# Heras EPO!!!



## wheel_suker (Feb 3, 2005)

http://www.cyclingnews.com/news.php?id=news/2005/nov05/nov08news


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## Dan Gerous (Mar 28, 2005)

This is getting pathetic!

Let's just 'pretend' every 'pros' are doped... Now, let the 'pros' race against each other...  No wonder some EPO producing companies are sponsoring bike races now, they have a lot of clients...


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## 2Fast2Furryious (Jun 11, 2004)

*Scandal!*

This should be in the doping forum! Or, where I looked to put it first - before checking General and Pro.

First Thought: Oh well, another Spaniard bites the dust (and after watching several Vueltas, I now believe the country is made entirely of dust.)

Second Thought: That guy Myles Rockwell, an ex-world champ MTBer, was busted for druges too; pot in his case. Why can't cyclists do "cool" drugs? Ya got Ullrich with the ecstacy, but c'mon, that's so 1994 -_ height of the fax machine, ferchristsakes._

Third Thought: This will hammer one more nail into the coffin of Lance's French reputation, if it is not already buried in an unmarked grave. Sure, he split with Postal/Disco 2 years ago. But still...

Manny Saiz seems to run his team in a manner contrarian to DS's. Listening to him holler out of that mic attached to the car during TTs, you know he is one hard-headed man. With the lack of evidence available I would conjecture that he would A) push drugs so hard on the team or certain riders that a certain Curtis Mayfield tune would apply, or B), that he runs a tight (tightest?) ship and his training methods, selection of team gear and oh-let's-be-nice-to-Manny "Thundering Motivational Voice" would keep his riders clean as much as possible. 

But one could always slip through the cracks. Plus CycleSport had a great pic of him giving officials both the stink-eye and potty-mouth during the infamous 1998 Tour. I hate needles, as do most people, but I'm afraid of him a hell of a lot more.


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## FTF (Aug 5, 2003)

The B sample hasn't been tested yet, and it sounds like it's only one positive. I'm not going to make up my mind about this one until more comes to light.


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## euro-trash (May 1, 2004)

Don't forget, because that triathlete fought the epo test and won, those with good lawyers aren't necessarily dead in the water.


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## asgelle (Apr 21, 2003)

Or good science


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## whit417 (Jul 5, 2005)

It doesn't say that he was positive. The article only says that it was a "non negative" sample  That's _completely_ different. Does anybody really believe that all these guys don't dope? Really, I don't see the big deal. If they are all doing it, kinda levels the playing field. EPO is not really dangerous if used correctly. All it does is allows the body to recover more quickly and boosts red blood cell production. It is a natural hormone that is produced by the body. Are its advantages really any different than, say, altitude training, aero bars, skinsuits, TT bikes, carbon fiber, etc, etc, etc.


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## rocco (Apr 30, 2005)

FTF said:


> The B sample hasn't been tested yet, and it sounds like it's only one positive. I'm not going to make up my mind about this one until more comes to light.


I second that.


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## 2Fast2Furryious (Jun 11, 2004)

Jeez.

We are the MASSES! PASS JUDGEMENT INDISCRIMINATELY! Please?

Everybody turns up a non-negative EPO test first, duh. Then it gets tested again. But, (gasp) a cyclist guilty of doping? Banish the thought!

Maybe it was for his dog. Or wife/granny. Both excuses worked, BTW.


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## lallo (Feb 20, 2005)

wheel_suker said:


> http://www.cyclingnews.com/news.php?id=news/2005/nov05/nov08news


Now he is really ready for the tour of California!!!!!!!


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## orange_julius (Jan 24, 2003)

*Non-negative?*



whit417 said:


> It doesn't say that he was positive. The article only says that it was a "non negative" sample  That's _completely_ different.


How are the two completely different? It's different only when there is a discrete, non-zero mass on the value "zero". For example, if you're talking about integers, then there is a difference between saying "positive integers" and "non-negative integers": In the former, you start from {1, 2, ...} while in the latter you start from {0, 1, 2, ...}.

As far as I know, the amount/mixture of certain substance such as EPO is measured as a *real, continuous* number, not a discrete one, so there is really no measurable difference between saying that it's "above the threshold" or "not below the threshold". The probability of being exactly at the threshold value will be zero, unless the accuracy is infinite and there is zero error.

I think that the use of "non-negative" appears only in the english-speaking press, as an attempt to be more politically correct or tone the reporting down.

From L'equipe (sure, roll your eyes):
<i> ... le coureur avait Ã©tÃ© contrÃ´lÃ© positif Ã* l'EPO (Ã©rythropoÃ¯Ã©tine) lors de la 20e Ã©tape ...</i>

And from Eurosport:
<i> Four-times Tour of Spain winner Roberto Heras has been suspended for a suspected positive doping test for the banned blood-boosting substance erythropoietin (EPO) during this year's race, his team Liberty Seguros said on Tuesday.</i>


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## Dwayne Barry (Feb 16, 2003)

Dan Gerous said:


> This is getting pathetic!
> 
> Let's just 'pretend' every 'pros' are doped...


I think the one's "pretending" are the ones who suffer under the illusion that doping isn't a widespread and still common occurance in professional cycling. Just assume they all dope then you'll never be disappointed when one of the unfortunate ones fails a test or has the cops show up at his front door


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## ttug (May 14, 2004)

*strange trivia*



Dwayne Barry said:


> I think the one's "pretending" are the ones who suffer under the illusion that doping isn't a widespread and still common occurance in professional cycling. Just assume they all dope then you'll never be disappointed when one of the unfortunate ones fails a test or has the cops show up at his front door


Isnt it a bit strange that when a known climber has the TT "of their life"; a doping scandal follows.

