Hematocrit Levels

[Anonymous]

So the typical male is walking around with a hematocrit in the low 40's, with the UCI limit at 50%. It would seem that realistically the best PED for cycling is the red blood cell, not steroids or HGH. The one thing that is going to get you up the hill faster is more oxygen carrying capacity via the red blood cell.

So how does a proposed doper explain a hematocrit at one point in the season of say 41%, then suddenly have a hematocrit of say 48% during the tour?

Also, how much time do the athletes have to tweak their levels before a potential doping control?

 

[Max Cadence]

So how does a proposed doper explain a hematocrit at one point in the season of say 41%, then suddenly have a hematocrit of say 48% during the tour?

Cite erroneous testing of the previous test.

Also, how much time do the athletes have to tweak their levels before a potential doping control?

A twenty minute shower should do the trick.

 

[Escarabajo]

So the typical male is walking around with a hematocrit in the low 40's, with the UCI limit at 50%. It would seem that realistically the best PED for cycling is the red blood cell, not steroids or HGH. The one thing that is going to get you up the hill faster is more oxygen carrying capacity via the red blood cell.So how does a proposed doper explain a hematocrit at one point in the season of say 41%, then suddenly have a hematocrit of say 48% during the tour?

Also, how much time do the athletes have to tweak their levels before a potential doping control?

Dehydration is another excuse. Check Dr. Ferrari website on this topic.
http://www.53x12.com/do/show?page=article&id=24

 

[elapid]

So the typical male is walking around with a hematocrit in the low 40's, with the UCI limit at 50%. It would seem that realistically the best PED for cycling is the red blood cell, not steroids or HGH. The one thing that is going to get you up the hill faster is more oxygen carrying capacity via the red blood cell.

You are correct. The red blood cell contains hemoglobin and hemoglobin is the oxygen-carrying molecule. The only way to increase oxygen-carrying capacity is to increase hemoglobin and the only way to do that is increase the number of red blood cells. This is frequently expressed as a hematocrit or packed cell volume (PCV). Blood transfusions and EPO are the two best methods of increasing hematocrit. However, there is more to doping than just improving performance. Recovery is also essential and that's where testosterone and HGH come into the mix. Natural production of testosterone is decreased with hard training and three-week racing, and this limits the body's ability to recover. Testosterone reverses this natural deficiency and helps the body to recover so cyclists can train/race hard the following day.

So how does a proposed doper explain a hematocrit at one point in the season of say 41%, then suddenly have a hematocrit of say 48% during the tour?

Pretty hard to explain it. The old 50% rule was introduced as more of a safety limit because riders were dropping dead because their blood was like sludge. A study of 353 cyclists competing in the TdF from 1980-1986 (ie, pre-EPO) showed a mean hematocrit of 43% and a range of 39-48%. Furthermore, Daamsgard's recently published their findings from internal tests of CSC and Astana from 2006-2007 and found that the mean hematocrit decreased by 4.3% during the racing season and this returned to normal during the off-season. So, in answer to your question, hematocrit should decrease during the season and an increase from 41% to 49% cannot be explained rationally. Some athletes claim an increased hematocrit with altitude tents and/or training at altitude, but this increases hematocrit by only 3-4%.

Also, how much time do the athletes have to tweak their levels before a potential doping control?

Good question. This is why there was such a controversy over Lance's recent absence during a visit from a drug tester, and also with Astana during the TdF. You can quickly dilute your intravascular volume with intravenous fluids to decrease your hematocrit (minutes). Drinking heaps will achieve the same effect but obviously takes longer. Most drug tests are done after the finish of races, and PEDs like HGH are not detectable after 2-3 hours. That's why many recommend pre-race drug tests rather than post-race.

 

[elapid]

Dehydration is another excuse. Check Dr. Ferrari website on this topic.
http://www.53x12.com/do/show?page=article&id=24

Trouble with the dehydration argument is that the measurement of total protein, which is quickly done (ie less than 10 seconds) at the same time as the hematocrit, will rule in or out dehydration. High total protein with high hematocrit = dehydration; normal total protein with high hematocrit = doping.

 

[Escarabajo]

Trouble with the dehydration argument is that the measurement of total protein, which is quickly done (ie less than 10 seconds) at the same time as the hematocrit, will rule in or out dehydration. High total protein with high hematocrit = dehydration; normal total protein with high hematocrit = doping.

Do they actually do it in the tests during a race?

