EPO is apparently useless

Page 6 - Get up to date with the latest news, scores & standings from the Cycling News Community.
It's interesting viewing club amateur road racing speeds and TT records where one assumes at least EPO & Blood is not used, yet all average speeds are 4-7% faster. Even local weekly crit races, what we used to race at around 24-25mph average are today 27-28mph and that's same 1 hour + 3 laps, same time each evening, probably about the same numbers. Always amazes me looking back even 10 years the difference.
Where am I going with it, not sure, just I'm not convinced club mates in the area are doping more today than 10 years ago, so is it simply improvement in the bikes, training, training with power, better nutrition and recover understanding etc. Not sure, but it gradually increases it seems anyway and I would highly doubt there's much PED abuse going on at such a low level to significantly allow everyone to improve.
 
It's more or less agreed upon that today's athletes in general are bigger and faster than they were 2 or so decades ago? Some of this is due to better understanding of nutrition as well as training. Is all of it, who knows, but a portion you would think actually would be. On the other hand, the NFL seems to also have more serious non contact injuries than were common just a couple of decades ago as well.

However, for this study, knowing what they would consider a "doped era" would be useful and helpful.
 
It's hard to judge with cycling because it's not a simple fixed event like say a 200m sprint. The rules, regulations and consistency changes yearly, incentives for the riders change such as jersey competitions over time and technology continually improves in every corner of the sport rapidly too. Add crashes, weather and general randomness of even the course not being the same each year or where rest days are placed, i'm not sure it's much to talk about. I mean team sizes have changed, so how do you compare a GC rider who had 11% more team support over the race in 2017 than another in 2018 who didn't and stuff like that. How does that affect things like average speed for a GC leading team on the front the whole day. Effectively they are having to do more work and so will be slightly slower over a stage, but their watts and stress scores are probably higher than the previous year with 11% more team to share the load. Does that mean the GC leader is just as fresh, or did he work more with one less riders slipstream and stuff like that.
 
Mar 18, 2009
148
0
0
Re:

samhocking said:
It's interesting viewing club amateur road racing speeds and TT records where one assumes at least EPO & Blood is not used, yet all average speeds are 4-7% faster. Even local weekly crit races, what we used to race at around 24-25mph average are today 27-28mph and that's same 1 hour + 3 laps, same time each evening, probably about the same numbers. Always amazes me looking back even 10 years the difference.
Where am I going with it, not sure, just I'm not convinced club mates in the area are doping more today than 10 years ago, so is it simply improvement in the bikes, training, training with power, better nutrition and recover understanding etc. Not sure, but it gradually increases it seems anyway and I would highly doubt there's much PED abuse going on at such a low level to significantly allow everyone to improve.
Are you in the UK? Given the growth of cycling there, a lot could be put down to an increased talent pool. My local crits, given the decline in road cycling in North America, seem about the same.
 
It might be, but there's always been Pro riders come out of the local area over the 20 years who were part of the crit training. I think it's just everyone knows how to train properly today and the bikes and clothing are so much more aero. I guess it's just the modernisation of amateur cycle racing.
 
I happened to obtain a copy of the 350+ page PhD of Dutch reseacher Bram Brouwer, published also as a book De mythe van de rode bloedcel in which he goes through the material about the efficacy of rHuEPO and (thinks that he) debunks them.

While I don't read Dutch, the abridged 20 page English summary of the thesis is a very interesting to read, because it is an interesting look into the way the rHuEPO-skeptics think and it is simultaneously superficially convincing even when there are a few strawmans and objections that have been addressed elsewhere such as these:

- Very weak or no correlation between intraindividual Hb concentration and performance/Vo2Max.
- Viscosity counteracts the benefit of extra oxygen carrying capacity of "doped" blood.
- Training doesn't increase hematocrit but absolute the contrary, so lower diluted Hct is beneficial from performance viewpoint.

