EPO and the placebo effect

unbrainwashed wrote:

But you haven't addressed the issue of HOW the extra red blood cells could be used, which would require more mitochondria and thus more muscle fiber recruitment, thus a higher workload, i.e. more effort required to go faster as per normal.

Calling me a troll is just ducking the issue.

You have a certain quantity of mitochondria, which can use a certain amount of oxygen.

You have a certain number of RBC, which can carry a certain amount of oxygen. Increasing the number of RBC increases the oxygen-carrying capacity of your blood. This means that more oxygen is available to your mitochondria. If they weren't previously working at 100%, meaning they weren't receiving enough oxygen, they are now. See? Furthermore, hard training tends to destroy red blood cells, so EPO use would bring you back up to normal ranges at the very least.

unbrainwashed wrote:

But you haven't addressed the issue of HOW the extra red blood cells could be used, which would require more mitochondria and thus more muscle fiber recruitment, thus a higher workload, i.e. more effort required to go faster as per normal.

Not a biochemist here but as long as the Cytochrome C oxidase enzyme that reduces oxygen in the mitochondria is working below the diffusion limit (which it does to my knowledge) then increased EPO that increases O2 transport to mitochondria should work WITHOUT necessitating more mitochondria.

You seem to be working under a model of "symmorphosis" that all the links in the causal chain are quantitatively matched otherwise any link with excess ability would be a waste.

middle professor wrote:

Not a biochemist here but as long as the Cytochrome C oxidase enzyme that reduces oxygen in the mitochondria is working below the diffusion limit (which it does to my knowledge) then increased EPO that increases O2 transport to mitochondria should work WITHOUT necessitating more mitochondria.

I think I'm backwards here. If the enzyme is slower than diffusion of O2 (which CCO is) then increased O2 flux won't generate ATP any faster.

FYI, I've read a number of the studies on EPO. In most of them, they state that the reason that they can't set up double-blind, placebo-controlled studies is because of ethical reasons.I've mentioned this before, but the best way to understand the benefits as mentioned by the aforementioned studies is being able to run your best 8k pace for 10k. That's negligible at best and could easily be explained by the placebo effect.

common wrote:

This is ridiculous. First of all, the bibliography is filled with editorials, not studies. This article is just one guy's opinion on whether EPO *should not* work. There is *zero* data to back up his assertion.

Ultimately, this is the problem with understanding human performance, and performance enhancement. Instead of doing actual science, and going out and doing double-blind, placebo-controlled studies, guys like this are sitting around in a coffee shop, reading a few papers, and publishing their sh1tty opinions in sh1tty journals. This isn't science, it's a third grader's book report.

"I've mentioned this before, but the best way to understand the benefits as mentioned by the aforementioned studies is being able to run your best 8k pace for 10k. That's negligible at best and could easily be explained by the placebo effect."

From the articles I've read written by actual users it's not just running your 8k for 10k, it's hitting mile 20 of a marathon and blasting away the last 10k. Or riding 100 miles on day one, and waking up and doing another 100 the next and feeling just fine on day two.

That's not a placebo. You can fake the funk for 2K, not those examples.

I've probably read some of those articles. I can't discount what you've said, especially since there is the associated hct increase. That being said, as much as I love anecdotal reports, there's way too much incomplete information.As far as your comment on faking the funk for 2K - it's relative. Something similar would be doing your best 21 mile pace for the full marathon. (I don't remember off the bat if the studies mentioned anything about RPE (rating of perceived exertion) - that'd be interesting.)

Aquafina wrote:

From the articles I've read written by actual users it's not just running your 8k for 10k, it's hitting mile 20 of a marathon and blasting away the last 10k. Or riding 100 miles on day one, and waking up and doing another 100 the next and feeling just fine on day two.

That's not a placebo. You can fake the funk for 2K, not those examples.

If you are saying it's a placebo should it be illegal?

Aquafina wrote:

If you are saying it's a placebo should it be illegal?

It's illegal because it can be performance enhancing in the quest for an early death too if used incorrectly.

Or did those who died after taking EPO just drop dead from the placebo effect?

Reminder: Cathal Lombard, admitted EPO cheat, improved from 30:30 to 27:30 in the 10k and 14:30 to 13:18 in the 5k at age 28, after already training at a high level for many years. Cite all the scientific jargon you want. Any rational person realizes this kind of improvement cannot be due to placebo.

Perhaps this is true but enough O2 has to get to the cells and mitochondria for the mitochondria to use the oxygen. So EPO can improve the delivery of O2 by making more hemoglobin. It all depends on which step is rate-limiting. There is no doubt that EPO improves excercise tolerance in kidney dialysis patients, virtually all of whom are anemic because natural EPO is kidney derived. You are saying that there is no benefit in those who have hemoglobin levels in the normal range. Maybe that is true, I don't know the answer, but I don't think you do either.

