In this article, we have gathered reviews from cardiologists and pharmacologists about the drug mildronate (meldonium) in sports.
To start, we recommend familiarizing yourself with the facts about the drug mildronate (meldonium) in our material Mildronate (meldonium) in sports: FACTS.
Main thoughts:
Review from the creator of mildronate Professor Ivar Kalvins after the drug’s ban
Immediately after the doping scandal with Maria Sharapova, the creator of mildronate, Professor Ivar Kalvins, noted in an interview with the BBC news agency 1:
“In the near future, we will see many deaths in professional sports due to the ban, as without mildronate, athletes’ bodies will be unable to supply oxygen to the cells during competitions.”
“Athletes, like other people, have human rights that should be protected… meldonium has been on the market as a heart protection agent for 32 years and only now (in January 2016) has it made it to the list of banned substances.”
Review from the creator of mildronate: “In the near future, we will see many deaths in professional sports… due to the ban on mildronate, which supports heart function“
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Cardiologist and Pharmacologist’s Review on the Mechanism of Action of Meldonium
Cardiologist Justin Trivax:
“Meldonium is widely used in professional sports as it has potential benefits in enhancing physical performance.
However, cardiologists in the USA are not allowed to prescribe it to athletes, as it is primarily a medication for treating heart problems, and in general, doctors know very little about it.
Small studies have shown the effectiveness of meldonium in treating ischemia and other conditions where blood vessel permeability is compromised.
Every organ in our body – from the biceps and lungs to the heart itself – needs a supply of oxygen-rich blood to function properly. Disruption of oxygen supply impairs function or reduces movement efficiency, which is important in sports.”
Pharmacologist Mohamed Jalloh:
“There are many other drugs that improve blood flow. The mechanism of action of almost all of them involves relaxing blood vessels and increasing their diameter.
Meldonium, however, works differently: it blocks the action of the substance L-carnitine, which functions in the body to use fats for energy.
That is, when using meldonium, the body uses more glucose instead of fats; and less oxygen is required for its conversion into energy.”
Pharmacologist Mohamed Jalloh: “Meldonium acts differently from other heart medications: it blocks the action of carnitine, forcing the body to use glucose.”
Cardiologist Trivax:
“This shift in metabolism explains why athletes who take mildronate can run, cycle, or play faster.Meldonium allows for a bit more energy production with slightly less oxygen. When you do not take it, you produce less energy while consuming the same amount of oxygen. The more energy, the better the result.”
“Better oxygen supply not only facilitates the work of the heart and muscles but also improves brain function, i.e., concentration and reaction speed – equally important qualities in sports.
It has been shown that meldonium improves memory, learning processes, reduces symptoms of depression, and treats neurodegenerative diseases such as Alzheimer’s disease.“
Cardiologist Trivax: “Meldonium allows for a bit more energy production with slightly less oxygen“
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Cardiologists’ opinions on Sharapova’s use of meldonium
Cardiologist Roderick Tung:
“After a positive doping test, Maria Sharapova claimed that she had a poor cardiogram and a family history of diabetes. Both conditions are not listed as indications for the use of meldonium.“
Cardiologist Trivax:
“This is a very rare case for athletes competing at the highest level to have such health problems for which mildronate is intended for treatment.”
Cardiologists’ opinion on Sharapova’s use of meldonium: “it is a very rare case for professional athletes to have such health problems as Sharapova mentions. Moreover, both of them are not listed as indications for the use of meldonium.”
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The harm of meldonium (mildronate): doctors’ reviews
Pharmacologist Jalloh:
“Doctors do not know the answer to the question of the harm of mildronate to health. The instructions for the use of this drug list several side effects, including high blood pressure, rapid heartbeat (tachycardia), and digestive disorders.”
Cardiologist Trivax:
“And like any new substance for the body, mildronate can cause allergies, especially considering that the quality and safety standards at enterprises of the former Soviet Union are questionable.
Available scientific data indicates the absence of serious side effects.
However, healthy individuals should take mildronate with caution: it was developed for treating specific heart problems; whether a healthy heart can be made to work just a little better with medication is a big question.”
Cardiologist Trivax on the harm of mildronate: “it was developed for treating heart diseases… whether a healthy heart can be made to work just a little better with medication is a big question“
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Should athletes take meldonium? Doctors’ reviews
Pharmacologist Jalloh:
“Mildronate is banned for use in the USA by the Food and Drug Administration (FDA) – the supreme regulatory authority. There are reasons for this.
To obtain permission for distribution, the manufacturer of any medical product must provide scientific evidence of safety and efficacy on hundreds of patients.”
Cardiologist Trivax adds: “Such studies are very expensive, and so far the manufacturer of meldonium, the Latvian company Grindeks, has not even attempted to conduct them.”
Cardiologist Trivax:
“If you are not scared by the lack of FDA approval, the inclusion of meldonium in the list of banned doping substances by WADA – think about the following: even if some drug does provide certain advantages in athletic performance (in the case of mildronate, this has not been proven 100%) – when you buy it from abroad, you CANNOT be sure that you received exactly what you wanted.”
“We do not issue official permission for the use of meldonium here in the USA simply because we know very little about it. I warn everyone (my patients, friends, athletes around the world) that meldonium is not a magic pill that will make them champions.”
The chief clinical pharmacologist of St. Petersburg, Alexander Khadzhidis 3:
“The effectiveness of “Mildronate” as a drug or as a doping agent has still not been confirmed by any practical evidence.
There have been several studies on its metabolic effects in cardiovascular diseases, but only one of them can be considered serious. This is questionable evidence.
And no one has studied its effects on healthy people at all. Therefore, buyers will waste their money.
In response to a question about the possible harm of the drug to healthy individuals, Alexander Khadzhidis notes that overall “all medications are harmful and only some can be beneficial.”
Pharmacologist Alexander Khadzhidis “The effectiveness of Mildronate as a drug or as a doping agent has still not been confirmed by any practical evidence… Buyers are wasting their money”
