Mo Farah denied receiving L-Carnitine injections in a four hour interview with investigators from the US Anti-Doping Agency (USADA), but immediately returned to admit receiving such injections after meeting Barry Fudge, Head of Endurance at UK Athletics, outside. BBC Panorama also obtained emails which it alleges show that Fudge flew to Zurich five days before the 2014 London Marathon after Farah’s coach, Alberto Salazar, introduced him to a contact that could obtain batch-tested L-Carnitine in the injectable form needed, which was not obtainable in the UK. 

Fudge brought a package containing injectable L-Carnitine back to the Tower Hotel, the official hotel for the London Marathon, where Farah was given four injections over two hours, it is alleged. Dr. Rob Chakraverty, now the England football team doctor, administered the injections, which Alberto Salazar had found was the most effective way to administer the permitted substance for performance benefit.

Farah did not declare L-Carnitine on his Doping Control Form (DCF) when tested after 2014 London Marathon, in which he finished eighth, recording a 2:08:21 time, a new English (but not British) record. Section 3 of the DCF requires athletes to ‘List any prescription / non-prescription medications or supplements, for e.g. Beta-2 Agonists and Glucocorticoids, taken over the past 7 days (include dosage and date last taken where possible) and (if a blood sample is collected) any blood transfusions received over the last three months’. Failure to declare a supplement, medication, substance or method on the DCF is not considered an anti-doping rule violation (ADRV).

When questioned by USADA investigators for almost five hours, Farah denied ever having received an L-Carnitine injection, BBC Panorama reported. After talking to Fudge, the BBC says that he rushed back to the Tower Hotel and changed his account, alleging that when originally questioned, he didn’t remember having received the injections. 

As previously discovered by USADA’s investigation into Salazar, he instructed Nike Oregon Project (NOP) athletes to deny having infusions, mistakenly believing that notification was not required by the World Anti-Doping Agency (WADA). It would appear that in denying receiving an L-Carnitine infusion, Farah was following Salazar’s orders. 

Context

It is important to point out that nobody is alleging that any anti-doping rules have been broken. L-Carnitine is not prohibited and in 2014, intravenous infusions or injections were only prohibited if they exceeded 50mL over a six hour period, UK Athletics (UKA) pointed out in a statement. It added that the dosage administered to Farah ahead of the 2014 London Marathon was within this limit. 

In its Combatting Doping in Sport Report, published almost exactly two years ago (PDF below), the Culture, Media and Sport (CMS) Committee of the UK Parliament was critical of UKA for not keeping records of the L-Carnitine administered to Farah, which Dr. Chakraverty admitted was “to help performance”. It called for the General Medical Council (GMC) to investigate, but it is understood that no investigation was launched.

As such, we only have UKA’s and Dr. Chakraverty’s word that the L-Carnitine administered to Farah fell within permissible limits. Steve Magness told BBC Panorama that Salazar administered over ten times the permissible limit to him in a 2011 test, before the substance was administered to Nike Oregon Project (NOP) athletes. Magness told the BBC that the test was successful, as he showed a significant improvement whilst using a treadmill to the point of exhaustion.

BBC Panorama’s report suggests that UKA was prepared to prioritise Salazar’s preferred treatments for Farah over its own ethical concerns. Emails accessed by the BBC reveal that Fudge had concerns about whether such treatment fell within the ‘spirit of sport’, and former UK Athletics Performance Director Neil Black admits to a ‘degree of discomfort’ regarding Salazar’s treatment of Farah. Yet despite this and despite Dr. Chakraverty’s concerns over the lack of a trial on another individual, Fudge flew to Zurich to obtain the L-Carnitine, which was administered to Farah days before the 2014 London Marathon.

Plausible deniability

There are obvious comparisons between Salazar’s relationship with UKA and Farah and the UK Parliament’s ‘belief’ that British Cycling and Team Sky abused the Therapeutic Use Exemption (TUE) system for performance gains. Both involved flights to courier particular substances to key athletes. Both involved doctors who failed to keep adequate medical records of substances administered to key athletes, enabling plausible deniability.

Famously or infamously, depending on your point of view, British Cycling operated a ‘marginal gains’ policy. Salazar operated a similar policy at the NOP, and a USADA investigation found that he had strayed into ADRVs in order to protect his key athletes. 

