Scientists & doctors please chime in - Is EPO a prescription given to malaria patients as a 2:05 marathoner claims?

rjm33 wrote:

The site

http://www.kenyarunners.com/pages/167372/index.htm

...also states that EPO was available in Europe as early as 1984...which means all of my previous research which established the earliest verified use of EPO by any endurance athletes in any sports as 1986 may be wrong!...since I was basing my information on US availability of EPO..

...EPO may have been available in Europe earlier than the US...I will try to check..

This is very interesting if true...Alberto Cova won 1984 10K gold for Italy, and in 1988 Salvatore Antibo won 10k silver (gold was won by Boutayeb(sp) a Moroccan runner!)...and Gelindo Bordin of Italy won the 1988 marathon gold, and Boston 1990...

.......this story gets better every day!....

The U.S. has always been late to the various doping techniques. Conte is the only guy who put in the effort to be original. Meldonium has been around for years and the U.S. barely knew about it. Europeans, more specifically the Scandinavian countries were blood doping by transfusing their own blood since the early 70s and using EPO since the late 70s. This is documented for endurance skiers, but I assume it wasn't long after that runners were using EPO as well. I am pretty sure, EPO predates the mid-80s.

rjm33 wrote:

You are right...malaria is prevalent in Africa...so it could just be a coincidence.

But the world record holder in the marathon running 2:03... 6 weeks after a bout of malaria...which causes anemia!...seems almost too unbelievable!...

...this is starting to sound familiar to another thread... which is now becoming very boring...

clueless

you have no clue about the topic & are waaaay outta your depth

primary untreated malaria is lethal

the majority of malaria in affluent people is recurrence of inadequately treated primary infection

there is huge incidence of recurrence because treatment drugs are terrible to take because of appalling side-effects & full course often not taken, meaning malaria is nearly but not quite fully eradicated & after some time will recur

the patient quickly knows malaria has recurred & they know it was because they didn't take full course of tablets

in 3rd world if a febrile illness occurs short time after diagnosed malaria it is always assumed to be recurrence providing no obvious URTI/UTI/etc

they immediately re-start medication & it is drummed into them that the full course is taken even if they feel terrible on the tablets

this results in just a mild bout of disease & an athlete can be in top form again within a short time period

Yes it could reasonably be prescribed in a case of anemia due to malaria.

Not sure what you expect, but it is. The new glasses maybe?

Fun stuff, as always.

Since the beginning of the biopassport sickness has been used to explain away suspicious fluctuations in scores. To review:

-The athlete gives blood samples, the passport is established and levels are monitored.

-If the computer program detects a "suspicious" value, the athlete is given a chance to give a written explanation to the review panel.

-A case is opened only if all three panelists agree to open a case. WADA's words are

The athlete's data, athlete's written explanation, context of racing, altitude or other circumstances are all used as evidence.

That first step is never public. The panel's request for more information, the procedure prior to opening a case, is never made known to the media or in any kind of release. And a case is only opened if all three panelists agree to open one.

The panelists don't open a case if there is any doubt. Things like altitude, malaria, bilharzia, and hypothyroidism (and dehydration probably, but there was no Panel or BP process yet during Radcliffe's WC race...) have been shown to be acceptable excuses for suspicious values. (That's not to mention what the excuses that haven't been made public...)

Let's start with an extreme example. Roman Kreuziger, caught while riding for Mr. 60% Hct's himself, Bjarne Riis.

Ret%

HGB

Dates of tests here:

Short version: tests number 46, 47.48.and 49 show the jump in HGB (and HCT) during a Grand Tour:

Sample 46 03-05-2012 Pre-Giro 15 1,46%

Sample 47 14-05-2012 Giro 14,5 1,44%

Sample 48 20-05-2012 Giro 14,8 1,52%

Sample 49 24-05-2012 Giro 16,1 1,4%

Kreuziger's HCT went from 43.2 to 48.1 in 10 days DURING the Giro. That kind of rise only happens with doping. The levels are supposed to drop during periods of hard efforts.

Very obvious he's doping. UCI opens case, which it only does if it knows it is a slam dunk. Case still goes through hell of appeals, National Federation rejections of case, team's banning of RK and then unbanning.

Long story short: he's still riding, and never faced a sanction.

