Parisotto analyzes Armstrong blood values

[Race Radio]

http://downthebackstretch.blogspot.com/2012/09/its-all-about-blood.html

To suggest that a 23% increase in Hemoglobin and a 50% decrease in reticulocytes was the result of time spent at altitude is stretching the bounds of the known and documented physiological responses to altitude exposure.

Whatever way you cut it, Armstrong's blood values are undoubtedly indicative of blood manipulation.

 

[D-Queued]

http://downthebackstretch.blogspot.com/2012/09/its-all-about-blood.html

To suggest that a 23% increase in Hemoglobin and a 50% decrease in reticulocytes was the result of time spent at altitude is stretching the bounds of the known and documented physiological responses to altitude exposure.

Great quote.

I realize that the application of this Lance quote risks diminishment through overuse, but it would appear that Parisotto doesn't believe in miracles either.

I feel sorry for him.

Dave.

 

[Merckx index]

I get what he’s saying, but this is not explained very well.

First he notes a decrease in both Hb and retics:

The following graphic indicates a fairly regular and normal pattern of Hemoglobin (Hb) values until a significant drop on May 5, 2009, four days before the start of the Giro d'Italia(the Tour of Italy which was contested from May 9-31, 2009 and where Armstrong placed 21st)… The decrease in Hemoglobin from April 30, 2009 to May 31, 2009 (149 – 130) in samples 10 to 13 is 15% however there is no expected increase in reticulocytes. In fact from October 16, 2008 the average reticulocyte levels are 1.1 but from May 18, 2009 the average reticulocyte levels are 0.6.

What is the reason for the drop in Hb? Parisotto says there should have been an “expected increase” in retics. By this he presumably means that a drop in Hb triggers a feedback mechanism that results in increased retic synthesis. However, one can imagine “natural” causes that would result in reduced retic synthesis, and the immediate effect of this would be to result in reduced Hb. In fact, if the latter samples in this group were taken during the Giro (?), one would indeed expect such a drop. Eventually, if Hb continued to fall, one would expect an increase in retics, but since no samples were taken for a couple of weeks after this, we can’t evaluate this. A drop in Hb could have resulted from a withdrawal of blood, but (beyond the fact that LA would most certainly not be withdrawing blood during or even right before the Giro) in this case it definitely should have been associated with an increase in retics, and this was not observed. So it’s difficult to make a very good case that this particular trend is suspicious; if I have my dates straight here, it seems to be a result of riding in a GT.

Then Parisotto notes a large increase in Hb in the samples taken in the middle of June:

The sudden increase in Hb from sample May 31, 2009 to June 16, 2009 (130 – 160) in samples 13 to 15 is 23%, however the response in reticulocytes is again not consistent with normal physiology. Such a scenario is consistent with a deceleration in red blood cell production following auto-bleed and re-infusion(i.e. removal of blood to store for later re-infusion, otherwise know as blood doping).

Parisotto is correct that an increase in Hb along with a decrease in retics is not consistent with normal physiology. It is not particularly consistent with a withdrawal followed by a transfusion, either, however, unless the amount transfused was significantly greater than the amount withdrawn. If the two amounts were roughly equal, one would expect to see little change in either parameter. It would be consistent with a transfusion not preceded by a withdrawal, but only if one assumes LA was not knowledgable enough to follow the transfusion with saline to dilute Hb concentration. Keep in mind that a typical transfusion would not raise Hb concentration by more than 10% at the most, even without saline dilution. In fact, if we assume the large decrease in May resulted from riding in the Giro, and that his Hb levels recovered to normal (150) before the June sample were taken, the increase is about 6-7% over the earlier, stable Hb levels. This is certainly consistent with blood doping, but the problem is that natural increases of this order can’t be easily ruled out, either.

The subsequent low reticulocyte values are consistent with re-infusion of blood and continued micro-doses of rhuEPO (recombinant erythropoietin) to ‘stabilize’ and therefore mask the expected response in reticulocytes.

