Systematic Doping in Track and Field

Everytime coach (or top athlete) state something like "no one use PEDs" or "PEDs don't work" I'm SURE he is somehow involved. It's impossible for people like top coaches or top athletes to be unfamiliar with PEDs advantages, so they state such nonsenses for purpose.

Just my opinion.

Ok, now we start with articles of scientists that have an opposite vision from what you say.

The first speaks about the increase of total volume of blood.

Medicine & Science in Sports & Exercise:

Blood volume: its adaptation to endurance training

CONVERTINO, V. A. Blood volume: its adaptation to endurance training. Med. Sci. Sports Exerc., Vol. 23, No. 12, pp. 1338-1348, 1991. Expansion of blood volume (hypervolemia) has been well documented in both cross-sectional and longitudinal studies as a consequence of endurance exercise training. Plasma volume expansion can account for nearly all of the exercise-induced hypervolemia up to 2-4 wk; after this time expansion may be distributed equally between plasma and red cell volumes. The exercise stimulus for hypervolemia has both thermal and nonthermal components that increase total circulating plasma levels of electrolytes and proteins. Although protein and fluid shifts from the extravascular to intravascular space may provide a mechanism for rapid hypervolemia immediately after exercise, evidence supports the notion that chronic hypervolemia associated with exercise naming represents a net expansion of total body water and solutes. This net increase of body fluids with exercise training is associated with increased water intake and decreased urine volume output. The mechanism of reduced urine output appears to be increased renal tubular reabsorption of sodium through a mate sensitive aldosterone action in man. Exercise training-induced hypervolemia appears to be universal among most animal species, although the mechanisms may be quite different. The hypervolemia may provide advantages of greater body fluid for heat dissipation and thermoregulatory stability as well as larger vascular volume and filling pressure for greater cardiac stroke volume and lower heart rates during exercise.

(C)1991The American College of Sports Medicine

Please Renato, WHAT DOES THAT ARTICLE HAVE TO DO WITH THE DEBATE AT ALL.

We all agree that training increase blood volume, mainly due to increased plasma volume.

I even wrote that earlier.

Citing myself:

"I know for a fact that an effect of long term training and improving shape hematocrit decrease due to increased plasma volume. Please not repeat this lesson. The athlete will just have even greater benefit of doping."

But blood doping work by enhacing oxygen carrying capacity by increasing the proportion of red cells in that volume of blood.

Having a high blood volume, and low hematocrit, MEANS THAT THE POTENTIAL OF INCREASE THE AMOUNT OF OXYGEN CARRIERS WITHOUT MAKING THE BLOOD TOO THICK IS HIGHER THAN IF THE VOLUME OF BLOOD IS LOW.

This way your african athlete with high blood volume, should respond EXTREMELY GOOD TO DOPING.

But you state the complete opposite, that this athlete can not have any benefit of doping. This statement i repeat is RIDICOLOS.

Please show us article where they find athlete with low hematocrit who do not respond to increasing his hematocrit to 50 or 55. YOU KNOW VERY WELL THAT THIS ATHLETE DO NOT EXIST, SO YOU INSTEAD SPEAK CONFUSING NONSENSE AVOIDING THE CORE.

Please, by all means, spoil my experience with verifiable facts. All we ever have are empty allegations, accusations, and insinuations.The facts are that the effects of EPO on sports performance is relatively unstudied.We know "high low" altitude training brings certain hematological benefits. How much more benefit does EPO bring than that? How much of EPO benefit is simply placebo? How do EPO benefits vary between amateur and elite athletes? Living at altitude, how are East Africans different than Western European and American athletes?Athletes take drugs because they think it works. That doesn't mean it works the way they think.Cycling is not running. There is a big difference in physiological demand and recovery requirements between 3 week events requiring top performances 6 days a week, and single track events, once every 2 week.

trollism wrote:

I think we're spoiling this fanboy's experience of the 'perfectly pure' sport that is distance running.

