Talk:Sodium polydihydroxyphenylene thiosulfonate

The sources in the new article are not credible and do not meet MEDRS
Please follow WP:MEDRS for sourcing. The sources from obscure Russian journals with illogical exaggerated claims of effect do not meet this standard. Zefr (talk) 19:11, 16 February 2022 (UTC)


 * What sources would you suggest should be used then? It is a Russian drug, developed in Russia, of course the sources are going to be Russian. The review article lists several other references but they are all in Russian. Anyway the patent at least is an acceptable source for what it is and what it is claimed to do - if you feel the Russian sources don't support medical claims then add text saying that it is not approved and the medical claims are unproven, but don't just delete the sources and leave it without any at all. It is clearly notable having just come up in a very high profile athletic doping case. Meodipt (talk) 19:13, 16 February 2022 (UTC)
 * No, if hypoxen had any significance as claimed in the Russian sources or your first draft, it would be a blockbuster worldwide. It is not. It is a hoax. Patents are not WP:RS sources, especially those for drugs, which must have the scrutiny to become a "prescription drug". Do not edit war, WP:WAR. Zefr (talk) 19:17, 16 February 2022 (UTC)
 * The notability of this drug relates entirely to the fact that it has showed up in a high profile sports doping case. Whether it actually does what it is claimed to do really isn't relevant here. The purpose of WP:MEDRS is to ensure that Wikipedia does not contain unreliable medical information, not to be used as a blunt tool to stamp out sources you don't like. You don't trust the sources? Fair enough, say that they are unreliable and their claims are unsubstantiated. Nevertheless those are the sources that are available for this substance.Meodipt (talk) 19:23, 16 February 2022 (UTC)
 * Also if you don't want to put the patent on there, what source do you propose to use for the chemical structure? It isn't on the WADA controlled list otherwise I would cite that. Yet there is no controversy about what the structure is.Meodipt (talk) 19:27, 16 February 2022 (UTC)
 * Although I agree with the neutral editing you did, I believe creation of this article was premature, as there is no reliable sourcing for the compound, only about its apparent abuse. Some Russian supplement manufacturers call it a ferric oxide agent, so I remain unsure about whether your characterization is actually the compound under investigation at the Olympics. See this discussion on the Kamila Valieva talk page - even the New York Times is getting this wrong by calling hypoxen and carnitine "heart drugs". Neither one is a drug for cardiovascular diseases, health, or athletic performance (they are only unproven supplements of unlikely benefit). There will likely be no good trustable sources on hypoxen, as there is no reliable publishing being done on it. WADA will possibly update their chemical information after this incident of alleged doping at the 2022 Winter Olympics. Zefr (talk) 19:36, 16 February 2022 (UTC)
 * The product description from the manufacturer's website here refers to the active ingredient as полидигидроксифенилентиосульфонат натрия which translates to sodium polydihydroxyphenylene thiosulfonate, and by searching for that it was straightforward to locate the relevant patent. Look I entirely agree that any claims of medical efficacy are dubious and unproven, but again this is not a core issue for whether this compound is notable and encyclopedic. My contention is that it is better to have non-WP:MEDRS compliant sources than no sources at all, we just need to be clear that these sources cannot be relied upon. And at any rate I think the patent is a better source to cite for the structure than the manufacturer's website. Meodipt (talk) 19:42, 16 February 2022 (UTC)
 * I wouldn't trust the patent information (an application or issued?), as there are too many unknowns and there are no preceding reliable scientific publications for its use as a supplement, WP:PATENTS. If you Google for "hypoxen" and read different websites for ingredients, there are other compounds involved. Which hypoxen supplement Valieva used is unknown. I think we should leave out other unscientific, unreliable sources for now, except for the limited news items that brought the compound into notability, as there will likely be increased scrutiny in coming days or weeks. The article reads fine for now as a stub. Zefr (talk) 19:55, 16 February 2022 (UTC)
 * The patent was granted in February 1998, its not just an application. And there are 25 references on PubMed for this compound, it is not newly invented, and it does seem to have been fairly widely used and researched over the last 20 years. Just because all the research has been published in Russian journals of questionable merit does not automatically mean that it should all be dismissed out of hand, especially if we are just saying what it is claimed to do and making no assertions about whether it actually does that. And again, if WADA didn't know the chemical structure then their lab would not be able to identify it and say that they found this compound in the sample and it is not on the banned list. Meodipt (talk) 20:12, 16 February 2022 (UTC)
 * On a closer look at the references on PubMed, several of them are human clinical trials and talk about patients who have been prescribed Hypoxen for various indications such as COPD. So it has been through clinical trials, and it is approved for prescription as a medicine (at least in Russia). Even if the Russian references don't meet WP:MEDRS standards I don't think this compound can be described as a "hoax" or even really a "dietary supplement", it is an approved medicine even if the grounds for approval would be deemed fairly dubious by Western standards. Meodipt (talk) 21:00, 16 February 2022 (UTC)

