Rewording of section on Prohibited Methods
In order to make Section M1 more encompassing so it includes all kinds of manipulation of blood and blood components, the title and body of Section M1 has been changed.

The title of M1 now reads ‘Manipulation of Blood and Blood Components’, while M2.3 has been deleted as it is now included in this revised category under M1.3, which reads “any form of intravascular manipulation of the blood or blood components by physical or chemical means.”

Section M3, which covers gene doping, has also been reworded to provide a more precise definition of this prohibited method.

Beta-blockers

Aeronautic (FAI), Boules (CMSB), Bridge (FMB), Ninepin and Tenpin Bowling (FIQ) and Powerboating (UIM) are removed from the list of sports in which beta-blockers are prohibited. 

Clarification of stimulants
To give more clarity, under Section 6 for Stimulants it has been confirmed that all optical isomers where relevant are prohibited.

Monitoring Program
In order to reveal potential patterns of abuse, tapentadol has been added to the Monitoring Program in 2013 under in-competition narcotics.

Methylhexaneamine (MHA), which sometimes is presented as dimethylamylamine, remains prohibited in competition as a specified stimulant under Section 6.b.

It has been considered a stimulant at least since WADA took over responsibility for the List in 2004. It was reclassified on the 2011 List to become a ‘specified substance’.

Methylhexaneamine was sold as a medicine up to the early 1970s and has medicinal properties, but to WADA’s knowledge it has not been sold as a medicine since then.

Recent scientific studies have clearly demonstrated that natural geranium oil does not contain methylhexaneamine (MHA), and the use of geranium oil cannot be considered as being the source of the presence of MHA or related metabolites in a urine sample collected for anti-doping purposes.

Methylhexaneamine (MHA) is a pharmacological substance classified as a stimulant that was commercialized up to the beginning of the seventies. MHA reappeared a few years ago as a constituent of dietary supplements sold freely on some markets or on the Internet.

MHA is prohibited as a stimulant under section S6.b of the 2013 List of Prohibited Substances and Methods.

Athletes should be aware that MHA has been made available under several names, one being geranium oil.

Clenbuterol is a prohibited substance and there is no threshold under which this substance is not prohibited.

At present, and based on expert opinions, there is no plan to introduce a threshold level for clenbuterol.

It is possible that under certain circumstance the presence of a low level of clenbuterol in an athlete sample can be the result of food contamination. However, each case is different and all elements need to be taken into account, along with the context of the case.

Under the World Anti-Doping Code, result management of cases foresees the opportunity for an athlete to explain how a prohibited substance entered his/her body

WADA is working closely with countries, International Federations and event organizers to help minimize the risk of contamination through the monitoring of meat to official hotels and restaurants. This is a government issue and not a WADA issue.

A specified substance is a substance which allows, under defined conditions, for a greater reduction of a two-year sanction when an athlete tests positive for that particular substance.

The purpose is to recognize that it is possible for a substance to enter an athlete’s body inadvertently, and therefore allow a tribunal more flexibility when making a sanctioning decision.

Specified substances are not necessarily less serious agents for the purpose of doping than other prohibited substances, and nor do they relieve athletes of the strict liability rule that makes them responsible for all substances that enter his or her body.

However, there is a greater likelihood that these substances could be susceptible to a credible non-doping explanation, as outlined in section 10.4 of the World Anti-Doping Code.

This greater likelihood is simply not credible for certain substances – such as steroids and human growth hormone – and this is why these are not classified as specified.

Colostrum is not prohibited per se, however it contains certain quantities of IGF-1 and other growth factors which are prohibited and can influence the outcome of anti-doping tests. Therefore WADA does not recommend the ingestion of this product.

Despite the presence of some growth factors, platelet-derived preparations were removed from the List as current studies on PRP do not demonstrate any potential for performance enhancement beyond a potential therapeutic effect.

Note that individual growth factors are still prohibited when given separately as purified substances as described in S.2.5

Yes, Hemodyalisis is prohibited under M1.1, as blood is taken out from the patient (in a closed circuit) and then reintroduced into the circulatory system.  An athlete needing this treatment requires a TUE

Plasmapheresis should be considered from 2 angles:

                a- For the donor, plasmapheresis is prohibited under M1.1 because the donor’s own red blood cells (and other blood components) are being reintroduced into the circulatory system after the   plasma has been separated.

                b- For the recipient, plasmapheresis is not prohibited under M1.1 or M1.3 as the patient receives only plasma but does not receive whole blood or red blood cells.  For the recipient  plasmapheresis would only be prohibited under M2.2 if it is not legitimately received in the course of a hospital admission when the volume is more than 50 mL per 6 hour period.

Yes it is prohibited under M1.3 as “Any form of intravascular manipulation of blood…”