Gosh, I wonder what could be going on........


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## Dwayne Barry (Feb 16, 2003)

whit417 said:


> All it does is allows the body to recover more quickly and boosts red blood cell production. It is a natural hormone that is produced by the body. Are its advantages really any different than, say, altitude training, aero bars, skinsuits, TT bikes, carbon fiber, etc, etc, etc.


The number I've seen is that it boosts sustainable power around 10%. It's probably the one drug that an endurance athlete can take and be certain they will see a substantial improvement in their performance.


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## wipeout (Jun 6, 2005)

Dwayne Barry said:


> The number I've seen is that it boosts sustainable power around 10%. It's probably the one drug that an endurance athlete can take and be certain they will see a substantial improvement in their performance.


Gee, where can I get some?


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## Dwayne Barry (Feb 16, 2003)

wipeout said:


> Gee, where can I get some?


The internet.


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## alembical (May 21, 2004)

> EPO is not really dangerous if used correctly. All it does is allows the body to recover more quickly and boosts red blood cell production


Epo not dangerous? Why because our bodies produce it naturally? Simply not true. While we do naturally produce some EPO, the quantities that athletes are taking are much higher, and the positives that come with EPO usage are directly related to the negatives and the gains from EPO can have devasting effects. When used correctly, EPO boost red blood cell counts. As red blood cell counts go up, so does the thickness of the blood, and in turn the risk for heart problems.

alembical

http://outside.away.com/outside/bodywork/200311/200311_drug_test_1.html 



> More red blood cells translates into more oxygen being distributed throughout the body, thus resulting in increased endurance.This worked just fine until a certain line was crossed—different in every individual and hard to predict—and thickened blood started turning to sludge. Heart attacks and strokes followed. Athletes would mysteriously die in their sleep, because their lowered heart rates were unable to pump the enriched, heavy blood. According to Dutch media reports, from 1987 to 1990, 17 Dutch and Belgian professional cyclists died as a result of abusing EPO.


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## Under ACrookedSky (Nov 8, 2005)

2Fast2Furryious said:


> Maybe it was for his dog.


I think it is far more likely that this is the result of a French conspiracy. 

French tabloids have decided to boost their readership by tearing down a great man. They are upset that the last Frenchman to win the Vuelta was Laurent Jalabert, many years ago, and now that Heras has broken the record for Vuelta wins they are willing to do anything to destroy his reputation. The French as a whole are upset about the poor showing of their own riders and will not accept that some people are willing to train harder that they are. 

We also cannot rule out the lab spiking Heras' sample. There is no evidence whatsoever that they spiked it; but we have to assume it none the less.

WADA and Dick Pound are also undoubtedly involved. Those dastardly europeans cannot be trusted.

I leave it to Jesse D Smith and his Minions for Truth, Justice, and the Non-French Way--you know who you are--to fill us all in on the finer points of the conspiracy.

P.S. Heras just does not seem like the type of guy who would dope. He is too nice and humble. I can tell these sorts of things from watching people on the telly and there is no way he would possibly dope. There is something fishy about the whole affair.


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## Dwayne Barry (Feb 16, 2003)

alembical said:


> http://outside.away.com/outside/bodywork/200311/200311_drug_test_1.html
> As red blood cell counts go up, so does the thickness of the blood, and in turn the risk for heart problems.
> 
> alembical


So says the internet? Sure that is what might happen theoretically, what supposedly happened to some amateur Dutch cyclists back before the 50% hematocrit rule but I would say it's usage is really pretty safe. Looking on Pubmed really the only concern that seems to be out there is that EPO use could promote tumor formation via its angiogenic effects. All the cardiac-related deaths over the last few years in elite cyclists that I'm aware of were arrhythmias. I can't remember a single time one died in their sleep which might allow for the "thick blood" as a cause of death.

Actually I forgot about the other potential deleterious affect of exogenous EPO use which is triggering an autoimmune response to EPO leading to severe anemia. This is supposedly what happened to Pantani following his Milan-Turin accident when he reportedly showed up in the hospital with his hematocrit thru the roof, but then developed a severe anemia over the following days. However, this is suppose to be a very rare occurance.


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## alembical (May 21, 2004)

Under ACrookedSky said:


> I think it is far more likely that this is the result of a French conspiracy.
> 
> French tabloids have decided to boost their readership by tearing down a great man. They are upset that the last Frenchman to win the Vuelta was Laurent Jalabert, many years ago, and now that Heras has broken the record for Vuelta wins they are willing to do anything to destroy his reputation. The French as a whole are upset about the poor showing of their own riders and will not accept that some people are willing to train harder that they are.
> 
> ...


My new favorite post.


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## rocco (Apr 30, 2005)

This is the forum on RBR where the most hysterical comments and debates occur. This beats PO without a doubt.


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## flying (Feb 17, 2004)

*Read These two*

http://www.cyclingnews.com/news.php?id=features/2005/epotest_problems

http://www.cyclingnews.com/news.php?id=features/2005/drmujika_eporeport

Just some additional info.
You know It is pretty much a given that drugs are used.
But also EPO is detectable for a very short time. I tend to doubt anyone is using at Stage 20 of the Vuelta. Not saying they dont use but am not convinced that the test is fool proof.
Remember the top guys have expensive doctors who know more about this stuff than the average bear.


