62% hematocrit. it's EPO?

Way outside of the normal range you'd likely to see. Altitude training would cause your body's natural production of EPO to increase RBC, Hgb, and Hematocrit, but this seems REALLY high. I would wonder about dehydration issues during testing, but everything else appears in the normal range. This looks suspicious to me, but I don't learn about hematology for 4-5 more months.

60% is (or was? I forget) the cutoff used in cycling to distinguish between natural and doping levels. To my knowledge most distance runners are way, way below 60% and you can't really get there without doping.

One hundred percent, it's not possible to reach values like this only staying 15 days in altitude. So high level of Hematocryt is almost common in people living on the Ande Mountains (between 3000 and 4000m, over than 12,000 feet), but for example is very far from the values of Africans in their highlands.

So, there are two possibilities only :

a) The athlete took some drug for enhancing her values

b) There is some problem in the machine (sometimes it happens)

However, these values can't give a real picture of the situation, without knowing other parameters.

For example, the volume of the Red Cells and their number (their product gives the hematocryt, that is a number).

In any case, haemoglobin at 21,1 is something crazy, and very, very dangerous for the life of the woman. And, between me and you, completely useless for running faster.

The blood of that lady is mud, with very high viscosity and consequent big problem in the body circulation.

During the next week-end, I will be in Colorado Springs for a summit of middle distance. In that occasion, I want to show the data of several athletes running, I think, very much faster than the lady you refer. Their hematocryt was about 37, their haemoglobin under 12.

Gelindo Bordin, that is a man (men have normally 2-3 points of haemoglobin higher than women), won the Marathon in Olympic Games 1988 with 12.8 of haemoglobin, in spite of all people thinking that only with very high values of hematocryt is possible running fast.

lllll wrote:

60% is (or was? I forget) the cutoff used in cycling to distinguish between natural and doping levels. To my knowledge most distance runners are way, way below 60% and you can't really get there without doping.

I thought I remember from a Tour de France broadcast last year them saying it was 50. Again, I could be wrong as well.

the cutoff was 50%, and if i understand correctly, exceeding the limit was billed as a health risk and not technically a doping violation. riders over the limit were inelegible to race for 2 weeks. also, riders who could provide evidence that their natural hematocrit level was over 50% (supposedly true of 2.5% of endurance athletes) were granted an exemption.

a bit more info in here:

http://velonews.competitor.com/2011/04/news/the-explainer-will-the-biological-passport-catch-micro-dosers_167800

here's the problem- the hematocrit can be easily manipulated with hydration/dehydration- the hemoglobin, not nearly as much. therefore, we pretty much know she's most likely NOT dehydrated (which would skew her hct higher). sorry, but i've only seen values like that one time in my life, and it was a guy who was at the tail end of a serious cycle, and at 5600ft altitude, training hard. not coincidentally, he went out and set more than couple pb's shortly thereafter.

Possibilities:

Lab error or procedure error. Maybe they stuck her finger instead of arm draw which sometimes results in the blood being too concentrated. Maybe she has something else in her blood that is interfering with the electrical current used to measure her RBCs. Maybe the machine was malfunctioning.

Dehydration will raise the hematocrit but not to this level and still be able to train.

I would like to see three things:

Her reticulocyte count

Her baseline or previous hgb/hct

A tube of her blood to actually see the viscosity.

From a health standpoint, you would want to rule out polycythemia vera, doubtful if she is elite athlete performing at elite level; or a renal tumor secreting erythropoietin (often diagnosed incidentally on workup for elevated hematocrit).

To be honest, from a health standpoint and if these values are accurate, the best thing would be EPO-abuse. Just about everything else would be bad longterm juju.

For a professional endurance athlete, my differential by likelihood if these values are accurate:

1. EPO abuse + intravenous iron

2. EPO abuse + intravenous iron

3. EPO abuse + intravenous iron

4. EPO abuse without intravenous iron

5. Renal tumor

but then, I'm cynical.

How did you get these results?

anonymous mouse wrote:the hematocrit can be easily manipulated with hydration/dehydration- the hemoglobin, not nearly as much.

why is the hemoglobin level not affected by hydration/dehydration if it is measured in grams hemoglobin per deciliter total blood?

those are crazy high levels either way.

Are we helping a drug cheat dodge a test?

I received an e-mail with a picture of this exams.

The email with the photo showing the results was sent by a person very close to the training camp at altitude.

The photo is 100% real.

And the girl in question smashed her PB'S 2/3 weeks after the tests were taken.

But I think the IAAF can not suspend because those tests were not taken by WADA testers, but own team doctors. am I wrong?

Curious Iced T wrote:

Are we helping a drug cheat dodge a test?

Either that or we are helping a drug tester interpret the results. I'm glad that we Letsrunners are entrusted in dealing in such matter.

I'm not trying to cover up the girl.

I feel robbed just like the other people who run against her in 10k road races or half marathons.

But I have a bad feeling that the local federation will cover the girl because the exams werent taken during the competition.

to the poster that mentions the 50 level in bicycle testing - isn't amazing that all the riders are at 49.++??? Or get the two weeks off to get their blood work legal?!?!??!

Name or this is bullshit.

This is an internet forum, it would be very dangerous for their owners if I gave names without evidence .See, many people got the e-mail with the photo, but for the Federation, it could be treated like "poor evidence".

The girl is not from the USA. But she's a respectable runner who is tryng to manage "A" mark from London 2012 in 10k or marathon.

Renato Canova wrote:

In any case, haemoglobin at 21,1 is something crazy, and very, very dangerous for the life of the woman. And, between me and you, completely useless for running faster.

The blood of that lady is mud, with very high viscosity and consequent big problem in the body circulation.

This is exactly my immediate concern, and my ONLY concern with these readings.

What can be done to make sure this woman can safely return to reasonable values and nothing dangerous happen????

Hematocrit of 62% risks organ infarction. Although massive doses of EPO, iron, androgens, etc. could be the source, a workup is needed to rule out a myeloproliferative disorder (polycythemia rubra), renal/hepatic tumor, and rare inherited disorders. Get her to a doctor.

Okay, good grief. Let's say she lives 30 days away from any doctor.

What can she do healthwise to return back to reasonable values?