Raising Questions on Athletes and Trimetazidine

Transcript:

Narrator: 0:00

Welcome to the MedEvidence Monday Minute radio show hosted by Kevin Geddings of WSOS St. Augustine Radio and powered by ENCORE Research Group. Each Monday morning, Dr. Michael Koren calls in to bring you the latest medical updates with insightful discussions. MedEvidence is where we help you navigate the real truth behind medical research, with both a clinical and research perspective. So sit back, relax and get ready to learn about the truth behind the data in medicine and healthcare. This is MedEvidence.

Kevin Geddings: 0:30

Dr. Michael Koren he joins us on Monday mornings and a big friend of WSOS and we appreciate him very, very much for his support of what we do here. Of course, he is a medical doctor, cardiologist, research scientist really on the leading edge of so many things that impact our lives, especially when it comes to our health and how we can participate in clinical research.

Kevin Geddings: 0:50

This morning there's a lot of national international headlines about a potential Chinese doping scandal involving Olympic swimmers, as we are literally days away, or weeks away anyway, from the Paris Olympics, right, doctor?

Dr. Michael Koren: 1:04

There is. There is I don't know how much press that got over the weekend but there's a drug that's available only in Europe that a lot of athletes, particularly, it seems, the Chinese and Russian athletes, have used for doping, and it's called trimetazidine. Trimetazidine is the generic name for the drug and, interestingly, it's a drug that we use for angina because it helps the utilization of oxygen in the muscles by switching your metabolism from fatty acids to glucose. So that sounds a little bit technical, but trimetazidine is the name of the drug available in Europe and it has potential as a performance-enhancing drug because of what it does to oxygen metabolism in the muscles.

Dr. Michael Koren: 1:54

So it's interesting because, again, it's not available in the United States and so we don't know that much about it here, but apparently in Europe and elsewhere it's a commonly used drug.

Kevin Geddings: 2:02

Right, right and indeed these kind of drugs, you know, obviously they show up in athletes and then of course the athletes get in trouble. But those of us who lead everyday lives, whether we're trying to have a CDL license or meet some other professional standard, sometimes, I guess, when you're doing clinical research work with participants, you find some interesting items in their blood.

Dr. Michael Koren: 2:21

Yeah, yeah, so it's interesting you bring that up. So this gets into doping and anti-doping. So, getting back to the Chinese, one of the controversies is that the Chinese so-called anti-doping society kind of covered this up. They found two dozen Chinese swimmers with trimetazidine in their blood and they didn't really say much about it. They said it was an accidental exposure to it and they didn't mention anything about it, even though the Chinese swimmers did incredibly well during the last Olympic Games in Tokyo and now we're coming up on the Olympic Games in Paris. So this is a big controversy.

Dr. Michael Koren: 2:55

But in my world a lot of people come in. We'll often do what we call a tox screen for people. It's all confidential and we do it just to make sure there's no drug-drug interactions between what we're giving in research and what people may have been exposed to, and a lot of patients are surprised to find out what they've been exposed to. We had a guy recently who had some traces of cocaine in his blood. He had no idea where that came from and it turned out he was taking a supplement from a relative for back pain and that was probably the source. CBD and THC are ubiquitous, including a concert I went to last night which we can talk about, and people get exposed to these things and it shows up in their blood tests. So one of the things that we do for people in research is let them know what they've been exposed to, completely confidentially. There's no reporting to insurance or anybody else, and we share that information with patients. So another benefit of clinical trials.

Kevin Geddings: 3:51

Yeah, absolutely. You know, routine testing and what's going on inside your body is part of the whole clinical trial participation process, correct, doctor?

Dr. Michael Koren: 3:59

It is, it is and again, it's done confidentially, so there's no reporting to the outside authorities. But you'd be surprised. Last night I went to the Billy Strings concert in St. Augustine. I don't know if you're familiar with Billy Strings, but he's kind of a bluegrass musician, really a virtuoso on the guitar. I guess the Florida public area smoking laws are no longer being enforced and the amount of marijuana and nicotine smoke in the audience was just off the charts. Literally, I had to walk out of the concert because I'm not used to those type of things and I'm wondering today if I should get my nicotine and my marijuana blood levels checked, just based on secondhand smoke. It was really quite remarkable.

