# Where's the (contaminated) Beef?



## Coolhand (Jul 28, 2002)

http://velonews.competitor.com/2010...nce-to-support-alberto-contadors-claim_149978



> But a report by WADA obtained by the newspaper El Pais said its experts visited the butcher’s shop in northern Spain where the meat was purchased and the slaughterhouse that supplies it, and found no evidence of clenbuterol in any of its products.
> 
> “None of the inspections, none of the tests on samples of meat found traces of clenbuterol, a banned drug used to fatten cattle quickly,” El Pais said.
> 
> ...


Not good for him.


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## Doctor Falsetti (Sep 24, 2010)

Velonews left this part of the article out



> " Contador would have had to have eaten a steak with 300 nanograms for his test to return an amount of 50 picograms. Therefore, the report states, Contador's clenbuterol trace must have come from another source."


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## spade2you (May 12, 2009)

300ng is a pretty small amount.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> 300ng is a pretty small amount.


No for Clen, The dosages are very small.


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## Alaska Mike (Sep 28, 2008)

Where's the (contaminated) Beef?

China.


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> No for Clen, The dosages are very small.


Tablets are usually to the tune of 60mcg or so. 300ng=0.3mcg. How does one ingest 1/200th of that?


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## den bakker (Nov 13, 2004)

spade2you said:


> Tablets are usually to the tune of 60mcg or so. 300ng=0.3mcg. How does one ingest 1/200th of that?


liquid form comes to mind. 
Otherwise: eat the tablet, wait a while. Tap blood. 
3 months later: re-inject blood. 12 hours later test positive.


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## den bakker (Nov 13, 2004)

spade2you said:


> Tablets are usually to the tune of 60mcg or so. 300ng=0.3mcg. How does one ingest 1/200th of that?


by the way, what is the half-life time of the drug in the human body?


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> Tablets are usually to the tune of 60mcg or so. 300ng=0.3mcg. How does one ingest 1/200th of that?


You are right, I thought it was mcg, not ncg. Need to confirm that measurement. 

Normal usage for a person would be 140 mcg, not sure what it is for a cow.


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## spade2you (May 12, 2009)

den bakker said:


> liquid form comes to mind.
> Otherwise: eat the tablet, wait a while. Tap blood.
> 3 months later: re-inject blood. 12 hours later test positive.


The contaminated blood is a possible cause, but we haven't been shown any evidence of blood doping, other than the plasticiser, which is a relatively new lab test with unknown reliability at this time. 

I'm sure there's no shortage of blood doping, but it bugs me that with all this $ and pro staff, that they'd make a mistake like blood banking while using a banned substance.


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## den bakker (Nov 13, 2004)

spade2you said:


> I'm sure there's no shortage of blood doping, but it bugs me that with all this $ and pro staff, that they'd make a mistake like blood banking while using a banned substance.


They did not make a mistake, assuming it would have been sent to a lab with the normal detection threshold. 
as for all that expertise, may I remind that a certain spanish doctor used the most moronic code names on the bags?


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## spade2you (May 12, 2009)

den bakker said:


> by the way, what is the half-life time of the drug in the human body?


Not sure. I looked it up on my hospital's drug info programs, which are very comprehensive, but I'm coming up with nada. 

Half-life is important, but so is the order of elimination. Zero order drugs will decay and/or be eliminated at a linear rate. Dilantin, a drug for epilepsy is an example of this. First order drugs will decay and/or be eliminated at a non-linear rate, but will be linear while on log paper. Second order still won't have a linear rate on log paper. 

I could go on, but much like biostats, not my favorite part of my job or schooling. :mad2:


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## den bakker (Nov 13, 2004)

spade2you said:


> Not sure. I looked it up on my hospital's drug info programs, which are very comprehensive, but I'm coming up with nada.
> 
> Half-life is important, but so is the order of elimination. Zero order drugs will decay and/or be eliminated at a linear rate. Dilantin, a drug for epilepsy is an example of this. First order drugs will decay and/or be eliminated at a non-linear rate, but will be linear while on log paper. Second order still won't have a linear rate on log paper.
> 
> I could go on, but much like biostats, not my favorite part of my job or schooling. :mad2:


well without that there's not much basis for discussing whether the dosis was small or large.


