62% hematocrit. it's EPO?

I`m not a doctor certainly wrote:

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

Well then I hope her system is back in balance.

FWIW if this happened to me, the first thing I would do would be to stay far AWAY from any doctors.

Secondly if I'd been taking any advice from a doctor, I would immediately stop doing that. For example doctors are invariably the ones prescribing high iron.

Doing those two things would probably solve 99.99 percent of any physical problems. So I don't really want to hear about any of those, or going to a doctor or epo or iron etc.

I'm interested if it is a holistic physical issue, then what holistic/natural things could the person do. Anyway I'll presume the condition was doctor caused, and that what I would do is the answer to resolve the condition.

DocB wrote:

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.

Can I hear a.... "STAT!"

if this happened to me wrote:

Well then I hope her system is back in balance.

FWIW if this happened to me, the first thing I would do would be to stay far AWAY from any doctors.

Secondly if I'd been taking any advice from a doctor, I would immediately stop doing that. For example doctors are invariably the ones prescribing high iron.

Doing those two things would probably solve 99.99 percent of any physical problems. So I don't really want to hear about any of those, or going to a doctor or epo or iron etc.

I'm interested if it is a holistic physical issue, then what holistic/natural things could the person do. Anyway I'll presume the condition was doctor caused, and that what I would do is the answer to resolve the condition.

Why in the world would you assume that? The condition was almost certainly caused by her taking massive amounts of EPO for a sustained cycle. She needs to get to hospital because her heart may give out in her sleep.

I found this quote on an article about a cyclist dying in his sleep:

"It brings to mind one of the most fascinating quotes I've ever come across in a cycling book - it was in the book "The death of Marco Pantani" by Matt Rendell, in which a story is recounted of how in the 1990's, with EPO use rampant, the cyclists would set their heart rate monitors to sound an alarm if their heart rate dropped below a certain level. On hearing the alarm, the cyclists would have to wake up, get the bike out and spend 10 minutes on the rollers, in their hotel rooms, just to jump start the circulation.

In the words of one cyclist: "During the day we live to ride, and at night, we ride to stay alive"."

And you believed that? That is so totally bogus. It is clearly hyperbole.

lllll wrote:

"It brings to mind one of the most fascinating quotes I've ever come across in a cycling book - it was in the book "The death of Marco Pantani" by Matt Rendell, in which a story is recounted of how in the 1990's, with EPO use rampant, the cyclists would set their heart rate monitors to sound an alarm if their heart rate dropped below a certain level. On hearing the alarm, the cyclists would have to wake up, get the bike out and spend 10 minutes on the rollers, in their hotel rooms, just to jump start the circulation.

In the words of one cyclist: "During the day we live to ride, and at night, we ride to stay alive"."

Why is it clearly hyperbole? It is a story about something that could be done. It also makes sense, given that a number of riders did die in their sleep during the EPO era.

I agree with the differential diagnosis above but items 1 through 99 are EPO abuse on my list; EPO secreting renal or hepatic tumors in a presumably 20-something world class athlete would be astoundingly rare

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.

Its 50%.

And there are a couple of guys with naturally hiogh numbers - Daniel Cuenego is 52%, so is his Dad, and he has a medical certificate to prove it.

This numbe ris o far off the scale it can not be corect.

Or she got the dose wrong, and better make sure she does stroke out while she's asleep.

get her to a doctor immediately. the hematocrit is extremely high, you need reticulocyte counts, as someone mentioned. What are her platelets? she could have polycythemia leading to the hematocrit and the 21 day period. she is at severe risk of organ infarction and hemorrhagic shock.

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.

Its 50%.

And there are a couple of guys with naturally hiogh numbers - Daniel Cuenego is 52%, so is his Dad, and he has a medical certificate to prove it.

This numbe ris o far off the scale it can not be corect.

Or she got the dose wrong, and better make sure she does stroke out while she's asleep.

I recall that this can be a genetic thing. There was a XC skier who had it (along with most of his family). He won a lot of races.

Are there other blood tests?

Also, no one short of maybe someone in Antartica is 30 days from a doctor.

Well i'd be more concerned if she never took EPO, she better get to a doctor. If she did, she can just donate a couple pints of blood. Levels should return back to normal.

62% is off the charts ridiculous. She's certainly on heavy heavy EPO and also dangering her life.

Doc Block wrote:

Well i'd be more concerned if she never took EPO, she better get to a doctor. If she did, she can just donate a couple pints of blood. Levels should return back to normal.

Thank you. In lieu of donating blood, she could probably just stop the cause, and the levels would return to reasonable numbers.

luv2run wrote:

no one short of maybe someone in Antartica is 30 days from a doctor.

I'm 30 years from a doctor and have never been to Antartica.

Raptured wrote:

62% is off the charts ridiculous. She's certainly on heavy heavy EPO and also dangering her life.

I average about 150 patients receiving EPO week to week. After seeing this thread, I pulled our numbers for the current year. Approx 150 patients, bimonthly lab draws, 5 months, so figure 1500 total lab draws, give or take. Of these 1500, the computer kicked out THREE lab draws that exceeded 50% hematocrit. All three were on intravenous iron at the time in addition to EPO, all three had newly-developed high iron levels that should have resulted in iron being held but it wasn't (human error). None of these three exceeded 57%.

Now this is a low error rate (of EPO administration/monitoring) but without the iron, I doubt even these three values would have exceeded 50%. The 62% value mentioned by the OP is indeed ridiculous. My guess is lack of experience in adjusting the dose of EPO and/or lack of adequate monitoring.

I`m not a doctor certainly wrote:

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?

The IAAF cannot suspend her because there is NO RULE in track and field that says you can't have an obscenely high hematocrit. In cycling there IS one, has been for 12 years now. A similar rule in track would put the SB's in each event back to 3:31; 7:30; 8:05; 13:05; 27:15.

"HEMATOCRITOLOGYCAL"

-- is not a word in any language. Were you trying for Hematological?

My mistake! sorry!

My guess would be dehydration (early adjustments to altitude, loss of appetite, overbreathing, intense work etc), iron overload (possibly countering anemia -- more likely due to previous overtraining at altitude, excessive oxidative stress -- and finally some measurement errors (which could be various factors). Check the standard errors of the measurements. Maybe they had trouble getting a stick?

http://jeanfrederic.brun.free.fr/overheorev.pdf

address the overtraining and focus with raising oxygen carrying capacity. just as likely she is missing the A due to training errors and a lack of peak speed capability.

email if you have questions:

good luck

dsrunner@juno.com