What was his defense? Hypothyroidism. WADA agreed, and UCI ended up dropping the case. (http://www.uci.ch/pressreleases/uci-and-wada-terminate-cas-case-concerning-roman-kreuziger/)

Because the burden of proof is so high, cases aren't opened unless the panel and governing body is certain it will be successful. RK's case is egg on the face of the UCI, but also a huge whole in the robustness of the passport, now that hypothyroidism is an acceptable excuse for suspicious blood values.

Take a look at this summary and raw data of Chris Horner. Famous Armstrong teammate, winner of his first Grand Tour at age 41. Rides around with this kind of data and doesn't even have a case against him.

We don't have much other raw data. Lance Armstrong's 2009 samples are available and questionable, but from a rhetorical standpoint, the Armstrong horse is beaten to death.

So Malaria. What other traumatic illnesses have athletes claimed to have? Fabio Aru had dysentery weeks before he finished 2nd in a Grand Tour (and sued another rider who called him out on twitter). Chris Froome had/has Bilharzia (and can't seem to keep his story straight). Tyler Hamilton had a disappearing twin in utero (sorry, but I just love that story).

____________________________________________

And none of that is to mention that the investigative letter sent to an athlete, before the panel review, serves as a warning to that athlete!. An analogy is getting pulled over, and the cop saying "Were you speeding? Because it looks like you were, but we still have to watch you a bit to find out."

And finally, as a minor point, while many aruge about the robustness of ABP sample collection in Kenya, take a look at how many samples are taken for Kreuziger and Horner. 50 plus? How many Kenyan's have that kind of passport data? How many runners at all have that much data...

It's getting late. I need to go to bed.

The answers have been offered already

EPO would be useful for treated malaria where Hb only drops to 8 or 9 & patient has sedentary lifestyle

Problem is untreated/poorly treated malaria can give get it as low as 2 or 3 which is fatal from resultant heart failure

Malaria also has reputation of having the worst hyper-pyrexias ever recorded with fevers well over 43 !!!

( only malignant neuroleptic syndrome comes close - schizos on ole-style chlorpromazine/haloperidol/etc )

This temperature liquefies the organs ( a full-time physician can expand on this ) & can cause catastrophic blood reactions known as disseminated intravascular coagulation which stops blood flow to organs thru multiple clots & causes multiple organ failure

Malaria is no joke, it is worst illness imaginable

Everyone has had a fever in their lives :

Think about what a 43+ !!! must feel like !!!

ventolin^3 wrote:

The answers have been offered already

EPO would be useful for treated malaria where Hb only drops to 8 or 9 & patient has sedentary lifestyle

Problem is untreated/poorly treated malaria can give get it as low as 2 or 3 which is fatal from resultant heart failure

Malaria also has reputation of having the worst hyper-pyrexias ever recorded with fevers well over 43 !!!

( only malignant neuroleptic syndrome comes close - schizos on ole-style chlorpromazine/haloperidol/etc )

This temperature liquefies the organs ( a full-time physician can expand on this ) & can cause catastrophic blood reactions known as disseminated intravascular coagulation which stops blood flow to organs thru multiple clots & causes multiple organ failure

Malaria is no joke, it is worst illness imaginable

Everyone has had a fever in their lives :

Think about what a 43+ !!! must feel like !!!

So, with regards to this athlete, I see a big issue: being able to come back from that kind of illness and perform as a 2:05 marathoner.

Not to mention that EPO wouldn't be the only treatment; there would be more record of the other medications if this was legitimately malaria

I had never even heard of meldonium until the stories hit.

I said " Meldonium!..what the hell is that!"

In my opinion... no way on the EPO since late 70s claim you are making.

Do you have some evidence to back that statement. I do not think it had even been synthesized in a lab at that point.

The first clinical trial with recombinant EPO(Epogen) made by the biotech firm Amgen in the NEJM in Jan. 1987, and was approved for use in the US by the FDA in 1989...but as I showed in the NYT article...actual use goes back to 1986 or 1987...and I am going to try to find out if possibly a little earlier in Europe?

For another coincidence...Amgen...the biotech firm that sells Epogen...became a major sponsor of the Tour of California pro cycling race in the US!

.......you can't make this stuff up any better than actual history...

Man, sure are a lot of doctors on here.

Though not sure how good of a degree that is when you are shocked that a high percentage of Africans have malaria.

