Transfusions and positives

[Escarabajo]

non-issue - it would be deviations from some baseline.

Which one is the baseline?

I believe the plastics have different components. So it would really make it a non issue.

 

[Merckx index]

Unless the extended testing that they have said they are doing is to investigate the possibility that the CB presence is a pointer to the transfusion.

Personally I think this, along with the statements made by Landis about his doping (I didn't do the testosterone patch thing, I was transfusing, so they fitted me up), indicate a potential line of transfusion testing that the science will be focused on quite heavily in the coming months.

If they can find independent evidence that Bert was transfusing, that evidence may stand on its own. But since no mention of this has been made up to now, I rather doubt that they have enough evidence to prove this. Even in cases where passport data clearly raise red flags, it has been very difficult for UCI to make a strong enough case to suspend the rider.

Maybe this talked-about plastics test will prove something, but I have not heard enough specifics about it to judge, e.g., does it really detect substances found only in blood bags? I wasn't aware that blood bags were composed of any substances not found in other types of containers. If these are molecular substances, as opposed to small particles, they probably would be absorbed into the bloodstream following oral ingestion, e.g., from plastic water bottles. In fact, plastic bottles have come under increasing attack from health and environmental officials recently for just such reasons.

Also, since CB at these very low levels clearly could have come from food contamination, even very strong other evidence for blood transfusion would not in any way establish that the CB came from this blood. I don't see how it would help the case for transfusion at all. Again, it's the sort of thing those of us who are not making career-affecting judgments about a rider can use to draw our own conclusions, but you can't hang him on this basis.

 

[Cobblestones]

Easy-peasy: It does, and it's proven beyond doubt through any number of tests. Ingest it, and it shows up in your bloodstream. It has been mentioned in connection with hormone disruption, as a chemical that might disrupt the production of human hormones, it's banned in children's toys, etc. etc. etc.
Look it up. Do some double-ought-investigation googling and you'll see.

After reading the study which was linked by Ingsve, I learned that the 50 percentile concentration of DEHP metabolites (MEHP, MEHHP, MEOHP) in the control group is around 20 ng/ml, while within the first 24 hours of a transfusion, this value goes up to over 200 ng/ml, a tenfold increase.

So, yes, the stuff is present in the environment, and some of it is ingested and absorbed in the bloodstream, but a transfusion will produce a spike ten times above background, of metabolites in the urine.

Appearance of metabolites in the urine after transfusion is much more significant than after ingestion, as I suspected. So much about the research.

 

[cyclanalyst]

There is the story from Willy Voet about this drug which indicates that it really works and that it leaves the system very fast on athletes. So we can not ignore that.

Good point - my guess is that Voet used a lab that couldn't achieve the Cologne group's limits of detection. Someone help me out if I'm wrong, but wasn't Voet writing about how things were done in the early 90s? LOD would probably be 100 to 500-fold higher in those days - the preferred assay was HPLC with UV detection at 245 nm. If you factor in 100x lower LOD, you're looking at 7 additional half-lives, that's about 11 days extended detection period.

 

[Merckx index]

After reading the study which was linked by Ingsve, I learned that the 50 percentile concentration of DEHP metabolites (MEHP, MEHHP, MEOHP) in the control group is around 20 ng/ml, while within the first 24 hours of a transfusion, this value goes up to over 200 ng/ml, a tenfold increase.

So, yes, the stuff is present in the environment, and some of it is ingested and absorbed in the bloodstream, but a transfusion will produce a spike ten times above background, of metabolites in the urine.

Appearance of metabolites in the urine after transfusion is much more significant than after ingestion, as I suspected. So much about the research.

Yes, but a couple of caveats. First, there are a lot false negatives, i.e., transfusers with relatively low levels of metabolites. So a test with a criterion set to reduce false positives to a very low level would miss a lot of transfusers, maybe as many as 50%. But by WADA standards, that is not so bad. The EPO test probably misses a lot more than that.

Second, some of the athletes, including cyclists, in the test had very high levels. Had they recently transfused without the testers knowing, or did they obtain high levels from some other source, like water bottles? This is a potentially serious problem, because WADA is, and justifiably IMO, very anal about false positives. If even only an occasional rider produced a high level of metabolites as a result of something other than transfusion, this could make it very difficult to develop a test.