Rekrunner: why are you speaking about something you dont know nothing about.

Go try attitude training, then go try EPO until your hematocrit is 55. Then come back here and repeat that we cant be sure if doping can have some benefit.

Trust me, you will not be the first to try. Get some knowledge before you speak.

Renato has this knowledge, but he dont speak the truth.

Of course it is a contest of running, not blood levels. So "benefit" must be measured in time. If you already have high oxygen delivery capacity, what is the performance benefit of increasing it? Has any study looked at this question using highly trained elite athletes?

Alberto Contadoro wrote:

But blood doping work by enhacing oxygen carrying capacity by increasing the proportion of red cells in that volume of blood.

Having a high blood volume, and low hematocrit, MEANS THAT THE POTENTIAL OF INCREASE THE AMOUNT OF OXYGEN CARRIERS WITHOUT MAKING THE BLOOD TOO THICK IS HIGHER THAN IF THE VOLUME OF BLOOD IS LOW.

This way your african athlete with high blood volume, should respond EXTREMELY GOOD TO DOPING.

But you state the complete opposite, that this athlete can not have any benefit of doping. This statement i repeat is RIDICOLOS.

Everyone here is speaking about what they don't know. Why should I be different?My personal experience and experiments can not be generalized or projected onto elite East African athletes. This is not a controlled double-blind study, and would only gain me personal knowledge about myself.I'm asking why there are so many insinuations and so few facts? Please enlighten me. You can show Renato is lying by bringing up facts that contradict him, but instead you chose to just re-accuse him of lying.If EPO is so effective, why are the best performances limited to poor, high altitude dwelling East Africans? Everyone has access to EPO, and everyone is subject to the same testing.

Alberto Contadoro wrote:

Rekrunner: why are you speaking about something you dont know nothing about.

Go try attitude training, then go try EPO until your hematocrit is 55. Then come back here and repeat that we cant be sure if doping can have some benefit.

Trust me, you will not be the first to try. Get some knowledge before you speak.

Renato has this knowledge, but he dont speak the truth.

The big mistake I find in this forum is that the most part of people look at the VALUES of blood as "cause" of top performances, instead as "effects" of a good training.

EPO, or the last edition called CERA (Continuous Erythropoietin Receptors Acrtivators) has the effect to stimulate and to increase the production of Erythrocytes. In the case of CERA, the use of this substance can have a "hemilife" of 135 hours, is used in veins. EPO, CERA and other substances ar part of the group of pharmacs called ESA (Erythropoietin Stimulating Agents). In our body, Erythtopoietin is made by liver, brain and heart.

EPO doesn't have any effect on the volume of Red Cells.

MCV (Mean Corpuscular Volume) is the measurement of the size of RBC (Red Cells), while MCH (Mean Corpuscular Heamoglobin) is the calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell.

Big RBC (Macrocytes) are large, so tend to have a higher MCH, while small RBC would have a lower volume.

So, if we take any type of ESA, we can have a high hematocryt BECAUSE WE ENHANCE THE NUMBER OF RED BLOOD CELLS, but we don't have any effect on the SINGLE ABILITY of each RBC in transporting oxygen.

For giving an example that everybody can understand, if I have to transport 1000 tons of bricks, I can use 100 lorries able to transport 10 tons each one, or 10 lorries able to transport 100 tons each one.

Of course, COULD BE BETTER TO HAVE 15 LORRIES FOR 100 tons, but this is not possible : you cant have your cake and eat it.

If we give EPO at the beginning of the preparation, WE INCREASE THE VOLUME OF BLOOD BECAUSE WE HAVE MORE RBC. These cells are not very big (value 85/88), so they are squized together, creating a high density (or viscosity) that increases the periferal resistance and makes the work of the "pump" (the heart) very difficult and expensive.

