When this nasty subject appears in news papers, following another cyclist being exposed, my friends ask me what it means to dope and why athletes do/don't get caught more often. So with the whole Lance saga I thought this post was apt.
Blood doping is useful (very useful) in any sport that requires aerobic activity over a prolonged period. The longer that period the better. So it's inevitable that the Tour de France (TdF) being the longest bike race in the world will have some problems with doping.
So what is doping?
There are two main types of blood doping. The first is by injection of a synthetic substance called erythropoietin (EPO). Erythropoietin is a naturally occurring hormone in the body that promotes development of red blood cells (RBC).
RBC are small containers that carry oxygen around our bodies. Since oxygen and fuel are essential for aerobic exercise it makes sense that extra RBC will mean a better supply of oxygen and therefore a better performance. It also contributes to a much speedier recovery, so that the athlete is on his/her "A game" everyday of the race.
When an athlete is tested during competition the testers are looking for abnormally high levels of EPO in the blood sample. If detection is to be avoided then the athlete/ director sportive must time administration of the drug in a very scientific manner, in order that all the EPO has been utilized to make RBC and is subsequently left the system before the samples are taken by the anti-doping agency. In the years since Lance last won the tour, testing is not only executed during and after the event but also takes place in the off-season. This process along with the "biological passport" of the athlete makes doping of this kind much more difficult to mask or conceal. It is argued that this is why we now regularly hear that cycling has got much cleaner in recent years. I remain skeptical!
Another way of blood doping is by blood transfusion. What they do in this case is much more clever. But let's understand a little physiology first.
Our kidneys are the filter system for our blood. All day long they test the blood and remove metabolic waste such as uric acid (a byproduct of metabolism), lactic acid (a byproduct of exercise), broken or damaged red blood cells, ions and excess water. All this is called urine. The kidneys also do ongoing tests on the blood and if they detect low levels of oxygen they release, in its natural form, erythropoietin. This tells our bones to make more RBC (RBC are made inside bones). These extra RBC mean more oxygen is carried and this makes the kidneys happy so the production of EPO can be stopped.
An athlete who trains at high altitude where the oxygen is low will have unhappy kidneys. The low saturation of oxygen (O2) in the air makes the kidneys release EPO and the bones make more RBC. Relative to normal the athlete has a high saturation rate but because he/she is at altitude where O2 is low; the benefit is not had yet. If the athlete returns to sea level for a race they will have much high saturation of O2 in their blood due to the extra RBC that where produced while at altitude. Their performance will be much better than it would have been if they never did a training camp at the high altitude. After 2-3 weeks the athlete's RBC levels will return to levels similar to those before the high altitude training. This is all physiological and every long distance and endurance athlete on the planet uses this. Nothing illegal has been done. Yet!
While at altitude a litre of concentrated blood is taken from the athlete and stored in a refrigerator. Remember this blood has a relatively high concentration of RBC, which will be hugely beneficial once his/her levels have returned to normal. Then during a stage race, like the TdF, the "medics" can extract a litre of blood from the athlete and replace it with the blood, which was taken at altitude and conveniently stored in refrigeration. Now the competitor, once again, has higher levels of RBC, which means higher O2 saturation and a superior performance. This is illegal! But if the athlete is feeling tired and losing time this can literally deliver him/her back to their peak performance over night. This method is very difficult to detect, remember no drugs were used. Testers now look for traces of the plastic from the inside of medical bags in the blood of athletes. Another reason why "they" say cycling is getting cleaner!
The health risks with both of these methods are high. Red blood cells constitute 45% of he blood, while plasma and white blood cells make up the remaining 55%. These levels give a specific viscosity to blood. If the viscosity is changed by increasing the % of RBC the blood becomes creamier. This thicker blood means that the heart has to work extra hard to pump it around the body. This isn't a problem while exercising because fluid replacement and movement is maintaining a balance. However when the body is at rest and the heart rate drops (usually significantly in an elite athlete) then the risk of a serious heart attack is elevated.
I am a huge cycling fan. I love the sport and spend countless hours watching footage on TV. I remain skeptical because I was a Livestrong devotee. I wore the, now shameful, yellow wristband and I bought all the gear, a "Trek Madone" included. So imagine how I felt a couple of years ago when it all began to come out. Around that time I switched my allegiance to "Alberto" but again I was disappointed by him and then let down by the "Schlecks".
I was sickened by the Gold medal win by Vinokourov at the London 2012 games and I was appalled by the presence of David Millar on team GB. Remember both these guys along with countless others have been caught doping in the past. The British Olympic Committee banned Millar but himself and Dwain Chambers took them to court and the decision was over turned. I know Millar does a lot of anti-doping campaigning now, But a doper is a doper. I applaud the standpoint of the British Olympic Committee and if the rest of the world were to follow their actions I believe that a fantastic and honest sport is achievable.
I remain very skeptical mainly because of the stance most of the cyclists take. Two of the top cyclists in the world at the moment are Mark Cavendish and Bradley Wiggins, both remarkable athletes in their own right. Both rode on Team SKY last year, a team known for it’s strong stance on anti-doping. Yet both of these felt it OK to support Millar in his bid to ride on team GB. Why? There are numerous other British riders who have never taken drugs so why not support those guys? Logic tells me that they all have something to hide. But who knows?
Lifetime bans are the only answer. Until then every big scandal will be the so-called last, remember Festina? Now Lance, next probably Contador.
A boy can dream right?
Vive le Tour!