Anti-inflammatory drugs that can enhance performance when misused but are permitted with legitimate medical exemptions (TUEs).
Corticosteroids are powerful anti-inflammatory medications that reduce pain and inflammation. Unlike anabolic steroids, they don't build muscle but can provide performance advantages through pain suppression and anti-inflammatory effects.
• Treatment of asthma and respiratory conditions • Management of severe allergic reactions • Skin conditions (topical application) • Acute inflammation or injury
• Required documentation from medical professionals • Must demonstrate medical necessity • Pre-approval required from anti-doping authorities • Subject to scrutiny and verification
• Reduced perception of pain and fatigue • Suppression of inflammation during stage races • Possible euphoric effects • Weight loss (potential benefit for climbing) • Anti-inflammatory effects aid recovery
• Unclear direct benefit (not like EPO) • Primarily allows riding through pain/illness • May permit training at higher volumes
• Bradley Wiggins' pre-competition TUE packages • Triamcinolone injections before major tours • Questions about medical necessity vs. performance gain • Fancy Bears hack (2016) exposed widespread TUE use
• High-profile TUE use for asthma medication • Salbutamol case (2017-2018) • Raised questions about therapeutic vs. performance use
• Triamcinolone injections before Tour de France wins • Technically legal via TUE • Ethical questions about sporting integrity
• Suppressed immune function • Bone density loss (osteoporosis) • Adrenal gland suppression • Increased infection risk • Weight gain (counterproductive for cyclists) • Psychological dependence
• Must document serious health condition • Treatment must be medically necessary • No reasonable alternative therapy • Use must not enhance performance beyond normal health restoration
• Oral and injectable corticosteroids require TUE • Topical and inhaled formulations have different thresholds • In-competition vs. out-of-competition distinctions
• Enhanced TUE documentation requirements • Independent medical review panels • Publication of aggregated TUE statistics • Limits on pre-competition corticosteroid use
• Should marginal gains via legal TUEs be permitted? • Where is the line between treatment and enhancement? • Transparency requirements for TUE disclosure
• Stricter TUE approval criteria • Public disclosure of athlete TUE use • Bans on pre-competition injections
Corticosteroids represent a gray area in cycling - legal when medically justified, but open to abuse through TUE systems. The controversy highlights the tension between treating legitimate medical conditions and preventing performance enhancement disguised as therapy.
The main misconception is that all corticosteroid use is doping. Many cyclists have legitimate asthma and allergies requiring treatment. However, the TUE system has been exploited in the past, leading to justified skepticism and calls for reform.