If we don't give any EPO to athletes that, during the same period of preparation, CAN INCREASE THEIR VOLUME OF BLOOD of about 1 and Half liter IN NATURAL WAY, as very simple stimula FOR INCREASING THE MCV OF RBC (value 105/110), we have the some result, with the advantage that the cells are more "free" to move faster, because the percentage of plasma is bigger and the viscosity is lower.

Many people here have the idea that RBC are like a bottle, and if you ADD some ESA we can have advantage. I's not like this. EPO can work for all people having a "deficit" in their ability of transporting oxygen, that's the reason because was created. Now, we can say that normal athletes don't have any "deficit" compared with the demands of a normal life, but of sure have some "deficit" compared with the attitudes of the other category of top athletes.

In this case, the assumption of ESA can give some advantage.

In the other case, NO.

So, the idea that, if an athlete winning WCh with 40 of hematocryt takes ESA for going to 50 can have advantage, IS NOT CORRECT, because the only effect EPO can provoke is an increase in the NUMBER of RBC, and this is not possible in athletes that already have 1,5 lt of blood in their body more than before. EPO doesn't change the composition of one single RBC, but only the number.

I hope I was clear. Anyway, I try to give you other information, because there were several researches, that of course NEVER were considered of general interest, BECAUSE TO FIGHT AGAINST SOMETHING SOMETIMES USELESS IS ONE OF THE BIGGEST BUSINESS OF THE SPORT TODAY (I speak about who sells doping, but also about who investigates against doping. For both the situation, doping is a veri big business, and for increasing this business on the side of antidoping, somebody has to over-evaluate the effects on the performances).

And, about cycling, do you think that, for pushing a gear with one tooth more (can be a development of one meter more for every revolution of pedal), is more important to take EPO or some substance for increasing the muscle strength ? Because I don't say that steroids don't work. The list of WR in throwing, jumping and sprinting for women, is very significant : NO RECORDS AFTER 1988.

Most of what Renato write is facts.

I will point out what is not facts.

-First the size of the blood cell is the same for the same person, regardless of ESA or not. The drug just stimulate the marrow to increase the number, in exactly the same manner as human EPO. (if you lack iron or other necessary nutrients, then the size and shape of the cells might change).

-Renato state that a person who trains normaly can increase the volume of blood by 1.5 liter. This might be true.

But then the same athlete using epo would have the same increase in volume. The volume increase is due to cappilarization and remodeling of the vasculature, none of which are inhibited by blood doping.

-Next renato state that a champion with hematocrit of 40 can not have any benefit of increasing this value to 50. Because this is apparently not possible in a person having 1.5 liters more than before. THIS IS OF COURSE POSSIBLE. BY INFUSING " UNITS OF FROZEN PACKED CELLS HIS HEMATOCRIT WILL ADJUST IMMEDIATLY TO CLOSE TO 50. The body will respond by getting rid of some plasma through urine. But the net effect is to have increased viscosity, and increased number of red cells.

Now we can question will this be beneficial, since increased viscosity means slower flow of blood? But all experience show that the increased viscosity is offset by the increased oxygen carrying capacity until your hematocrit reach a value roughly between 60 and 65.

At this value there is no longer a benefit to increase the number of carriers.

Now i have omitted the discussion of plasma expanders, increasing the volume of blood so that you can infuse even more red cells and keep viscosity and hematocrit constant.

Here it is important that the athlete have good elasticity in his vessels. Renato have before talked how his kenyans are perfect in this area.

Kari Olli Kuha wrote:

Last, to Christian Fletcher, that clearly know nothing about doping, but still want to speak nonsense.

Today it is really very easy to beat the tests even if you are out of combat tested on the iaaf prioritized list. There are so many human identical substances, some that are not testable, and other with half life of hours.

In addition the use of self transfusion is one fool proof method if you know what you are doing.

I am going to suppose that I am more familiar with the process than you. Besides that, if it's so easy for run of the mill rube to evade testing, you wouldn't see anyone of name recognition test positive but you do again and again. You think it's so easy to go around today's international anti-doping authorities? So did Soboleva, Tomashova and Chizenko.