The Russian processes for conducting well-designed clinical trials on drug candidates and obtaining drug approval are not accepted internationally, and the Russian journals listed for hypoxen on PubMed are not Medline-indexed, which means Wikipedia Medicine doesn't use them, as they do not have sufficient history or reliability of journalistic practices to justify indexing them. In the absence of conventional publishing in rigorous journals, I remain skeptical that the Russian practice of using a dubious supplement like hypoxen to enhance sports performance is the issue at hand. We should not be tempted to give credibility to what is likely to be a useless agent by acknowledging vague and dubious sources nowhere near the quality defined by WP:SCIRS for lab research or WP:MEDRS to imply an effect on human health or diseases. Zefr (talk) 21:26, 16 February 2022 (UTC)
 * I'm not saying that we should rely upon these references to make claims of medical efficacy. As you say, the evidence is weak and the claims are dubious until this substance is tested independently and published in more reputable journals. Nevertheless it seems that many Russian doctors believe this substance to be effective for some applications and prescribe it to patients on that basis, and apparently also dole it out to Russian athletes in international competitions. I quite agree that there don't appear to be any WP:MEDRS compliant references to support the claims of medical efficacy, but there are references to show that it is used as a drug and prescribed as a drug in Russia. I would argue that these references can be relied upon to support describing the substance as a "drug" or "medicine" despite the lack of suitable references to show that it actually works. Again, the WP:MEDRS guideline is not a strict rule. If there are simply no WP:MEDRS compliant references available, but there are a whole bunch of references which don't meet WP:MEDRS standards, it is still better to include some of these than have no references at all. Its all about what you are using the reference to support, and these references do support the claims that Hypoxen is used as a medicine in Russia, even if they are not adequate to prove that Hypoxen is actually effective for any medical indication. Meodipt (talk) 21:38, 16 February 2022 (UTC)
 * And in alternative medicine, there are dubious publications about using animal parts as medications. As the Russian sources do not meet the WP:V or WP:RS burden, we shouldn't use them. My views are clear; if you insist on pursuing whether to include the Russian sources as "reliable", raise a discussion among medical editors at WT:MED. Zefr (talk) 22:15, 16 February 2022 (UTC)
 * Oh I expect with all the scrutiny on this case there will probably be some higher quality sources to cite within a month or two anyway, WADA is bound to make some kind of official statement at some point if nothing else. More just wanted to have this discussion all recorded on the talk page here so other editors can understand why there are no references cited aside from the newspaper articles. Meodipt (talk) 22:24, 16 February 2022 (UTC)
 * Returning to the issue of Valieva for a moment. The main concern for her use of substances is guided by the Olympics list of banned drugs, and not guidelines from the FDA in the USA or WP:MEDRS at Wikipedia. Although I have a high regard for the FDA, the list of controlled substances used there does not match up one-for-one with the Olympics list of banned substances which will need to be the primary reference point for discussion of the Valieva case in her Wikipedia article. Currently, Trimetezidine must be the main concern for the Valieva article since it is an Olympics banned substance. At a secondary level, the combination of these drugs (mentioned in the discussion above of Zefr and Meodipt) with trimetazidine has been called a "trifecta of substances" by Travis Tygart, the chief executive of the United States Anti-Doping Agency, and a lawyer with experience prosecuting the use of Olympics banned substances. If he is stating in his quote presented in the Valieva article that he believes that the other two substances can be used as catalysts for the effectiveness of Trimetazidine, then this seems pertinent to the article since he is capable of evaluating her counter-claims made to the Olympics committees evaluating the Olympics list of banned drugs. ErnestKrause (talk) 01:16, 17 February 2022 (UTC)
 * Well exactly, the issue here is the legal implication of these substances being present in the samples and whether this breaches the Olympics anti-doping rules. From a legal perspective it is essentially irrelevant whether these substances are actually producing significant performance enhancement - the amount of trimetazidine reportedly detected in Valieva's sample was in the nanograms which is clearly not going to be medically relevant when the active dose is 20 milligrams plus. If the intention of adding on hypoxen and L-carnitine was to act as a "booster" for a low dose of trimetazidine that they thought would be undetectable, then clearly this looks a lot like attempted athletic doping, and legally it is the intention which is significant much more than whether any actual performance enhancement was obtained. Meodipt (talk) 01:42, 17 February 2022 (UTC)
 * Agree on that summary. The main points of my raising science-based doubts about the use of carnitine and hypoxen are a) Valieva's team of clinicians, trainers and nutrition advisers have oversight about what to give her (assuming a 15 year old has little idea about such matters), b) the combination of platforms for drug overview - FDA, EMA, WADA, and even WP:MEDRS plus the published review literature - are the way we as editors screen for objective, authoritative sources, and c) the "trifecta" of agents detected in her blood is not necessarily evidence of synergism among them (this is doubtful), but rather reveals the extent of doping desired by the adults of her team. As stated in USA Today yesterday: use of three agents (with only one having proven heart effects - trimetazidine) "creates the appearance of an athlete seeking to increase endurance and performance." Zefr (talk) 01:44, 17 February 2022 (UTC)


 * How can I see if a journal here is Medline indexed or not?
 * https://pubmed.ncbi.nlm.nih.gov/?term=hypoxen --91.159.188.74 (talk) 19:24, 17 February 2022 (UTC)
 * Click on the article title, click on the journal name in the upper left, choose "Search in NLM catalog", see "Current indexing status". Zefr (talk) 19:34, 17 February 2022 (UTC)

"Oxygen booster"
The unscientific lay term, "oxygen booster", was included with this edit. Numerous media and non-scientific Olympics commentators use the term, examples here and here, to apply both to hypoxen and carnitine, generally referring to them as substances that 'increase endurance and reduce fatigue'. Neither substance has scientifically-confirmed "oxygen boosting" or "heart supporting" properties that would affect athletic endurance or fatigue. There are no good scientific sources to support or refute such claims, so we are left with news reports to cite use of the term in the lay media. Zefr (talk) 00:11, 19 February 2022 (UTC)