I've never quite figured out what is the "Dutch" recommendation for anti-doping policy (if there is one uniform approach), but Brouwer doesn't outrule even taking blood doping out of the banned list:
One may even question whether RBC doping should be considered to be doping. After all, altitude training and low-altitude tents (or hotel rooms) give almost the same effects (more red blood cells) and are not classified as doping. That seems arbitrary.
...
We advise an anti-doping policy based on compliance, where the goal is to convince the cyclists with objective information that the use of doping is not only unwise, but even stupid. Indeed, doping seems to harm aerobic performances rather than enhancing them, similar to classical doping. Such a policy may be more productive and will very likely cost a fraction of the current expenses.
 
Aragon said:
I happened to obtain a copy of the 350+ page PhD of Dutch reseacher Bram Brouwer, published also as a book De mythe van de rode bloedcel in which he goes through the material about the efficacy of rHuEPO and (thinks that he) debunks them.

While I don't read Dutch, the abridged 20 page English summary of the thesis is a very interesting to read, because it is an interesting look into the way the rHuEPO-skeptics think and it is simultaneously superficially convincing even when there are a few strawmans and objections that have been addressed elsewhere such as these:

- Very weak or no correlation between intraindividual Hb concentration and performance/Vo2Max.
- Viscosity counteracts the benefit of extra oxygen carrying capacity of "doped" blood.
- Training doesn't increase hematocrit but absolute the contrary, so lower diluted Hct is beneficial from performance viewpoint.

I've never quite figured out what is the "Dutch" recommendation for anti-doping policy (if there is one uniform approach), but Brouwer doesn't outrule even taking blood doping out of the banned list:
One may even question whether RBC doping should be considered to be doping. After all, altitude training and low-altitude tents (or hotel rooms) give almost the same effects (more red blood cells) and are not classified as doping. That seems arbitrary.
...
We advise an anti-doping policy based on compliance, where the goal is to convince the cyclists with objective information that the use of doping is not only unwise, but even stupid. Indeed, doping seems to harm aerobic performances rather than enhancing them, similar to classical doping. Such a policy may be more productive and will very likely cost a fraction of the current expenses.
WRT should RBC doping be allowed.

First, and foremost, performance enhancing is - as we all know - only one of three criteria used to ban substances / methods. The other two are danger and image. Recent research says that blood transfusions were banned primarily on health grounds, contaminated blood. You could argue that might have been a problem in the 80s, when other people's blood was being used, but not so today, when athletes use their own. But anecdotal evidence, from Hamilton to Riccò, might suggest there is still a danger with blood bags, a danger one does not associate with altitude training or oxygen tents.

The image issue: in the 1970s, there was clearly an image problem. In the 1980s, there was clearly an image problem. That image problem is still there today.

Brouwer's argument seems like a lot of the nonsense put forward by critics of the current anti-doping system: it is not based on the current anti-doping system, it is based on what Brouwer thinks an anti-doping system should be doing.
 
Re: Re:

hulkgogan said:
samhocking said:
It's interesting viewing club amateur road racing speeds and TT records where one assumes at least EPO & Blood is not used, yet all average speeds are 4-7% faster. Even local weekly crit races, what we used to race at around 24-25mph average are today 27-28mph and that's same 1 hour + 3 laps, same time each evening, probably about the same numbers. Always amazes me looking back even 10 years the difference.
Where am I going with it, not sure, just I'm not convinced club mates in the area are doping more today than 10 years ago, so is it simply improvement in the bikes, training, training with power, better nutrition and recover understanding etc. Not sure, but it gradually increases it seems anyway and I would highly doubt there's much PED abuse going on at such a low level to significantly allow everyone to improve.
Are you in the UK? Given the growth of cycling there, a lot could be put down to an increased talent pool. My local crits, given the decline in road cycling in North America, seem about the same.
I believe all the aero equipment really does add up to something, especially the clothing. I look at pictures of myself and friends from 10 years ago and laugh at the parachutes we wore. I also suspect that amateurs train more now because of social media pressuring them to always be riding.
 