Those Russian women would have gotten away with it had they not been daft enough to substitute their urine with a pregnant woman's.

You're pretty stupid if you honestly believe that catching them is evidence that the system works.

Contadoro:

You are an absolute blessing to this site, particularly to this thread. Seriously. I finally feel that all of us who've been screaming loudly without avail, finally has a voice that can be heard. Clearly, you have the knowledge and understanding to support your words and others' fabrication of "facts".

Thank you and PLEASE continue contributing to this debate which is clearly no debate. EPO does work, including with top athletes. I'll step aside now and let you continue:)

trollism wrote:

Those Russian women would have gotten away with it had they not been daft enough to substitute their urine with a pregnant woman's.

You're pretty stupid if you honestly believe that catching them is evidence that the system works.

How was Ramzi daft? How was LaVerne Jones daft? How was Jose Luis Blanco daft? Ramzi thought that he had gotten away with murder, but he and the Boulamis hadn't counted on the IOC retesting samples for CERA. LaVerne Jones blasted her way through the indoor season and thought she was home free with a medal, setting herself up to be a top sprinter outdoors, but was busted back in April of last year. Blanco raced for how many years before getting nailed? Given enough time, you expose yourself to test after test after test and at some point your number is going to get called. Quite separately, there's also the issue that these are controlled substances, so if you live and train in a country that gives a shit, those controlled substances need to be accounted for, as Marta Dominguez has recently found out.

Fletcher Christian wrote:

How was Ramzi daft? How was LaVerne Jones daft? How was Jose Luis Blanco daft? Ramzi thought that he had gotten away with murder, but he and the Boulamis hadn't counted on the IOC retesting samples for CERA. LaVerne Jones blasted her way through the indoor season and thought she was home free with a medal, setting herself up to be a top sprinter outdoors, but was busted back in April of last year. Blanco raced for how many years before getting nailed? Given enough time, you expose yourself to test after test after test and at some point your number is going to get called. Quite separately, there's also the issue that these are controlled substances, so if you live and train in a country that gives a shit, those controlled substances need to be accounted for, as Marta Dominguez has recently found out.

3 people fail drug tests and you're using that as proof that the system is working. Get a grip.

The BALCO cases and the Spanish business simply underlines that the system doesn't work. These guys were tested and tested but none ever failed over a long period.

What about these athletes that come from countries that don't give a shit (Kenya/Ethiopia)?

On another point, I'm aware that they are subject to IAAF testing because of their lack of NADO. Has any athlete been subject to a ban for failing to adhere to the 'whereabouts' rule when tested by the IAAF? I don't think they have, and given that this system has been in action for a while now, I'm given to believing that they're not that strict. I'm certain that Kenenisa Kipselassie is currently 'training in the mountains' wink wink, is a valid excuse to avoid testing when the vamps come a calling.

According to you, they should have never have been caught because it's so easy to avoid. I am saying that given enough exposure you are likely to come up dirty if you are using, and that separately, the criminal investigations provide another avenue of pressure for those that use and traffic the drugs. If I steal from the company coffers once, I might very well go undetected. But if I do it again and again and again, I run a much greater risk of getting caught. This is especially true when I don't run the company and the company owner aren't with me in the scheme.

I don't work in the IAAF Anti-Doping office so I'm not privy to information you request, but I do know that athletes in countries that lack an independent anti-doping authority are subject to the missed test rule and that "not being reachable" at your specified training location isn't an excuse.

Alberto, finally the discussion is about physiology, and not about personal attacks from people not knowing one another and, often, what they are speaking about.

1) I don’t agree with your first point. It’s not true that the size of RBC can remain the same in the same person. I had, some year ago, several investigations with the first group of KenyanI coached, in Turin University (lab of hematology).

We had tests with Kenyan on the first/second day at sea level after coming from Kenyan altitude and, how already I explained, the average of their MCV was between 105/110 (for the Italians was 85/90). I had again tests after one month, 2 months and 3 months (they stayed for a long and continuous period near Torino, at sea level). Their MCV became lower every time, and after 3 months there was no difference between their value, and tha average value of Italian athletes.

