Though TUE’s don’t involve any breach of anti-doping rules, the leaks have brought them under the spotlight, with the suspicion that they create a grey area whereby an athlete can apply for medical treatment which enhances performance under a spurious medical pretext.
Skinner, who won a gold and silver medal on the track for Great Britain at the Rio Olympics, has availed of two TUEs in his career to treat asthma, a condition that has raised eyebrows given its prevalence among the elite athletes whose TUE histories have been made public.
“When I went on Twitter and saw a headline with my name and stories with my picture I knew that people would be sceptical and think my TUEs could be questionable," Skinner writes in The Scotsman.
"And to be honest, I sympathise. I imagine myself a few years ago, as a cycling fan. I would have read the headline, not bothered opening the article, and moved on, putting two and two together and concluding that it all sounded a bit dodgy."
“After the leak I resolved to release my NHS medical records, so I’ve spent the past week phoning doctors I’ve seen and the hospitals to which I have been admitted on four occasions having suffered asthma attacks. I was keen to make my records public for two reasons: to prove that my condition is real, but also to show that asthma need not stop somebody competing at the highest level.”
The asthma
Skinner has published scans of hospital visit records on his personal website in a bid to prove he has genuinely suffered with asthma since childhood.
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The first document, from a school health service visit in 1999, when Skinner was aged six, details concerns over his frequent use of his inhaler, and notes that he suffered his first ‘wheezy attack’ aged five when he came into contact with a cat. He was prescribed Ventolin Becotide for a period of three weeks.
The other documents also show how Skinner had to go to hospital on numerous occasions after suffering asthma attacks. In 2001 he went to the A&E department of Kent and Canterbury hospital and, after X-rays, was prescribed a salbutamol nebuliser.
In 2003 he was treated with salbutamol in hospital and prescribed a course of prednisolone after another asthma attack brought on by contact with a dog, while the following year he was treated with salbutamol and given prednisolone for reserve after going on holiday without his inhalers. Also in 2004, Skinner spent two days in hospital, claiming he suffered from pneumonia after the worst of his asthma attacks. The notes on his discharge form note a ‘chest infection’ and show that he was given courses of co-amoxiclav, becotide, and salbutamol. He was also referred to an asthma clinic.
"I started cycling when I was 12. The story of me being inspired by Chris Hoy is true, but I also wonder whether I was attracted to the sprint events because these seemed easier for an asthmatic. You go and do your effort then come off the track and, if your chest is tight, use your inhaler before you go again," said Skinner.
"As I got more serious about cycling I also got serious about trying to manage my asthma,” he adds, explaining that nowadays he tries to rely less on medication while taking measures such as using an air purifier and a health monitoring smartphone app, spending time in the sun to top up vitamin D levels, avoiding cats and dogs, and being ‘religious’ about taking omega pills and probiotics.
“Not so long ago my training would be compromised for up to three months of the year. Now it’s typically two to three weeks. This has been one of the keys to my more recent success; that, and learning how to react to health issues,” he claimed.
Explanation for the TUEs
Skinner also offered an explanation concerning his two TUE's, the first a five-day course of prednisolone in late November 2014 ahead of the London leg of the Track World Cup, and the second, from January 2016, a two-day prescription for a dosage of salbutamol that was above the ordinarily permitted threshold.
In discussing the first, Skinner concedes he was too ill to race, putting in 'one of my worst-ever performances', but claims he learnt his lesson and decided not to apply for a TUE under similar circumstances the following year.
"I should have been tucked up in bed," Skinner writes, "but my desire to compete outweighed common sense. The following year, 2015, I was ill again – any illness goes straight to my chest, which Prof Woodcock attributes to the pneumonia leaving scars in my lungs – but this time, instead of applying for a TUE, I pulled out of competition. It meant missing the European championships and a World Cup, which was a big call. But, in the long run, it paid off."
As for his second TUE for salbutamol, he said: "Sometimes TUEs are necessary – I had my second in January after falling ill, with a two-day treatment of salbutamol clearing up the problem and causing minimum disruption to my training."
"I’m not claiming the TUE system is perfect," Skinner concludes. "One athlete using the system for performance enhancement rather than for genuine health reasons is one too many. But personally, I have no issue with all my TUEs, and drug test results, being made public. If you have nothing to hide, you have nothing to fear."
Patrick is a freelance sports writer and editor. He’s an NCTJ-accredited journalist with a bachelor’s degree in modern languages (French and Spanish). Patrick worked full-time at Cyclingnews for eight years between 2015 and 2023, latterly as Deputy Editor.