 

[Escarabajo]

Pretty hard to explain it. The old 50% rule was introduced as more of a safety limit because riders were dropping dead because their blood was like sludge. A study of 353 cyclists competing in the TdF from 1980-1986 (ie, pre-EPO) showed a mean hematocrit of 43% and a range of 39-48%. Furthermore, Daamsgard's recently published their findings from internal tests of CSC and Astana from 2006-2007 and found that the mean hematocrit decreased by 4.3% during the racing season and this returned to normal during the off-season. So, in answer to your question, hematocrit should decrease during the season and an increase from 41% to 49% cannot be explained rationally. Some athletes claim an increased hematocrit with altitude tents and/or training at altitude, but this increases hematocrit by only 3-4%.

They don't only check for hematocrit level but for the "Off Score", right?
Do they do that during the race?
http://trustbut.blogspot.com/2008/08/blood-values-landis-garmin-and-that-485.html

 

[elapid]

Do they actually do it during the tests?

Good question. Jackhammer asked me the same thing in another thread a couple of months ago. I don't know. I don't see why they shouldn't. We run both hematocrit and total protein together on every patient we do blood tests on (and have done this in every hospital I have worked in in Australia, America and Canada). This can be done manually or, more commonly, using automated means. Automated techniques include a complete hematological profile including total protein (as well as other factors like reticulocytes and white blood cells).

So although I don't know the answer to your question, it would surprise me if they were not. I think Dr. Ferrari is trying to pull the wool over the eyes of non-medical cycling fans because as a hematologist he definitely knows about total protein and dehydration.

 

[BroDeal]

So how does a proposed doper explain a hematocrit at one point in the season of say 41%, then suddenly have a hematocrit of say 48% during the tour?

They have never had to explain it. The UCI has looked the other way as long as a rider's hematocrit did not go over 50% (or a while after the simple 50% rule, the more complicated criteria that includes the off score). If we had hematocrit data from the last ten years at the Tour then I am sure we would see some wild fluctuations or surprisingly stable high hematocrits.

Supposedly the bio passport changes this, and the variation will set off alarms. So far the ones most likely to be blood doping, contenders for the top ten in GTs, have been untouched by the passport.

 

[Escarabajo]

Good question. Jackhammer asked me the same thing in another thread a couple of months ago. I don't know. I don't see why they shouldn't. We run both hematocrit and total protein together on every patient we do blood tests on (and have done this in every hospital I have worked in in Australia, America and Canada). This can be done manually or, more commonly, using automated means. Automated techniques include a complete hematological profile including total protein (as well as other factors like reticulocytes and white blood cells).

So although I don't know the answer to your question, it would surprise me if they were not. I think Dr. Ferrari is trying to pull the wool over the eyes of non-medical cycling fans because as a hematologist he definitely knows about total protein and dehydration.

Thanks.

 

[elapid]

Supposedly the bio passport changes this, and the variation will set off alarms. So far the ones most likely to be blood doping, contenders for the top ten in GTs, have been untouched by the passport.

And known dopers like Kohl, Schumacher and Rebellin.

 

[Dr. Maserati]

They have never had to explain it. The UCI has looked the other way as long as a rider's hematocrit did not go over 50% (or a while after the simple 50% rule, the more complicated criteria that includes the off score). If we had hematocrit data from the last ten years at the Tour then I am sure we would see some wild fluctuations or surprisingly stable high hematocrits....

Here are some values from the Gewiss Ballan team which was heavily involved with EPO: This was well before the 50% rule.
December 15, 1994 to the second figure which was taken on May 24, 1995.

Vladislav Bobrik (Rus) : 42.7 to 53
Bruno Cenghialta (Ita): 37.2 to 54.5
Francesco Frattini (Ita) : 46 to 54
Giorgio Furlan (Ita) : 38.8 to 51
Nicola Minali (Ita) : 41.7 to 54
Piotr Ugrumov (Rus) : 32.8 to 60
Alberto Volpi (Ita) : 38.5 to 52.6

 

[BroDeal]

Here are some values from the Gewiss Ballan team which was heavily involved with EPO: This was well before the 50% rule.
December 15, 1994 to the second figure which was taken on May 24, 1995.

Vladislav Bobrik (Rus) : 42.7 to 53
Bruno Cenghialta (Ita): 37.2 to 54.5
Francesco Frattini (Ita) : 46 to 54
Giorgio Furlan (Ita) : 38.8 to 51
Nicola Minali (Ita) : 41.7 to 54
Piotr Ugrumov (Rus) : 32.8 to 60
Alberto Volpi (Ita) : 38.5 to 52.6

Straight from Dr. Ferrari's files...

You have to love Ugrumov's figures. From 33% to the real Mr 60%. The strength of ten grinches plus two.

Ivan Gotti should also be in there. I remember his figures topping out at 58%. Riis was at 56% during this same time frame.