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## spade2you (May 12, 2009)

den bakker said:


> well without that there's not much basis for discussing whether the dosis was small or large.


Pretty much. Assuming it's first order, which most drugs tend to be, you'd need another data point, then back extrapolate using the elimination constant. Even then, since we don't know when it was consumed, it's a guessing game of how much he might have taken at a given time. Maybe he took a full dose a long time ago or he just took a very small dose close to the time of the lab draw.


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## Fredke (Dec 10, 2004)

spade2you said:


> Pretty much. Assuming it's first order, which most drugs tend to be, you'd need another data point, then back extrapolate using the elimination constant. Even then, since we don't know when it was consumed, it's a guessing game of how much he might have taken at a given time. Maybe he took a full dose a long time ago or he just took a very small dose close to the time of the lab draw.


http://dx.doi.org/10.1016/S0378-4274(99)00270-2
_... the pharmacokinetic model described in human volunteers after the administration of single doses of 20; 40 or 80 μg clenbuterol/__toto as a parent drug was considered (Yamamoto et al., 1985). About 3–5% of orally administered (±) clenbuterol as a single dose to men is found in the 1500 ml of urine excreted in the period 24–48 h later, during the steady-state period of the excretion curve. For example, a dose of 40 μg/__toto would induce, during the said period, an excretion of 1.6 μg clenbuterol in 1500 ml urine, and therefore we should find a level of about 1.1 ng/ml urine in the sample collected 36 h after poisoning, i.e. 1.65–3.85 μg clenbuterol found in 1500 ml (or 3500 ml urine), corresponding to a theoretical amount of 41 to 91 μg/__toto, ingested with the meat. Assuming that β stimulants do have a linear kinetic, as the literature states (Yamamoto and Morgan), the ingestion of 100 μg would result, 36 h later, in a level of about 2.7 ng/ml urine, 300 μg of 8.1 ng/ml, and so on._​


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## spade2you (May 12, 2009)

Fredke said:


> http://dx.doi.org/10.1016/S0378-4274(99)00270-2
> _... the pharmacokinetic model described in human volunteers after the administration of single doses of 20; 40 or 80 μg clenbuterol/__toto as a parent drug was considered (Yamamoto et al., 1985). About 3–5% of orally administered (±) clenbuterol as a single dose to men is found in the 1500 ml of urine excreted in the period 24–48 h later, during the steady-state period of the excretion curve. For example, a dose of 40 μg/__toto would induce, during the said period, an excretion of 1.6 μg clenbuterol in 1500 ml urine, and therefore we should find a level of about 1.1 ng/ml urine in the sample collected 36 h after poisoning, i.e. 1.65–3.85 μg clenbuterol found in 1500 ml (or 3500 ml urine), corresponding to a theoretical amount of 41 to 91 μg/__toto, ingested with the meat. Assuming that β stimulants do have a linear kinetic, as the literature states (Yamamoto and Morgan), the ingestion of 100 μg would result, 36 h later, in a level of about 2.7 ng/ml urine, 300 μg of 8.1 ng/ml, and so on._​


I might have nightmares of cramming for toxicology exams tonight.


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## den bakker (Nov 13, 2004)

scrap that. It was 300ng for the steak not the animal.


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## T K (Feb 11, 2009)

So this is all way over my head, but would he have had to eat one bite or 10lbs of meat to get that level.


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## Gatorback (Jul 11, 2009)

Well I'm not going to swear by Wikipedia, but the half-life is listed there as 36-39 hours:

http://en.wikipedia.org/wiki/Clenbuterol

Can't this be easily referenced in the PDR? I've got one at my office, but not at home.


