Intrinsic Sleep Disorders
29 de março de 2021Cardiovascular Conditions
29 de março de 2021Checklist for Therapeutic Use Exemption (TUE) Application:
Adrenal Insufficiency
Prohibited Substances: Gluco- and mineralocorticoids
This Checklist is to guide the athlete and their physician on the requirements for a TUE application that will allow the TUE Committee to assess whether the relevant ISTUE Criteria are met.
Please note that the completed TUE application form alone is not sufficient; supporting documents MUST be provided. A completed application and checklist DO NOT guarantee the granting of a TUE. Conversely, in some situations a legitimate application may not include every element on the checklist.
| • | TUE Application form must include: | |
| • | All sections completed in legible handwriting | |
| • | All information submitted in [language] | |
| • | A signature from the applying physician | |
| • | The Athlete’s signature | |
| • | Medical report should include details of: | |
| • | Medical history: symptoms, age at onset, presentation at first manifestation (acute crisis/ chronic symptoms), course of disease, start of treatment | |
| • | Findings on examination | |
| • | Interpretation of symptoms, signs and test results by a specialist physician, i.e. endocrinologist | |
| • | Diagnosis: specify whether primary or secondary adrenal insufficiency | |
| • | Gluco- and mineralocorticoids (where applicable) prescribed (both are prohibited in-competition) including dosage, frequency, administration route | |
| • | Response to treatment/course of disease under treatment | |
| • | Diagnostic test results should include copies of: | |
| • | Laboratory tests as applicable: electrolytes, fasting blood glucose, serum cortisol, plasma ACTH, renin and aldosterone | |
| • | Imaging findings as applicable: cranial or abdominal CT/MRI | |
| • | Provocation tests or other test results as applicable: cosyntropin (corticotropin stimulation) test, CRH stimulation, insulin tolerance test, metyrapone stimulation, antibodies | |
| • | Additional information included | |
| | Where applicable, statement on previous glucocorticoid treatment, administration routes, frequency, granted TUEs by physician/athlete | |