Re: Re:

Here is an interesting chart where data from five quite similar blood reinfusion studies (900 ml, cryopreserved) have been put together with the X-axis being the initial relative Vo2Max-level of the subjects (ml/kg/min) and the Y-axis the change in % (the data is from Sawka et al review + the data from Spriet et al 1986 reinfusion study, blue lines are averages of 40-49, 50-59 etc):

It at least heavily looks as if the Vo2Max-figure increases significantly less the higher the initial level is and this can't be due to Hb mass being increased significantly less with elites vs. recreational athletes, because the subjects of the Canadian studies (Buick/Spriet) with elite level athletes had their blood volumes (~5,5 l) and Hb concentrations (~15 g/dl) quite normal, and correspondingly their total Hb increased on average by more than 10 % after reinfusion.

Unfortunately there is no comparable extra data from elite level athletes, and it is an open question whether FTP value is influenced by the (presumed) lowish Vo2Max increase.
 
I might get this one (slightly) wrong having no background in statistics (had a few courses when I studied programming some fifteen years ago), but here is another paragraph from the Bram Brouwer thesis about the rHuEPO studies that I found interesting:
The sub-study [of the thesis] analyzed the results of 59 comparisons in 17 laboratory studies on the ergogenic effects of EPO and examined effect sizes (unbiased d and r2) of the EPO-stimulated increases in aerobic performance capacity in these EPO studies (expressed in VO2max, PAmax and other measurements). The effect size (d) is a dimensionless statistical measure of the strength of a phenomenon, in our case the improvement in aerobic capacity after EPO treatment. For reliable results the first analysis showed too much heterogeneity. When restricting analyses to maximal performances demonstrated by participants at sea level in double-blind, placebo-controlled studies the disturbing heterogeneity disappeared and the fixed pooled effect sizes were moderate: d = 0.41–0.49. In ~67 - ~72.6%, the experiments could not distinguish whether the progression of aerobic performance capacity could be attributed to EPO or not. The associated amounts of variation in aerobic capacity attributable to EPO treatment (explained variance or r2) varied between 4–19%. This suggests that a considerable 81–96% of the differences in improvement in aerobic exercise capacity observed in the EPO studies cannot be attributed to the EPO treatment. This means that other, yet unknown, variables influenced participants’ performances in these studies to a considerable extent.
The actual paper Brouwer refers in his thesis was published in a peer-reviewed journal a few years ago and was easy to locate and is available on the Internet:


It seriously looks as if the paper has a major shortcoming when the Dutch researchers observe that "EPO treatment" gives too heterogenonus results and most of the results must be caused by some other factor than the hormone. But their error is that they aren't at all interested about dose used or how long the treatment lasted and seem to think that every "EPO treatment" should give similar outcome. But - for instance - there is chart in one review by Carsten Lundby and Paul Robach in which different administration protocols of different durations caused the mean Hb/Hct of only eleven different cohorts to increase between 6.6 % and 19.0 %:


It actually would be interesting if someone calculated how much heterogeneity there is in rHuEPO-studies with similar increases in Hb/Hct level or if there is some close to fixed ratio between increase in Hct/Hb and increase in Vo2Max in studies where Hct/Hb has had a different increase.
 
I might get this one (slightly) wrong having no background in statistics (had a few courses when I studied programming some fifteen years ago), but here is another paragraph from the Bram Brouwer thesis about the rHuEPO studies that I found interesting:
Without reading this paper and going over the results in detail, I'll just point out that early studies of EPO showed that the really large effects are not on V02max or maximum power output--studied by these authors--but in the ability to prolong sustainable power. One often-quoted study, e.g., found that there was > 50% increase in the time to exhaustion.

In fact, the authors refer to this in the introduction, when they say, "findings of field research [11,12,13,14,15]suggest that VO2max is but one of the many determinants of endurance performance and other variables, such as lactate metabolism and biomechanical efficiency [11], also constitute important factors." This is certainly true, but then the question becomes, to what degree does EPO affect sustainable power?

