was surmised he could have injected nandrolone.

That same year, Marion Jones’ husband, the shot putter CJ Hunter, tested positive for nandrolone four times. At the time, both Hunter and Jones were doing their best to conceal their doping with the support of the chemist Victor Conte. Nevertheless, Conte still maintains, even today, that the positive test was caused by iron supplements they had been unaware were contaminated with prohormones.

And in 2003, a seemingly clean athlete, the US swimmer Kicker Vencill, won a lawsuit against a dietary supplement company for having contaminated multivitamins which caused him to test positive for nandrolone. Vencill was awarded $500,000 in damages.

Over a ten-year period, the unregulated world of prohormones had wreaked havoc in professional sport. The number of nandrolone positives only started to subside once prohormones were prohibited as part of the 2004 Anabolic Steroid Control Act of 2004.

“When these were banned in 2005, the number of findings decreased,” explains Professor Christine Ayotte.

Criminal proceedings against Guardiola

By 2005, Guardiola had successfully demonstrated to two civil tribunals that he had not knowingly ingested nandrolone however he had still been unable to locate the source of the steroid metabolites found in his sample. As such, more problems lay ahead.

Several years earlier, doping had been criminalised in Italy and after being sanctioned at a civil level, Guardiola was soon charged with criminal offences by the Brescia public prosecutor.

A renowned anti-doping expert testified on Guardiola’s behalf in court.

Dr. Jordi Segura, not to be confused with Ramón Segura, attempted to demonstrate endocrinologically to Judge Matteo Mantovani of the Court of Brescia, that Guardiola suffered from Gilbert syndrome and that this was the cause of his positive nandrolone test.

Gilbert syndrome is a genetic condition which can sometimes give rise to jaundice, which is the yellowing of the whites of the eyes and the skin. The condition is largely harmless, and patients do not usually need treatment but Jordi Segura testified that this condition had caused Guardiola’s body to endogenously produce nandrolone.

In the year of both de Boer and Guardiola’s positive tests, the Spanish sports doctor Marcos Maynar had already attempted to demonstrate, by conducting experiments, that physical exercise can cause the human body to produce nandrolone levels above those permitted by WADA.

The human body does indeed endogenously produce nandrolone, but Maynar’s experiments, while the science may have had merit, have in hindsight lost credibility. Maynar was banned for ten years for doping athletes in 2010, and upon his return to sport he was arrested again by the Guardia Civil, Spain’s military police, for providing cyclists with banned drugs. Such is Maynar’s lack of credibility, he still maintains he did not re-engage in doping athletes despite clear evidence of him doing so.

While Maynar has been cited as a ‘medical consultant’ to Guardiola in relation to nandrolone excretion. Maynar was never Guardiola’s doctor. Maynar was never used as an expert witness throughout any of Guardiola’s appeals and his doping of athletes was not known publicly at the time.

In October 2001, Maynar published the scientific paper titled ‘Determination of nandrolone and metabolites in urine samples from sedentary persons and sportsmen’.

In May 2005, despite the expert testimony of Jordi Segura, the then-director of WADA-accredited laboratory in Barcelona, Judge Matteo Mantovani convicted Guardiola. He was sentenced to a seven-month suspended prison sentence. Guardiola was also fined €9,000, and he was required to pay the prosecution’s legal fees.  It was the first criminal conviction for doping in Italy after the special law 376 came into force in 2000 which legislated doping as a criminal offence.

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After the trial, Guardiola’s lawyers were dismayed at how a man who was cleared of intent to cheat at a civil level could have also been convicted in the criminal courts.

“The presumption of guilt in a sporting context may exist, but in ordinary justice the burden of proof lies with the prosecution,” said Guardiola’s lawyer, “The prosecution has not brought a shred of evidence”.

Guardiola’s appeals allowed at last

Manel Estiarte is one of the greatest water polo players in history. He competed at six summer Olympics for Spain from Moscow 1980 to Sydney 2000. He is also one of Pep Guardiola’s trusted friends and confidants.

The Catalan pair met for the first time on the last day of the 1992 La Liga season during FC Barcelona’s title celebrations. From that point forth, Guardiola and Estiarte remained in close contact, and in 2008, Guardiola asked Estiarte if he would accompany him to Barcelona to assist him in his role as head coach. Estiarte now forms part of Guardiola’s inner circle.

“I don't know if angels exist and, if they do, if they help us. Much less if guardian angels exist. But, if they do exist, I believe you are one of them,” wrote Guardiola to his friend in the foreword to Estiarte’s autobiography.

Today, Estiarte occupies the role of Head of Player Relations at Manchester City, and the glowing terms in which Guardiola speaks of Estiarte can be better understood when one considers the pivotal role he played in ensuring Guardiola’s doping convictions were overturned.

It was Estiarte who discovered the pivotal ‘new evidence’ that allowed Guardiola to file motions for both his civil and criminal cases to be reopened.

In 2005, WADA scientists discovered that a phenomenon called ‘unstable urine’ could lead to positive tests for low levels of nandrolone. In very rare cases, the scientists found that this could be caused by a chemical reaction that took place in urine vials during storage. Guardiola believed he was a victim of ‘false’ nandrolone positives.

In order to avoid any future ‘false’ positives, WADA amended its laboratory operating guidelines and instructed all accredited labs to perform ‘stability tests’ on urine samples that returned positive results for nandrolone between the levels of 2 and 10ng/ml. The levels found in Guardiola’s two ‘A’ samples were 9ng/ml and 5ng/ml.

If a sample was deemed ‘stable’ protocols would continue as normal. If a sample was found to be ‘unstable’ the nandrolone positive was voided.

Guardiola’s defence team contested that both of Guardiola’s urine samples, collected two weeks apart, on 21^st October and 4^th November 2001, were both ‘unstable’. And that this was the cause of both positive tests.

The Italian anti-doping prosecutors argued that Guardiola’s appeal was not admissible because the change in WADA’s guidelines did not constitute ‘new evidence’.

When Guardiola samples were collected in 2001, the anti-doping laboratory correctly followed the testing procedures set by WADA at the time. The prosecutors also argued that Guardiola’s representatives had never contested how the sample was collected, or analysed, in his previous defence.

Nevertheless, Guardiola’s appeal was allowed in both his criminal and civil convictions.

Guardiola’s doping samples could not be tested for ‘instability’ as no samples remained to be analysed. However, Guardiola’s lawyers argued that his samples met all the parameters to be tested for instability.

Ultimately, the judge ruled in Guardiola’s favour and overturned his criminal conviction. In 2009, using the same defence, Guardiola was also successful in his appeal against the four-month doping suspension initially dealt by the Italian Olympic Committee in 2001.

“For these reasons, the CGF (Federal Court of Appeal) declares the appeal for revision pursuant to art. 39 CGS (Judicial Sports Code) admissible, as proposed above by Mr. Guardiola Sala Josep, accepts him and, as a result, absolves him of the ascribed guilt,” read the final appeal decision in 2009.

Guardiola’s eight-year fight was finally over. Guardiola’s convictions had been overturned. And he spoke with glee after one of the rulings.

"When the news spread all over the world it was very nasty. But today is the most beautiful day of my life since becoming a father," said Guardiola.

For other athletes however, who tested positive for nandrolone, Guardiola’s exoneration did not serve as a watershed moment in anti-doping. The hundreds of nandrolone convictions that been processed between 1995 and 2004 were never annulled.

When the unstable urine phenomena was discovered in 2005, WADA stood by the credibility of its nandrolone testing.

The then-WADA Director General David Howman contested that the thousands of past nandrolone positives remained valid. He said the chances of one urine sample being unstable was “very rare”. The chances were between 1 out of 1,000 and 1 out of 10,000 positive tests for nandrolone, according to Howman.

