10.1073/pnas.0403412101 Proc
doi:10.1163/156856208784909435 Pickart L, Vasquez-Soltero JM, Margolina A
TUE guidance documents including new regulations on glucocorticoids In order to assist physicians and athletes, in the last few weeks, WADA published the following guidance documents on managing TUEs to include the new regulations on glucocorticoids: General document on glucocorticoids and TUEs Checklists for athletes and treating physicians on a number of medical conditions for which glucocorticoids may be used TUE Physician Guidelines for TUE Committees on how to evaluate TUE requests for glucocorticoids for different medical conditions Educational resources In addition to the guidance documents listed above, WADA has provided a number of educational resources as part of its Code Implementation Support Program (CISP), which can be accessed on the Agencys Anti-Doping Education and Learning Platform (ADEL)
Its activity intersects two major metabolic pathways simultaneously: the NAD+ biosynthesis pathway (by consuming nicotinamide, an NAD+ precursor, NNMT competes with the NAD+ salvage pathway) and the methyl-donor pathway (by consuming SAM, NNMT reduces the availability of methyl groups for epigenetic and metabolic methylation reactions)
Chronic conditions and post-surgical recovery extend the protocol to 6 to 12 weeks, with practitioner-guided cases running 16 weeks under close monitoring
Buse JB, Bain SC, Mann JF, et al
