“It would cure his [Wiggins’s] hay fever, no doubt about that,” Lipworth said. “But the side effects are totally unacceptable in my humble opinion. We see patients who get side effects even on the higher potency inhaled corticosteroids like fluticasone, let alone injectables, which is why it’s utterly bonkers to prescribe it.

“Maybe he had tried everything and this was a last resort. But it still seems a bit bizarre to me when there are so many alternatives which are just as effective but with less severe adverse effects.”

The injections were given over five years ago now, but Lipworth said he could not remember the last time he had prescribed triamcinolone for hay fever.

Durham said that it was not part of guideline management for asthma and was "largely outlawed", calling it an inappropriate TUE for asthma in athletes "on grounds of poor benefit/risk ratio, independent of consideration of potential performance enhancement".

Pavord did point out that the perception of symptoms in patients was very context-specific and said he could see a scenario whereby it was granted as a TUE.

"Mild asthma and hay fever may be intolerable if one aspires to win the Tour," he said. "If it can be used in clinical practice and there is no well-established performance enhancing effect then I don't see a problem. I would want to know if the presence of allergy was well documented (i.e. positive skin test or blood tests showing grass pollen allergy)."