 

[mastersracer]

If they can find independent evidence that Bert was transfusing, that evidence may stand on its own. But since no mention of this has been made up to now, I rather doubt that they have enough evidence to prove this. Even in cases where passport data clearly raise red flags, it has been very difficult for UCI to make a strong enough case to suspend the rider.

Maybe this talked-about plastics test will prove something, but I have not heard enough specifics about it to judge, e.g., does it really detect substances found only in blood bags? I wasn't aware that blood bags were composed of any substances not found in other types of containers. If these are molecular substances, as opposed to small particles, they probably would be absorbed into the bloodstream following oral ingestion, e.g., from plastic water bottles. In fact, plastic bottles have come under increasing attack from health and environmental officials recently for just such reasons.

Also, since CB at these very low levels clearly could have come from food contamination, even very strong other evidence for blood transfusion would not in any way establish that the CB came from this blood. I don't see how it would help the case for transfusion at all. Again, it's the sort of thing those of us who are not making career-affecting judgments about a rider can use to draw our own conclusions, but you can't hang him on this basis.

hold on - Contador has already tested positive. The burden is on him to provide some compelling evidence to reduce a suspension, right? Why is there any burden to demonstrate he was transfusing? Isn't the point that the possibility of a transfusion only has to be as plausible as the food contamination scenario to introduce uncertainty?

 

[Cobblestones]

Yes, but a couple of caveats. First, there are a lot false negatives, i.e., transfusers with relatively low levels of metabolites. So a test with a criterion set to reduce false positives to a very low level would miss a lot of transfusers, maybe as many as 50%. But by WADA standards, that is not so bad. The EPO test probably misses a lot more than that.

Second, some of the athletes, including cyclists, in the test had very high levels. Had they recently transfused without the testers knowing, or did they obtain high levels from some other source, like water bottles? This is a potentially serious problem, because WADA is, and justifiably IMO, very anal about false positives. If even only an occasional rider produced a high level of metabolites as a result of something other than transfusion, this could make it very difficult to develop a test.

I made a post about it in the 'blood doping' and 'Contador blood doped' threads. The discussion is spread out over all these threads.

 

[Merckx index]

hold on - Contador has already tested positive. The burden is on him to provide some compelling evidence to reduce a suspension, right? Why is there any burden to demonstrate he was transfusing? Isn't the point that the possibility of a transfusion only has to be as plausible as the food contamination scenario to introduce uncertainty?

I agree. As I posted earlier, this is not about getting Bert off, it's speculation about what might have happened.

Added later: The situation is getting complicated. Howman is now saying that the DEHP (plasiticizer) test evidence can be used in an anti-doping tribunal (I posted a link in another thread, I can't keep track of all these threads). So it appears that WADA may actually pursue the transfusion idea.

 

[East Sycamore]

I'm still stuck at this point: why would AC be using clen at all? Even if you assume he used blood doping techniques, it still doesn't make sense to use this particular drug at any time in a training or racing period. Too narrow a therapeutic window, too well-known, too easily detected, and too long-lived. This is not a doping product for the top ranks.

I don't know anything about anything, but I do remember that a lot of people made this same point about Landis and testosterone. In fact, I think one of his earlier defenses was that there would be no performance enhancement from taking testosterone, so why would he bother?

These substances got on the banned list somehow, and Voet's description of its benefits is pretty compelling...

 

[Blakeslee]

I'm still stuck at this point: why would AC be using clen at all? Even if you assume he used blood doping techniques, it still doesn't make sense to use this particular drug at any time in a training or racing period. Too narrow a therapeutic window, too well-known, too easily detected, and too long-lived. This is not a doping product for the top ranks.

As the testing has improved over the last couple of years, I think we are seeing a shift in the kinds of drugs riders are using. The established methods for taking EPO/CERA etc have become too risky, riders are increasingly turning to drugs like clenbuterol and reviving older methods of doping. I would speculate riders are using a combination of drugs and blood transfusions in an attempt to recreate the kinds of performance enhancement which used to be possible with just EPO alone.