I now see that the authors did consider some studies of sub-maximal power, but their main emphasis is on V02max and maximum power (Wmap). If I understand them correctly, their main conclusion seems to be that the effect of EPO is rather small compared to the variation observed that isn't attributable to EPO, but then the question becomes, why is the variation so great? The absolute effects on V02max and Wmap seem to be fairly significant, and could definitely give racers an advantage, and we don't see huge variations in other factors during an actual race. Or do we?
 
Last edited:
The Vo2Max-issue is an interesting one, because whereas mainstream view is that it almost equals performance, the Dutch skeptic view is that it is a "mismeasure of man" (to use term popularized/invented by paleontologist Stephen Jay Gould).

While there is an interindividual correlation between Vo2Max and performance, it is indeed not clear if blood doping- induced increases in Vo2Max or power output at Vo2Max - as such - have much of a performance boosting effect if absolute velocity/Watts at thresholds (OBLA, LT) aren't increased, because the latter correlate far better with level of sustainable speed as the Dutch guys like to emphasize.

But as Dr. Michael J. Joyner pointed out when commenting another Dutch rHuEPO-review a few years ago, the idea is that while the thresholds remain proportionally same as a percentage of Vo2Max after rHuEPO treatment, "a rising tide lifts all boats":
It goes back to basic exercise physiology and the science of how races are won, Joyner says. The researchers don’t understand the relationship between VO2 max—your body’s maximum ability to consume oxygen, or your “performance ceiling”—and other metrics like lactate threshold, a key predictor of endurance performance, Joyner says.
...
“They don’t realize that your lactate threshold is a percentage of your VO2 max,” he says. “If your LT [lactate threshold] normally is 80 percent of VO2 max, and your VO2 max goes up, it’s 80 percent of a higher number. Your performance improves.”
I seriously do hope that other researchers have had deeper interest into the subject, because with all respect to Dr. Joyner, there is very limited evidence that the percentage of sustaineable power (his 80 %) remains the same as percentage of Vo2Max after blood doping even when it LT/OBLA etc. tend to increase more-or-less in absolute terms.

- When Dr. Björn Ekblom coauthored a blood reinfusion paper (Celsing et al. 1987), elevating total Hb by some 15 % increased Vo2Max by 7 %, but speed at 4 mmol increased ona average only by 2 %. "The Vo2Max at [4 mmol] was calculated to increase by an average of 100 ml, compared to the 420 ml increase in Vo2Max," the authors write. "Accordingly, a leftward shift of the blood lactate curve in relation to the oxygen uptake, as expressed as a percentage of the individual's Vo2Max, was noted".

- There is the study (Thomsen et al, 2007) in which submaximal TTE (80 % of baseline-Vo2Max) was increased by over 50 % (~35 vs 22 min) after rHuEPO treatment when the scientists used the same fixed workload after Vo2Max had increased by 12-13 % (ie. the latter was ~68-69 % of the new Vo2Max). But when the same guys tried to cycle at 80 % of the new Vo2Max, their performance time was worse after the rHuEPO treatment and fell by some 27 % (~16 vs 22 min) when compared to baseline even when their lactate readings were higher (c:a 12 vs. 10).

- Just by going through a handful of studies, there seems to be generally a fall in lactate at submaximal intensities in the blood doping papers, and interestingly LT as a % of Vo2Max falls only slightly (from ~91 % to ~88-89 % by only some 2.5 %) in the tests of the Mont Ventoux - paper from 2017 in the rHuEPO-group. Because Vo2Max has been increased by almost 10 %, there was only slightly lower increase in the power output at LT (290 W vs 305-310 W).

Of course the key criticism by the Dutch researchers is valid even today -- In the end we don't really know how much of a performance boost elites get from blood doping regimens in absense of reliable data. Even the anecdotes are tricky if 100 % accurate, e.g. leaving aside training effect, if JV observed some 4-6 % boost in his watt output after taking rHuEPO, it can simultanously be totally true that watt output at a given submaximal heart rate zone (e.g. 120-130 BPM) increased by some 4-6 % but that watts at LT (and "true" performance) increased far less (or not at all), if LT-heart rate fell too much (e.g. from 175 to 170 or 165).
 