Kevin Geddings: 4:45

Yeah, it is amazing nowadays you go to some of these shows; apparently Willie Nelson, when he was here last year, you know, there was a purple cloud over the amphitheater. So I guess law enforcement just says, nah, we're not going to worry about that, not today, but yeah. I'm like you I don't do well with that.

Dr. Michael Koren: 5:01

Yeah, I was actually feeling physically ill during the concert I had to leave. You know, as you know, I have a little bit of a music background. I love music, I love to analyze it and this guy, Billy Strings, is really quite talented, really virtuoso. It's interesting he uses a Mixolydian scale we call it Mixolydian scale, excuse me A Mixolydian scale in his music and that's actually associated with intoxication. So not to get too technical, but there are different types of musical scales and, for example, the Mixolydian scale is something that's used in the song Comfortably Numb by Pink Floyd, which was associated with intoxication when I was growing up, and he uses a lot of that. So there may be some brain signaling that's going on through the way he plays his music and certainly the audience he attracts. Anyhow, I could appreciate his real talent, but I literally had to walk out.

Kevin Geddings: 5:56

Yeah, back in the day they would have called you and me squares. Just not cool enough for that. Yeah.

Dr. Michael Koren: 6:02

I'm not a prude. I'm not a prude. I don't really care what people do. I just couldn't. I try to suck it up for about 30 minutes and I really had to leave.

Kevin Geddings: 6:10

Yeah, no, I'm with you. Dr. Michael Koren, you can learn more by going to ENCOREdocs. com. But before we let the doctor go, you've got a great website too that has good healthcare information, not just the garbage sometimes we pull up when we use Dr. Google, right?

Dr. Michael Koren: 6:25

It is. That's our MedEvidence platform and, yeah, we're getting more and more positive feedback on it. It's a neat way to get objective information. It's not trying to sell you anything? It's literally just having physicians and other experts talk about their field and you can glean a lot of information. We just sort of overhear people talking about their field in a way that addresses patient questions. So hopefully it'll be something that this listening audience can access and get to enjoy.

Kevin Geddings: 6:53

Speaking of great musicians, virtuosos and the like. Have you ever seen Peter Frampton in concert?

Dr. Michael Koren: 6:59

Yeah, I did a long time ago. Of course, he was very popular when I was a teenager.

Kevin Geddings: 7:05

Yeah.

Dr. Michael Koren: 7:06

And yeah, he was certainly a virtuoso no doubt.

Kevin Geddings: 7:08

Yeah, he is 74 years young today, Dr. Koren. Wow, amazing.

Dr. Michael Koren: 7:14

So happy birthday to him. I haven't heard anything of that. Is he still touring? Do you know that?

Kevin Geddings: 7:18

Yeah, apparently he's still touring. He had a couple of little health issues, but he hasn't announced his permanent retirement like ELO just did about 10 days ago. They're on their quote farewell retirement tour, so he's part of that generation.

Dr. Michael Koren: 7:33

Elton John has been on his farewell tour for the last five years.

Kevin Geddings: 7:36

Yeah, that's the way to do it. Just keep it going, farewell, until you actually ultimately do have to say farewell.

Dr. Michael Koren: 7:46

When you're making $300 to $500 a ticket, there's a lot of incentive to make it a long farewell.

Kevin Geddings: 7:48

Heck yeah, that's a good way to live in retirement. Dr. Michael Koren, of course we appreciate your time. Thank you very much. Go to the website MedEvidence. com and you'll get some great information.

Dr. Michael Koren: 8:01

Okay, Sounds great, Kevin.

Narrator: 8:02

Thanks for joining the MedEvidence podcast. To learn more, head over to MedEvidence. com or subscribe to our podcast on your favorite podcast platform.