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## cosmo3 (Nov 1, 2005)

flying said:


> But also EPO is detectable for a very short time. I tend to doubt anyone is using at Stage 20 of the Vuelta.


I made this same point when the story broke. Almost immediately, someone suggested mircodoping, but I can find very little information on that. This page has a very brief description: 

"'Artificial boosting of hematocrit levels a week or more before a race can be maintained by micro-dosing with EPO three-times a week and still go undetected,’ said Michel Audran of the organisation Science and Industry Against Blood Doping."

That still doesn't seem to explain Heras' positive on the penultimate stage. Did he get carried away? Why didn't he get caught over the previous two weeks?

I'm not searching for reasons why this result is wrong, I'm just confused is all.


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## Dwayne Barry (Feb 16, 2003)

flying said:


> http://www.cyclingnews.com/news.php?id=features/2005/epotest_problems
> 
> http://www.cyclingnews.com/news.php?id=features/2005/drmujika_eporeport
> Not saying they dont use but am not convinced that the test is fool proof.


No test is perfect. There is usually a trade-off between being able to detect what you're looking for and incurring false-positives. From what I've read about the test, if you're deemed positive you're a pretty long way from a normal EPO metabolite profile. IOW, it's pretty unlikely you'll turn up a false positive and in fact it's much more likely you'll get away with doping as the test is erring on the side of not giving false positives. There are also a bunch of other parameters they look at besides the EPO metabolite test that have to be "positive" before you're declared positive for rhEPO use.


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## Dwayne Barry (Feb 16, 2003)

cosmo3 said:


> I made this same point Why didn't he get caught over the previous two weeks?


I can't remember anyone turning up a rash of positives. I would suggest that it's probably because the docs and soigneurs know what they are doing and keep the parameters below the detectable level and probably also the fact to be "positive" you have to be really "positive" not just give a minor indication you're using EPO. It isn't an either or test.

A more interesting question is how come all the guys that were busted by the cops and/or admitted to using EPO never tested positive?


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## flying (Feb 17, 2004)

Dwayne Barry said:


> No test is perfect. There is usually a trade-off between being able to detect what you're looking for and incurring false-positives. From what I've read about the test, if you're deemed positive you're a pretty long way from a normal EPO metabolite profile. IOW, it's pretty unlikely you'll turn up a false positive and in fact it's much more likely you'll get away with doping as the test is erring on the side of not giving false positives. There are also a bunch of other parameters they look at besides the EPO metabolite test that have to be "positive" before you're declared positive for rhEPO use.



I guess that is my gripe with it.
If your going to ruin a persons career, personal life & mental state be 100% certain or forget it.
I think the folks mentioned in the two articles I posted should have a class action law suit & bankrupt WADA & anyone else involved.
Again I am not saying I am for drugs or anything of that nature. But these folks are wrecked over what sometimes is untruths.
For all we know???
I mean when reading the tone of the article I posted I got the impression WADA feels untouchable & yet they know they have problems? They even said well most labs dont really know what they are looking at so when they get a suspicious one they should send it to the 2 or 3 labs that are qualified to determine it? Man I think they better get a new system. 
On another forum I read someone posted a interesting idea. Why not have the drug companies who make the PED's include a tracer in the drug? It could be some non harmful trace of something that shows up in the system for a month or more? Why not? 

Also I think once this blood boosting really takes hold & the upper class of racers start storing their own blood instead of using others with same type blood. That wil be undetectable won't it?

It is all sad really but it is in all sports. ;(


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## Dwayne Barry (Feb 16, 2003)

flying said:


> Why not have the drug companies who make the PED's include a tracer in the drug?(


I suspect all the athletes in the world using EPO don't add up to what's used legitimately in a single good sized US city. And it's not the manufacturer's problem. What about FDA approval? I suspect even a minor modification of a drug would cost a company millions.


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## flying (Feb 17, 2004)

Dwayne Barry said:


> I suspect all the athletes in the world using EPO don't add up to what's used legitimately in a single good sized US city. And it's not the manufacturer's problem. What about FDA approval? I suspect even a minor modification of a drug would cost a company millions.


That is probably true ;(


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## PdxMark (Feb 3, 2004)

*Are the tests right and the athletes really this stupid?*

These test results are not making any sense. 

I'm not burying my head in the sand, and Heras, Lance, Tyler, etc., could all be doping, but in the case of Heras, why do it late in a race that he's winning? He KNOWS he's going to be tested. Isn't it possible that the tests and the interpretation of them are picking-up false positives? 

I don't know the chemistry or the physiology of the dopants the tests are looking for, but it seems insane that these guys would be doping mid-race when there are testing regimes in place. The tests seem to be subject to interpretation and application of thresholds. Those thresholds were apparently determined to account for a wide range of physiological differences between athletes, but what if those thresholds are too restrictive. Afterall, these guys are some of the best in the world. They are different from others in the peloton. It could be because they dope better, or maybe it's because they have physiologies that are different.

I suppose that Heras would have historic numbers that are much different from this positive result, which would support a conclusion of doping, but why do it at that time? Were his numbers creeping up or high throughout the Vuelta, and finally tipped over the threshold? Or was he well within the limits and then get a spike on the penultimate day? The first case looks like micro-doping that went too far. The second could be a big doping shot at that late stage, but to what effect and for what purpose? 

