One way of interpreting these findings, Iljukov says, is to conclude that for elite athletes, “a significant amount of blood transfusion could improve running times by 1 to 4 percent, depending on the distance, but on average 2 to 3 percent.” The paper compares this estimate with early studies of blood doping in elite athletes, including some old Soviet studies that don’t show up in the usual PubMed searches, which support the idea of a 1 to 4 percent range of improvement from a transfusion of 750 to 1,200 milliliters of blood.
In many respects, these results are anything but surprising: it’s been clear to most observers for a long time that the Russian women were doing something funny. What I always wondered was: where were the Russian men? In the 1980s and early 1990s, when anabolic steroids were the drug category of choice, the usual theory for the middle-distance success of Eastern Bloc women (and relative absence of Eastern Bloc men) was that they responded more strongly to steroids because they started with lower levels of hormones such as testosterone compared to men. But if the problem now is blood doping, what explains the difference?
According to Iljukov, the answer is basically the same. The old Soviet blood doping studies, which include four-decade-old dissertations with titles like “Autohemotransfusion for Enhancing Work Capacity in Athletes,” found that women get a bigger boost from blood transfusions than men. Though the studies don’t directly address why this happens, the key may be baseline levels of total hemoglobin, which tend to be lower in women: “The lower the initial level,” Iljukov hypothesizes, “the more you can benefit from blood doping.”