Telling it like it is wrote:
I think they should have given the EPO group other PEDs (e.g. anabolic steroids, testosterone, GH, etc) to make it more realistic of what the elites are really taking.
I think that's where we've been losing sight is the synergistic effects of these multiple PEDs being used --- the "cocktails" so popular with endurance athletes.
Since the Tour de France is a very hot topic right now with the shocking, Earth-shattering performance of Tadej Pogocar winning an HC mountain top stage & shattering the record held by Marco Pantini by 3 minutes! 😲 (see the multiple threads on this site alone).
This led me to do some research on Pantani (considered the GOAT of climbers) & his well-publicized doping history. He not only used EPO but a multiple of other compounds such as anabolic steroids, testosterone, GH, IGF-1 & corticosteroids. He was involved in Operation Puerto --- the doping ring that was administering these doping products to both professional cyclists & distance runners by the infamous Dr Fuentes.
So, at least the minimum for endurance athletes, seems to be EPO/blood transfusions + an anabolic steroid or testosterone. When you look at multiple doping raids over the past (Operation's Puero, Galgo, Chamberi, Jama Aden raid, etc) multiple compounds were always found in addition to EPO.
Matt Mosman's excellent video focuses on combination of EPO + anabolic steroids/testosterone for endurance athletes:
We know, for example, the Moroccan doping program was using additional compounds in conjunction with EPO. And I don't need to remind of their shocking PED-Powered performances with the likes of Ramzi, Boulami & El G (and yes...El G).
We know in the pharmacology world the synergistic effects of multiple drugs administered to patients with varying diseases have a clinical benefit than just one pharmaceutical used alone.
Even LA who touts EPO as his "ten-percenter" was also using testosterone, GH & corticosteroids --- all administered to him by his doping coach Ferrari. Lol. Perhaps the combination of these compounds is his real "ten-percenter."
Multiple PEDs with good responders = PED-Powered performances.
The EPO time trial shows that despite significant gains in all these other indirect measures (hemoglobin, VO2max, power) in the lab, it didn't translate to superior performance on the road.
In two other papers, Heuberger reviews the body of literature, and finds a lack of evidence for efficacy specifically for EPO, and then more broadly for all classes of WADA banned substances with respect to endurance performance (as opposed to strength and sprint performance).
It goes without saying that synergy from doping cocktails is equally unstudied. The highest quality research appears to be from a youtube Chief Endurance Officer of a legal endurance supplement company with apparently no experience in doping, and no experience in coaching distance running athletes.
And for all this new talk of synergy from doping cocktails, we still have the non-African distance runner anomaly that the progress of all distance athletes (men), from 1500m to the marathon, originating from the 5 non-African continents, virtually slowed to a crawl during the EPO-era, for about three decades, and only started bouncing back with the new shoes. One of the best non-African examples seems to be an athlete who used EPO (synergistically in a cocktail?) to replicate performances from the 1970s.