I said that malaria was very prevalent in Africa...did you miss that part?

I've been working with a government-sponsored health centre in Uganda for the last 10 months (through Peace Corps) and there is no culture of using EPO to treat here. Standard treatment is a three day course of Coartem (three pills a day), with quinine IVs for more acute cases. Pretty sure this guy is full of it.

Well done Clerk!

I just learned a new doping excuse from you...I had never heard of hypothyroidism before as an excuse...creative...and yet makes no sense...so that does sound perfect to be used as an explanation at UCI!

The Tyler Hamilton excuse... when he was caught doing a homologous blood transfusion... used by his lawyers...to explain why he had blood from another person in his bloodstream...was that Tyler was a human chimera with a vanishing twin.

This doping explanation wins the comedy prize world record for funniest doping excuse ever!

In fact... I think his comedy record may stand forever!

So, with regards to this athlete, I see a big issue: being able to come back from that kind of illness and perform as a 2:05 marathoner.

Filbert Bayi, the great world record setting miler, had recurring malaria.

Billy Konchellah won two world 800m titles. Pretty sure he missed one of the world championships in between his two titles because he had tuberculosis, and had to stop training on more than one occasion because of TB. He was also sick in another way, but no need to dredge that up again.

Never heard of hypothyroidism as an excuse? Did you follow the story on Salazar last year at all?

I am familiar all the way back to... when Alberto Salazar was coach of Mary Decker Slaney when she tested positive for elevated testosterone levels that were above the 6:1 Testosterone/Epitestosterone ratio that was used back then (and later lowered to the present day 4:1 ratio).

There is also a history of Alberto Salazar rubbing testosterone gel on his son and getting blood tests done...to see if potential sabotage could trigger a positive doping test for testosterone.

We are not referring to a TUE or any other use of thyroid as a PED. Clerk was talking about the use of hypothyroidism as an explanation of abnormal blood test results for hemoglobin, reticulocytes, and hematocrit that were actually caused by the use of EPO.

Are you confused about what Clerk is talking about?

Mary Decker Slaney tested positive for elevated testosterone levels in 1996...it is the 20 year anniversary this year!

Dennis Kimetto ran a 2:03:45 marathon to win the 2013 Chicago Marathon...6 weeks after a bout of malaria... which can cause anemia.

This was the same year that Rita Jeptoo won the women's division in 2:19:57.

After she was positive for EPO...her explanation to her manager Frederico Rosa was that she had malaria and went to a doctor to get treated. Even Frederico Rosa had to admit that he did not believe her...because malaria is not usually treated with EPO injections.

http://sports.yahoo.com/news/kenyas-dennis-kimetto-wins-chicago-145430963--spt.html

;_ylt=AwrXgCMm4wZXnhYAkCKTmYlQ;_ylu=X3oDMTByZDNzZTI1BGNvbG8DZ3ExBHBvcwMyBHZ0aWQDBHNlYwNzYw--

check this Frederico Rosa interview out:

ttp://running.competitor.com/2014/11/news/rita-jeptoos-agent-federico-rosa_117410

rjm33 wrote:

Oh my!

Here is a partial list of Kenyan runners who have had bouts of malaria:

1) Cosmos Ndeti

2) Moses Kiptanui

3) Paul Tergat

4) Dennis Kimetto

http://www.kenyarunners.com/pages/167372/index.htm

Keep reading the whole site page down!

...the Italian manager Dr. Gabriele Rosa (who was manager to Moses Tanui and Paul Tergat, and many other famous Kenyan runners both male and female) and EPO use rumors by top Kenyan runners is discussed a lot on this site!.....

Come on guys, anyone with even minimal experience of Kenya and Kenyan people know that 'malaria' is used to casually describe all and any flu and cold like symptoms.

Of course there are genuine malaria cases as well but when an athlete says their training was disrupted by malaria it should be taken with a huge pinch of salt.

I've had employees (in Kenya) tell me they can't come to work due to 'a small malaria' and they are back the next day or two completely fine. The same with Typhoid to mean any kind of stomach/dihherea type symptoms.

Spend any amount of time in Kenya amongst the runner and you will hear 'Malaria' used to describe all manor of minor illnesses.

check out this Frederico Rosa interview:

http://running.competitor.com/2014/11/news/rita-jeptoos-agent-federico-rosa_117410

...suspicious?...