I just don't get it...


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## wiles (Apr 17, 2005)

*the real punishment*

I don't get it either. I don't think we have enough information to make a judgement yet either way.

One place I will make a judgement, however, is that athletes are being punished whether they are guilty of doping or not. The time it takes to resolve these issues is punishing and unforgiveable. Every day a professional cyclist misses racing and training because doping accusation is a day they will never get back. When the process takes more than a year as in the case of Tyler, it becomes criminal. How can these institutions really expect us to respect them when day after precious day in a short career is just pissed away while meetings are scheduled and cancelled and scheduled and cancelled.

Timeliness in reaching a final judgement has got to be part of the doping discussion. Otherwise the process itself is punishing.

wiles


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## ttug (May 14, 2004)

*so....*



flying said:


> http://www.cyclingnews.com/news.php?id=features/2005/epotest_problems
> 
> http://www.cyclingnews.com/news.php?id=features/2005/drmujika_eporeport
> 
> ...


So if I have a budget and a good doc, Its ok to dope?

Sorry. Again, is it not odd that a great climber has the TT of a lifetime and WOWEEEEE tests positive?

Heras and at one time, Marco. Anyone else recall the TT of a lifetime Marco had in 98. That was indeed special.

I cant IMO, again IMO believe that you TT at nearly 30 mph after climbing cols at nearly or above 15 mph where its so steep even goats show up in wheel chairs. Sorry. Its my opinion but I also try to be a bit realistic as well.


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## dagger (Jul 22, 2004)

*I don't believe it*

Why would the strongest rider on a stage that is already his in a race he has a big lead overdose on EPO or even take in the first place KNOWING that he is going to be scrutinized? I just don't believe he's that stupid.


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## Dwayne Barry (Feb 16, 2003)

dagger said:


> Why would the strongest rider on a stage that is already his in a race he has a big lead overdose on EPO or even take in the first place KNOWING that he is going to be scrutinized? I just don't believe he's that stupid.


It doesn't seem all that unreasonable to me. If it is true that the way riders are getting away with it is by "microdosing" EPO daily after the stage so that it clears by the next day when they may be tested again, and remembering how it was a killer final week and this was buidling up to the TT, he may have simply used too much and it tipped his test over to the "positive" side. He should have been tested from stage 16 on as the race leader. I wonder what his EPO isoforms looked like leading up to stage 20 and his hematocrit numbers?


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## dagger (Jul 22, 2004)

*Why top off*



Dwayne Barry said:


> It doesn't seem all that unreasonable to me. If it is true that the way riders are getting away with it is by "microdosing" EPO daily after the stage so that it clears by the next day when they may be tested again, and remembering how it was a killer final week and this was buidling up to the TT, he may have simply used too much and it tipped his test over to the "positive" side. He should have been tested from stage 16 on as the race leader. I wonder what his EPO isoforms looked like leading up to stage 20 and his hematocrit numbers?


when it takes 2-3 weeks to have any effect? It is a hormone that affects production of redblood cells right? Topping off doesn't seem to me that it will give you a benefit. So why top off the night before? Especially in the last few days of a race and at the END of the season.


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## Dwayne Barry (Feb 16, 2003)

dagger said:


> when it takes 2-3 weeks to have any effect? It is a hormone that affects production of redblood cells right? Topping off doesn't seem to me that it will give you a benefit. So why top off the night before? Especially in the last few days of a race and at the END of the season.


As I understand it, a big therapeutic dose might take 2-3 weeks to raise hematocrit the first time you take it. Presumably these guys already have dosed up before the race starts to get their hematocrit as close to 50% as possible and then use the microdoses to maintain it as close as possible to that number without giving a positive. If you've been doing this all race and the big day is coming up why would stop if you've been getting away with it? Surely Heras wasn't the only one doping in the Vuelta but he was the only one to get caught, the tests are clearly beatable as evidenced by all the confessed/caught dopers who never returned a positive.


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## Fogdweller (Mar 26, 2004)

I'm running out of heros in this sport.


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## Bianchigirl (Sep 17, 2004)

ttug said:


> So if I have a budget and a good doc, Its ok to dope?
> 
> Sorry. Again, is it not odd that a great climber has the TT of a lifetime and WOWEEEEE tests positive?
> 
> ...


But Armstrong's clean, right?


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## spox (May 10, 2002)

*epo is not a problem*

Problem is that sanctions are given to individuals. Only individual who needs hard sanction in a case like this is DS and maybe doctor or team as a whole, it would work better and quite much for itself.


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## johngfoster (Jan 14, 2005)

*Don't get me wrong, I'm not for doping, but...*

someone please correct me here. The problem with EPO is increasing the viscosity of the blood to sludge by raising the HCT, right? Yes, there are the other less common risks too, but the major one is of turning your blood into sludge and having it clot or clog up the vessels, as I see it.

Now, that said, is there a performance advantage to someone who uses EPO to get their HCT to 49.9% over someone who uses an altitude tent, or trains at elevation and arrives at the race with exactly the same HCT, but never took EPO? If there is still an advantage, then I see the big deal about it not being fair, but if the advantage is really only linked to O2 carrying capacity, then they both should be on a level playing field. What difference does it make then if a rider uses EPO to get to 49.9% vs someone who actually trains and gets his numbers up there naturally? I would think the guy who did it naturally would have the advantage, because of the extra work involved getting there. The way I understand it, is the real safety issue here is having an HCT that is too high, and anyone with an HCT under the pre-determined limit should be on a level playing field.

