Athletes have never been more closely scrutinised and more frequently tested for...
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It's all about blood. Increasing the ability of the blood to deliver oxygen to the muscles is a potent performance-enhancer. Athletes are prepared to go to tremendous lengths to beat the tests.
Athletes have never been more closely scrutinised and more frequently tested for performance-enhancing drugs, both in and out of competition. Anti-doping authorities regularly make confident statements about the efficacy of the regime. But can athletes still beat the system? Jeff Jones reports.
When athletes test positive for performance-enhancing substances, they often point to a long history of negative tests as evidence of their innocence. In cycling, riders such as David Millar have subsequently confessed to using banned, detectable substances at times when they must surely have been under scrutiny.
The question that must be asked, in the light of such incidents and l'Equipe's accusations against Lance Armstrong, is: is it still possible to take illegal performance enhancing substances but remain clean in the eyes of the drug testers? A confidential medical source told Cyclingnews that they believed it was quite possible, and outlined a simple but plausible method to do it.
1) EPO can be taken in smaller doses but on a regular basis, which has several advantages over taking one big hit every now and again. Firstly, it reduces the possibility of detection by the urine test by lowering the percent of basic isoforms (see sidebar) in the urine.
A smaller dose means a drug tester might only have 12 hours to detect the last injection, and given the fact that drug tests aren't usually carried out in the middle of the night, this leaves only a very small window open.
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Taking small, regular doses also simulates the body's natural physiology more closely than a super-sized dose, which means that it could even get under the radar for the longer term blood testing.
Presumably that would require a more care to be taken over the course of a season, but with a knowledgeable doctor's supervision, that is entirely possible.
2) Autologous blood doping is still undetectable, and not particularly complicated. In this technique, the athlete extracts and stores some of their own blood, and reinfuses it when the body has recovered its normal red blood cell level. The effect is an immediate boost in red cells and oxygen carrying capacity.
All that's required is a set of bags and tubing, the proper substance to preserve the blood overnight, and a fridge. The blood - which can also be boosted with EPO - can be withdrawn in the weeks leading up to a big event, when an rider is not in competition.
Then it can be reinfused on the morning of an important stage, even as late as 9:00am, which is after any possible UCI medical inspector visits, but before the stage starts.
The red cell boost could enable a rider to do the stage with an elevated hemoglobin/hematocrit, and oxygen carrying capacity to burn. But they should have enough time to rehydrate and get back to normal before a possible blood test the next morning.
A urine test on the day should present no problems, as there will be no traces of artificial EPO left. To coin a phrase, it's like "racing high, sleeping low."
This method might only be used a few times during the course of a three week stage race, but it's considered to be even more effective than merely taking EPO.
Autologous blood doping requires careful scheduling of the athlete's racing program. Red cells can be stored for up to 42 days if properly refrigerated, but the body needs time to replace the red cells that have been removed.
Usually, red cells survive for 120 days and the body produces them at a replacement rate, but if blood has been lost the body can increase its rate of production as much as seven-fold.
It's therefore possible that the red cell level would be back to normal after about three weeks, giving a three-week 'window of opportunity' to use the stored cells.
Athletes might therefore stop racing for a period some weeks before a major event and closet themselves away for a 'training camp' somewhere remote and secluded.
In a situation where it's hard to be subjected to an out-of-competition test, they can store red cells and spend time recovering from their extraction without the resulting sudden and suspicious drop in racing performance.
3) Recovery products such as growth hormone and testosterone can be used with little risk of detection, at least with the current methods. Growth hormone is undetectable at the moment anyway, while testosterone can be injected as long as the athlete stays below the 4:1 testosterone:epitestosterone ratio. If his normal ratio is 2:1, that gives him a wide range to work within.
This situation is similar to that of blood before the EPO test was introduced, when the 50 percent hematocrit rule was the only limit preventing riders from injecting unhealthy amounts of EPO. A rider could start at 41 percent and go all the way up to 49.9 percent without being declared "unfit to start". Even that only warrants a 2 week suspension, as it's not a positive test.
There is no doubt that the current tests are still catching riders, as it's not always possible to be this careful. And certainly, the introduction of a powerful blood test has made it easier to pick up changes in a rider's profile over the course of a season, and determine whether to target test them.
Add in a harsher penalty for missing an out of competition test, and the net becomes tighter. But as the above shows, there is clearly a lot more work to be done if doping is to be eliminated from cycling.
Cyclingnews coverage of the L'Equipe allegations
June 27, 2006 - Carmichael defends Armstrong, Armstrong answers L'Equipe & LeMond June 26, 2006 - LeMond: "Armstrong threatened my life" June 19, 2006 - Armstrong calls for Pound's exit June 18, 2006 - Lance Armstrong's open letter against Dick Pound June 4, 2006 - UCI hits back at WADA June 3, 2006 - WADA slams the Vrijman report June 2, 2006 - L'Equipe stands by its story, UCI supports Vrijman's findings June 1, 2006 - UCI, WADA and Armstrong react to Vrijman's report May 31, 2006 - UCI lawyer asks for Armstrong's name to be cleared May 14, 2006 - Two more weeks for Armstrong investigation
Click here for full coverage of the L'Equipe allegations.
