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| Claire Squires: amphetamine stimulant 'had role' in runner's fatal heart attack | Claire Squires: amphetamine stimulant 'had role' in runner's fatal heart attack |
| (about 2 hours later) | |
| The unexplained death of Claire Squires, a fit and healthy 30-year-old, one mile from the end of the London marathon last year, caught the country's imagination. In less than a week, tens of thousands of people had donated so much money to her chosen charity, the Samaritans, that her total surged from £500 to more than £1m. | The unexplained death of Claire Squires, a fit and healthy 30-year-old, one mile from the end of the London marathon last year, caught the country's imagination. In less than a week, tens of thousands of people had donated so much money to her chosen charity, the Samaritans, that her total surged from £500 to more than £1m. |
| On Wednesday a coroner ruled that the most likely cause off her death was a single dose of Jack3d, a performance-enhancing supplement that at the time was legal to buy, possess and use. | On Wednesday a coroner ruled that the most likely cause off her death was a single dose of Jack3d, a performance-enhancing supplement that at the time was legal to buy, possess and use. |
| That supplement, with its amphetamine-type effects, was to be banned four months later by the Medicines and Healthcare products Regulatory Agency, though the organisation had first received complaints about the supplement's main active ingredient six years before. | That supplement, with its amphetamine-type effects, was to be banned four months later by the Medicines and Healthcare products Regulatory Agency, though the organisation had first received complaints about the supplement's main active ingredient six years before. |
| At the inquest at Southwark coroner's court, the coroner Philip Barlow said he hoped the publicity around Squires' death would draw attention to the dangers faced by those who innocently endangered their health by buying even legal performance enhancing products. | At the inquest at Southwark coroner's court, the coroner Philip Barlow said he hoped the publicity around Squires' death would draw attention to the dangers faced by those who innocently endangered their health by buying even legal performance enhancing products. |
| Simon Van Herrewege, Squires' partner, said she had purchased the Jack3d powder online, where it was advertised as workout aid or a weight-loss supplement that boosted energy, concentration and metabolism. | Simon Van Herrewege, Squires' partner, said she had purchased the Jack3d powder online, where it was advertised as workout aid or a weight-loss supplement that boosted energy, concentration and metabolism. |
| Neither Squires nor Van Herrewege knew at the time that the powder – which users added to water – contained the amphetamine-like stimulant DMAA (1,3-dimethylamylamine), which was linked to psychiatric disorders, heart attacks, strokes and a death. It was also on the list of substances banned by the World Anti-Doping Agency. | Neither Squires nor Van Herrewege knew at the time that the powder – which users added to water – contained the amphetamine-like stimulant DMAA (1,3-dimethylamylamine), which was linked to psychiatric disorders, heart attacks, strokes and a death. It was also on the list of substances banned by the World Anti-Doping Agency. |
| "Claire was always in the gym, where this stuff was being widely talked about," said van Herrewege. "She took it a couple of times [while training for the marathon] but didn't really get on with it. She never particularly liked it but wanted to beat her previous marathon time [of just over four hours]. She said she was going to take one scoop, as recommended. In her own words, 'if I hit a bit of a wall, I might take this drink and see if it pushes me through the end of the marathon'." | "Claire was always in the gym, where this stuff was being widely talked about," said van Herrewege. "She took it a couple of times [while training for the marathon] but didn't really get on with it. She never particularly liked it but wanted to beat her previous marathon time [of just over four hours]. She said she was going to take one scoop, as recommended. In her own words, 'if I hit a bit of a wall, I might take this drink and see if it pushes me through the end of the marathon'." |
| A spokesman for the MHRA confirmed that the organisation had first received complaints about DMAA in 2006, and had begun banning products containing it. | A spokesman for the MHRA confirmed that the organisation had first received complaints about DMAA in 2006, and had begun banning products containing it. |
| Complaints were first made about Jack3d in 2010 but after an appeal from one retailer it took until 2012 to get it, and all other products containing DMAA, properly banned. Similar rulings were made around the world, including in Canada and in Australia, where a man died after buying DMAA online. It was banned in the US, early in 2012, after two soldiers who had taken the drug, which was available at stores on military bases, died from cardiac arrests during fitness exercises. | Complaints were first made about Jack3d in 2010 but after an appeal from one retailer it took until 2012 to get it, and all other products containing DMAA, properly banned. Similar rulings were made around the world, including in Canada and in Australia, where a man died after buying DMAA online. It was banned in the US, early in 2012, after two soldiers who had taken the drug, which was available at stores on military bases, died from cardiac arrests during fitness exercises. |
| Nick Bitel, chief executive of the London marathon, said the medical advisory group of UK Athletics Group, which represents all the main races in the UK, would be meeting to consider how to change the advice they gave competitors, to present the risks of supplements including DMAA. | Nick Bitel, chief executive of the London marathon, said the medical advisory group of UK Athletics Group, which represents all the main races in the UK, would be meeting to consider how to change the advice they gave competitors, to present the risks of supplements including DMAA. |
