Naturally high hematocrit levels

[craig1985]

Dario David Cioni has one, as does Damiano Cunego, Markus Fothen, and even Riccardo Ricco has one (these are just four examples), and they all have a letter from the UCI stating that this is the case, and this is taken into account when they do their blood profiles.

If a rider gets pulled up for having a hematocrit level over %0%, he is suspended. But these guys levels are naturally over 50% (?). So how does this occur? Were these guys born and raised at high altitude (or maybe in the Himalayas, or some sort of genetic freak (and most people on here have debunked LA's claim that he has a a much larger heart and set of lungs and can scoop in my oxygen. I'm not sure if it has been proven to be a ie, will stand to be corrected)?

 

[karlboss]

Lance does have a larger heart and lungs than most people, but then so does everyone he races, thats typical of elite athletes. Yes some athletes have high Hct, again, this is one reason they excel. Sometimes related to altitude sometimes not. Often proven through a family member.

 

[Alexzulle]

There is a genetic blood condition called polycythemia which basically results in massive hct values throughout life. My dad had it, and basically had a crit of between 55-65 his entire life. While it explained alot of his personal physiology (collegiate track star with minimal training, unexplained ability to work multiple 22 hour days in med school and residency) it comes with a rather sad side effect of extremely high risk for AML leukemia, which killed him in about a week at the age of 60.

I didn't actually know this until he was in the hospital and the doctor came in with the results of a blood test and when he should have been anemic (low hct) due to the leukemia he had an hct of 57. He then said he had a high hct his whole life.

Finding that out explained alot, like how I (27 year old cat III) was not able to drop a 60 year old man 2 weeks before he died when he had only been cycling for about 2 years.

So yes, it is entirely possible to have huge crits naturally, however there are serious consequences to this 'advantage'.

edit. I got curious about this recently, as I am pretty competitive without serious training, and while i'm not nearly at his level I have a natural crit of around 49.

 

[ak-zaaf]

edit. I got curious about this recently, as I am pretty competitive without serious training, and while i'm not nearly at his level I have a natural crit of around 49.

START TRAINING DAILY NOW.

Do you know how many people would kill (themselves slowly) for that kind of (natural) advantage.

 

[Alpe d'Huez]

Good post Alex, thanks for sharing.

I believe Kevin Livingston had a naturally high HCT over 50. Our own BroDeal does as well.

Physiology is a fascinating study. I had my HCT taken once at the age of 29, it was 42. I've been lucky in another regard though in that I respond quite well to altitude training. Once I acclimate, I'm good to go. Use to climb mountains, fairly hard core. Getting over 20,000' wasn't an issue. I felt like I easily could have gone up another few hours, or days. Should have tried an 8,000m peak when I was younger/fitter/single. (Sorry for the digression!)

 

[Alexzulle]

HA. Would love to have lots of time to train but unfortunately i'm in medical school now and most of my 'training' is done in a library.

One thing I noticed about both of us (my dad and I) is that when whenever we went to a very high altitude (like 10,000 feet at copper mountain, we got very sick for a few days, more so than most and more so than my brothers who have more normal crits) My dad had it even worse off than me. I actually learned that this is most likely due to the fact that our tissues are used to having more oxygen than a person with a lower crit, so when we went to a low oxygen environment we were immediately affected more than a person whose tissues were used to less oxygen. Once acclimated we were fine, and I loved going to altitude for a week, getting somewhat acclimated, then coming back to low altitude as I was superman for a few days.

 

[blackcat]

Dario David Cioni has one, as does Damiano Cunego, Markus Fothen, and even Riccardo Ricco has one (these are just four examples), and they all have a letter from the UCI stating that this is the case, and this is taken into account when they do their blood profiles.