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## tbgtbg (Mar 13, 2009)

*Let me add to the confusion*

Say 100mcg dose for 150 lbs person is same as for a beefer....
If it evenly disperses throughout the tissues, this gives about 666ng/pound before the clenbuterol starts to get excreted and/or metabolized. So if it took a day or two before the cow "gave up its beef", a pound of steak might have about 300ng in it. 
Plausible, but I don't believe it for a second...


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## spade2you (May 12, 2009)

T K said:


> So this is all way over my head, but would he have had to eat one bite or 10lbs of meat to get that level.


That would depend on how much the cow had, how much it weighs, and how long before slaughter, I guess. Then it would depend on tissue concentration, how much steak AC ate, how long to the test, and planetary alignment.


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## tbgtbg (Mar 13, 2009)

*Another thought....*

Say it wasn't a pound of beef containing 300ng Clenbuterol, but a pound (pint) of blood containing that level... Seems then the blood was drawn shortly after taking a dose of the Clen, and also seems its a level that easily could have been detected had the "frozen" sample been screened.


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## spade2you (May 12, 2009)

tbgtbg said:


> Say it wasn't a pound of beef containing 300ng Clenbuterol, but a pound (pint) of blood containing that level... Seems then the blood was drawn shortly after taking a dose of the Clen, and also seems its a level that easily could have been detected had the "frozen" sample been screened.


The math for this makes sense. I hope this isn't the case because it would really indicate how dumb dopers are. 

I still would think that if he was blood doping that we'd be able to detect some increase in RBCs, given the very low levels of anything that we can now detect.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> The math for this makes sense. I hope this isn't the case because it would really indicate how dumb dopers are.
> 
> I still would think that if he was blood doping that we'd be able to detect some increase in RBCs, given the very low levels of anything that we can now detect.


An Astana insider has said the it was due to a transfusion. He said that they reduced the size of the transfusions and increased the frequency in order to not trip the Biopassport.Add some saline and plasma expandors and it is possible not to show dramatic movement in your numbers
http://www.velonation.com/News/ID/5...-transfusion-prior-to-the-Tour-de-France.aspx


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> An Astana insider has said the it was due to a transfusion. He said that they reduced the size of the transfusions and increased the frequency in order to not trip the Biopassport.Add some saline and plasma expandors and it is possible not to show dramatic movement in your numbers
> http://www.velonation.com/News/ID/5...-transfusion-prior-to-the-Tour-de-France.aspx


I've seen those articles, but I don't much much into an article with an anonymous source. My friends in journalism once told me that it's just as easy for someone to make up crap and claim it's anonymous. 

Saline has nothing to do with the process and will not hide anything. Now that they can test for plasma expanders, they should be able to detect that. As for micro doping for the biological passport, I don't think that process is too effective.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> I've seen those articles, but I don't much much into an article with an anonymous source. My friends in journalism once told me that it's just as easy for someone to make up crap and claim it's anonymous.
> 
> Saline has nothing to do with the process and will not hide anything. Now that they can test for plasma expanders, they should be able to detect that. As for micro doping for the biological passport, I don't think that process is too effective.


A saline drip would not bring down Hct?


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## jnschwie (Apr 17, 2008)

spade2you said:


> Half-life is important, but so is the order of elimination. Zero order drugs will decay and/or be eliminated at a linear rate. Dilantin, a drug for epilepsy is an example of this. First order drugs will decay and/or be eliminated at a non-linear rate, but will be linear while on log paper. Second order still won't have a linear rate on log paper.


You wouldn't really characterize a zero order drug with a half-life. You could, technically speaking, but no one does. About the only thing in common use with a zero-order decay is ethanol.


Also, I'd classify dilantin as michaelis-menten, personally. As long as you're not past saturable metabolism, and you shouldn't be within the therapeutic window, it'll behave first order, like 95% of the drugs we use.



You could also get past all the problems of "log paper" by using non-compartmental PK, if you were so inclined. I'm not into that personally, but it has its place.


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## jnschwie (Apr 17, 2008)

Why would you add a plasma expander?