My question again then is: with an identical HCT, is there still a performance advantage with EPO over none, everything else being equal?


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## johngfoster (Jan 14, 2005)

Fogdweller said:


> I'm running out of heros in this sport.


You're my hero, Scott.


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## Bianchigirl (Sep 17, 2004)

johngfoster said:


> someone please correct me here. The problem with EPO is increasing the viscosity of the blood to sludge by raising the HCT, right? Yes, there are the other less common risks too, but the major one is of turning your blood into sludge and having it clot or clog up the vessels, as I see it.
> 
> Now, that said, is there a performance advantage to someone who uses EPO to get their HCT to 49.9% over someone who uses an altitude tent, or trains at elevation and arrives at the race with exactly the same HCT, but never took EPO? If there is still an advantage, then I see the big deal about it not being fair, but if the advantage is really only linked to O2 carrying capacity, then they both should be on a level playing field. What difference does it make then if a rider uses EPO to get to 49.9% vs someone who actually trains and gets his numbers up there naturally? I would think the guy who did it naturally would have the advantage, because of the extra work involved getting there. The way I understand it, is the real safety issue here is having an HCT that is too high, and anyone with an HCT under the pre-determined limit should be on a level playing field.
> 
> My question again then is: with an identical HCT, is there still a performance advantage with EPO over none, everything else being equal?


the difference is that EPO gives a pretty much guaranteed improvement whereas the jury is still out on whether altitude training or tents really give much improvement at all.


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## ttug (May 14, 2004)

*where or how?*



Bianchigirl said:


> But Armstrong's clean, right?


A Lance hijack! No thanks.

I have no idea about Armstrong, my opinion says why not?  Did you want me to say oh no, Lance is perfect and here we have non American hence, he must be doping?  

Look, its a bit strange that Roberto loses a past Vuelta in a TT. A Vuelata where he did have a decent lead. In fact, I believe his lead was just at 1 minute or so (not exactly certain) However, he lost that Vuelta in a TT. SO, he has the TT "of his life" and he wins another Vuelta and he is now under investigation for doping.... I think its strange, thats again IMO.


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## ttug (May 14, 2004)

*what?*



Bianchigirl said:


> the difference is that EPO gives a pretty much guaranteed improvement whereas the jury is still out on whether altitude training or tents really give much improvement at all.


So why do people train at altitude or for that matter in Colorado? Odds are, something works well there......

The jury has been in for the last 15 years........


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## whit417 (Jul 5, 2005)

orange_julius said:


> How are the two completely different? It's different only when there is a discrete, non-zero mass on the value "zero". For example, if you're talking about integers, then there is a difference between saying "positive integers" and "non-negative integers": In the former, you start from {1, 2, ...} while in the latter you start from {0, 1, 2, ...}.
> 
> I was just kidding. To me, non negative and positive are the same thing. After that you lost me.


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## Dwayne Barry (Feb 16, 2003)

ttug said:


> So why do people train at altitude or for that matter in Colorado? Odds are, something works well there......
> 
> The jury has been in for the last 15 years........


This is a very complicated question and the jury is decidely still out. The problem with training at altitude is that power is compromised because of the decreased oxygen availability. This is what has led to the "live high/train low" (or train low/sleep in an altitude tent) which doesn't even show consistent results.


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## ttug (May 14, 2004)

*Why?*



Dwayne Barry said:


> This is a very complicated question and the jury is decidely still out. The problem with training at altitude is that power is compromised because of the decreased oxygen availability. This is what has led to the "live high/train low" (or train low/sleep in an altitude tent) which doesn't even show consistent results.



The best example I can think of was the hour record in Mexico City by Merckx. Eddy made a mask (for the trainer) and would train with the mask to simulate the air.

While yes, on an individual basis, I see what you mean, however, if its iffy at best, why are so many resources dedicated to making that happen. If you train in a deprived environment, I thought, you compendate by making more RBR. THEN you "go low". However, I do not know how long this higher RBR count would or could benefit a rider. BUT, to see the training at altitude so pervasive, its hard to think that well, it might work.....

As to EPO usage being a definite, isnt that also dependant ion the subject as well? In other words, is there (I have not seen it) a scale where you take x amount, you get y result........So, its not a certain thing that any of the above methods will create a desired outcome, is it?


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## Dwayne Barry (Feb 16, 2003)

Bianchigirl said:


> the difference is that EPO gives a pretty much guaranteed improvement whereas the jury is still out on whether altitude training or tents really give much improvement at all.


Right, with altitude you are relying on the body to respond by increasing EPO production. What altitude and for what duration produces what kind of EPO response? I bet this varies greatly amongst people. If you directly inject the EPO I suspenct the dose/response is much more easy to control and predict.

You also have the problem that sleeping at altitude probably compromises recovery and that altitude may induce undesirable adaptations as well as the desired positive one of increased EPO production. You don't have to worry about either of the former if injecting EPO.


