re: Cycling, Too
As controversy rages over the (alleged) role of Lance Armstrong in perpetuating the dominance of performance-enhancing drugs in professional cycling, the sport is seeking to convince the public and commercial sponsors that it is becoming largely drug-free.

These efforts have been boosted by the appearance of vehemently and publicly anti-doping teams, which include Team Sky – led by Britain’s 2012 Tour de France winner, Bradley Wiggins.

In the wake of the Armstrong revelations, Sky last week announced they would oblige all staff and riders to sign a pledge saying they have never doped.

The magnitude of the doping problem in cycling was summarized by Daniel Delegove, the presiding judge of the 2000 doping trial of France’s cycling superstar Richard Virenque.

After hearing compelling evidence of widespread doping, Judge Delegove said, “These are not racers, they are pedaling test tubes.”

So, Why Do They Do It?
Most often, the goal of the user is to increase strength, or overcome fatigue.

In 1967 Jacques Anquetil, a five-time winner of the Tour de France, stated:
“For 50 years bike racers have been taking stimulants. Obviously we can do without them in a race, but then we will pedal 15 miles an hour [instead of 25]. Since we are constantly asked to go faster and to make even greater efforts, we are obliged to take stimulants.”

With the introduction of increasingly sophisticated methods of detection and testing, from the late 1980s, the performance-enhancing drug and delivery methods of choice have been blood doping, and the use of erythropoietin or EPO.

What’s Blood Doping?
Blood doping is defined by WADA (World Anti-Doping Agency) as the misuse of techniques and/or substances to increases one’s red blood cell count.

Most commonly this involves the removal of two units (approximately 2 pints) of the athlete’s blood, several weeks prior to competition.

The blood is then frozen until 1-2 days before the competition, when it is thawed and injected back into the athlete.

This is known as autologous blood doping.

Homologous doping is the injection of fresh blood, removed from a second person, straight into the athlete.

A second method of blood doping involves the use of artificial oxygen carriers.

Hemoglobin oxygen carriers (HBOC’s) and Perfluorocarbons (PFC’s) are chemicals or purified proteins which have the ability to carry oxygen. Initially developed for therapeutic use, they are now being misused as performance enhancers.

Artificial Oxygen carriers are the only form of blood doping which have a medical purpose. They were developed for use in emergencies when there is no time for determining and cross-matching a patient’s blood-type for transfusion, when there is a high risk of infection, or simply when no blood is available.

Tests were introduced in 2004 which are capable of detecting the use of homologous transfusions and the presence of artificial oxygen carriers.

A sufficiently rigorous test has not yet been developed to detect autologous blood doping.

Effects on Performance
Blood doping is most commonly used by endurance athletes, such as distance runners, skiers and cyclists.

By increasing the number of red blood cells within the blood, higher volumes of the protein haemoglobin are present. Haemoglobin binds to and carries Oxygen from the lungs, to the muscles where it can be used for aerobic respiration.

Blood doping therefore allows extra Oxygen to be transported to the working muscles, resulting in a higher level of performance, without the use of the anaerobic energy systems.

The following are side-effects which can occur in any form of blood doping:

• Increased blood viscosity (thickness)
• Myocardial infarction (scarring of tissue, leading to blockage and eventual heart attack)
• Pulmonary embolism (a blockage – which can be fat, air or a blood clot – of the pulmonary artery)
• Cerebral embolism (a blockage, formed elsewhere in the body, which becomes lodged in an artery within or leading to the brain)
• Cerebrovascular accident (stroke)
• Infections

Homologous transfusions are prone to further side-effects:

• Allergic reaction
• Risk of blood-borne diseases (hepatitis C, B and HIV)

After the emergence of EPO, the use of blood doping fell considerably.

However, since the development of a test for EPO detection and the lack of testing for autologous doping, it is once more on the rise.

Again, With the EPO. What IS It?
Erythropoietin (often shortened to EPO) is a naturally occurring hormone, secreted by the kidneys, whose function is to regulate red blood cell production.

The use of EPO started in the 1980’s as a quicker, cleaner alternative to blood doping.

Testing for EPO only became possible in 2000, by using both blood and urine samples. Prior to this, comparisons to a ‘normal level’ (Yeah, right. Normal, for WHOM?) were used to highlight possible offenders.

Medical Uses of Erythropoietin
EPO has a number of medical uses. It is usually employed to treat anaemia, secondary to other conditions, such as:

• Renal failure
• Cancer
• Pre/Post-surgery to reduce the need for blood transfusion

Effects on Performance
EPO stimulates bone marrow to produce more red blood cells (RBC) and therefore haemoglobin. For this reason EPO is most commonly used amongst endurance athletes as a higher RBC count means better oxygen transportation and so a higher rate of aerobic respiration.

The faster the rate of aerobic respiration, the higher the level at which the athlete can work without utilizing the anaerobic systems which produce lactic acid and cause fatigue.

Side-Effects of EPO?
Major ones. Which have proven to be fatal in previous cases:

• Increased viscosity (thickness) of the blood (which increases the risk of heart attack and stroke)
• Fever
• Seizures (fits)
• Nausea
• Headache
• Anxiety
• Lethargy (Weakness characterized by a lack of vitality or energy)

Great. So, Again: Why Do They Do It?
Who knows?

Why do athletes in any sport try to gain an unfair advantage?

I’ll be looking into that, in my next instalment.

Till then.