| "It will happen," he said. "I'm sure they will want to take this into account and it can happen very quickly. They meet on a very regular basis." | "It will happen," he said. "I'm sure they will want to take this into account and it can happen very quickly. They meet on a very regular basis." |
| The inquest heard that Squires may been particularly vulnerable to the drug because she may have suffered an irregular heartbeat, which was identified by Stephanie Curnoe, a registered acupuncturist, who had given the runner an initial consultation in 2011. | The inquest heard that Squires may been particularly vulnerable to the drug because she may have suffered an irregular heartbeat, which was identified by Stephanie Curnoe, a registered acupuncturist, who had given the runner an initial consultation in 2011. |
| Squires didn't mention the diagnosis to her partner or her family. Her GP testified that she had not consulted with him about it. | |
| William McKenna, a professor at the University College London hospitals trust, who reviewed Squires' medical records, said he thought the irregular heartbeat was "a red herring" and that the substance found in the blood was "an important factor in the outcome". | William McKenna, a professor at the University College London hospitals trust, who reviewed Squires' medical records, said he thought the irregular heartbeat was "a red herring" and that the substance found in the blood was "an important factor in the outcome". |
| Jon van der Walt, the doctor carried out Squires' postmortem, agreed. He said that, on the "balance of probability" based on his own examination of Squires and on evidence from the inquest, the cause of death had been a heart attack caused by "extreme physical exertion complicated by [DMAA]". | Jon van der Walt, the doctor carried out Squires' postmortem, agreed. He said that, on the "balance of probability" based on his own examination of Squires and on evidence from the inquest, the cause of death had been a heart attack caused by "extreme physical exertion complicated by [DMAA]". |
| He added: "[Squires] had taken vigorous exercise over many years. I would regard that as a stress test: she has been able to do all this before, therefore it is unlikely that she had fatal arrhythmia." | He added: "[Squires] had taken vigorous exercise over many years. I would regard that as a stress test: she has been able to do all this before, therefore it is unlikely that she had fatal arrhythmia." |
| Andrew Kicman, head of research and development at Kings College London, analysed a blood sample from Squires. DMAA had been present but he said she, like others who took legal ly available stimulants, was unlikely to have known of its amphetamine-like properties. | Andrew Kicman, head of research and development at Kings College London, analysed a blood sample from Squires. DMAA had been present but he said she, like others who took legal ly available stimulants, was unlikely to have known of its amphetamine-like properties. |
| "I suspect many people who take supplements like Jack3D are not aware of what DMAA is," he said. "Many performing-enhancing drugs can be bought from the internet quite legally." | "I suspect many people who take supplements like Jack3D are not aware of what DMAA is," he said. "Many performing-enhancing drugs can be bought from the internet quite legally." |
| After the inquest Van Herrewege said the finding had left Squires' family and himself "numb". | After the inquest Van Herrewege said the finding had left Squires' family and himself "numb". |
| He said: "Claire was passionately against the use of drugs and would never, ever, have taken anything that would have caused her harm or even worse risked her life. She innocently took a supplement which at the time was entirely legal, and widely available on the high-street, and somewhat worryingly, apparently used by so many others. | He said: "Claire was passionately against the use of drugs and would never, ever, have taken anything that would have caused her harm or even worse risked her life. She innocently took a supplement which at the time was entirely legal, and widely available on the high-street, and somewhat worryingly, apparently used by so many others. |
| "It's clear there needs to be far better supervision of the so-called health foods and supplements industry so that no more tragedies like this happen again, causing other families to … go through what we have been through this past year." | "It's clear there needs to be far better supervision of the so-called health foods and supplements industry so that no more tragedies like this happen again, causing other families to … go through what we have been through this past year." |
| The hearing was told Jack3d was still being sold on Amazon but that DMAA had been removed as an ingredient. | The hearing was told Jack3d was still being sold on Amazon but that DMAA had been removed as an ingredient. |
| Drug danger | |
| The effects of performance-enhancing stimulants on an athlete's body can be profound. "If you look at 20 miles into a marathon, you will already be dehydrated and that is putting extra strain on the body and causing the heart rate to be higher, body temperature to be higher," said John Brewer, professor of sports science at the University of Bedfordshire. "Your heart rate is probably 160-180 beats per minute. If you then take a stimulant to enable you to run through the very difficult last five or six miles of a marathon and to ignore many of the signals the body is giving out ... you therefore artificially enable to push yourself too hard, then you are running a grave risk of doing something damaging to your body. | |
| Brewer added: If somebody offers you a product that they suggest is going to suddenly revolutionise your performance, you can bet your bottom dollar that either everyone else will have been using it and you will already have heard about it, or there is something not quite right about it." | |
| But he said that no amount of drug testing or regulation could prevent somone from making a personal choice to take a banned substance. "When you see claims on supplements that claim they are some form of wonder product – if it seems too good to be true, it probably is too good to be true." |