Still today the WADA regulations say unstable urine leads to positive nandrolone tests “in extremely rare circumstances”.

For many athletes therefore, their suspensions, although long ago elapsed, still officially stand.

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I publish Long Reads on doping in sport.

The Town Square is a place where I cover recent anti-doping issues, and answer any questions my subscribers have about my longer doping investigations.

The Town Square also has resources to learn about doping in sport (link).

13% of British athletes, across 50 sports, admitted to doping as part of a UK Anti-Doping (UKAD) study conducted during the Paris 2024 Olympic cycle, Honest Sport reports.

A leading academic, who has previously called on anti-doping agencies to establish the true prevalence of doping in sport, says that the findings underline just how ineffective the global anti-doping system is at catching cheats.

UKAD says that more athlete responses are needed before the full extent of doping in the UK can be estimated.

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In 2011, as part of a similar study, 43% of athletes at the 2011 World Athletics Championships were estimated to have admitted to doping in the twelve months prior to the event. However, the publication of those results was famously delayed, and the authors of the study assumed that World Athletics was afraid to reveal the true extent of doping across the sport.

UKAD, on the other hand, openly published the results of its 2022 study at a World Anti-Doping Agency (WADA) symposium in March this year, and by press release, but the results have yet to be reported on by the international media.

In 2022, UKAD approached approximately 800 British athletes to understand the prevalence of doping across the United Kingdom. 42% of the athletes who participated competed at international level, across around 50 sports.

The study was conducted by using the “WADA Prevalence Survey trial”.

The athletes were contacted either by email by data collectors. They were asked if they would like to complete an anonymous questionnaire, as part of which they may later be asked if they had engaged in doping.

The survey also included questions on the use of nutritional supplements, and prescription medicines.

“Question 4: I have intentionally used a prohibited substance or method without a Therapeutic Use Exemption (TUE) in the last 12 months,” read one of the questions.

The questionnaire was designed to hide the respondents’ identities. The full methodology was published in a peer-reviewed scientific journal in February 2024.

A remarkable 13% of the British athletes admitted to doping, according to the study’s estimates. The 95% interval lay between 7 and 19% meaning that the academics could be 95% confident that the estimated prevalence of doping in the study was between those two percentages. Therefore, as many as 19% of the study participants could have admitted to doping.

In order to hide the respondents’ identities, the academics employed an indirect estimation approach which means that they cannot know the exact number of athletes who admitted to doping. Instead they arrive at an accurate estimation.

To put the alarming numbers in context, approximately 104 British athletes (13% of the 800 person sample) admitted to doping during the study, however UKAD only sanctions, on average, 21 athletes a year for testing positive (2013-2020).

In fact, UKAD collected 8023 doping samples in 2022 but only 0.4% of them led to positive drug tests, also known as adverse analytical findings (AAF).

When Honest Sport showed these findings to Roger Pielke Jr., a leading US academic who published an editorial on the prevalence of doping in the Springer journal in 2018, he said that generally far too many athletes are getting away with doping.

“Taking these numbers at face value and comparing them to athletes sanctions for doping would suggest that for every doper who is caught, 10-20 or more are not. With those odds, of course athletes looking for an edge might decide that the risks are worth it,” said Pielke Jr.

“The fact that greater than 10% of athletes break anti-doping rules means that every time you watch an event with multiple participants you are almost certainly watching someone who is doping.”

However, UKAD asserts that more data is needed before an accurate picture of doping in the UK can be fully estimated.

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“But for future prevalence-related endeavours in the UK, we will need significantly more responses to strengthen the robustness of findings, and work closely with more sports organisations to increase visibility,” said UKAD’s Head of Insight and Innovation, and member of WADA’s Prevalence Working Group, Sam Pool.

The agency also said that it would develop the tool further to provide more targeted education and deterrence.

It must be said that UKAD has a near-identical ‘catch rate’ to all other anti-doping agencies and that the findings of the study are more damning for the global anti-doping system as a whole, rather than UKAD.

However, the study raises obvious concerns that doping in the UK is more endemic than previously known.

In 2011, academics at the University of Tübingen in Germany approached hundreds of international athletes competing at the 2011 World Athletics Championships in Daegu, South Korea, and estimated that 43% of them confessed to doping in the previous twelve months.

It was reported that World Athletics sought to suppress the results of the study but Lord Sebastian Coe, the governing body’s president, told a British parliamentary committee that the federation first needed to assess the adopted methodology before agreeing to its release.

The same parliamentary committee later released a report criticising the actions of World Athletics.

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“We find the IAAF’s (World Athletics) stated reasons for blocking publication of the study to be unconvincing. We are concerned that their behaviour indicates a lack of transparency and, worse, an apparent desire to suppress revelations about doping in sport,” read the report.

UKAD, however, has taken a different approach and, earlier this year, reported its findings at a WADA symposium. The agency states that it is its intention to roll the questionnaire out to more athletes across the UK.

When Honest Sport asked Roger Pielke Jr. why attempts have not been made, by all anti-doping agencies, to establish the prevalence of doping across all sports, and all countries, his response was telling.

“Maybe we really just don't want to know.”

Soon, I will be telling another story about UKAD that is nearly two years in the making. Subscribe to receive it in your inbox.

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Every Monday and Thursday, I publish a weekly press-round up of all the doping stories in the media from the past seven days.

In the Town Square, you can find recommended articles, documentaries, books, reports and websites to learn about doping in sports, how it works, and understand what it is like to dope. It is also a place where I post about recent anti-doping issues.

This investigation into clostebol use in Italy began in 2023, before the world number one tennis player Jannik Sinner twice tested positive for the drug.

You can read a follow-up investigation specifically related to Sinner’s case here (link).

In the months leading up to the 1987 World Athletics Championships, Birgit Dressel had taken a concoction of drugs and medications in order to train harder, and harder, as she sought to bring heptathlon gold home to West Germany. Tragically, Dressel never made it to the Championships nor the Olympics in Seoul the following season. Dressel died from organ failure in April that year.

Dressel passed away in the intensive care unit of Mainz hospital after suffering from paraplegic shock. She had taken copious amounts of narcotics, under the directions of her doctors, to treat painful muscle hardening caused by her anabolic steroid use. Dressel considered anabolic steroids to be harmless which had contributed to her liberal use of the drug class.

“They are all harmless drugs. All athletes take them. It's really nothing special”, said Dressel before her death.

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An autopsy revealed traces of 101 different medications in Dressel’s body. At the time, the West German athlete was sadly in the hands of doctors who were so far down the rabbit hole of sports performance that they had lost sight of the line between sports medicine and healthcare. Dressel had been provided steroids by a doctor seen as part-mad, part-genius - Dr. Armin Klümper.

Klümper had also reportedly provided steroids to the Bundesliga football teams Vfb Stuttgart and SC Freiburg in the seventies and eighties. When documents were reviewed in 2015 detailing the substances Klümper had allegedly provided to both clubs, the German national team manager Joachim Löw, who played for both teams at the time, had to answer whether he had visited the doctor’s clinic.

"Of course, I was there a time or two. At 18 or 19, of course, I wouldn't have dared to ask and tell him that I might want to have what he gave me tested in the laboratory. My trust in this profession of medicine was immense," said Löw.

Löw was asked about his relationship with Klümper a year after he led Germany to their fourth World Cup triumph, but the questions concerned events some thirty-five years earlier, although before Klümper had passed away. But it is a substance that Klümper reportedly provided to both Dressel and VfB Stuttgart that has, unlike Klümper, come back from the dead – the anabolic steroid clostebol.

Over the past decade the drug has resurfaced in Italian football and across Italy’s wider sporting landscape. Between 2019 and 2023, 38 Italian athletes have tested positive for clostebol despite the fact it is scarcely produced in oral or injectable form by pharmaceutical companies, as it was during the Dr. Klümper era.