On the opposite, I had other tests with the Italian runners, after going to altitude. In this case, NEVER I found some difference in their MCV : the effects they had after the altitude (also if not exactly with the same trend for everybody) regarded ONLY the increase in the RBC number, and consequentely in the Haematocryt.

So, what does it means ? That the high MCV is an effect of “Permanent living” in altitude, connected not with some type of stimulation, but of “adaptation”, while the effect of altitude (or of assumption of EPO) for people living at sea level is a “stimulation” for producing more RBC.

2) I don’t agree again in your second point. It’s not true that a person trains normally can raise his volume of blood of 1.5 liters. This is possible for some particular typology only, and for athletes using a hard aerobic training at high intensity. The most part of athletes (may be 99.9 %) don’t have characteristics for reaching this goal, also with hard training. You also admit that this depends on the high elasticity in their vessels, and in the ability to remodell their vasculature. This is exactly the most important difference between a good athlete and a top champion. This is what we can call “specific talent”.

3) I don’t understand when you write “but then the same athlete using EPO would have the same increase in volume, due to the capillarization and remodelling of the vasculature”. Since we are speaking about top athletes, they completed any possibility of capillarization already years before, so this factor doesn’t exist, in their case. But what I don’t understand is that “then”. You accept the fact that a top athletes of endurance events, after a hard serobic training lasting 3-4 months, can increase his total volume of blood of 1.5 liters in natural way. So, when you write “then”, I suppose you want to say that, AFTER having 1,5 liters of blood more in his body, the same athlete taking ESA can add another 1.5 liter. This means to have 3 liters of blood more, that is obviously impossible. So, I think that your correct idea is that “the same athlete, using EPO with LESS TRAINING, can have the same increase in volume”. I can accept this theory. But this theory means that YOU CAN HAVE WITH EPO THE SAME EFFECT THAT YOU CAN HAVE WITH HIGH LEVEL OF TRAINING, may be in shorter time, BUT NOT BETTER EFFECTS. In other words, I accept that EPO can work for athletes with not maximal training, but you must accept that EPO can’t give something more to the athletes perfectly trained, BECAUSE THE FINAL EFFECT IS THE SAME : to increase the number of RBC, and it’s not possible to have a summation of effects, since one effect leaves out the other.

The final point is : WHICH ARE THE DIFFERENCES ABOUT A TOP MACHINE (for long endurance races) AS THE BEST RUNNERS IN THE WORLD, AND GOOD MACHINES ? What can produce the difference ? There is of course a component of ambience (people hungry, aggressive in training, living in altitude). May be there is a component in different morphology (when I come back to Kenya after Boston Marathon, we have a research as IAAF with somebody of the best Kenyan runners about the morphology and the way of working of their Achilles tendon, compared with European and Japaneses distance runners : may be we can find something explaining biomechanical differences). But, of course, there is a difference in their physiology, exactly like the engine of a Formula One follows the same principles of the engine of a good sport car, having in any case something different and something more.

Fletcher Christian wrote:

I don't work in the IAAF Anti-Doping office so I'm not privy to information you request, but I do know that athletes in countries that lack an independent anti-doping authority are subject to the missed test rule and that "not being reachable" at your specified training location isn't an excuse.

But don't you think that it's strange that no athlete has ever been sanctioned for missing tests (whereabouts rule) when tested by the IAAF?

Are athletes from Russia, Kenya, Ethiopia, Jamaica, etc just more honest and available for testing than athletes from nations that have their own systems to catch cheats? Do they also never make mistakes with timings, etc.

The IAAF wouldn't dare ban an African for missing tests.

Thank you Renato for your replies, this is an interesting topic.

1) You present interesting data regarding kenyan athletes arriving from attitude reducing their MCV(size of red blood cell, linked to carrying capacity per unit cell).