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## dagger (Jul 22, 2004)

*Do you have first hand medical experience*



Dwayne Barry said:


> As I understand it, a big therapeutic dose might take 2-3 weeks to raise hematocrit the first time you take it. Presumably these guys already have dosed up before the race starts to get their hematocrit as close to 50% as possible and then use the microdoses to maintain it as close as possible to that number without giving a positive. If you've been doing this all race and the big day is coming up why would stop if you've been getting away with it? Surely Heras wasn't the only one doping in the Vuelta but he was the only one to get caught, the tests are clearly beatable as evidenced by all the confessed/caught dopers who never returned a positive.


or can point out your source(s) of information on how endurance athletes use EPO? You need to qualify your "expertise" if you are going to continue your advising us on the subject. I by no means am trying to show any disrespect but as a reasonable and prudent person I require something more substantial than just statements. I am not convinced that "topping off" can affect the next few days production of bloodcells nor can I find any internet resources. You'd think that if this was widespread then there are going to be somekind of loose lips


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## ttug (May 14, 2004)

*EPO risk? Usage and or "certain" outcome??*



Dwayne Barry said:


> Right, with altitude you are relying on the body to respond by increasing EPO production. What altitude and for what duration produces what kind of EPO response? I bet this varies greatly amongst people. If you directly inject the EPO I suspenct the dose/response is much more easy to control and predict.
> 
> You also have the problem that sleeping at altitude probably compromises recovery and that altitude may induce undesirable adaptations as well as the desired positive one of increased EPO production. You don't have to worry about either of the former if injecting EPO.



http://www.bioportfolio.com/news/btech_021802_1.htm

Is Pure Red-Cell Aplasia Linked to All Epo Products or Just Eprex? 

According to a recently published study, treatment with Johnson & Johnson's (NYSE: JNJ) Eprex can, in rare cases, lead to the nearly total shut down of red blood cell production. The study, published last week in the New England Journal of Medicine, found that European patients with chronic renal failure treated with recombinant human erythropoietin are at risk for forming neutralizing anti-erythropoietin antibodies that can result in the development of the inability to make red blood cells, a condition called pure red-cell aplasia.

French investigators identified thirteen chronic dialysis patients who developed severe transfusion-dependent anemia between 1998 and 2000 after taking recombinant human erythropoietin (epo). The diagnosis of pure red-cell aplasia was based on the characteristic appearance of the bone marrow and circulating blood. 12 of the 13 patients had been treated with epoetin-alpha (Eprex), and one with epoetin-beta, (Roche's [Swiss: ROG] NeoRecormon). Their severe anemia developed after 3 to 67 months of treatment. After discontinuing erythropoietin treatment, six patients were able to develop red cell synthetic bone marrow function on their own after being treated with immunosuppressants or a renal allograft, while three remain transfusion-dependent more than 2 years later. Four still require transfusions, but it is not yet clear if they will remain transfusion-dependent.

In all the patients studied, the red-cell aplasia was caused by an immune reaction against the therapeutic epo. The patients made antibodies that neutralized not only the drug, but also their own natural epo. Without epo in their body, they were not able to make red blood cells. Serum concentrations of the antibodies declined after manufactured epo was discontinued.

In December 2001, Johnson & Johnson warned doctors in Europe and Canada that an immune response to Eprex could result in pure red-cell aplasia. At that time, Johnson & Johnson had discovered that 40 patients on Eprex had developed pure red-cell aplasia, and it had revised its warning label on Eprex to reflect these incident cases. The total number of patients that have experienced this complication is now approximately 75. The risk of patients being treated with Eprex developing pure red-cell aplasia appears to be less than one in 10,000. Pure red-cell aplasia is the only serious adverse effect of recombinant epo administered under appropriate medical supervision.

Marketing of epo is complicated: Johnson & Johnson markets recombinant epo as Eprex in Europe and to cancer patients in the U.S. as Procrit. The drug was originally developed by Amgen (NASDAQ: AMGN), who sells it to kidney dialysis and certain other patients in the U.S. as Epogen. It is not clear whether or not pure red-cell aplasia will be an adverse effect of all of these drugs or only Eprex. Although Eprex, Procrit, and Epogen are often considered identical drugs, differences in manufacturing could be responsible for the adverse effect that has been seen mainly with Eprex so far. Further complicating the picture is the entry of Amgen's Aranesp, a longer lasting epo formulation, to the market in both Europe and the U.S.

Until investigators determine exactly what aspect of Eprex causes red-cell aplasia, there is much speculation about the role of the European manufacturing process versus the role of the carbohydrate structure of epo itself. Although the incidence of red-cell aplasia is low enough that it will probably not affect overall sales of epo, a problem with Eprex manufacturing could significantly benefit Amgen, especially with physicians offered the new choice of using Aranesp. Further boosting the case for Amgen 's products is the fact that, in 12 years of marketing Epogen, there has been only one case of a patient developing pure red-cell aplasia.

On the other hand, if red-cell aplasia is a rare side effect of all epo based products, it could have a negative impact on Aranesp sales. Because Aranesp is longer acting due to the addition of more sugar residues (hyperglycosylation) to the epo protein, it has the potential to be more immunogenic than unmodified recombinant epo (Eprex, Procrit, and Epogen). However, this theoretical possibility has not been seen in real patients - none of the over 6,000 patients receiving Aranesp have had any indication of red-cell aplasia. However, even if Aranesp patients do not develop red-cell aplasia, the fact that this adverse effect has been demonstrated in an epo product may slow future label expansion of Aranesp into anemia of chronic diseases such as lupus, inflammatory bowel disease, or diabetes.