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## jnschwie (Apr 17, 2008)

Here's some more PK fun I yanked from micromedex, just for giggles:



> *2.2 Drug Concentration Levels*
> A) Time to Peak Concentration
> 1) Oral: 2 to 3 hours (Couet et al, 1989; Boner et al, 1987aa; Kamburoff et al, 1977).
> a) Peak serum levels of clenbuterol occur 2 to 3 hours following single doses or during multiple-dose administration (Boner et al, 1987aa; Couet et al, 1989; Kamburoff et al, 1977). With doses of 20 mcg twice daily, steady-state serum levels of clenbuterol are achieved in approximately 8 days (Couet et al, 1989).
> ...


Also to note, I'm seeing a half-life listed as short as 25 hours, but on up through the numbers that Gatorback listed. This is neither here nor there, as pointed out, if it came from a frozen blood sample (rather than beef), the "expected" concentration could be anything. I have no stability data to suggest it would break down or otherwise, but beta-agonists are moderately stable.

The typical oral doses micromedex lists are 20-40mcg BID. You can't just jump from that to a concentration however, the math listed above tends to neglect bioavailability, which is approximately 75%. Do your math with that in mind. Either way, though, the target site of action is the lung. So, inhaled will be much more effective as well as much less likely to be found in such concentrations in the blood. Think about how we treat asthma in the US: Do we use inhalers or albuterol syrup? Typically, only the kids and those who simply will never get technique get the oral products. It would be stupid to do. 


I honestly haven't really followed this story. I don't really GAF about Contador. What was his concentration? 50pg/mL? Less than expected for therapeutic use in a "normal" asthmatic. He could be trying to microdope orally, although using the inhaled product would have been better.



This is all just mental masturbation, however. No matter the scenario, the drug simply should not be in his blood.


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> A saline drip would not bring down Hct?


Nope.


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## terzo rene (Mar 23, 2002)

It doesn't matter what the half life is or any other number. The burden of proof is on Contador to prove it was from the meat, not on WADA to prove it wasn't (which isn't possible to prove anyway).

WADA also didn't prove a pixie didn't administer clenbuterol to Contador in the middle of the night so perhaps that would be a better defense than contaminated meat since, unlike the rate for meat contamination, it would be harder for WADA to establish the incidence rate of pixie PED attacks.


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## Coolhand (Jul 28, 2002)

BTW- this is my favorite Doping thread; ton's of good information. Thanks to everyone who contributed so far. 

:thumbsup:


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> Nope.


Sorry, but that makes no sense. 

If you increase the amount of liquid in the blood your % of red blood cells drops. This is one of the reasons saline drips were banned in 2005. Catlin, Ashenden, and others have said this was a common tactic. It was discussed often when Armstrong delayed testers for 40 minutes when he took a shower, 50 minutes after a stage in 2009, and 55 minutes before a morning test. The consistent concern was that this was enough time to take an saline infusion that could bring down his Hct temporary


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## Doctor Falsetti (Sep 24, 2010)

jnschwie said:


> Why would you add a plasma expander?


to reduce the % red blood cells. Most can be tested for but there have been rumors for years that there are some are untestable


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> Sorry, but that makes no sense.
> 
> If you increase the amount of liquid in the blood your % of red blood cells drops. This is one of the reasons saline drips were banned in 2005. Catlin, Ashenden, and others have said this was a common tactic. It was discussed often when Armstrong delayed testers for 40 minutes when he took a shower, 50 minutes after a stage in 2009, and 55 minutes before a morning test. The consistent concern was that this was enough time to take an saline infusion that could bring down his Hct temporary


Unfortunately, your post is what makes no medical sense. If it were true, everyone on saline would need to be transfused. I trust you're thinking of using Google to argue against my point, but saline has no real pertinence in this equation. You can use Google all you want, but I'll settle for the piece of paper I got when I grajiated.


