Twenty-two years into the EPO era, and...

[fatandfast]

For how long? That Pantani's system was screwed up while jacking his HCT to 60% says nothing about whether he had long term adverse effects. Was he forced to take EPO in the off-season? Did he have to take it when he stopped racing? Are Indurain, Riis, Ullrich, and Armstrong using EPO today?

The guys you mentioned are probably not still using EPO(I know it was rhetorical )
There are thousands of patients that have used EPO and I was not able to find anything saying that once you are a user it is a life sentence.

Most people in Pantani's life think that depression,combined with substance abuse was what caused the circumstances of his death.

I would think that the FDA would probably show great concern if EPO when used to supplement the treatment of a seriously ill patient was now the source or stimulant that caused the liver to produce normal hormone levels forever.

Indurain , for what little I saw or read about him appeared pretty chill. All the other guys you named all had signs that maybe they had hormone problems. If anybody is still on EPO or is playing with hormone therapy it's Armstrong.

Brodeal is trying the nutkick thing, like I am at town council meeting asking for whipped cream or cough syrup controls because of the abuse the product facilitates. I am not.
I am curious why the federal government, at least in the US would not ask the drug makers to include some inert identifier in the drugs manufacturing process. A simple marker could be pitched in the batch if the substance was so highly abused and had dangerous outcomes if it is.

Most of the dead people involved in illegal EPO use were pre-internet era. Most users now have access to info from lots of "reliable" sources, meaning you can use without dying. Some of these athletes may have gone the way of Len Bias, just a routine drug use, all had done it before, but some underlying medical problem puts you in the wrong place at the wrong time

 

[Le breton]

who was the cyclists that died in his sleep and when he was examined by a coroner they found his heart was that of an old man from EPO abuse or was it a myth?

Draaijer died feb 27, 1990. His wife asked for an autopsy.
Soon after L'Equipe (I bought that day and may still have it somewhere) quoted her, saying that according to the Dr who did the autopsy he had the heart of an old man.

So, if it was a myth it was propagated either by Mrs Draaijer or by L'Equipe.

 

[Velodude]

I am well aware of this happening in response to androgens but not with EPO and supression post use does not happen greatly with all hormones like GH and thyroid hormone where natural production comes back quickly even with long term use,

Quite an assumption to make considering all EPO users as far as I am aware of do not experience a drop in haematocrit after EPO use all. A different story with steroids yes. I am not arguing that EPO use slows or haults natural EPO production as this is the case but rather that it does not remain suppressed for long post use and comes back very quickly.

I do not live in a cave you know and it wouldn't be the first time that "experts" have got it wrong even on purpose just because they are wanting to appear strongly anti-doping.

When Pantani's lowered natural production of RBC's became known after his death there was a high brow scientific discussion on another forum on this subject in the mid 90's.

A poster, known through his posting history as a professional medical research scientist, determined the debate by informing that it had been an issue with early EPO variants and its administering but was no longer an issue.

I found a bulletin dated October 2002 titled "EPO-associated PRCA" warning heathcare professionals about the problem.

Some extracts:

Pure red cell aplasia (PRCA) caused by anti-EPO antibodies has been increasingly recognised worldwide since 1998, although rare instances of the phenomenon had been reported in the preceding decade since EPO became available for the treatment of the anaemia of chronic renal failure.

The cause of this increase is still not fully explained, but is under major investigation at present, including involvement of the regulatory authorities (such as FDA, MCA, etc.)

There is "clustering" of cases in several European countries, e.g. France and the UK, while the incidence in other European countries (such as Germany and Italy) has remained low. The incidence is also very low in the USA.

Almost all cases have been associated with subcutaneous administration of the drug.

Epoetin alfa has been associated with most cases. The prescribing information for epoietin alfa in Europe (sold under the name Eprex) was altered in December 2002 to state that it should no longer be administered by subcutaneous injection.

In 2003 the number of new cases fell dramatically, following these changes. A very small number of further cases have been reported, usually associated with subcutaneous administration of other types of epoetin.

Consideration must also be given to the facts that ethical health care professionals are dealing with maintaining normal RBC levels not supercharged levels up to 50% higher as used by Pantani.