This would be correct, expect we don’t see a strong sign of stabilization in the right time frame. The Hb increase is in samples 14 and 15. Retics drop in sample 14, and though they are slightly higher in sample 15, they are still down considerably from sample 13 (and most previous samples). They are seen to stabilize after that, but Hb levels are also much lower then. So this relationship is consistent with normal physiology.

Bottom line: Certainly this could be the result of blood manipulation, but I don’t see the conclusion as definitive as Parisotto makes out. Perhaps, as someone who studies this phenomenon, he has seen other samples of known blood doping that reflect the same relationships, but taken in isolation, these data lend themselves to alternative explanations.

 

[zigmeister]

So let me get this right, this guy has just taken the same information from 3yrs ago and did his own article?

Can you say ad naseum?

http://www.cyclingnews.com/features/analysis-armstrongs-tour-blood-levels-debated

Nothing new here to see.

 

[D-Queued]

So let me get this right, this guy has just taken the same information from 3yrs ago and did his own article?

Can you say ad naseum?

http://www.cyclingnews.com/features/analysis-armstrongs-tour-blood-levels-debated

Nothing new here to see.

For there is nothing covered, that shall not be revealed; and hid, that shall not be known. Mathew 10:26.

aka, in time, the truth will be exposed.

Even if it just another 'reasoned' opinion, this is useful as confirmation.

Dave.

 

[Tyler'sTwin]

The decrease in Hemoglobin from April 30, 2009 to May 31, 2009 (149 – 130) in samples 10 to 13 is 15% however there is no expected increase in reticulocytes.

Why would you expect an increase in retics when Hb concentration dives due to plasma expansion?

To suggest that a 23% increase in Hemoglobin and a 50% decrease in reticulocytes was the result of time spent at altitude is stretching the bounds of the known and documented physiological responses to altitude exposure.

We all know that riding a GT decreases Hb significantly, but it's not due to a significant loss of RBC mass, but an increase in plasma volume. How long does it take to return to baseline after finishing a GT? Doesn't plasma volume shift rather quickly? Perhaps it's more reasonable to compare his post-Giro altitude values to baseline rather than end of the Giro?

But I suppose the altitude would be expected to increase retics rather than the opposite, right?

For example, the Ashenden et al study in 2003 demonstrated that in no less than 7 study groups either at natural or simulated altitudes (above 2600 metres – about 8500 feet) that even after 4 weeks of exposure the increase in Hb was, at best, muted.

The largest increase in Hemoglobin was 9.5% in a group of elite cyclists returning from living and training in Toluca (Mexico) after 4 weeks. The Hemoglobin measures were taken 7 days after returning to sea level conditions. In all other study groups there was no increase or at best a 1-2% increase in Hemoglobin. Similar responses were noted with reticulocyte levels.

Weren't LA's elevated values measured at altitude and not after returning to sea level?

 

[Race Radio]

So let me get this right, this guy has just taken the same information from 3yrs ago and did his own article?

Can you say ad naseum?

http://www.cyclingnews.com/features/analysis-armstrongs-tour-blood-levels-debated

Nothing new here to see.

Nope, there is a lot new.

Including the altitude training studies and the fact that as a member of the biopassport committee Parisotto would have recommended a sanction.

That makes two Biopassport committee members who would have recommended sanctions. Why did the UCI ignore it?

 

[Velodude]

So let me get this right, this guy has just taken the same information from 3yrs ago and did his own article?

Can you say ad naseum?

http://www.cyclingnews.com/features/analysis-armstrongs-tour-blood-levels-debated

Nothing new here to see.

Ziggy:

Ever sought a second legal or medical opinion from an equal or superior authority for comfort?

It would be discomforting for your deity.

 

[Benotti69]

So let me get this right, this guy has just taken the same information from 3yrs ago and did his own article?

