I have seen several posts recently that refer to Paula's RBC values or Hct values, which are being confused with hemoglobin(Hb) values. RBC values are measured in different units, with a normal range typically of 4 to 6 x 10^8 RBCs per cubic mm of blood. Hematocrit (Hct) is measured as a volume % of RBCs as a percentage of the volume of whole blood, (for example, the cycling Hct cutoff of 50%). Hemoglobin is measured in g/dl. There are no values for RBCs or Hct which have been released for Paula, only OFF scores, Hb, and a few reticulocyte scores.
Reticulocytes are new, young RBCs, which show basophilic staining. Reticulocytes will not increase with hemoconcentration from decreased plasma volume due to dehydration, like hemoglobin values can. Why not? Because reticulocytes are measured as a percentage(normal range of 0.5 to 1.5%) of total RBCs, not blood volume. Have the actual number of RBCs changed due to dehydration? No, they have not, so the reticulocyte score will not be altered by dehydration. Things can get complicated.
Macrodosing of EPO will usually show high hemoglobin values with a high reticulocyte score of over 1.5%, even up to 2.0 or 2.5%. Paula has a value of 0.77% in her 2012 OOC test in Monaco (and remember she can always use altitude to explain blood values, because she can always be using an altitude tent, no matter her location). She could be microdosing EPO to keep the reticulocytes lower, but she had a negative EPO urine test at the time.
So I would give her a pass on the 2012 test, but it is still suspicious and extremely unusual. In a search of literature, I found evidence of rare, isolated cases of female cross country skiers who had Hb values of 15.8 and 16.0, supposedly from clean athletes training at altitude, so I will give Paula the benefit of the doubt, and say that 16.2 must be possible for superwoman Paula, right?
Having said that, I am a physician who has lived and worked at 7000ft. altitude for the last 24 years. I have seen hundreds and hundreds of CBC with complete differentials, Hb, RBCs Hct, retics, MCV, MCH, MCHC, etc. in lots of men and women. I also know the hemoglobin values of several 2:30 female marathoners who live here, and several other national class female runners. None of the national class female runners and none of the normal females (without polycythemia vera) in 24 years have ever shown a hemoglobin value above 15.0g/dl. Many females show low hemoglobin values because anemia is very common among females. And now we have recently found out that Paula has a history of anemia! People with a history of anemia typically stay that way, even taking iron, with their Hb values typically in low normal range around 12 to 13g/dl(normal range 12 to 15g/dl for a female). Not Paula, because she has treated her anemia with ostrich, venison, and wheatgrass and has showed Hb values of 15.6,15.1, and 16.2 on three different occasions. The odds of a female with a history of anemia ever showing Hb values above upper range of normal is extremely low in my opinion.
When a blood transfusion is done, there is a large and rapid increase in Hb values, and reticulocytes will show a below normal value at the same time, because the reculocytes(new,young RBCs) are being diluted by the massive amount of old RBCs from the transfusion, which has "older" blood which has been stored for a while (maybe in the freezer of Dr. Fuentes).
Now let's assume that Paula's normal reticulocyte value is around the 0.77% measured in 2012. Her reticulocyte values of 0.47% in 2003 and 2005 World Championships show below normal reticulocyte values at the same times as a rapid increase in hemoglobin value from an anemic 12.0 prerace to an above normal value of 15.6 postrace in 2003, with an OFF score that goes from 82 prerace to 114.87 postrace in 2003 and from 92 to 109.87, with a postrace Hb of 15.1 in 2005. These values are entirely consistent with what would happen with an autologous blood transfusion,in both 2003 and 2005.
Paula can really quickly fix her anemic hemoglobin value of 12.0, because in just 2 days it becomes 15.6(above upper range of normal!). It normally takes a long time to fix anemic hemoglobin values, since the half-life of an RBC is about 60 days, but not for Paula! She can really, really fix her anemia in 2 days! Go Paula!!!
At the 2003 race, an official is discussing Paula's blood tests and hemoglobin score with her, which seems highly unusual! At the 2005 WC race they do a heterologous blood transfusion test for RBC membrane antigens to see if there was a transfusion of blood from a different person, and the test was negative. It won't detect an autologous blood transfusion. It does look like they were suspicious of Paula to even perform that test at the 2005 World Championships.
The IAAF in their reports just explained away high OFF scores in isolation. They never discussed or even mentioned the prerace OFF scores of 82 and 92. They never mentioned or explained the incredible 33 point increase in 2 days or 18 point increase in 1 day. The most suspicious elements of Paula's blood tests, the rapid and large magnitude changes in OFF scores are completely ignored and are completely absent in the report, which I find to be highly suspicious. The most suspicious elements are OMITTED in the IAAF report! That sure is strange, isn't it?
Then Paula refers to her blood test expert in an article, as the lab director of the Lausanne lab, but never mentions his name. Why not ? His name of course is Dr. Martial Saugy!!! Informed readers would know the history of Dr. Martial Saugy, which includes destroying 67 Russian samples. The fact that Paula has him as her blood test expert is very, very, very suspicious!
And of course nothing before the 2009 ABP actually counts (including Shobukhova's outrageous OFF scores) because there could of possibly been massive lab error/variation to explain Paula's rapid and massive 33 point and 18 point changes. Any blood test result before 2009, according to the IAAF and rekrunner, no matter how outrageous (like Shobukhova's results) simply do not count!!! So that is just too bad for all you Paula doubters!!! Lots of other athletes were tested pre and post race on the same equipment at the same labs on the same days. Where are all of their lab errors? There should be many other athletes with abnormal changes if it was due to lab variation. In fact, if the lab error was this large, hopefully the results would have all been thrown out, and would have never entered the IAAF database, to then be leaked later. But they were entered. Is there massive lab error affecting other athletes or is lab error just affecting Paula again and again?
The IAAF had suspicious blood tests on Shobukhova going back nine years before they did anything. Without a positive EPO test, and no ABP before 2009, it seems there wasn't much they could do or wanted to do. The IAAF
also has suspicious blood test results for Kenyan athletes who have won medals at the Olympics and world championships, but we have not seen any of those so far, or the names on the 200 blood bags of Dr. Fuentes, which includes winners of the London marathon.
To give Paula a small break on all this, at least she has not shown (so far) any evidence of outrageous EPO use with consequent outrageous hemoglobin values of 18 to 21 g/dl, such as some athletes have shown.
While it may be possible to produce outrageous, world class, world record performances with normal hemoglobin values, we know that many outrageous performances were obtained with outrageous hemoglobin values.
Paula could be transparent, and remove all doubts about her outrageous 2:15 and two 2:17 marathon performances, by releasing normal looking pre and post-race hemoglobin values from these races, but she chooses not to so far, so the doubts and suspicion about her will stay for now. What do you think, readers? If you had normal looking scores from your best races, and there were doubts about you, wouldn't you release them? I know I would. I think it adds to suspicions to not release them at this point.
Do you think Paula's hemoglobin values and OFF scores around her outrageous races were normal or outrageous?
........Go Paula!!!!......................