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> to reduce the % red blood cells. Most can be tested for but there have been rumors for years that there are some are untestable


Reducing the percent of RBCs would go completely against the goals of blood doping. The theory is that plasma expanders can help hide an increase in RBCs and/or mask EPO. I can understand how it might work in theory, but it was never taught in school since I graduated well before most would have thought this up. I suppose it won't be used very long because we can test for it now, too.


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## wiz525 (Dec 31, 2007)

Curious: If Contador's positive is from a transfusion taken from blood right after the Dauphine, is there no more sample from the doping controls during the Dauphine to test for Clen???


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## spade2you (May 12, 2009)

terzo rene said:


> It doesn't matter what the half life is or any other number. The burden of proof is on Contador to prove it was from the meat, not on WADA to prove it wasn't (which isn't possible to prove anyway).
> 
> WADA also didn't prove a pixie didn't administer clenbuterol to Contador in the middle of the night so perhaps that would be a better defense than contaminated meat since, unlike the rate for meat contamination, it would be harder for WADA to establish the incidence rate of pixie PED attacks.


I'm in no way denying any wrong doing on AC's part, but such small numbers (a pg is ten to the -12 power of a gram) becomes an interesting debate that involve a lot of @$^@ math with elimination constants, quantitative analysis, etc. 

I vote that jnschwie handles all the subject matter of the analysis and chemical properties from this point on.  This way, I do not need to relive those classes, math, and cramming for exams!


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## Eyorerox (Feb 19, 2008)

A litre of saline will reduce the haematocrit, but only for a very short time say 60 min, so called plasma expanders, (starches) will do so for much longer around 4 hours.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> Unfortunately, your post is what makes no medical sense. If it were true, everyone on saline would need to be transfused. I trust you're thinking of using Google to argue against my point, but saline has no real pertinence in this equation. You can use Google all you want, but I'll settle for the piece of paper I got when I grajiated.


Lets make this simple Doctor. 

If you add something to your blood.... plasma, saline, bourbon....this will decrease the percentage of your blood that is RBC's. All the parts can only add up to 100%.

I did not even need Google to find this 

http://sports.espn.go.com/oly/cycling/news/story?id=5222488



> "We always knew when the blood testers were going to be there the following morning, so we would know when to have the saline solution bags so we could dilute our blood the night before,


http://sports.espn.go.com/oly/cycling/news/story?id=5222488



> they were measuring their hemoglobin five or six times a day with a little handheld machine. They had all kinds of ways to do it. If their hemoglobin got too high, they took a bottle of saline and lowered it. If it got too low, they squirted in some red cells.”


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> Lets make this simple Doctor.
> 
> If you add something to your blood.... plasma, saline, bourbon....this will decrease the percentage of your blood that is RBC's. All the parts can only add up to 100%.
> 
> ...


Why did I *know* you were going to argue with my clinical experience. You've become the next Blackjack. 

Trying to push extreme amounts of fluid to hide doping is nothing new. In fact, osmolarity is tested for this exact purpose. In micro doping, this plays a finite role, but so does the finesse of using small amounts of EPO. Get the fluid amount or the EPO amount wrong and they get caught, much like the BMC rider earlier this year.


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## jnschwie (Apr 17, 2008)

Seems like the addition of Hespan (or analogous) would raise many more red flags.


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## spade2you (May 12, 2009)

jnschwie said:


> Seems like the addition of Hespan (or analogous) would raise many more red flags.


It does now that we're on to 'em. Pretty clever. I wonder if Di Luca divulged that to shorten his suspension.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> Why did I *know* you were going to argue with my clinical experience. You've become the next Blackjack.
> 
> Trying to push extreme amounts of fluid to hide doping is nothing new. In fact, osmolarity is tested for this exact purpose. In micro doping, this plays a finite role, but so does the finesse of using small amounts of EPO. Get the fluid amount or the EPO amount wrong and they get caught, much like the BMC rider earlier this year.


I am not arguing. 

You disagreed with what I have written, I produced some articles quoting experts in the field that support what I have written........ and you compare me to a banned troll because I produced information that supports what I wrote. Strange. 