If a rider gets pulled up for having a hematocrit level over %0%, he is suspended. But these guys levels are naturally over 50% (?). So how does this occur? Were these guys born and raised at high altitude (or maybe in the Himalayas, or some sort of genetic freak (and most people on here have debunked LA's claim that he has a a much larger heart and set of lungs and can scoop in my oxygen. I'm not sure if it has been proven to be a ie, will stand to be corrected)?

all those riders have fraudulent passes imo

 

[craig1985]

all those riders have fraudulent passes imo

If Fothen is doping, then he should get a refund IMO. Or a better doctor/supplier.

 

[blackcat]

If Fothen is doping, then he should get a refund IMO. Or a better doctor/supplier.

see the 2006 Tour when he was about 10th overall for most of the Tour til he dropped a few places and Cunego took the white jersey off him.

He also had a problem in the Deutschland espoir setup with Wegmann. When he won the world u23 tt champs.

 

[elapid]

I agree with Blackcat. The likelihood that these cyclists have naturally-occurring hematocrits greater than 50% is extremely unlikely. BroDeal's high hematocrit can be explained by the fact that he lives and trains permanently above 5000 feet. Professional cyclists in the Pro peloton do not live and train permanently at high altitudes. Some like Alexzulle's father and my father (who has acquired rather than genetic polycythemia) have conditions which increase their hematocrit to freakishly high levels, but this would not explain cyclists on the borderline of the 50% mark. In one study of 353 professional cyclists competing in the TdF before the EPO era and at the start of the blood transfusion era (1980-1986), the mean hematocrit was 43% and the range was 39-48% (Saris and others, Lancet, 1998). The situation should not be any different in the current peloton if it weren't for EPO and blood transfusions.

 

[Alpe d'Huez]

Good research on the pre-EPO era study Elapid. It would be interesting to see what the mean HCT level is in a similar study today. One could do it with the biological passport fairly easily. Though even those numbers may be askew, because of other forms of manipulation to avoid detection discussed many times here in the past.

Also curious to see what Cunego's numbers are today on hct. If he got a pass which likely dates to about 2004 or maybe even earlier. And in his statements from this past May he told the truth between the lines that he doped in the past, but now rides clean...

Forgot where BroDeal lived, good point.

 

[Oldman]

START TRAINING DAILY NOW.

Do you know how many people would kill (themselves slowly) for that kind of (natural) advantage.

It is a recovery advantage. I've run a 48-49 my doctor attributes to bad early season allergies (like altitude workouts). Trouble is, I can't go into the red zone. Once the allergies go away I feel great but the body seems to equalize, somewhat. The real advantage is when you boost the MoFo up 6 points to 49 from a natural 43. That's turbo charging you can use.

 

[Galic Ho]

Lance does have a larger heart and lungs than most people, but then so does everyone he races, thats typical of elite athletes. Yes some athletes have high Hct, again, this is one reason they excel. Sometimes related to altitude sometimes not. Often proven through a family member.

Look up what happens to people with larger hearts. Massive health risks and complications to their general living. I've never heard of someone with an abnormally large heart not having serious complications. We are not talking about thoroughbred horses who do get performance benefits. Lance's heart is normal size. Look at the volume of blood it can pump in comparison to a non athlete. Efficiency and volume throughput, not size are where he differs.

Dario David Cioni has one, as does Damiano Cunego, Markus Fothen, and even Riccardo Ricco has one

How high are we talking in crit? I knew about Cunego but heard it was about 49 or 50. That is higher than normal but not freakishly high. I'd believe someone as high naturally as the 50% cut-off but more than that...nah. At least in theory the blood passport stops this. Riders have to be close to their normal levels, otherwise the statistics will show something amiss.

 

[craig1985]

see the 2006 Tour when he was about 10th overall for most of the Tour til he dropped a few places and Cunego took the white jersey off him.

He also had a problem in the Deutschland espoir setup with Wegmann. When he won the world u23 tt champs.