Oh boy it so frustrating arguing with morons on here. If you can't see how the cited work is related to the effects of EPO doping then you have critical thinking problems. The cited research states that the best way to predict whether someone shows a positive response to altitude training is by the magnitude of the increase in EPO following altitude training. While this is not definitive (as it is correlative), it is suggestive that EPO doping would be very beneficial. Furthermore, the very article you linked which suggested that EPO does not work basis this on studies of moderate altitude exposure (not on EPO doping). So you should ask the author of that cite, "What has altitude training got to do with synthetic EPO administration?"

There is that, and then there is unbrainwashed COMPLETELY ignoring the massive list of studies that were provided demonstrating beyond any doubt that EPO administration and blood packing result in a substantial increase in aerobic performance.

Time wasting troll at best.

That's definitely good solid anecdotal evidence. However, to me, it's still incomplete information (all the stuff I read about him a while back, anyway). Maybe I'm approaching this too rationally - I can't say with definite certainty how much of that improvement is from EPO or from the placebo effect.

So.... wrote:

Oh boy it so frustrating arguing with morons on here. If you can't see how the cited work is related to the effects of EPO doping then you have critical thinking problems.

The cited research states that the best way to predict whether someone shows a positive response to altitude training is by the magnitude of the increase in EPO following altitude training. While this is not definitive (as it is correlative), it is suggestive that EPO doping would be very beneficial.

The latest studies on LHTL simulation that at least attempt to control for placebo are highly suggestive that altitude training is in fact largely placebo. There are some increases in physiological factors shown in some blinded studies, but these don't appear to lead to increases in actual performance. Extending from this as you suggest, it is not a giant leap to assume that EPO administration may also be a placebo in well trained athletes, given the theorised mechanisms are similar.

Here is one example study, but in the last 12 months there have been several others with similar conclusions:

Doesn't count - it used "elite" race walkers. I can easily see how race walking is not helped by race walking. What about a study which uses runners?

rly wrote:

The latest studies on LHTL simulation that at least attempt to control for placebo are highly suggestive that altitude training is in fact largely placebo. There are some increases in physiological factors shown in some blinded studies, but these don't appear to lead to increases in actual performance. Extending from this as you suggest, it is not a giant leap to assume that EPO administration may also be a placebo in well trained athletes, given the theorised mechanisms are similar.

Here is one example study, but in the last 12 months there have been several others with similar conclusions:

http://www.ncbi.nlm.nih.gov/pubmed/21266736

That should say:I can easily see how race walking is not helped by EPO

Mona Lisa wrote:

Doesn't count - it used "elite" race walkers. I can easily see how race walking is not helped by race walking. What about a study which uses runners?

rly wrote:

The latest studies on LHTL simulation that at least attempt to control for placebo are highly suggestive that altitude training is in fact largely placebo. There are some increases in physiological factors shown in some blinded studies, but these don't appear to lead to increases in actual performance. Extending from this as you suggest, it is not a giant leap to assume that EPO administration may also be a placebo in well trained athletes, given the theorised mechanisms are similar.

Here is one example study, but in the last 12 months there have been several others with similar conclusions:

http://www.ncbi.nlm.nih.gov/pubmed/21266736

Mona Lisa wrote:

Doesn't count - it used "elite" race walkers. I can easily see how race walking is not helped by race walking. What about a study which uses runners?

These placebo controlled studies have only just started arriving. Several use cycling, not sure if there are any with runners yet. Look them up yourself.

Jesus Christ guys. Come on.

Are you seriously suggesting that the effects of EPO are purely placebo effect? Are you retarded? Honest question. Are you mentally retarded?

Okay, next question. Are you suggesting that, because the effect of LHTL stimulation is smaller than EPO dosing, or blood packing, that the OBJECTIVE, MEASURABLE PHYSICAL EFFECTS are not real? That increase in hematocrit is just the placebo effect? Is that what you're saying? And then you want to extend that flawed logic to conclude that effects of EPO must also be a placebo effect?

IT IS A GIANT LEAP. YOU ARE AN IMBECILE.

Altitude training produces small, but MEASURABLE changes in hematocrit for some people (responders). Because the changes are small, and inconsistent, statistically, it could easily be shown that there is no difference from placebo.

EPO and blood packing can produce as large a change as you would like, depending on the dosage, and the performance increase tracks right along with the increase in hematocrit. At least up to the point where you die of a heart attack in your sleep, or suffer a massive stroke or pulmonary embolism because you've turned your blood to pudding.

Altitude training will simply never show the dose effect of EPO or blood packing, so you ABSOLUTELY have to separate them in the discussion. They have similar effects on hematocrit, in that they both increase it. The degree to which each approach works is a huge, and fundamental difference.

common wrote:

Blood packing (autologous RBC infusion) was shown, in a double-blinded, placebo-controlled study, to have significant performance enhancing properties. Blood packing and EPO are two paths to the same destination. They absolutely increase performance at every level for every human being.

There is strong evidence that blood packing improves performance in well trained athletes. Blood packing and erythropoietin administration are not the same thing, so your studies are irrelevant. EPO administration does not have the same total blood volume effects as blood packing:

"Thus, the use of recombinant human erythropoietin as a performance-enhancing agent is dangerous, particularly in the less fit athlete, and probably of little benefit in the highly conditioned one."