 

[tockit]

Straight from Dr. Ferrari's files...

You have to love Ugrumov's figures. From 33% to the real Mr 60%. The strength of ten grinches plus two.

Ivan Gotti should also be in there. I remember his figures topping out at 58%. Riis was at 56% during this same time frame.

Anyone know where Indurain fell in this category?

 

[Anonymous]

This is why there was such a controversy over Lance's recent absence during a visit from a drug tester, and also with Astana during the TdF. You can quickly dilute your intravascular volume with intravenous fluids to decrease your hematocrit (minutes). Drinking heaps will achieve the same effect but obviously takes longer. Most drug tests are done after the finish of races, and PEDs like HGH are not detectable after 2-3 hours. That's why many recommend pre-race drug tests rather than post-race.

So a rider wins a stage, then what are the next chain of events that occurs before a doping control. He crosses the finish line, then what? Specifically, on average, how long until a doping control? And with that, does he have time alone where he could have someone pop in an IV and infuse a couple liters of saline on a pressure bag over 15 minutes?

I'm just trying to figure out the real world logistics of how a rider would pull off doping in a hectic tour schedule.

 

[elapid]

So a rider wins a stage, then what are the next chain of events that occurs before a doping control. He crosses the finish line, then what? Specifically, on average, how long until a doping control? And with that, does he have time alone where he could have someone pop in an IV and infuse a couple liters of saline on a pressure bag over 15 minutes?

I'm just trying to figure out the real world logistics of how a rider would pull off doping in a hectic tour schedule.

Doping controls are pretty tight. After a stage, they are basically taken straight from the finish to the doping control. For out-of-competition tests, the tester should always be in the presence of athlete. So there is not much opportunity to manipulate your plasma volume around the time of testing.

I think the answer to your question really lies in the doctors and their programs. There is a link in this or another thread that Digger posted regarding an athlete caught in the BALCO scandal: doctor basically tells the athlete to stop getting worried if he has stuck to the program. He did not test positive. The dopers and their doctors are usually ahead of the testers.

 

[Parrot23]

And what is it that they drink when they are very closely shepherded by a team staff person right at the finish line as they finish?

I always see these folks very present at the finish: innocent enough, but I'd like to know what they give "some" riders to drink.

Can there be quick absorption liquids designed to mask whatever (surely there are some liquids that absorb faster than straight up water/sports drinks)? Then again, funny stuff would show up on the blood test, wouldn't it?

 

[Anonymous]

Doping controls are pretty tight. After a stage, they are basically taken straight from the finish to the doping control. For out-of-competition tests, the tester should always be in the presence of athlete. So there is not much opportunity to manipulate your plasma volume around the time of testing.

So how do alleged long term dopers (nameless in this discussion) continually manage to avoid detection?

How are they hemodiluting or getting a hematocrit within the parameters? Or are they just hovering at 47-49% and calling that their physio norm?

 

[elapid]

So how do alleged long term dopers (nameless in this discussion) continually manage to avoid detection?

How are they hemodiluting or getting a hematocrit within the parameters? Or are they just hovering at 47-49% and calling that their physio norm?

Hematocrit is easily manipulated by diluting the intravascular volume, and this can be done by overhydrating (whether it by with intravenous fluids or drinking copious amounts of fluids). Some riders, notably Ricco in the recent past, had TUEs for "naturally high" hematocrits but this is absolute BS for riders that do not live year around at altitude. A study from 300+ TdF riders between 1980-1986 (ie, pre-EPO) showed a mean hematocrit of 43% with a range of 39-48%.

However, hematocrit alone is no longer important. The biological passport uses other parameters to identify doping, such as reticulocytes (immature red blood cells). Reticulocytes are decreased with EPO for instance. So it is now harder to dope with EPO because the biological passport should identify EPO use. Should ... But team doctors, and even the results of the biological passport (at least according to Kohl), are used to fine tune blood results because they can monitor these internally.

In regards to your first question, dopers avoid detection because they are usually ahead of the testers. They stay ahead because of good doctors, good programs, and the cutoffs for the tests being set too high (for legal reasons) to catch the dopers. See Digger's post which details an excerpt from Dwaine Chamberlain's book about BALCO, drug testing, and a phone call with his doctor (http://forum.cyclingnews.com/showthread.php?p=48717&highlight=balco#post48717). This is revealing and probably answers your first question well.

 

[R.0.t.O]

Why fuss around with raising your crit level when PFC molecules will carry 40-50 times more oxygen than hemoglobin and are expelled by breathing? Someone will have cracked a protocol for using these in sport for sure, and it might even be leading to some more 'compelling' crit numbers.

 

[mountaingoat]

what are pfc molecules?