And he rode a strong Giro d'Italia the year before, where he and Wim van Huffel looked pretty good (and van Huffel has gone downhill quite a lot). But since 2007, he hasn't done a lot, save win a stage at the Tour of Romandie in 2007 and at the 2008 Tour of Switzerland when Frank Schleck crashed and went over the barrier when Schleck and Fothen were in a two man break.

Other then that he has been pack fodder and is usually in the autobus these days in the TdF, Giro, or Vuelta mountain stages.

I agree with Blackcat. The likelihood that these cyclists have naturally-occurring hematocrits greater than 50% is extremely unlikely. BroDeal's high hematocrit can be explained by the fact that he lives and trains permanently above 5000 feet. Professional cyclists in the Pro peloton do not live and train permanently at high altitudes. Some like Alexzulle's father and my father (who has acquired rather than genetic polycythemia) have conditions which increase their hematocrit to freakishly high levels, but this would not explain cyclists on the borderline of the 50% mark. In one study of 353 professional cyclists competing in the TdF before the EPO era and at the start of the blood transfusion era (1980-1986), the mean hematocrit was 43% and the range was 39-48% (Saris and others, Lancet, 1998). The situation should not be any different in the current peloton if it weren't for EPO and blood transfusions.

Where does he live, Colarado? Do forgive me though, that is the place in America that I can thing of that is high altitude (I know Denver is at high alt.). Anywhere else?

 

[elapid]

Where does he live, Colarado? Do forgive me though, that is the place in America that I can thing of that is high altitude (I know Denver is at high alt.). Anywhere else?

BroDeal lives in Colorado. I think he lives around the Steamboat area.

 

[CentralCaliBike]

And he rode a strong Giro d'Italia the year before, where he and Wim van Huffel looked pretty good (and van Huffel has gone downhill quite a lot). But since 2007, he hasn't done a lot, save win a stage at the Tour of Romandie in 2007 and at the 2008 Tour of Switzerland when Frank Schleck crashed and went over the barrier when Schleck and Fothen were in a two man break.

Other then that he has been pack fodder and is usually in the autobus these days in the TdF, Giro, or Vuelta mountain stages.



Where does he live, Colarado? Do forgive me though, that is the place in America that I can thing of that is high altitude (I know Denver is at high alt.). Anywhere else?

Flagstaff Arizona is over 7000 feet of altitude.

 

[Dr. Maserati]

Where does he live, Colarado? Do forgive me though, that is the place in America that I can thing of that is high altitude (I know Denver is at high alt.). Anywhere else?

That might explain why Jonathan Vaughters admitted he had a dispensation up to 52% while riding for USPS, although it does not explain why his teammates were all close to the 50%.

 

[Cerberus]

I agree with Blackcat. The likelihood that these cyclists have naturally-occurring hematocrits greater than 50% is extremely unlikely. BroDeal's high hematocrit can be explained by the fact that he lives and trains permanently above 5000 feet. Professional cyclists in the Pro peloton do not live and train permanently at high altitudes. Some like Alexzulle's father and my father (who has acquired rather than genetic polycythemia) have conditions which increase their hematocrit to freakishly high levels, but this would not explain cyclists on the borderline of the 50% mark.

Why wouldn't such a condition explain hematocrit values around 50? The study you cite merely prove that such high hematocrit values are unusual - not that they're impossible. Unless there is some specific reason it's impossible any performance enhancing medical condition should be overrepresented in elite athletes.

 

[python]

elevated hct/hg in endurance athletes is a well researched and fairly well understood issue.

even the effects of blood doping are quite well documented. - refer to the uci’s own zorzoli report to see how the peloton averages meandered in the 90s and 00s with the introduction of epo, blood transfusions etc. google on ashenden for in-depth understanding of hematology in cycling. He’s top notch in sports hematology.