Serie A footballers, tennis players and Olympic athletes in Italy have all had to explain how the steroid accidently found its way into their bodies, and in most cases they have been deemed to have done so convincingly. But an investigation by Honest Sport has now found that cases involving the drug are appearing in small athlete networks. There are also experts in anti-doping who are concerned that clostebol is now being used in cream form by Italian athletes in search of the type of illegal edge once sought by the late Birgit Dressel.

Clostebol arrives in elite Italian sport

“Wake up tomorrow morning…frozen…and to transport you mahogany boxes are needed”.

These were the death threats directed at NADO Italia from Fabio Lucioni’s Instagram account soon after the anti-doping agency sentenced the player to a one-year doping suspension in 2018. Over the course of the previous two seasons, Lucioni had captained his club, Benevento Calcio, to back-to-back promotions from Serie C to Serie A – the most successful period in Benevento’s history.

Unfortunately for Lucioni, his talismanic impact on Benevento would not be felt in Italy’s top-flight division. Lucioni tested positive for clostebol after only the third match of the newly promoted side’s Serie A season. The club captain’s season was over before he knew it.

Even though clostebol is an anabolic steroid that builds muscle mass and enhances performance, an Italian tribunal was lenient with Lucioni and accepted that he had not knowingly cheated. However, the club’s doctor, Walter Giorgione, was banned for four years because he had administered Giorgione a drug from his own personal medical box, rather than the club’s. Giorgione confessed that he had used a spray on Lucioni containing clostebol to help heal the footballer’s cut more quickly.

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The Lucioni case made national news, but it did not serve as a cautionary tale to Italy’s elite athletes. The number of clostebol cases in Italian sport ranges far and wide across the country. Italian athletes have tested positive for the drug before the Olympics, four tennis players have been caught for clostebol and two basketballer players on the same team were careless enough to both ingest the anabolic steroid.

Four years after the Lucioni case, two Italian junior tennis players, one just seventeen years old at the time, tested positive for clostebol within three months of each other. One of the players Matilde Paoletti, who played at the Junior French Open, was training at the Olympic training centre in Formia in 2021, the year she was caught. The other Mariano Tammaro, a minor, was a top ranked world junior, and in 2021 was training under the national team coach.

Any concerns that these players were the victim of child doping were officially misplaced. Paoletti tested positive after petting her pet chihuahua who had been administered clostebol spray by her mother to heal a wound. While in the case of Mariano Tammaro, his father applied a spray to a wound on his son’s knee.

But away from tennis, the spray of clostebol cases has been felt further across Italian sport.

When the girlfriend of the Olimpia Milano basketballer, Riccardo Moraschini, sliced her finger while cooking, she used a clostebol spray to heal the cut. Like Lucioni’s doctor, Paoletti’s mother and Tammaro’s father, she was unaware that clostebol was prohibited for use in professional sport. Unfortunately, when she naturally came into contact with her boyfriend, clostebol unknowingly entered his system. Equally unfortunately for Olimpia Milano, Italy’s most successful basketball club, their power forward Christian Burns had tested positive for clostebol two years earlier.

And, in pre-games doping testing before the 2016 Rio Olympics, two qualified athletes both tested positive for clostebol, out-of-competition in the month of July. Both athletes, the volleyball player Orsi Toth and the sailor Roberto Caputo, missed the Rio Olympics for Italy.

Italy has quite clearly been in the midst of a clostebol crisis, of some form or another, for much of the past decade. A decade in which clostebol detection methods have become more sensitive.

According to the World Anti-Doping Agency (WADA), half of the world’s clostebol cases come from Italy. A statistic partially explained by the fact that Italy is one of the only remaining countries in which clostebol is still sold.

When WADA banned the heart medication Meldonium in 2016, the drug at the centre of the Maria Sharapova affair, the hundreds of positive cases were largely concentrated in Russia. In order for an athlete to test positive for a drug, inadvertently or not, the drug has to be available in their geographical location. Therefore, doping cases involving specific drugs can be location specific.

Outside of Eastern Europe, Meldonium is not widely available. Therefore most of the cases involve Russians. Outside of Italy, clostebol is not widely available in Europe, therefore the majority of cases involve Italians.

It remains bewildering, however, that Italy’s athletes are missing the warning sign printed on clostebol creams and sprays in Italy, which clearly states that the product contains ‘doping’ substances.

Clostebol readily available in Italian pharmacies

During the time Dr. Armin Klümper was reportedly supplying clostebol to Bundesliga football clubs the drug was sold under the brand name Megagrisevit-Mono®. Megagrisevit was an injectable and at the time was marketed by the Italian pharmaceutical company Farmitalia.

The drug was initially developed in East Germany, before it was synthesised with other drugs and given to the state’s Olympic athletes, but since the collapse of the Berlin Wall the drug is scarcely available in Europe.

However, in Italy and Brazil, the countries faced with the most clostebol cases, the drug can be bought in pharmacies without a prescription. In Italy, it is most commonly sold in cream form as Trofodermin, and a tube can cost as little as twelve euros. Trofodermin is applied to the skin to treat abrasions, lesions, burns and infected wounds.

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If an athlete handles the cream, even in applying it to another individual, then they can risk testing positive. This has been one of the common defences used in Clostebol cases. And in 2020, this defence was assessed in a controlled experiment by scientists at Rome’s anti-doping laboratory and published in the paper, ‘Detection of clostebol in sports: Accidental doping?’. Scientists were able to detect Clostebol in the urine of a subject who had applied Trofodermin cream to another individual.

But it is a sentence within that paper that perforates the argument that only the innocent have befallen to the clostebol curse. “According to Italian law, a visible sign indicating the presence of a substance included in the WADA list of prohibited substances must be present”, reads the paper.

Trofodermin cream, as mandated by law, is sold in a packaging emblazoned with a warning that the product contains a doping agent. This warning would seemingly make any argument of inadvertent use untenable. A warning so problematic that athletes’ lawyers have had to address the warning head-on during disciplinary hearings.

For example, in perhaps the most famous clostebol case, the Norwegian Olympic skier Theresa Yohaug claimed to have tested positive for the steroid after applying Trofodermin cream to treat her sunburn while training in Italy. Yohaug acknowledged she had seen the packaging, but an independent tribunal still accepted she had missed the red warning sign on the box. She was allowed to return for the Beijing Olympics in 2022 and win three gold medals. At those same Olympics the Spanish skater Laura Barquero tested positive for clostebol. To no surprise Barquero is based in Italy.

Anti-doping insiders are now concerned there is another reality to at least some other clostebol cases. Trofodermin is a cheaper, more obtainable alternative to testosterone gels for athletes operating on the darker side of sport.

Clostebol creams, testosterone gels and passing drug tests

“It will be interesting to determine the minimal amount of topical male hormone required to create a positive test".

In the summer of 2009, the Nike Oregon Project coach Alberto Salazar exchanged emails with the Nike CEO Mark Parker about arranging an experiment to determine how much testosterone gel could be applied to skin before an athlete failed a drugs test.

Salazar, who was banned for trafficking testosterone as part of the experiment by US Anti-Doping Agency, claims that the genesis of the experiment arose after he became concerned that rival athletes may sabotage his runners by rubbing drugs onto them after races. To dampen his concerns, Salazar wanted to ensure that, even if his athletes were sabotaged, they would not fail a drug test.

The other explanation was that Salazar wanted to ascertain how much testosterone a doping athlete could take without testing positive. A narrative, while still contested, made more believable when a Nike Oregon Project whistle-blower released a document that stated Salazar’s runner Galen Rupp had been on testosterone since he 16 years old. Both Rupp and Salazar said the document was inaccurate. The same whistleblower, Steve Magness, saw testosterone on the kitchen counter of an apartment shared by Salazar and Sir Mo Farah at a training camp in Albuquerque, New Mexico in 2012.