 

[thehog]

http://www.theage.com.au/victoria/cycling-champ-guilty-on-obscene-sex-counts-20111205-1oefk.html

I knew Gary growing up. Humble guy & a very hard trainer. Steroids messed him completely. He's never been the same in trying to keep up with the East Germans...

Seriously anything hormonal really messes you up. EPO is a different story. Feels like someone else's blood is circulating through your body.

 

[Nick777]

http://www.theage.com.au/victoria/cycling-champ-guilty-on-obscene-sex-counts-20111205-1oefk.html

I knew Gary growing up. Humble guy & a very hard trainer. Steroids messed him completely. He's never been the same in trying to keep up with the East Germans...

Seriously anything hormonal really messes you up. EPO is a different story. Feels like someone else's blood is circulating through your body.

I was just reading that article - he was from the same part of the world as me.

The guy just can't seem to get it back together, unfortunately.

 

[WD-40.]

Seriously anything hormonal really...s that a comment based on anything but facts?

 

[WD-40.]

When Pantani's lowered natural production of RBC's became known after his death there was a high brow scientific discussion on another forum on this subject in the mid 90's.

A poster, known through his posting history as a professional medical research scientist, determined the debate by informing that it had been an issue with early EPO variants and its administering but was no longer an issue.

I found a bulletin dated October 2002 titled "EPO-associated PRCA" warning heathcare professionals about the problem.

I am aware of PRCA which is very rare though extremely serious but it is an entirely different condition than the body's suppression of natural EPO production following exogenous EPO use.

 

[BotanyBay]

So PED's are a "gateway" drug to cocaine and alcohol? C'mon, man. Please.

The whole concept of "Gateway Drugs" is a flawed concept. You must consider the cycles that are "addiction" and learn that addiction itself is the only constant. The drugs and respective "addictions" either change or add up, or multiply over time. The addictive self is what remains unchanged. Some people quit using drugs and shift-over to daily trips to McDonalds. They trade one addiction for another. Because the addiction isn't the drugs per-se. It's a deep internal need for comfort. They find comfort in these "addictions" (when they're actually either physical substances, sexual activity, gaming, crackberries, etc).

Just have a look at Clinger or Decanio. They'll tell you the same thing. The problems didn't end with EPO. Nor did they begin there. The problems begin inside. People change addictions like they change their hats. Some addictions get more press than others, because they truly have a physically addictive component (such as Heroin, coke, meth, etc).

 

[BotanyBay]

No, the article is not ambiguous. Pantani was dependent on synthetic EPO to physically survive.

Another comment after reading Rendell's book on Pantani relating to his dependency:

Did Pantani ever regain the ability to produce natural EPO in his system? I wrote a college physiology paper about his broken femur and his dependency on EPO. I've long been interested in how that situation improved (if it did at all).

I wonder how many ex-EPO abusers are still walking around today with a permanent post-cycling EPO addiction?

 

[Boeing]

Why does it make perfect sense?
To me it doesn't - I could probably come up with a convincing argument that regulating PED use is far better for the health of athletes than the current behind the scenes scenario - even if I would not agree with it.

Obviously there are health concerns - but over simplification or exaggerating those concerns could be more harmful to those who are considering taking PEDs.

It makes sence that an ongoing scientific study should accopmpany any claims and it appears there are none to document either side of the arguenemt.

 

[Boeing]

The whole concept of "Gateway Drugs" is a flawed concept. You must consider the cycles that are "addiction" and learn that addiction itself is the only constant. The drugs and respective "addictions" either change or add up, or multiply over time. The addictive self is what remains unchanged. Some people quit using drugs and shift-over to daily trips to McDonalds. They trade one addiction for another. Because the addiction isn't the drugs per-se. It's a deep internal need for comfort. They find comfort in these "addictions" (when they're actually either physical substances, sexual activity, gaming, crackberries, etc).

Just have a look at Clinger or Decanio. They'll tell you the same thing. The problems didn't end with EPO. Nor did they begin there. The problems begin inside. People change addictions like they change their hats. Some addictions get more press than others, because they truly have a physically addictive component (such as Heroin, coke, meth, etc).

my private study says EPO leads to internet porn. but it is incomplete at the moment and in need of more samples

 

[thehog]

Armstrong was a big coke user up to about 2009.