Briefly,
(i) only about 3-4% of the general population have htcs above 50%. A similar figure applies to endurance athletes.
(ii) ashenden always advocated hct health limit of 52% not 50% as currently used by most nat federations.
(iii) it’s a great oversimplification if not a fallacy that the higher hct automatically translates into superior aerobic performance. it may but many more links in the aerobic chain exist and need to be strengthened.
(iiii) keep in mind the well documented athletic or pseudo anemia issue. iow, the natural increase in plasma volume in well trained endurance athletes. it’s an adaptation mechanism to reduce blood viscosity. it tends to lower hct by several points. iow paradoxically an un-doped totally detrained rider should have his hct higher than when in tip top.
(iiiii) uncontrolled increase in hct will (not may!) cause increase in vascular friction. at some point the increased ability to carry more oxygen by more rbcs will simply be negated by the reduced blood flow. athletes with older less flexible "pipes" will particularly be affected - if they survive!
(iiiiii) hct is no longer a primary blood index in sports medicine. hg is. because it’s 3 times less variable or a more stable parameter to deal with and measure (issues with rbc swelling depending on several conditions including the position during sample taking)

etc etc etc..

 

[karlboss]

High Hct is advantageous, but many physiological factors go into performance. As an example I used to race state level tri's did ok, Vo2 68, sustainable power 320w...took a few years off. First test back, Vo2 68 sustainable watts...250. Key point is most would expect guys with a similar Vo2 to perform similarly, clearly not.

 

[Alpe d'Huez]

BroDeal lives in Colorado. I think he lives around the Steamboat area.

I thought he was outside of Park City, Utah? He needs to come out of his cave and post for us.

Flagstaff Arizona is over 7000 feet of altitude.

Mammoth Lakes, California is about 8,000, but the town is very hilly, and parts reach 9,000'.

Here's a really cool site. It shows highest elevation towns per state. Lots of info there. Great for preparing your next "rbc altitude training" vacation.

 

[craig1985]

I know where I'm going for my next overseas training camp (that and Belgium and the French Alps).

 

[elapid]

Why wouldn't such a condition explain hematocrit values around 50? The study you cite merely prove that such high hematocrit values are unusual - not that they're impossible. Unless there is some specific reason it's impossible any performance enhancing medical condition should be overrepresented in elite athletes.

Primary polycythemia results in hematocrits in excess of 55%. My father's maximum hematocrit is around 65% and he is on blood thinners and is bled every 2-4 weeks with the aim to maintain a hematocrit around the 48-50% mark.

So, yes there are athletes out there who will have normal hematocrits higher than 50%, but primary polycythemia is not the reason for their high hematocrits. I also again point to the study of 363 TdF cyclists with a median hematocrit of 43% with none exceeding 48%. Why would so many professional cyclists in the preEPO era (1980-1986) have hematocrits less than 50% and not now? For this reason I am very suspicious of some of the cyclists with naturally high hematocrits because of their known doping history, particularly the likes of Ricco and perhaps Cunego.

 

[CentralCaliBike]

I thought he was outside of Park City, Utah? He needs to come out of his cave and post for us.

Mammoth Lakes, California is about 8,000, but the town is very hilly, and parts reach 9,000'.

Here's a really cool site. It shows highest elevation towns per state. Lots of info there. Great for preparing your next "rbc altitude training" vacation.

Not sure about a rbc altitude training vacation, seems a little obsessive to me I actually lived in Flagstaff for over a decade and really did enjoy riding up there when I found the sport (unfortunately I moved to Tucson right after getting into cycling). If you go there in the summer you can find a lot of riding and plenty of hill climb (fore-instance - up to the ski area which is about 8500 feet). You can also ride down to Sedona through Oak Creek Canyon which drops to 4300 feet in about 30 miles - the return ride is a little strenuous.

I have never been to Mammoth Lakes but my trips to that side of the Sierra has always been lacking in scenery - something that Flagstaff has plenty of with mountains with Pines, Aspens, and the ride to Sedona is one of the best I have ever been on.

 

[Sprocket01]

Just a question here.

These dopers that raise their hematocrit levels. If they didn't use saline or blood thinners, would it come down naturally over time, or would it be stuck like that?