Whilst the purpose of Salazar’s experiment is still disputed, testosterone gels have long been used in professional sport. The BALCO chemist Victor Conte, after being arrested by the FBI, admitted that he had provided the former sprint queen Marion Jones with testosterone creams before the Sydney 2000 Olympics.

Conte also provided the creams to baseball players and explained that testosterone cleared the system so quickly that baseball players were taking it daily, and still not testing positive. When testosterone gels are applied to the skin regularly, the accumulation of testosterone helps athletes build muscle and boost their haemoglobin, the oxygen carrying capacity of their blood.

Despite the cumulative effect of testosterone, the athlete never tests positive as they only take a small amount each day.

“Currently a player can go home or to the hotel after a game, use a testosterone cream, gel or patch, and it will be undetectable by the time he goes to the ballpark the next day. I think these guys are using testosterone every single day of the week," said Conte in 2013.

Salazar, and his disgraced doctor, Jeffrey Brown were able to ascertain that an individual could apply four pumps of testosterone gel yet pass a drug test an hour later. The experiment took place on Salazar’s sons at the Nike Labs in Oregon, USA.

The former head of the Portuguese anti-doping agency, Luis Horta, has now told Honest Sport that he is concerned that sports doctors have begun to use Clostebol creams as they do testosterone gels.

“I think there are some doctors involved in doping strategies that are using this strategy to avoid detection or to have a low risk to be detected”.

In 2019, Salazar’s trusted doctor Jeffrey Brown was suspended by USADA for possessing and trafficking testosterone.

“I suspect that they use creams. Because creams as clostebol, or testosterone by cream or by gel. The detection window it's very, very short. It's sometimes some hours, then it's a good way to dope. With a lower risk to be tested, positive,” Horta told Honest Sport.

Clostebol creams are less potent than testosterone gels, so the performance-enhancing effect is more debatable. However, athletes often inject a stronger anabolic steroid, and then ‘top themselves up’ with weaker creams as competition, and more drug testing, approaches.

“It's like with a bathtub. The shot fills the tub. The cream keeps replenishing it every day to top it off,” a sports medicine doctor once said about testosterone creams.

Horta, who has also worked in Brazilian anti-doping, says he has been involved in at least one doping case in which he had suspected the athlete had been using clostebol as a doping agent.

“In one case the athlete received the standard punishment because he couldn’t explain the case. In another case the athlete had a reduced sanction because he demonstrated that was negligent by applying a cream with clostebol on his dog without using gloves,” said Horta.

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There are numerous cases to support Horta’s affirmations. In 2023, the Italian tennis player Stefano Battaglino was banned for four years after he failed to show that he had taken Clostebol inadvertently. And curiously before the 2010 Commonwealth Games, the British shot-putter Mark Edwards tested positive for both clostebol and testosterone. He was not able to prove a lack of intent.

When Honest Sport asked a leading scientist at a WADA-accredited laboratory whether they too suspected that clostebol creams were being abused, they wondered whether it was instead still being used in injection, rather than cream, form.

“My perception is that the use of clostebol cream (e.g. trofodermin), in common therapeutic amounts, is hardly performance-enhancing, but despite the limited availability of other formulations (of clostebol), the misuse by other routes (e.g. injection) cannot be excluded, and differentiating by analytical means between the ways the anabolic agent entered an athlete’s organism is difficult. Hence, disregarding clostebol (as a doping agent) is probably not an option.”

A Carabinieri police officer in Italy told Honest Sport that it is rumoured that clostebol creams may be being used to hide the presence of other more potent doping substances.

“I heard other rumours, i.e. that it can be used to mask another substance. That means to hide positives for other substances that must have been taken advertently, and it interferes with laboratory analysis. Even in this case only science can tell us if it is legends, or if it is reality,” said the source.

Whether by injection, or by gel, or whether used as a masking agent, there is obvious concern surrounding the number of ever-continuing clostebol cases in Italy, and it is the ever-presence of doping doctors in professional sport that raises that concern higher.

Doctors never far away in doping cases

Olimpia Milano are the most successful basketball team in Italy, and have won 30 Italian basketball league championships, but in the spring of 2022 the club was facing a moment of shame rather than glory.

The club was in the midst of its third anabolic steroid case in just three years, and it was the presence of a doping doctor in the background that increased the severity of the case.

After a match against Real Madrid in March 2022, the Greek forward Dinos Mitolgou tested positive for the anabolic steroid Dianabol. The case had arisen shortly after two of the club’s players, Riccardo Moraschini and Christian Burns, tested positive for the much-discussed steroid Clostebol. The cases came in 2019 and 2021, respectively.

Dianabol, like clostebol, was originally developed in the 1950s and marketed in Germany. It is an immensely potent anabolic steroid that was administered to the entire USA wrestling team at 1960 Olympics. It has obvious performance-enhancing benefits.

During the time Mitoglou was waiting for a decision in his case from the Italian anti-doping agency, the Greek police raided the premises of his sports medicine doctor on the outskirts of Athens.

Since March 2020, the doctor had been supplying athletes with prohibited doping substances. The doctor procured the substances from Bulgaria, imported them to Greece and re-labelled them in order to convince her clients that they were approved medicines.

Mitoglou was able to argue that he had been doped with a serum unknowingly. The doctor claimed otherwise.

“The doctor assured me that the tablets were a 'miracle drug' from Russia’. She gave me a clear serum. After my related question, she answered me that this serum would help to...cleanse my body", said Mitoglou.

The Court of Arbitration for Sport believed Mitoglou and significantly reduced the 36-month sanction he had been dealt by NADO Italia. Olimpia Milano maintained their zero tolerance to doping, and quid pro quo their lack of involvement in Mitoglou’s case.

Nevertheless, the case serves as a reminder that doping doctors are never too far away in many doping cases, and Honest Sport has now found that a sports doctor, who is not Italian, was reported to anti-doping authorities in 2016, who later had one of his athletes test positive for clostebol.

A whistle-blower sent the agency in question a photograph of a bottle of pills that a sports doctor had prescribed. The prescription was for the anabolic steroid oxandrolone. The patient’s name had been redacted in the photo and therefore it was not known if the steroid was prescribed to an athlete. The doctor could therefore not be sanctioned. Officially, that was the outcome of the incident.

When an athlete the doctor was treating tested positive for clostebol they, too, were cleared of knowingly doping, as is so often the case.

But as the Italian Carabinieri officer told Honest Sport, the sheer number of clostebol cases, at least in Italy, can no longer be considered an anomaly.

“Of course, except in cases of accidental doping, if the use of a substance spreads it’s not just a coincidence.”

It is now the decision of anti-doping authorities to determine how seriously they want to investigate Italy’s problem with a drug once central to the East German, and West German, doping programmes.

This investigation into clostebol use in Italy began in 2023, before the world number one tennis player Jannik Sinner twice tested positive for the drug.

You can read a follow-up investigation specifically related to Sinner’s case here (link).

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Every Monday and Thursday, I publish a weekly press-round up of all the doping stories in the media from the past seven days.

In the Town Square, you can find recommended articles, documentaries, books, reports and websites to learn about doping in sports, how it works, and understand what it is like to dope. It is also a place where I post about recent anti-doping issues.

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Forty-eight days before Paul Pogba tested positive for synthetic testosterone metabolites, on the opening weekend of the ongoing Serie A season, the French World Cup winner reported to pre-season at Juventus a full week before his fellow teammates.

From that moment forth, until the day he submitted his fated doping sample, Pogba was under the professional supervision of Juventus staff at both the club’s training ground, La Continassa, and its avant-garde medical facility, J|Medical.