This might very well be true. And one simple explanation could be that coming from attitude, suddenly they are in hyperoxic situation, their body respond by making almost no new reticulocytes. And as reticulocyte is larger than the mature cell, this could be part of explanaition. But i dont think the full one. Also diet might play a role. To me it sounds like interesting topic for physiologist to investigate further.

2) and 3): Now you are placing words in my mouth i did never say.

I never said everyone could increase their volume by 1.5 liter. But suppose we have some athlete that can.

Then you say it is impossible to increase blood volume by another 1.5 liters (and almost certainly it is, i never said so). What i say is. FOR THIS ATHLETE, HAVING NOW A LARGE VOLUME OF BLOOD IN HIS BODY (say 7 liters just to have some large number). THEN IF HIS HEMATOCRIT IS 40 I CAN INFUSE THREE UNITS OF PACKED CELLS IN HIS BODY. OR USE AN ESA FOR THE SAME GOAL. MAKING HIS HEMATOCRIT BECOME 50 (and his performance improve strongly).

SO I MAKE HIS BLOOD THICKER, REPLACING PLASMA BY RED BLOOD CELLS. KEEPING HIS VOLUME OF 7 LITRES.

For those who think this sounds impossible, adding something to 7 liters keeping the volume constant. It is very normal and not some magic. By homeostasis the body regulate plasma volume by itself, when volume is added in terms of extra red cells, the body will immediatly respond by diuretic hormons, making you pee out excess plasma.

Alberto, may be you have reason about what you wright. However, I want to explain because I believe in training in altitude, and not in EPO.

a) The first goal of every training (or of every doping) is to stimulate the body for having some higher adaptation. So, while for an athlete living and training at sea level the primarly stimulus going in altitude is to raise the number of his RBC (and we agree that is the same goal you have taking ESA), for an athlete living and training in altitude (that doesn’t have any new stimulus in this situation) the primarly effect is to switch to a more economic mode of oxygen utilization (according to two famous scientists, Chris Gore from AUS and Will Hopkins from NZ).

b) Angiogenesis, glucose transport, glycolisis, PH regulation are activities that can be bettered with training in altitude, and each one partially improves endurance performances, INDIPENDENT OF A LARGE NUMBER OF RBC.

c) Training in altitude has been shown to cause muscular adjustements of selected hene transcripts, and improvement of mitochondrial properties in skeletal muscles.

d) Muscle fibres types change according to homeostatic challenges which led to an increased metaboloic efficiency during the BETA OXYDATIVE CYCLE, and during the CITRIC ACID CYCLE, showing an increased utilization of ATP for aerobic perfromances.

Apart the raise in the number of RBC, noone of these goals can be reached with the only fact to use EPO. And, for what I explained above, the two situation are not combined together.

This is the scientific reason because doping can’t work with anybody in the same way.

But about every thing there are no sure proves. Somebody can say that athletes using doping ran very fast, like Ramzi. But I can say that athletes clean, using only hard (and I suppose “effective”) training in altitude were able to beat World Records and to win several World Championships.

There is no proof at all that Ramzi without doping couldn’t run so fast, or that my athletes with EPO could run faster.

But my position is not only because ethic and moral values : is also for very precise scientific points.

I never say nobody uses doping. I say the top Kenyans and Ethiopians don’t use for all the reasons we discussed. And, because they are the best, personally I don’t believe with them can work.

For those reasons, also if I well know there are doped and dopers, I become very angry when I see this type of generalization, especially from people don’t having any specific culture, but only bad and stupid stereotyps fruit of partial of false informations. Of course, if an athlete is doped that’s a news, if an athlete is clean no…

I apologyze because I attacked you with some violence that is not my used behavior, but you, too, had a position that I cannot accept (doping is the normality for all the athletes).

I know what I know, but I don’t know what I don’t know. That’s the reason because I’m always ready to learn (of course what I don’t know), and I’m always ready to teach (of course, what I know).