Can you say ad naseum?

http://www.cyclingnews.com/features/analysis-armstrongs-tour-blood-levels-debated

Nothing new here to see.

ahhh! Did the derailment not work

 

[Pastavore]

http://downthebackstretch.blogspot.com/2012/09/its-all-about-blood.html

RR, great to see you posting again. Thanks.

 

[rata de sentina]

Nope, there is a lot new.

Including the altitude training studies and the fact that as a member of the biopassport committee Parisotto would have recommended a sanction.

That makes two Biopassport committee members who would have recommended sanctions. Why did the UCI ignore it?

Well I beleive Parisotto says something like "if he had seen it" which kind of indicates he didn't when he was on the committee. You can draw your own conclusions about that.....

 

[Race Radio]

Well I beleive Parisotto says something like "if he had seen it" which kind of indicates he didn't when he was on the committee. You can draw your own conclusions about that.....

The values are given to the member anonymously. He would not have know if he had seen Lance's values

So what we have is 2 member of the UCI Biopassport committee who have reviewed Armstrong's numbers and said he doped.....yet the UCI did nothing?



http://online.wsj.com/article/SB10001424052748703309704575413732974367988.html

 

[sittingbison]

Lets not forget that this article states the blood figures are from those posted by disgraced Armstrong on his web - didn't he change these figures when someone pointed out this problem, then pull them altogether?

 

[rata de sentina]

The values are given to the member anonymously. He would not have know if he had seen Lance's values

So what we have is 2 member of the UCI Biopassport committee who have reviewed Armstrong's numbers and said he doped.....yet the UCI did nothing?

Maybe, but I would think generally if you were going to hide something it would be easier to hide data than to hide a committee's recommendation. Especially an independent committe with some strong minded people on it.

 

[Alpe d'Huez]

http://downthebackstretch.blogspot.com/2012/09/its-all-about-blood.html

Welcome back. Thanks for sharing this latest info.

 

[CharacterFirst]

RR, great to see you posting again. Thanks.

Here, here.

 

[the big ring]

Maybe, but I would think generally if you were going to hide something it would be easier to hide data than to hide a committee's recommendation. Especially an independent committe with some strong minded people on it.

I am not sure how the data for an ABP result is disseminated. If it goes to WADA, no way you can modify the data. Otherwise, yes it would seem to be easier, but keep in mind there are 3 variables being tracked, and the slightest mistake would be catastrophic. High risk activity. You'd need software to generate values that looked "normal".

ETA: Armstrong changed his values personally post-publication.

I disagree that the panel is difficult to control: http://www.cyclingnews.com/news/ashenden-speaks-out-on-leaving-biological-passport-panel

Michael Ashenden: That's correct insofar as I will not be an expert on Lausanne's Athlete Passport Management Unit (APMU).
...
In their terms of agreement, Lausanne inserted an additional confidentiality clause that precluded an expert from making any public comment or giving any personal opinion on any aspect of their role as an expert on the panel. Not just now, but for eight years after the expert leaves the panel.

http://www.cyclebetting.com/category/franco-pellizotti/

The nine-member Biological Passport panel assembled by the UCI

I cannot find the article now, but I think it had to be a majority of panelists who had to agree the rider in question had to be investigated further, and that decision lead to another panel looking at the figures also before a case was brought.

 

[DirtyWorks]

I cannot find the article now, but I think it had to be a majority of panelists who had to agree the rider in question had to be investigated further, and that decision lead to another panel looking at the figures.

I think we read the same thing because this is what I remember.

As Ashenden pointed out in another unattributed reference, there's the scientific case, and then there's the legal case. A solid scientific case does not make a solid legal case.

Even then the UCI has discretion to do as they please with the findings and that is by design. If anything is to come of the Wonderboy drama, it's that the IOC will be forced to give WADA the authority to open cases and leave the sports federation as athlete advocate at best.