The whole concept of "Gateway Drugs" is a flawed concept. You must consider the cycles that are "addiction" and learn that addiction itself is the only constant. The drugs and respective "addictions" either change or add up, or multiply over time. The addictive self is what remains unchanged. Some people quit using drugs and shift-over to daily trips to McDonalds. They trade one addiction for another. Because the addiction isn't the drugs per-se. It's a deep internal need for comfort. They find comfort in these "addictions" (when they're actually either physical substances, sexual activity, gaming, crackberries, etc).

Just have a look at Clinger or Decanio. They'll tell you the same thing. The problems didn't end with EPO. Nor did they begin there. The problems begin inside. People change addictions like they change their hats. Some addictions get more press than others, because they truly have a physically addictive component (such as Heroin, coke, meth, etc).

 

[fatandfast]

Armstrong was a big coke user up to about 2009.

Everybody was saying that Armstrong gave them an 8ball at training camp

 

[Granville57]

...and they all got same message. Odd.

 

[BotanyBay]

Did Pantani ever regain the ability to produce natural EPO in his system? I wrote a college physiology paper about his broken femur and his dependency on EPO. I've long been interested in how that situation improved (if it did at all).

I wonder how many ex-EPO abusers are still walking around today with a permanent post-cycling EPO addiction?

And on this note, when Froid tested positive, I wondered if he'd possibly had been abusing Testosterone for so long that he'd lost the ability to produce it naturally (a possible side effect of long-term use).

There will be some guys in the peloton who have to use the synthetic stuff just to be able to ride at a functional level.

 

[Digger]

Pantani would have needed to have been treated for anaemia for the rest of his life...due to the quantity of EPO he used.

 

[WD-40.]

Pantani would have needed to have been treated for anaemia for the rest of his life...due to the quantity of EPO he used.

Why would Pantani need to be treated for anemia for the rest of his life when his fellow athletes do not need to be?

Honestly people here are getting totally carried away with fantasy and thinking they know things they really don't.

THIS MADE UP GARBAGE AND THE "CLINIC CULTURE" OF MAKING THINGS UP HAS GOT TO STOP!!!

Stick to reality folks!

 

[BroDeal]

Why would Pantani need to be treated for anemia for the rest of his life when his fellow athletes do not need to be?

Honestly people here are getting totally carried away with fantasy and thinking they know things they really don't.

THIS MADE UP GARBAGE AND THE "CLINIC CULTURE" OF MAKING THINGS UP HAS GOT TO STOP!!!

Stick to reality folks!

In the above case the poster was obviously exaggerating for a joke.

But, yeah, crap like telling whether someone is doping by the shape of his jaw and other such stupidities do not do this place a service.

Still waiting for someone to post something that shows that Pantani had long term issues. Having his system screwed up while he was using enough EPO to turn his blood into the viscosity of pancake syrup does not count.

 

[BotanyBay]

In the above case the poster was obviously exaggerating for a joke.

But, yeah, crap like telling whether someone is doping by the shape of his jaw and other stuch stupidities do not do this place a service.

Still waiting for someone to post something that shows that Pantani had long term issues. Having his system screwed up while he was using enough EPO to turn his blood into the viscosity of pancake syrup does not count.

I can't speak to "longer term", but when he was hospitalized for the broken femur, he most certainly had a chemical dependency on sythetic EPO. When they first wanted to operate, his crit was so high, they felt they needed to "wait it out" and let it come back down a bit. But instead of coming down, it literally crashed to a level so low that it essentially proved he was not producing it naturally. I have no idea how long it takes one to "get over" such a chemical dependency (if it's even possible). It's not like we have lots of "volunteers" willing to participate in such a study. It's hard enough getting them to admit having used it at all, and even after, they lie up-and-down the street, trying to downplay the problem. Even Floyd (with all of his supposed recent honesty) seems to not be terrribly forthcoming and truly open.

 

[Dekker_Tifosi]

doctors of gewiss had to wake up riis in the middle of the night and make him walk a little because otherwise the blood would get to clodded and he'd die, because of his 60% hematocrite

what more proof do you need!?!?! too much epo is bad mkay.