Somehow Pogba, his private support staff in Miami, where the player spent the month of June, and Juventus staff, throughout July and August, all missed that the player had consumed a banned substance unknowingly, as Pogba says.

This defence was rejected by an independent tribunal and the World Cup winner has now been banned for four years by the Italian anti-doping agency, NADO Italia. 

And in wake of this ruling, it is a decision by Juventus and J|Medical to continue to consult a ‘tainted’ doctor that will spare the club little sympathy as it attempts to rid itself of any negative press, even justifiably, in the Pogba saga.

This doctor who draws a line from Juventus’ alleged doping past to the current J|Medical doctors and consultants. 

This doctor was re-hired by the club in 2017 after being convicted, and then cleared, at a criminal level, of blood doping the club’s players in the 1990s.

The decision is demonstrative of Juventus and the club’s former players’ loyalty to the staff employed during that era. 

Rather than distancing themselves from the actions of the club at the time, Juventus legends-turned-managers, such as Zinedine Zidane, Antonio Conte and Didier Deschamps, have instead continued to hire ex-Juventus fitness trainers on their coaching journeys from Real Madrid to Chelsea.

However, after the former Juventus captain Gianluca Vialli passed away from a second bout of pancreatic cancer last year, at the age of 58, one former Juventus player, Dino Baggio, expressed concern over whether legal supplements he was given at several Italian clubs could have led to health complications for him later in his life. The type of supplements provided to Juventus players by a sports doctor still trusted by Juventus today – Dr. Riccardo Agricola.

J|Medical - the Juventus medical centre

J|Medical is a private, independent medical centre, funded by Juventus and the Santa Clara Group, to treat both private clients and all Juventus players. It offers new and advanced techniques. The club’s own website describes J|Medical as ‘an avant-garde centre for health and wellbeing’.

The centre is situated on the East side of Juventus’ 42,000-seater Allianz Stadium in Turin. The J|Medical website states that it has over 100 specialists at its disposal and that it sets the ‘highest standard’ when it comes to sports medicine.

Juventus invested €10m in the centre to open it to the world in 2016 and put the club at the forefront of sports medicine. At the start of every pre-season, Juventus players report to the facility to undergo testing and have their fitness assessed ahead of the new season. 

On 14 July 2023, as seen on the Juventus Youtube page, all of the club’s players, including Paul Pogba, reported to J|Medical to undergo these physical tests. By that time, Pogba had already been training at Juventus for 11 days. The player, as a commitment to the club, chose to start his pre-season early in an attempt to justify his place at the top of Juventus’ wage bill and make a break from the prior injury-laden Serie A season where he failed to start a single match.

But over this period, and at some point between early June and 20 August, Pogba consumed the anabolic agent DHEA that led him to fail a doping test for testosterone metabolites in the Serie A season opener versus Udinese.

We could assume that, at this point, Pogba and his lawyers planned to argue that the player consumed a contaminated or mislabelled supplement in Miami and without the knowledge of Juventus.  They apparently did so at the hearing against NADO Italia, and will probably continue to do so during any appeal.

But it must be noted, Pogba tested positive in Italy, not the USA, and once the Serie A season had begun.

If J|Medical is a leader in cutting edge sports medicine, then the types of precautions that should have been taken with Pogba can only be classed under the most basic of administrative tasks: communicate with players and ensure their supplements do not contain banned substances.

That these steps did not take place at Juventus, or that Pogba did not communicate with the club about some of the supplements he was taking, is not only surprising but also at odds with protocols that were put in place by a recent J|Medical director during the major Juventus doping scandal twenty-five years ago.

At that time, the former club doctor, Riccardo Agricola, made himself available to all Juventus players practically 24 hours a day, even during the summer, and the players were recommended to call the doctor to consult him on any type of health problem and, above all, when taking supplements or medication.

The rogue pharmacy at the heart of the Juventus doping scandal

"Italian football must move away from the pharmacies." 

When the Czech-Italian football manager Zdeněk Zeman gave an interview to L’Espresso magazine in 1998 about widespread doping in Italian football, Zeman could not have known that a Turin prosecutor, Raffaele Guariniello, and a Turin court were listening to him.

Zeman revealed that when he was managing Lazio between 1994 and 1997, some of his players informed him they had received prohibited substances while away on international duty with the Italian national team, the Azzurri. 

“Some Lazio players told me they had been given certain prohibited substances,” he said.

But it was his words about Juventus, that would ultimately lead to the club and its head doctor Riccardo Agricola being investigated for doping, in the context of sports fraud, by the Turin prosecutors.

"I was surprised by the size of Vialli's thighs and the sudden bulking up of Del Piero," he added. "Have you seen the bodies of these two players? Have you seen how they suddenly developed? I thought that such changes only occurred after years of working with weights."

Vialli and Del Piero threatened to sue Zeman but the Turin prosecutors soon showed that Zeman’s words were not so far from the truth. The pair would eventually be cross-examined in court.

Documents from the case, reviewed by Honest Sport, describe how the club doctor Agricola used a system, involving a local pharmacy and nursing home that allowed him to purchase prescription drugs at will, on the open market, and administer them to the entire Juventus squad unencumbered.

The Juventus medical centre resembled a ‘small hospital’ both because of the enormous quantities of pharmaceuticals found in its warehouse, and because only in a hospital can so many drugs be stored without prescription.

The warehouse was organised in such a way that if the number of packages of each drug in any cabinet fell below a certain quantity, set by Dr Agricola, then the warehouse manager Luca Martini arranged for the purchase of new drugs to replenish the stock.

“I manage the computerised program of the warehouse stocks, I always check that they are present the drugs on the list, when stocks are exhausted or when I am asked for a drug that is not present I inform Dr Tencone or Dr Agricola and fill in the appropriate form for the request. [It’s] Agricola who checks and signs,” Martini told the court.

Dr. Fabrizio Tencone was Agricola’s assistant at the time, and would remain at the club until June 2016.

The majority of drugs, in fact two thirds of them, required a prescription and many were not purchased to meet the therapeutic needs of Juventus players but were used instead to enhance performance.

As a demonstration of the extent of the over-medicalisation of football taking place at the club, Juventus purchased over 900 hexaphosphine intravenous infusions between the end of 1994 and June 1998. When inspectors visited their premises, they found less than 50 remaining. In other words, it seemed Juventus players had undergone an average of 250 infusions a season.

Last year, consultant doctors from Tottenham and Newcastle United raised concerns that prohibited infusions were increasingly being used by athletes across all sports as part of their pre-game and post-game ritual despite a lack of scientific literature on their efficacy. 

“The ‘food first’ (rather than infusions) and ‘no needle’ messages need to be amplified among all athletes and multidisciplinary support teams to avoid what was previously a ‘last resort’ treatment becoming normal without scientific evidence of benefit”, read the editorial in the British Journal of Sports Medicine.

Infusions, no matter their content, were only banned by the World Anti-Doping Agency (WADA) in 2005, but their widespread administration provided a window into the most successful club in Italy. From 1994 to 1998, Juventus won three Serie A titles and one Champions League, while being coached by the World Cup 2006 manager Marcello Lippi. Their star players included Zinedine Zidane, Didier Deschamps and Edgar Davids. 

The rampant administration of drugs and medicines to these players, would not have been possible had it not been for a pharmacist at Farmacia Rossano, a short drive from Juventus’ stadium.

When Juventus needed to replenish their pharmaceutical supplies, they would order from Farmacia Rossano. On several occasions, the pharmacist took an order from a local nursing home, cut it in half, added Juventus’  order to the bottom and photocopied it. When the drugs arrived at the pharmacy from suppliers, they were simply sent to Juventus rather than the nursing home.