 

[scribe]

How much cler would translate if lance consumed contador steak?

 

[scribe]

As the testing has improved over the last couple of years, I think we are seeing a shift in the kinds of drugs riders are using. The established methods for taking EPO/CERA etc have become too risky, riders are increasingly turning to drugs like clenbuterol and reviving older methods of doping. I would speculate riders are using a combination of drugs and blood transfusions in an attempt to recreate the kinds of performance enhancement which used to be possible with just EPO alone.

there might also be some masking agents that are being developed. While people say this is a long ago forgotten ped, there have been a few positives popping up recently that would suggest there is a reasonable cause for use. Also, this tainted food defense is quite effective in this instance.

Regarding translations in transfusions? Why not is the question.

 

[Balabar]

Thanks for the well-informed discussion, especially the contributions from cyclanalyst and Merckx index. I think we can reasonably say that the carry over of clenbuterol from a transfusion is possible, even if some of the supporting data is from non-human sources.

As to whether it's a plausible explanation for Contador's positive, that may be a discussion for another thread. However, supporting data like the reported presence of DEHP and its metabolites in Contador's blood sample does make this theory more plausible.

As to why Contador would take a drug that is reportedly so easy to detect? Remember that only the Cologne lab has detection limits this low and that Contador's out-of-competition samples would probably go to a different lab. He may have thought that clenbuterol was a 'safe' drug to take during training, as it clears faster than other anabolics. He was also likely taking a lower dose than a body builder would take, considering he would have different training goals.

I believe that the burden of proof now rests with Contador - he needs to show not only that the meat contamination scenario is plausible, but that it is more plausible than the blood transfusion scenario. That may be difficult to do. He has no other supporting data other than "he ate some meat from Spain" and "Spain has had a problem with clenbuterol contamination of its meat supply in the past". If he had actual samples of meat from the same source as the one he ate and they also contained clenbuterol, he might have a compelling case. But it looks like WADA is intending to use the DEHP data and is examining his blood profile with a fine-toothed comb.

I think Contador has an uphill battle ahead of him.

 

[Escarabajo]

...
As to why Contador would take a drug that is reportedly so easy to detect? Remember that only the Cologne lab has detection limits this low and that Contador's out-of-competition samples would probably go to a different lab. He may have thought that clenbuterol was a 'safe' drug to take during training, as it clears faster than other anabolics. He was also likely taking a lower dose than a body builder would take, considering he would have different training goals.

...

This is very key also.

Add this to the fact that the evacuation time in this type of athletes is a lot faster according to Willy Voet.

 

[Merckx index]

I believe that the burden of proof now rests with Contador - he needs to show not only that the meat contamination scenario is plausible, but that it is more plausible than the blood transfusion scenario. That may be difficult to do. He has no other supporting data other than "he ate some meat from Spain" and "Spain has had a problem with clenbuterol contamination of its meat supply in the past". If he had actual samples of meat from the same source as the one he ate and they also contained clenbuterol, he might have a compelling case. But it looks like WADA is intending to use the DEHP data and is examining his blood profile with a fine-toothed comb.

I think Contador has an uphill battle ahead of him.

For sure. It will be almost impossible to prove in any meaningful sense that the CB came from contaminated meat. It's way too late for that. The best he likely can do is show that a) meat he ate might have been contaminated; and b) if it was, he could have ingested enough CB to detect at 50 pg/ml.

Also, at a minimum, there can be zero evidence pointing to a blood transfusion. I have thought all along WADA would not pursue this possibility, since they can't prove it and since they do, after all, have a positive for a banned substance. But Howman is now strongly implying that they will or might use DEHP tests. Even if the test is not approved, certainly can't be used to prove blood transfusion, if AC's urine has in fact been tested (conflicting reports on that) and shown to have a very high level of these metabolites--and even worse, if samples taken at later days show these levels dropping to controls--then it adds suspicion.

In a way, Howman's statement is good news for Bert. It implies that the CB positive by itself is not enough. If it were, why bother with showing he MIGHT have transfused? Howman apparently believes the verdict is far from decided, and any evidence possibly relevant needs to be brought in.

