Meldonium

On January 26th 2016, Maria Sharapova received a two-year ban from tennis for failing a drug test during the Australian Open. The drug she was taking is called Meldonium.🤔🤔 Meldonium (also known as Mildronate) has been shown to alleviate complications associated with myocardial ischemia (lack of blood flow to body parts). It is widely used in Eastern Europe by cardiologists for treating sufferers of heart disease to increase blood flow. 🤕🤕Fatty acids are the main energy source of the heart. 🔥🔥However, glucose oxidation is more oxygen efficient than fatty acid oxidation. (Oxidation=breakdown) Glucose oxidation uses less oxygen than fatty acid oxidation to provide the same amount of energy.✅🙏🏾In myocardial ischemia, blood flow to heart tissue is restricted. This means that the oxygen flow to the heart is restricted. 🚫🚫Therefore, it would be beneficial if heart tissue switches from fatty acid oxidation to glucose oxidation during ischemia as it would produce ATP if it did.
Meldonium works by inhibiting carnitine synthesis. Carnitine is an amino acid that is important for the uptake of fatty acids into the mitochondria for oxidation. 🍽🔝By inhibiting the formation of carnitine, meldonium prevents the entry of fatty acids into the mitochondria in heart tissue and therefore prevents beta-oxidation of fatty acids, an oxygen hungry process🔃🔃. This allows the ischemic heart to conserve oxygen that it is obviously lacking and invest it in a more oxygen-efficient process, glucose oxidation. By doing this, meldonium also prevents the accumulation of toxic byproducts of fatty acid oxidation✖⚠️Studies have shown in patients that received this drug, improvements in mood, mobility, motor function and nausea. It most likely does this by improving blood flow to the brain. Whether or not it actually improves athletic performance is up for debate. But because of its effect on blood flow, one can understand why the higher-ups decided to add it to the ban-list.
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