Although signs of red-cell aplasia and other adverse effects should be closely monitored, all indications are that Aranesp is significantly more convenient than other epo products and is being well accepted by physicians. We expect strong sales of Aranesp in both the U.S. and in Europe, with a significant boost in sales after its use in the oncology market picks up, especially after its impending registry for oncology in the United States Pharmacopeia. 

Or 

http://jasn.asnjournals.org/cgi/content/full/15/10/2728


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## dagger (Jul 22, 2004)

*Where are all these "confessions"*



Dwayne Barry said:


> As I understand it, a big therapeutic dose might take 2-3 weeks to raise hematocrit the first time you take it. Presumably these guys already have dosed up before the race starts to get their hematocrit as close to 50% as possible and then use the microdoses to maintain it as close as possible to that number without giving a positive. If you've been doing this all race and the big day is coming up why would stop if you've been getting away with it? Surely Heras wasn't the only one doping in the Vuelta but he was the only one to get caught, the tests are clearly beatable as evidenced by all the confessed/caught dopers who never returned a positive.


documented by all these former cyclists, that some of you refer to. Your rational seems ok but I am becoming convinced that the essence of this topic is good thinking going down the wrong road. It appears that it is a "creature" that lives only on the various message boards.


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## ttug (May 14, 2004)

*1 I can recall*



dagger said:


> documented by all these former cyclists, that some of you refer to. Your rational seems ok but I am becoming convinced that the essence of this topic is good thinking going down the wrong road. It appears that it is a "creature" that lives only on the various message boards.



Richard Virenque confessed and he was clean on I believe every test. Others????


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## Dwayne Barry (Feb 16, 2003)

dagger said:


> or can point out your source(s) of information on how endurance athletes use EPO? You need to qualify your "expertise" if you are going to continue your advising us on the subject. I by no means am trying to show any disrespect but as a reasonable and prudent person I require something more substantial than just statements. I am not convinced that "topping off" can affect the next few days production of bloodcells nor can I find any internet resources. You'd think that if this was widespread then there are going to be somekind of loose lips


Go to cyclingnews.com and read the news from the loose lips. I believe it was Lotz who 1st talked about this openly after the cops raided his house and found EPO. In fact, saying something like "i'd never been caught if it weren't for the cops showing up at my front door!" The other way they're suppose to be "beating" the system these days is by removing their own blood and then putting it back it between the hematocrit testing in the morning and the start of the stage thus allowing them to ride with hematocrit over 50%. This lends credance to the "mixed bag theory" that got Santi Perez and Hamilton busted for blood doping.


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## Dwayne Barry (Feb 16, 2003)

dagger said:


> documented by all these former cyclists, that some of you refer to. Your rational seems ok but I am becoming convinced that the essence of this topic is good thinking going down the wrong road. It appears that it is a "creature" that lives only on the various message boards.


Gaumont, Manzano (sp?) and Lotz come immediately to mind.


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## dagger (Jul 22, 2004)

*My question is*



Dwayne Barry said:


> Gaumont, Manzano (sp?) and Lotz come immediately to mind.



Where are the confessions on how is EPO used and applied to endurance sports such as this mythical creature "microdosing". You guys are giving me names of people who got caught! I am more interested in finding out how these guys tested negative and their techniques to accomplish so because all I have read is speculation on message boards. Where are the confessions that say I used it and here's how I did it but didn't get caught? or "Here's how it's done" by someone who was involved in the sport. I honestly believe that the users are getting caught, and it widespread use within the peloton is just speculation.


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## Dwayne Barry (Feb 16, 2003)

Right, this auto-immune induced anemia is what supposedly happened to Pantani in the hospital following his Milan-Turin crash when he broke his leg severely (in '96 I believe).


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## Dwayne Barry (Feb 16, 2003)

dagger said:


> You guys are giving me names of people who got caught! I am more interested in finding out how these guys tested negative and their techniques to accomplish so because all I have read is speculation on message boards.


They got caught by the cops (certainly Lotz, pretty sure the same with Gaumont, can't remember about Manzano) not by failing drug tests. Others who almost certainly were doping (some even admittedly) yet never failed drug tests were pretty much the WHOLE Festina team (Virenque, Brochard, Zulle, etc), Millar, Museeuw, De Clerq, Pantani, VDB, Frigo, Gotti, etc.. 

Only people who are caught are going to talk about it, why else would anyone come clean? The UCI put the stop to that from the get go when that mountain biker (Chiotti?)admitted to using EPO to win the world champs and they gave him 2 years.

You could read Breaking the Chain by Willy Voet, he goes into details about how they beat the tests back in the day, although it's probably not how they beat them today for the most part.


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## dagger (Jul 22, 2004)

*But*



Dwayne Barry said:


> .
> 
> You could read Breaking the Chain by Willy Voet, he goes into details about how they beat the tests back in the day, although it's probably not how they beat them today for the most part.


This book is based on events prior to 1998 right? So testing has adapted to actually detect the EPO substance and not the possible byproducts(hemocratic levels) and cycling culture has changed also since then.


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## Dwayne Barry (Feb 16, 2003)

dagger said:


> This book is based on events prior to 1998 right? So testing has adapted to actually detect the EPO substance and not the possible byproducts(hemocratic levels) and cycling culture has changed also since then.


