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.