Such a ‘marginal gains’ approach requires total control over many aspects of an athlete’s life. Dr. Richard Freeman’s book details how diet, drink and toilet habits were controlled in order to optimise performance. In female cycling, this went as far as telling women not to shave their pubic hair.

At the NOP, it appears that ‘marginal gains’ involved putting athletes on thyroid medication, whether they needed it or not. Former NOP athlete Ari Lambie told BBC Panorama that Salazar and Dr. Jeff Brown insisted that she was given thyroid medication, despite not needing it. She said that it made her feel unwell. Two other NOP athletes, Kara Goucher and Galen Rupp, were also prescribed thyroid medication.

In her first interview, former athlete Ari Lambie, claims banned coach Alberto Salazar, asked her to take a supplement as part of an experiment to see if she would fail a drugs test.#BBCPanorama #AlbertoSalazar pic.twitter.com/uUYjwtZzms

— Panorama ? (@BBCPanorama) February 24, 2020

It would appear that a focus on ‘marginal gains’ and control over athlete lives does not lead to a healthy athlete/coach relationship. As well as making athletes resentful, it would appear that such close control can lead coaches towards inappropriate treatment. At British Cycling, this manifested itself in the treatment of Jess Varnish, and disparaging remarks made about para-cyclists. 

USADA sanctioned Salazar after its investigation found that he behaved inappropriately by:

• Trafficking his own testosterone prescription to his sons to see if sabotage of NOP athletes was possible by rubbing cream onto them;
• Administering an infusion to Magness at above WADA’s permissible limits;
• Instructing his own athletes to deny having infusions, as he incorrectly thought that this wasn’t required by WADA.

It also appears that he behaved inappropriately towards NOP athletes. Kara Goucher told BBC Panorama that he made inappropriate remarks about the size of her breasts after her pregnancy.

'He was obsessed with the size of my breasts.’

Kara Goucher says her former coach, Alberto Salazar, made sexually inappropriate comments after the birth of her son.

She became a key whistle-blower in the case that saw him banned for four years for doping violations. pic.twitter.com/IvzYY6a62a

— Panorama ? (@BBCPanorama) February 24, 2020

Quest for success

The new allegations that Farah changed his story will pour further suspicion onto the British sporting icon. As previously reported, questions remain as to his time spent training in Kenya with pacemakers who had bought erythropoietin (EPO) at camps where EPO was found in the bins, close to villages where EPO remains readily available. His apparent use of L-Carnitine shows that Farah was prepared to receive injections on the instructions of Salazar, who had discovered that such procedures boosted performance due to experiments performed on Magness. Farah has recently returned to Kenya to train.

This morning was my last session down at #Tambach. Thanks to @britishathletics for the support
.
It was great to see @andybutchart91 & @Mo_Farah smashing out some 'easy' 200's. I joined them for a few laps of our cool down…#inclusion
.#themarathonproject
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It's time to #taper pic.twitter.com/ll1KEQhjar

— Derek Rae (@derekrae_85) January 16, 2020

However, it is not a smoking gun. In denying receiving L-Carnitine when questioned by USADA, it would appear that Farah was following Salazar’s instructions. Although Salazar and UKA apparently knew that the L-Carnitine was to improve Farah’s performance, there is no evidence that Farah knew, or that he ‘cheated’. But the methods he has used will leave a bad taste in the mouth of sport’s purists.

It would appear that the quest for sporting success is to blame. Farah continued to work with Salazar for a reason – success. That success was due to exploring any ‘marginal gain’ possible, even when such methods appeared contrary to the ‘spirit of sport’. UKA has questions to ask about why its doctors failed to record the treatment and why it failed to take action, despite its concerns about Salazar’s methods. Perhaps it also wanted Farah to succeed.

Again, apologies to purists, but many elite athletes do take supplements. This can also involve the use of saline IV drips containing supplements for recovery purposes. This doesn’t make them a ‘cheat’, so long as they don’t break the rules. It would appear that Farah was prepared to take Salazar’s advice about the legal use of a supplement via an IV drip, which Salazar had found would improve his performance. No rules have been broken. However, the levels that elite coaches and athletes are prepared to take in order to win at all costs has once again been painfully exposed.