Certainly EPO use has changed (as has performance). A lot of the record times on climbs were set in that mid-90's period before the hematocrit reigned in the potential gains from the drug. The problem with the EPO test is that it has a limited window of 3 days for a big therapeutic dose, so is it really surprising that microdosing is suppose to be the way to do it now? Do you really think guys like Ferrari and Chechini make their money by doing lactate threshold tests that any undergrad exercise physiology student can perform? 

Some other drug's use probably haven't changed Gaumont says riders are still taking the corticosteroid race-day injections (Kenacort) and then using prescriptions for saddles sores etc. to explain away what shows up on the tests. Still can't detect growth hormone or insulin (i believe). Blood doping is still undetectable as long as you're using your own. We know designer anabolic exist. At least all of these drugs have questionable benefits to endurance performance.


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## Under ACrookedSky (Nov 8, 2005)

Dwayne Barry said:


> Do you really think guys like Ferrari and Chechini make their money by doing lactate threshold tests that any undergrad exercise physiology student can perform?


Speaking about Dr. Ferrari and money, what is he going to do now? As I understand it, Armstrong signed him to an exclusive deal where he could not "train" other riders. Which rider or riders get his services for the 2006 season? Seems to me that if you are a betting man, you might want to place some money on his new clients.


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## Fogdweller (Mar 26, 2004)

johngfoster said:


> You're my hero, Scott.


I miss you John. Any chance on doing the TdC with us this year?


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## ultimobici (Jul 16, 2005)

Under ACrookedSky said:


> I think it is far more likely that this is the result of a French conspiracy.
> 
> French tabloids have decided to boost their readership by tearing down a great man. They are upset that the last Frenchman to win the Vuelta was Laurent Jalabert, many years ago, and now that Heras has broken the record for Vuelta wins they are willing to do anything to destroy his reputation. The French as a whole are upset about the poor showing of their own riders and will not accept that some people are willing to train harder that they are.
> 
> ...


? 
Isn't DP Canadian?


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## Dwayne Barry (Feb 16, 2003)

Under ACrookedSky said:


> Speaking about Dr. Ferrari and money, what is he going to do now? As I understand it, Armstrong signed him to an exclusive deal where he could not "train" other riders. Which rider or riders get his services for the 2006 season? Seems to me that if you are a betting man, you might want to place some money on his new clients.


I'm not certain, but I think Ferrari couldn't train Armstrong's TdF rivals per his contract, I'm pretty sure he was still training other riders.


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## Under ACrookedSky (Nov 8, 2005)

ultimobici said:


> ?
> Isn't DP Canadian?


You cannot trust Canadians either. With their free healthcare, they are pretty much commies. Many speak french, so that alone makes them suspect.


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## terzo rene (Mar 23, 2002)

Dwayne Barry said:


> Actually I forgot about the other potential deleterious affect of exogenous EPO use which is triggering an autoimmune response to EPO leading to severe anemia. This is supposedly what happened to Pantani following his Milan-Turin accident when he reportedly showed up in the hospital with his hematocrit thru the roof, but then developed a severe anemia over the following days. However, this is suppose to be a very rare occurance.


That is absolutely not what happened with Pantani. Once an immune response is triggered and pure red cell aplasia results the only cures are to totally destroy your bone marrow and rebuild your immune system from the ground up, which is highly likely to kill you in the process, or to go on immunosuppressive drugs for the rest of your life. Unless cocaine has some unknown potent immunosuppressive properties Pantani clearly did neither.

Red cell counts will drop following suspension of long term EPO use because bodily production is reduced when you take exogenous EPO for long periods, but the drop takes some time to manifest as the blood cells die and are replaced at a lower rate. It certianly wouldn't drop to that degree in any case and even with resumed EPO use the recovery to significantly higher levels would take several weeks at the minimum. Those lab results were clearly erroneous or the result of something other than him not getting his EPO fix.


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## terzo rene (Mar 23, 2002)

johngfoster said:


> My question again then is: with an identical HCT, is there still a performance advantage with EPO over none, everything else being equal?


Assuming you could attain identical RBC values with both methods you would be better off with an altitude tent. By itself EPO does nothing to improve your ability to use the increased O2 carrying capacity, while tents do. I really think the most effective thing would be to do both, as Armstrong apparently was.

I think much of the reason altitude tents have shown inconsistent results in testing is because of poor experimental design. Levels of circulating EPO are remarkably consistent between individuals whether their HCT is 40 or 53 so responsiveness to EPO is obviously quite variable and presumably inter-individual response to altitude is as well. Both factors would need to be controlled to determine what the real effect of the tent was and not have it be overwhelmed by the tremendous variability between people.

If costs weren't such a hurdle doing tests with large numbers of people would also overcome the confounding variable problem but I suspect no tent maker or university wants to round up 5000 tents and subjects to do that.

The "science" behind the EPO test suffers from the same problem. Clinical trials have only been done with a handful of subjects and the fact that what was basically a proof of concept trial got published in Nature doesn't mean the method is sound. Beke was able to show that his positive was the result of his body producing metabolites that the testers had previously maintained could only come from exogenous EPO. Of course after he won in court and in the lab they started saying they knew all along.

The "evil" pharmaceutical companies rountinely get blasted in the press over drug side effects that only show up after 10's of thousands of people start taking them, but somehow we are supposed to accept this EPO test as good science.

I am not saying they aren't catching dopers with it. You could throw a dart at the start list and probably be right 80-90% of the time.


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