To add a layer of comfort to the system, Agricola was concurrently working for the nursing home in question, called Villa Cristina, as a neuropsychiatrist. When Agricola left the centre to become the Juventus first-team doctor, he never actually handed in his resignation officially. After introducing the pharmacy to the club in 1994, Agricola only officially resigned when prosecutors came calling in 1998.

Such was the incestuous relationship between the pharmacy, the nursing home and Juventus, Agricola’s father and sister held positions at Villa Cristina. The court judge said that in such a solid and close-knit environment where friendship and common interest prevailed, it became almost impossible for rules to be respected.

As a sum of its parts, Dr Agricola had built a system using which a wide array of prescription drug could be purchased with little trace and then administered to Juventus players.

No documentation was found regarding the use and administration of these medicines, and the judge openly opined whether this was because if presented in court it may have incriminated Agricola.

As such, it was the remit of the prosecution to reconstruct events at Juventus and establish, using invoices, doping control forms, and witness testimony, whether the club players had engaged in doping.

The most serious accusation centred around 15 Juventus players, including Antonio Conte, Didier Deschamps and Zinedine Zidane, and their alleged use of a blood doping drug that was concurrently ruining professional cycling – EPO.

Dr. Agricola’s alleged blood doping of Juventus players

In early 1998, a Spanish sports doctor named Guillermo ‘Bill’ Laich flew to Turin for a series of meetings with Agricola to discuss the ‘biological’ preparation of Juventus players.

In court, Juventus were not forthcoming about the exact content of those meetings, but judge Giuseppe Casalbore viewed them as continuing evidence of Dr Agricola’s ‘disquieting willingness’ to acquire information and to establish partnerships in order to identify innovative substances and methods to enhance athletic performance.

What was evident, however, was that Juventus knew that Laich carried with him a bad reputation. In the press, Laich was known for specialising in the use of stimulants that could not be detected in doping controls, which was in part evidenced when Diego Maradona, under Laich’s supervision, tested positive for the stimulant ephedrine at the 1994 World Cup. 

This same desire to collaborate with Laich had also been exhibited, a decade earlier, by a more infamous sports doctor - Eufemiano Fuentes from the Operation Puerto doping scandal.

In the mid-1980s, Fuentes partnered with Laich to establish biological preparations for the Spanish athletes. Eventually in 2006, Fuentes was arrested by the Spanish military police, the Guardia Civil, and hundreds of blood bags belonging to elite Spanish athletes were found in his flat. Spain spent much of the next decade successfully covering-up the extent of the scandal.

In the months that followed Agricola’s meetings with Laich, from April to May 1998, each Juventus player was prescribed 10 tablets to be taken on alternate days before the Champions League final, which Juve then lost to Real Madrid. However, the court would focus on more serious events before and after Juventus’ successful Champions League final versus Ajax in 1996 - Dr Agricola’s alleged administration of EPO.

EPO, an acronym for synthetic erythropoietin, is a kidney drug that is used to treat patients with anaemia caused by chronic kidney disease or chemotherapy. The drug works by triggering the body to produce more new red blood cells, reticulocytes, which can become dangerously low when a patient has anaemia.

In 1990, the International Olympic Committee prohibited the use of EPO in professional sport after sports doctors realised that the drug had an effect in the order of 10% on endurance. By increasing the number of reticulocytes, EPO helps an athlete boost their haemoglobin, the protein that transports oxygen, and thus the oxygen carrying capacity of their body.

After the drug was discovered, the speed of the peloton increased rapidly throughout the 1990s until it dipped, albeit briefly, when WADA introduced a test for EPO. Had the drug also made its way into football?

At the end of Agricola’s lengthy criminal case, the judge concluded that Agricola had administered EPO to Juventus players in 1996, in a team which included Edgar Davids, Alessandro Del Piero, Zinedine Zidane, Didier Deschamps and Antonio Conte.

And it was the case of the future Chelsea and Tottenham manager Conte that provided some of the most compelling, yet disputed, evidence that blood doping had taken place at Juventus.

After the 1996 Champions League final versus Ajax, Conte was attempting to overcome a left thigh injury to be fit in time for Euro 1996 in England and over the course of several medical appointments, he submitted several blood tests.

Prosecutors used these blood tests to show that Conte’s wild fluctuations in his haemoglobin levels, again a protein that facilitates the transport of oxygen, were evidence he had taken the drug. 

They relied on an expert testimony from Professor Giuseppe d’Onofrio, one of the world experts in what is now known as the Athlete Biological Passport (ABP), a tool introduced in 2009 by WADA to detect blood doping indirectly by monitoring athlete blood values.

The prosecution pointed to Conte’s rapid rise in haemoglobin over a 24-day period, from 9.6 to 16.2g/dl as evidence the ex-Chelsea manager had been using EPO. The defence argued that this was a natural response to injury, while the prosecution argued that it was caused by the stimulation of red blood cells from EPO.

However, it was another abnormal blood parameter that even the defence struggled to explain. The defence, according to court documents, did not attempt to give a scientific explanation for Conte’s raised blood levels but instead hypothesised the data could have been annotated incorrectly.

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On 29 May 1996, as part of a blood test, Conte had a reticulocyte reading of 6%, the percentage of new red blood cells in the entire body’s blood supply. Injections of EPO, will boost an athlete’s reticulocyte count.

So high was Conte’s reticulocyte count that it was three times higher than the amount (2%) that World Athletics, then known as the IAAF, considered “suggestive of the presence of r-EPO”.

In such cases, the IAAF would perform a follow-up direct test for EPO on the athlete. However a test for EPO was not developed until before the Syndey 2000 Olympics.

“Dr Agricola did not mention it (the reticulocyte reading), evidently, because he could never have given a convincing explanation, not only to try to justify the found percentage value of 6% which, as we have seen, is equal to three times the maximum allowed limit”, reads the judge’s decision. 

The judge wrote that this value was ‘absolutely decisive’ in concluding that Conte had been administered EPO, as had his teammates. Juventus’ defence experts argued Conte’s elevated blood values were a natural reaction to a state of temporary anaemia.

“Erythropoietin has certainly been purchased and has been administered to the players, as has been widely highlighted, in an acute form in the reported cases concerning Conte and Tacchinardi and in other circumstances, in a chronic form, to the various players also specifically examined,” read the sentence.

Agricola was dealt a 22-month suspended prison sentence, fined and found guilty of providing a performance enhancing drug to Juventus players.

Juventus however, rather than parting ways with the disgraced doctor, helped him successfully appeal the decision and clear his name, at least at a criminal level. Remarkably in 2017, they re-hired Agricola as the director of the club’s state-of-the-art medical centre J|Medical. A clinic where he remains a trusted consultant.

Part 2 of this ‘Long Read’ will be published soon. If you want to read more deep dives into ‘Doping in Football’ you can here and here.

Also, every Monday and Thursday I publish a weekly press-round of all the doping stories in the media from the past seven days.

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There have been at least thirteen failed doping tests involving professional footballers playing in Spain since 2017, but only two players were banned from sport, Honest Sport has found.

This spate of positives has arisen despite the fact that the Spanish anti-doping agency (CELAD) has collected zero blood samples from La Liga footballers in three of the last four years for which statistics are available.

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As Human Growth Hormone (HGH) can only be tested for in blood from subjects, it seems the agency is not conforming to the World Anti-Doping Agency’s (WADA) requirement that 10% of footballers’ samples should be tested for the drug. HGH is a potent performance enhancer that can boost recovery and build muscle mass.

The former head of the Spanish football federation has said previously that there is so little doping in the Spanish game because footballers are tested so often.

In 2023, it emerged that CELAD had sanctioned the Argentine 2022 World Cup winner Papu Gomez after he failed a doping test one day after a La Liga match versus Real Madrid, and a month before the start of Qatar 2022.