 

[fatandfast]

doctors of gewiss had to wake up riis in the middle of the night and make him walk a little because otherwise the blood would get to clodded and he'd die, because of his 60% hematocrite

what more proof do you need!?!?! too much epo is bad mkay.

don't know the Nederlander equiv of pancake syrup? Armstrong was probably grazed a few times per night or he would have had a heart seize. Where all all the stories about the stars? What keeps people quiet? Can't be money cause there was none for most of the sports history . People talk like EPO can't be used solo, you need handlers to keep you alive..no?
Why is Nihon or Emco never mentioned? If EPO is the standard these guys make the speedometers ?

 

[Velodude]

I can't speak to "longer term", but when he was hospitalized for the broken femur, he most certainly had a chemical dependency on sythetic EPO. When they first wanted to operate, his crit was so high, they felt they needed to "wait it out" and let it come back down a bit. But instead of coming down, it literally crashed to a level so low that it essentially proved he was not producing it naturally. I have no idea how long it takes one to "get over" such a chemical dependency (if it's even possible). It's not like we have lots of "volunteers" willing to participate in such a study. It's hard enough getting them to admit having used it at all, and even after, they lie up-and-down the street, trying to downplay the problem. Even Floyd (with all of his supposed recent honesty) seems to not be terrribly forthcoming and truly open.

+1 You have hit Pantani's uniqueness on the head.

I would speculate his condition is why he became morose. To circa 2000 he could use EPO with impunity - only need to pass the 50% "health" checks.

Pantani could not autologously blood dope, like US Postal et al, as the alternative to beat direct EPO testing as his condition required more stockpiling of self blood donations and infusions.

If his hct dropped from 60% to 15% in 7 days then he needed topping up throughout those 7 days to maintain a competitive hct level. Teams these days, according to Floyd, use the two rest days during the Tour to top up. That would be too late for Pantani.

 

[BroDeal]

+1 You have hit Pantani's uniqueness on the head.

I would speculate his condition is why he became morose. To circa 2000 he could use EPO with impunity - only need to pass the 50% "health" checks.

Pantani could not autologously blood dope, like US Postal et al, as the alternative to beat direct EPO testing as his condition required more stockpiling of self blood donations and infusions.

If his hct dropped from 60% to 15% in 7 days then he needed topping up throughout those 7 days to maintain a competitive hct level. Teams these days, according to Floyd, use the two rest days during the Tour to top up. That would be too late for Pantani.

So now not only did Pantani have long term adverse effect from prior EPO use--something for which there is no evidence whatsoever--it was also responsible for his depression.

 

[Le breton]

+1 You have hit Pantani's uniqueness on the head.

.............

If his hct dropped from 60% to 15% in 7 days then he needed topping up throughout those 7 days to maintain a competitive hct level. .....

.

IF, this is a big IF as far as I am concerned. Actually, I remember reading 65% at the time, not 60%.

What I question is the possibility for his Hct to drop so drastically in 7 days as it would mean that his red cells were somehow diseased : normally those cells have a lifetime of about 120 days, so that even if he completely stopped producing reticulocytes (new born red cells), his Hct drop should only have been 7/120 ~6%, in other words a drop from 65 to 61%, not 15%. It is generally accepted that when you come down from high altitude you maintain for a good 4 weeks the advantage of an above normal Hct level.

I would be interested to hear (read) what experts have to say on the subject. Joe Papp maybe?

Note added in proof: the 65% could have been somewhat overestimated if measured when he was still dehydrated from the hours of hard racing. But even if his real value was, say, 55%, it does not go very far towards explaining a 15% value a week later.

 

[Le breton]

...........
I would be interested to hear (read) what experts have to say on the subject. Joe Papp maybe?
..........
.

SOMETHING I FOUND:
Ref(1) – Tainted Glory – Doping and Athletic Performance. Noakes, TD. NEJM. 351:9. Aug.26. 2004


Why is EPO dangerous?
Additional dangers of EPO include sudden death during sleep, which has killed approximately 18 pro cyclists in the past fifteen years, and the development of antibodies directed against EPO. In this later circumstance the individual develops anemia as a result of the body’s reaction against repeated EPO injections.

Could this be a sufficient explanation?