If AC can do this--paint a plausible picture of food contamination, and point to lack of any evidence for blood doping--then maybe his connections to powerful people will get him off. Failing that, I would think he would at least be in line for a reduced suspension, missing no more than next year's Tour (and of course forfeiting this year's). It seems to me there are two battles here. The more important one is avoiding sanctions, but failing that, it's keeping his image (in many fans' eyes) of being clean. If he gets sanctioned for a "we know you didn't dope, but rules are rules" type of violation, at least his image will survive.

 

[Balabar]

Unfortunately, I don't think the science will be the deciding factor in Contador's case. For one thing, I don't think there's enough data to fully support either scenario.

I suspect what will happen will be a face-off between the UCI and WADA, with UCI supporting the food contamination theory and WADA supporting blood transfusion. I expect the outcome will be a comprimise, with Contador getting a reduced suspension, similar to Jessica Hardy's. WADA won't be able to conclusively prove a blood transfusion, but the UCI will have to acknowledge that Condator tested positive for a banned substance with no permissible threshold. Under the current regulations, Contador is responsible for what he ingests, whether intentionally or not.

 

[luckyboy]

Under the current regulations, Contador is responsible for what he ingests, whether intentionally or not.

As much as I think he doped, I really don't see how anyone could be expected to 100% know if their food is contaminated. Unless pro riders are gonna start carrying out tests on everything they eat.

 

[Tyler'sTwin]

After reading the study which was linked by Ingsve, I learned that the 50 percentile concentration of DEHP metabolites (MEHP, MEHHP, MEOHP) in the control group is around 20 ng/ml, while within the first 24 hours of a transfusion, this value goes up to over 200 ng/ml, a tenfold increase.

Contador had 480 ng/ml...

http://nos.nl/video/188564-arditem-over-dopingtest-contador.html

 

[python]

As much as I think he doped, I really don't see how anyone could be expected to 100% know if their food is contaminated. Unless pro riders are gonna start carrying out tests on everything they eat.

you know that there are companies specializing in certified contamination-free foods and supplements...for a fee ofcourse.

a friend personally heard armstrong saying he spends 150 000 a year on that.

some pros and teams are known to use such services. don't know about berto or astana except that vino is almost neurotic about what he puts in his mouth except when it's vodka

 

[Parrot23]

I don't know enough to say that the level that the level found for Contador should be too low to constitute a positive, but there surely exists a level that is too low. Anyone who handles money could be found positive for illegal drugs if the testing was sensitive enough.

Yes, I've heard--seriously, no joke here--that a high proportion of paper money in Spain and some other countries has definite and easily detectable levels of cocaine residue.

And there are anti-depressants, birth control pill residues, etc., in easily detectable levels in most industrial countries' rivers. The list goes on.

I don't believe Bertie (think he's finding an excuse, the real worry being the transfusion one), but the point in principle remains valid.

 

[tubularglue]

In Italy it is a known fact that DS's never approve of riders swimming in rivers during in season. Ever

http://www.nytimes.com/2005/08/12/world/europe/12iht-cocaine.html

The researchers discovered that water samples collected along one section of the Po indicated that around 40,000 doses of cocaine per day were being consumed in the surrounding catch basin of about five million people. Based on this data, the study estimates that 2.7 percent of Italians aged 15 to 34 use cocaine every day. This greatly exceeds official national figures indicating that 1.1 percent of the same age group uses cocaine at least once a month.

 

[flicker]

In Italy it is a known fact that DS's never approve of riders swimming in rivers during in season. Ever

http://www.nytimes.com/2005/08/12/world/europe/12iht-cocaine.html

The researchers discovered that water samples collected along one section of the Po indicated that around 40,000 doses of cocaine per day were being consumed in the surrounding catch basin of about five million people. Based on this data, the study estimates that 2.7 percent of Italians aged 15 to 34 use cocaine every day. This greatly exceeds official national figures indicating that 1.1 percent of the same age group uses cocaine at least once a month.

I wondered when I saw fishermen catching smelt type fish out of the river in Florence what type of chemicals might be in the fish. Myself I would not eat the fish from the Po or the Seine.