Gomez, who was no longer playing in Spain when he was banned, is one of the two players whose identity has been made public. In all the cases in which the footballers were cleared, CELAD ruled that the players had a medical justification for why the drugs were found in their system.

These findings cast doubt on whether anti-doping authorities treat all professional athletes equally. According to official figures, Spanish footballers who fail a drugs test are four times less likely to be sanctioned than the average Spanish athlete.

In 2022, this writer similarly revealed in The Mail on Sunday that 15 Premier League footballers had failed drug tests but that none of them were banned. However, footballers below the ‘top flight’ were sanctioned 67% of the time.

On 23^rd October 2022, in a surprise visit to the Sevilla FC training ground, doping control officers took a sample from the Argentine player Papu Gomez that would soon return a positive finding for terbutaline. The drug in recent times has been used by Kenyan distance runners to increase performance and is banned for use in-competition by the World Anti-Doping Agency.

Days after submitting the sample, Gomez flew to the Qatar World Cup where he played in 2 matches as his nation won the tournament led by their star captain Lionel Messi.

Gomez, some ten months later, having been transferred to the Italian club Monza, was banned from sport for two years by the Spanish anti-doping agency (CELAD). The player denies any wrongdoing and has appealed the decision. His ban was backdated to before the start of Qatar 2022. Argentina have faced no punishment despite his involvement in the World Cup. The Sevilla manager at the time of Gomez’s positive result was Jorge Sampaoli, the Argentine national team manager at the 2018 World Cup.

According to Gomez’s version of events, in the days before a match against Real Madrid, and after a bad night, the player took some of his child’s cold syrup, which contained the drug he would later test positive for. The Sevilla doctors were not aware of Gomez’s mistake because he had neither informed, nor consulted them.

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Whether Gomez’s account is accurate, and he was banned for two years, one thing is clear – it is the remit of the Sevilla medical staff to avoid such problems. The fact Gomez did not inform the club staff nor check with them the contents of what he was taking is bemusing.

On the Sevilla FC website, it states that the mission of the club’s medical staff is to ensure the health of all first team players and carry out the task ‘Prevention of doping’. Gomez was either reckless or the club’s doctors do not check every medication the players are taking.

While there is no suggestion of wrongdoing on behalf of Sevilla medical staff, the club may have shown a lack of decision making when hiring a doctor in 2011.

When Sevilla signed the manager Marcelino, now managing Villarreal, the coach brought with him the ‘tainted’ cycling doctor – Nicolas Terrados.

During the 1998 Tour de France, Terrados was arrested by French police in connection with the Festina Doping Affair and was accused of having brought controlled substances into France. Alex Zülle had told police that he had been administered erythropoietin (EPO) by Terrados. Terrados denied the allegations.

As shown in an ONCE team poster in the early 1990s, Terrados shared his role of team doctor with the notorious doping doctor Eufemiano Fuentes. In the 2002/03 season, Fuentes was paid by Real Sociedad in their miraculous run to second in La Liga. He is famously known for the Spanish military police investigation Operacion Puerto during which Fuentes had been blood doping many of Spain’s elite sportsmen.

Terrados, Fuentes’ former colleague, admitted to the possession of the unauthorised substances when he was arrested in 1998 but he claimed they were not for the riders but for support staff in the team. Terrados was found guilty and given a fine of €4,573. He appealed the decision, and in 2002 was acquitted of all charges.

However, this acquittal at criminal level, did not fully repair his reputation. In 2013, as part of a French senate investigation, the ONCE cyclist Laurent Jalabert had his samples from the 1998 Tour de France retested. They came back positive for EPO. Terrados was Jalabert’s team doctor at the time.

During the 1995 Vuelta a España, Danish journalists found discarded EPO and syringes in the ONCE team hotel. The drugs were in the room of the other team doctor – Terrados’ colleague Jose Aramendi.

There is no evidence that Terrados, who denies any wrongdoing, engaged in doping after leaving cycling or while at Sevilla in the 2011/12 season but when clubs employ doctors with such reputations, it will always leave them with little margin to play the sympathy card if one of their players ever tests positive. The Sevilla coach and medical staff have now changed, but the decision to hire Terrados, and now Papu Gomez’s doping case, are unwanted footnotes in Sevilla’s illustrious history.

Any which way Gomez and the club parted on amicable terms, and in a press release before his doping case was made public, the club thanked him for his contributions, “He leaves the club with a UEFA Europa League winners' medal from last season, in which his playing time was affected by an ankle injury. The Club thanks Papu for his efforts and wishes him the very best in the future.”

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Since 2017, there have been thirteen failed doping tests in Spanish football but only two, including Papu Gomez’s, have led to a sanction. The other player was banned but his doping infraction was deemed ‘not serious’ so his identity, as written in Spanish law, was not publicly disclosed. In the eleven other cases the Spanish anti-doping agency accepted that the positive drug tests were all explained by a justifiable medical reason. The only other player whose identity is known is the UD Almeria goalkeeper Yan Eteki who was cleared after receiving an injection to treat an ankle injury, according to Relevo.

In football, this low conversion rate (15%) from positive drug tests to doping bans is not represented across the wider athlete population in Spain. Between 2017 and 2020 (2021 and onwards figures not yet released), there were 157 positive doping tests in the country, and 98 led to sanctions (62%).

Similarly, in the English Premier League, 15 footballers failed drug tests between 2015 and 2020, and zero were banned. However, over the same period, 16 players in the lower leagues were sanctioned after 24 tested positive (67%).

This spate of positives in Spain begs the question - how many more positives there would be in Spanish football if CELAD carried out more robust testing?

In 2013, the head of the Spanish Football Federation (RFEF) said that there was no doping in Spanish football because the testing was stringent. “Thank God, there is no doping,” Villar said. “Well, very little - so little that the cases that have come to light are just an anecdote within an anecdote. In Spain, players take a lot of tests every weekend, and nobody has tested positive. This is the reality,” said the then-president Ángel María Villar.

Honest Sport has now found that, according to WADA and CELAD statistics, CELAD carried out zero blood tests for the three years between 2019 and 2021. In 2022, the agency carried out just four blood tests despite the fact over 1000 footballers play in the two top divisions in Spain.

These figures become particularly alarming when one considers that Human Growth Hormone can only be tested for in blood.

Human Growth Hormone (HGH) is an effective performance-enhancer, must be stored cold, and boosts recovery, increases muscle mass and reduces fat. In 2019, a young footballer at a Premier League club was found in possession of the drug.

This blunt testing is seemingly not in line with WADA standards. In the WADA Technical Document for Sport Specific Analysis (TDSSA), which states how many samples must be tested for specific substances in specific sports, it says that 10% of all samples in football should be tested for HGH. As CELAD collected zero blood samples from footballers between 2019 and 2021, it seems the league did not test for HGH at all. In fact in 2022, CELAD collected 2599 samples across all sports but only tested 23 for HGH (0.9%).

A large hole in drug testing in La Liga - CELAD is yet to respond to this story.

If you enjoyed this article please subscribe to receive a new investigation on doping in professional sports every week. Or you can read this deep dive on doping in football, with particular focus on the English game.

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The Outer Temple chambers, just a stone’s throw away from London’s Fleet Street, is home to almost one hundred barristers and solicitors who represent clients in legal cases ranging anywhere from white collar crime to land disputes.

But it was a short press release, posted on the chambers’ website, one December morning, that almost brought the world of British triathlon to its knees. The post wrongly implied that there was a one in four chance that one of Alistair or Jonny Brownlee, the British triathlon brothers who starred at London 2012, had failed a doping test in late 2016.

The press release stated that an elite male triathlete had tested positive for clenbuterol, which has anabolic properties, at the World Triathlon Championship in Mexico. The intention of the post was perhaps to tout the expertise of the lawyer who represented the athlete, but in doing so the text revealed potentially key information concerning the identity of the British triathlete in question.

