Oh and back to this: I think I've mentioned earlier that I don't think it would be a miracle that a long-term bilharzia sufferer's organs might process salbutamol strangely as the disease can mess them up. Does anyone know if it's ever been studied before? Seems like a rather niche question.
Well bilharzia is associated with damage to liver and kidneys.
I'm not in the medical profession but my daughter went through an episode of renal failure so I have absorbed some knowledge of how the kidneys work. Anyone who's been on a renal ward will have seen urine darker than coca cola, but it's not plausible to suggest CF's kidneys are in that state!
However, it's very plausible that his kidneys are damaged - in the form of scarring to the glomerulus. This would impair kidney function to some degree, but this could only be quantified with a GFR test.
The GFR score is a direct measurement of the effectiveness of the kidneys. The score declines significantly over a lifetime, and also response to environmental conditions including different foods and medications (!). I would imagine the extreme conditions in a pro bike race to cause swings in GFR too, maybe enough to cause an
apparent overdose.