Reactions: PrimusPilus12
Interesting stuff. As a follow-up / sidenote to the view that maybe we need to look beyond vo2max.

My thinking has been for a long time that for grand tour riders especially a high ceiling (vo2max or wattage at vo2max) is required, but the rate of utilization of vo2max at the threshold output is probably even more important. Climbs are long. On this topic, there was a quite recent and interesting talk by Dan Lorang, who coaches Bora. The audio quality sucks, though. Among other things such as laying bare the framework he uses, Lorang analyses changes in the performance determinants of an elite climber (my guess: Buchmann) after a successful training and altitude block in 2018.

In the talk Lorang works with the vo2max & vlamax framework. Vlamax is the anaerobic counterpart of vo2max, ie maximum ability to produce lactate over a given period (usually mmol / sec). These two variables co determine threshold and often, but not always, move in opposite directions. There is quite a bit of vlamax literature out there, but I am not an expert. Alois Mader is a scholar who often features, and so does Sebastian Weber who too has coached elite cyclists (HTC, tony martin).

In brief, In Lorang's talk (arond 30-35min) the rider's Vo2max and rate of utilization also seem to have moved into different directions in the relevant blocks in april-june 2018. First, after a vo2max peak is attained, fractional utilization starts to increase and vo2max decreases, probably thanks to training intervention to decrease vlamax. At vo2max level output a significant part of the energy demands are met via anaerobic sources, so the two moving in opposite directions is quite logical. Then the process is reversed after fractional utilisation has peaked, and vo2max starts to increase again while threshold decreases. Also, fatmax wattage (wattage at max fat combustion, essentially the ability to ride tempo for a long time) also moves with fractional utilization.

If this is so, then clearly the team and the rider were willing to sacrifice some of his vo2max in order to gain in threshold and fatmax. So indeed, just looking at vo2maxes would not give the correct picture of relevant performance metrics, and to relate all this to epo/blood doping becomes more complex still. My assumtion remains that there is a tangible benefit. I mainly posted so as to offer additional info about what training parameters at least Bora coaches track and what kind of developments they consider successful outcomes.
 
Reactions: PrimusPilus12
Must be buddies with Cancer Jesus to sling this nonsensical BS around. What's even funnier, is that people here actually believe this, then again, I'm not surprised, as many of you believed Wonderboy and believed every word out of his mouth for over a decade, so there you go.
 
Reactions: fmk_RoI
Must be buddies with Cancer Jesus to sling this nonsensical BS around. What's even funnier, is that people here actually believe this...
Who the hell are you talking about?

Because I am not sure if I have seen anyone "believing" in the Dutch research here and taking the claims at face value, on the contrary even the most pro-Armstrong folks have had their criticism of the claims that rHuEPO is apparently useless.
 
Reactions: fmk_RoI
Who the hell are you talking about?

Because I am not sure if I have seen anyone "believing" in the Dutch research here and taking the claims at face value, on the contrary even the most pro-Armstrong folks have had their criticism of the claims that rHuEPO is apparently useless.
The "Dr(s)" who did the "research". You missed the sarcasm. I was saying that these Drs must be friends with Cancer Jesus and pissed off he got busted, so they created some phony nonsensical "EPO is useless" nonsense.

Try to keep up.
 
Reactions: fmk_RoI
There are two apparent problems with your key claim:

1) Some random rHuEPO-skeptic Dutch language articles started appearing in the academic journals at latest around 2006-2009 if not earlier going totally unnoticed by the media, well before the USADA case started. Just look for names of Kuipers, Brouwer, Lodewijkx etc. from GoogleScholar. Of these "skeptics", I think Kuipers actually does think that rHuEPO is an effective drug, but coauthors some material with the other "Dutch Drs" because he sees some problems with the standard narrative.

2) Lance Armstrong hasn't vouched for the credibility of the "Dutch" material, but continues to describe rHuEPO as "10 % drug", "game changer", "drug without which one couldn't compete" etc.
 
Reactions: fmk_RoI

ASK THE COMMUNITY

TRENDING THREADS