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The year was 2016. The ‘World Championships in Mexico’ referred to either the World Triathlon Grand Final or Aquathlon Championships in Cozumel, Mexico. The word ‘he’ narrowed the group of fingered athletes to males competing at the events. But then, the use of the term ‘elite’ suggested that the triathlete was one of the following – Adam Bowden, Tom Bishop, Alistair Brownlee, Jonny Brownlee or Richard Allen.

In triathlon, the word ‘elite’ specifically refers to professional World Triathlon categories, and at the two World Triathlon events in Cozumel there were only two elite male races (Elite men’s triathlon, elite men’s aquathlon). The five aforementioned athletes were the only Britons competing. If the word had been used as intended, the athlete had to be one of the five.

As news of the scandal broke, the word ‘elite’ was removed from the original post, thus widening the pool of athletes significantly. The post was then taken down all together. A seemingly innocuous press release had created a storm in British triathlon.

British Triathlon was forced to make an official statement. The federation did not specifically deny that the athlete came from the original group of five, but it stated that the triathlete was not part of ‘British Triathlon’s World Class Performance Programme’. It was understood that Bowden, Bishop, the Brownlee brothers and Allen were all a part of this programme, and it therefore had to be assumed that none of the five had tested positive for clenbuterol.

Further, the athlete was cleared by World Triathlon. The federation, along with the with World Anti-Doping Agency (WADA), had decided that the source of the drug in the triathlete’s doping sample was likely to be from contaminated meat consumed in Mexico, where clenbuterol is used to fatten livestock.

Case closed, yes – but the intrigue now continues.

Clenbuterol has long been used by triathletes to illegally enhance performance. In 2013, the Spanish military police, the Guardia Civil, dismantled a doping network in which a pharmacy in Andorra, where many triathletes train, mailed prohibited substances to many athletes, as well as eleven sports doctors, throughout Spain.

The Guardia Civil, in what is known as Operacion Cursa, intercepted phone calls between the Spanish triathlete Xavier Llobet, who competed at the 2004 Athens Olympics, and a cyclist during which they discussed the price of clenbuterol, referred to as ‘clembu’. It was clear the drug was being used by the triathlete to engage in doping.

Dealer: Do you want two clembus (clenbuterol) or one?

Llobet: One, one, one, one, one, yes, put one, but then it's less. Then there are six... Well 700, 700.

Dealer: Each box of clembu (clenbuterol) costs 60, but they cost more.

Llobet: Well, 700, in the end it's 700 euros. Fair.

Dealer: Okay, wait, three Acts, a clemb...

The benefits of clenbuterol to triathletes are clear. ‘Clen’, as it is commonly known, is a fat-burning drug that also builds muscle. The drug increases body temperature through a process called thermogenesis. Once the body’s temperature is increased, one’s metabolism is then primed to burn off more calories. However, because clenbuterol raises systemic body temperature, it can cause tremors and severe anxiety.

Nonetheless, triathletes take clenbuterol to burn body fat and lower their overall weight. The less weight they have to transport around a triathlon course, the faster they are.

The drug has now found its way into British triathlon circles.

In February 2023, a British Age-Group (amateur) triathlete was in the car of her then-boyfriend Louis Walker, also a triathlete, when she discovered a box of clenbuterol tablets, branded Clenoxin, belonging to Walker. Both Walker and his ex-partner competed in the amateur category at the 2023 World Triathlon Championships in Ibiza, Spain.

Upon discovery, Walker’s then-girlfriend immediately confronted him and he promptly admitted that he had been taking clenbuterol for the last two weeks. She informed Walker’s triathlon coach and he was quickly reported to UK Anti-Doping (UKAD), the agency that patrols doping in Britain.

It soon became unequivocally clear that Walker was knowingly doping in an attempt to enhance performance. On 3^rd April, Walker told UKAD that he had been taking one Clenoxin pill a day in a bid to lose weight in the ten days before his drugs were discovered. He admitted to storing them in his car.

Walker’s case, as well as 12 British rugby cases in which players have either tested positive for or been found in possession of clenbuterol, demonstrate that the drug is not hard to come by in Britain. The different types of doping substances taken by athletes from different countries can vary depending on the availability of a drug in a certain country. In Britain, Clenoxin tablets can be readily purchased online for £46. Walker said he purchased the drugs in a local gym.

Despite Walker’s confession, he was allowed to compete at the World Championships 26 days later. He finished 32^nd in the 25-29 age group amateur duathlon sprint event. Finally, nine months later he was banned by UKAD for three years for the possession of a prohibited substance.

In some instances, an amateur doping case such as this would have little significance to the world of elite sport, but the Walker case casts new doubt on whether we can blindly trust the decision made by World Triathlon to attribute the 2016 British athlete’s clenbuterol positive to meat contamination. A decision shrouded in a cloud of opacity, set against a background of both clenbuterol use across the sport and meat contamination in Mexico.

In 2010, a Brazilian triathlete, Raphael Menezes, failed a test for clenbuterol, also in Mexico. He was charged with a doping offence and was required to defend himself in front on an independent tribunal. His defence, which relied on meat contamination in Mexico, was rigorously examined before it was finally rejected and he was suspended for two years.

In 2008, an International Olympic Committee witness testified that clenbuterol cases were “very rare and unlikely to occur and, even then, solely under very specific and extreme circumstances”. This evidence was presented in the case of the Polish canoeist Adam Seroczynski who tested positive for the drug at the Beijing 2008 Olympics. He too was banned for two years.

The British athlete was not subjected to the same procedure.

According to the British Triathlon press release, the British athlete was deemed to have ‘no case to answer’ meaning that he was either never charged with a doping violation or the charge was later withdrawn.

According to the WADA ‘Anti-Doping Rule Violation Report’, it lists three examples in which an athlete may have ‘no case to answer’. “Such cases include for example: authorized route of administration for glucocorticosteroids; departure from International Standards; or cases outside of WADA’s jurisdiction”. None of these examples applied to the British athlete.

World Triathlon, whose vice-president was the head of British Triathlon at London 2012, and WADA still decided to close the case even though clenbuterol contamination cases apparently only occur under ‘very specific’ conditions. The facts of ‘his’ case nor the detail of ‘his’ defence have ever been shared publicly. They therefore cannot be examined alongside the other legitimate clenbuterol contamination cases that have occurred in Mexico.

At the 2011 Under 17 FIFA World Cup in Mexico, over one hundred players tested positive after unknowingly eating contaminated meat. Earlier this year, the British tennis player Tara Moore was cleared after testing positive for the anabolic steroids nandrolone and boldenone, which are both used to fatten livestock in Colombia.

Moore presented detailed evidence concerning which restaurants she had eaten at in Colombia, how much meat she had consumed and whether these amounts were consistent with the drugs found in her doping sample. A panel ruled that another tennis player, who tested positive at the same tournament in Colombia, was also a victim of contamination. The decision can be read in full on the tennis anti-doping agency’s website. The agency has appealed the decision.

The British triathlete’s case was dealt with differently, and behind closed doors. The athlete may well have been a victim of meat contamination but the legitimacy of ‘his’ defence was not examined at a rigorous independent tribunal, as part of disciplinary proceedings. At most ‘he’ was subjected to a preliminary hearing.

There were also no reports of any other clenbuterol positives at the same event. All we know is that British Triathlon’s failure to warn the athlete that meat contamination was common in Mexico was factored into the decision to close ‘his’ case.

Ultimately, one is left wondering how differently the case may have unfolded had it played out in the public arena.

Transparency breeds integrity, and, without it, a cloud will always hang over those cases in which it has not been exhibited.

You can add this British triathlon case to the list. As for ‘his’ identity it will seemingly never be known.

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