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Ruth Chepngetich, the women’s marathon world-record holder, has been provisionally suspended due to the presence of the diuretic hydrochlorothiazide (HCTZ) in her urine, the Athletics Integrity Unit announced today.
The Athletics Integrity Unit (AIU) is an independent anti-doping authority created by World Athletics to manage all integrity issues in the sport, including doping and other forms of ethical misconduct. According to a press release from the AIU the adverse sample was collected from Chepngetich on March 14, roughly five months after Chepngetich won the 2024 Chicago Marathon in a world-record time of two hours, nine minutes, and 56 seconds.
The positive result was reported to the World Anti-Doping Agency (WADA) on April 3, and the Kenyan athlete was informed on April 16. She voluntarily accepted the provisional suspension on April 19 while the AIU proceeded with the case, and she will be allowed to have her case heard before a Disciplinary Tribunal.
WADA lists HCTZ as a substance that is “prohibited at all times” within the category of diuretics and masking agents, and is specifically named in the organization’s list of banned substances under Section 5. According to the AIU, Chepngetich’s urine sample came back at an estimated concentration of 3800 ng/mL in urine, exceeding WADA’s threshold level of 20 ng/mL by nearly 200-fold.
“When there is a positive test for diuretics and masking agents, a provisional suspension is not mandatory under the World Anti-Doping Code,” AIU Head Brett Clothier said in the release. “Chepngetich was not provisionally suspended by the AIU at the time of notification, however, on 19 April, she opted for a voluntary provisional suspension while the AIU’s investigation was ongoing.”
Though there was no public announcement since the voluntary provisional suspension began, the AIU said it has been investigating and decided to publicly announce the provisional suspension on July 17, 2025.
Most recently, Chepngetich withdrew from the 2025 London Marathon on April 18, two days after being notified by the AIU, telling organizers: “I’m not in the right place mentally or physically to race my best in London and I am therefore withdrawing. I am very sad to miss the race and I hope to be back next year.”
What Does Ruth Chepngetich’s Provisional Doping Suspension Mean for the Women’s Marathon World Record?
Chepngetich set the world record on October 13, 2024 at the 2024 Chicago Marathon. Her time of 2:09:56 was a 1:57 improvement over Ethiopian Tigst Assefa’s 2:11:53 world record set in 2023—in doing so, she became the first woman to average under 5 minutes per mile for the marathon.
“The Bank of America Chicago Marathon has and continues to be an advocate for strict anti-doping measures including drug testing procedures and protocols both in and out of competition,” race officials told Outside Run via email. “As a World Athletics Platinum Label event, every professional athlete who competes in the Chicago Marathon’s professional athlete field is subject to the rules, regulations and anti-doping processes set forth by World Athletics, the World Anti-Doping Agency and the United States Anti-Doping Agency.”
While Chepngetich’s adverse sample was collected five months after the event, the Chicago Marathon’s anti-doping policy states that, “Every professional athlete who competes in the Chicago Marathon’s elite field is subject to drug testing. If an athlete receives a ban from World Athletics based on a drug test (in or out of competition) or findings from the Athlete’s Biological Passport (ABP), the athlete’s records will be annulled and the standing of athletes who placed behind the disqualified athlete will be updated.”
The Chicago Marathon’s anti-doping policy does not specify how tests with adverse results taken after the race impact previous race performances. “The Bank of America Chicago Marathon is aware of the announcement by the Athletics Integrity Unit (AIU) regarding Ruth Chepngetich,” race officials told Outside Run. “We will await the completion of the process by the AIU and any appeal by Chepngetich before providing further comment.”
Chepngetich earned a total of $150,000 in prize money from the Chicago Marathon for her world-record win, broken down into $100,000 for the win and $50,000 for a world-record bonus. Outside Run also reached out to the Chicago Marathon for more information around this payment to find out whether that has been paid out, will be rescinded, or would be redistributed in some way.
What is Hydrochlorothiazide (HCTZ), the Substance Found in Ruth Chepngetich’s Positive Drug Test?
Hydrochlorothiazide (HCTZ) is a diuretic and antihypertensive drug, which was first approved under the brand name Esidrix to treat hypertension and peripheral edema back in 1959, according to the U.S. Food & Drug Administration (FDA). It is currently sold under a variety of other brand names, including Microzide, HydroDIURIL, Oretic, and Zide.
HCTZ and similar diuretics are prohibited both in- and out-of-competition by WADA because of the potential for use in two main categories: rapid weight loss and the masking of other prohibited performance-enhancing substances. A 2010 study in the British Journal of Pharmacology, which specifically explored how diuretics can be abused, explains:
Diuretics were first banned in sport (both in competition and out of competition) in 1988 because they can be used by athletes for two primary reasons. First, their potent ability to remove water from the body can cause a rapid weight loss that can be required to meet a weight category in sporting events. Second, they can be used to mask the administration of other doping agents by reducing their concentration in urine primarily because of an increase in urine volume.
Most famously, three-time Olympic gold medalist Veronica Campbell-Brown tested positive for a diuretic, furosemide, in 2013, though she was eventually cleared nearly a year later due to mistakes made during sample collection.
American hurdler and two-time Olympic medalist Dawn Harper-Nelson also tested positive for a diuretic in 2016, specifically for hydrochlorothiazide, the same substance found in Chepngetich’s sample. However, Harper-Nelson only served a reduced three-month ban after proving it was required to manage her blood pressure.
Other athletes who received full bans for HCTZ specifically include Pasuta Wongwieng, a Thai pole vaulter, and Brazilian ultramarathoner Sebastião Ferreira da Guia Neto.
What Are The Next Steps in The Ruth Chepngetich Anti-Doping Violation Case?
According to the AIU, Chepngetich has “the right for her case to be heard before a Disciplinary Tribunal,” in accordance with the AIU’s disciplinary process before the provisional suspension becomes a “first-instance decision,”given that Chepngetich does not have any previous violations.
If the decision is affirmed, Chepngetich could face two years of ineligibility. She is also given an opportunity to appeal the decision in the Court of Arbitration for Sport (CAS).
Despite attempts, Chepngetich and her agent, Federico Rosa, could not be reached by Outside Run for comment on this story and have yet to release a statement as of this writing.
This is an ongoing story.