In the future the best thing to do is to just provide a clear explanation of why Catlin, Ashenden, and the USPS doping program were wrong.


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> I am not arguing.
> 
> You disagreed with what I have written, I produced some articles quoting experts in the field that support what I have written........ and you compare me to a banned troll because I produced information that supports what I wrote. Strange.
> 
> In the future the best thing to do is to just provide a clear explanation of why Catlin, Ashenden, and the USPS doping program were wrong.


Experts in the field? If they wanna claim that, whatever. As for "producing information", Google an the web in general is often fairly weak. You'd need a background in biostats to know why.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> Experts in the field? If they wanna claim that, whatever. As for "producing information", Google an the web in general is often fairly weak. You'd need a background in biostats to know why.


Really? Ashenden and Catlin are not experts? How about Jakob Mørkeberg and Bo Belhage? They have said the same thing. Better not tell the UCI as Ashenden helped develop the BioPassport parameters. 

Ok, I guess it is time to come clean. Even though I use the name "Doctor" in my name I am not actually a doctor. Please don't tell the AMA......ok, now your turn.


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## SilasCL (Jun 14, 2004)

spade2you said:


> Nope.


You sure about that?

http://en.wikipedia.org/wiki/Hematocrit


> There have been cases in which the blood for testing was inadvertently drawn proximal to an intravenous line that was infusing packed red cells or fluids. In these situations, the hemoglobin level in the blood sample will not be the true level for the patient because the sample would contain a large amount of the infused material rather than what is diluted into the circulating whole blood. That is, if packed red cells are being supplied, the sample will contain a large amount of those cells and the hematocrit will be artificially very high. On the converse, if saline or other fluids are being supplied, the blood sample would be diluted and the hematocrit will be artificially low.


http://www.sportsci.org/jour/0002/inbrief.html


> When told they are to be tested, apparently they have 10 minutes to report to the medical team. Why 10 minutes? A cynical informant claims that's long enough for an athlete to run 500 ml of saline into a vein. By diluting the blood, the saline immediately brings the hematocrit down by a few percent. The normal hematocrit for "clean" elite cyclists is around 44% (Saris et al., 1998; Schumacher et al., 2000). So it's possible for a cyclist to take enough EPO to increase the hematocrit to around 52%, then infuse saline just before the test to bring the hematocrit back below the limit of 50% (or 51%, to allow for error of measurement).


http://velocitynation.com/content/interviews/2009/michael-ashenden


> AS: As long as they kept their hematocrit below 50.
> 
> MA: And that's a relatively easy thing to accomplish. I mean, you can either use careful adjustments of your dosage, or you can use saline to dilute the blood. It's a relatively simple and fast procedure to bring your hematocrit below 50.
> 
> ...


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## spade2you (May 12, 2009)

SilasCL said:


> You sure about that?


Yeah. Just checked on a patient's H&H on a saline drip. No change.


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## SilasCL (Jun 14, 2004)

spade2you said:


> Yeah. Just checked on a patient's H&H on a saline drip. No change.


What's the flow rate on their line? I think that would have a big impact...


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## spade2you (May 12, 2009)

SilasCL said:


> What's the flow rate on their line? I think that would have a big impact...


125ml/hr and we're on about 48h so far.


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## rubbersoul (Mar 1, 2010)

I vote for spade2you. Dr. Falsetti may know how to use the internet, but he isn't a clinician


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## spade2you (May 12, 2009)

rubbersoul said:


> I vote for spade2you. Dr. Falsetti may know how to use the internet, but he isn't a clinician


I'm no hater of teh interw3b, but too much junk out there and you can often find stuff to contradict what you just found if you really want. A side note: it's not uncommon for people to fudge data to get it to say exactly what they want, but that's a story for another day......... 

Ultimately, it takes a certain skill to know how to weed out the good stuff from junk. To be honest, I tend to hate having to reference studies unless 100% absolutely necessary, otherwise I just go with what I've seen gets results.


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## SilasCL (Jun 14, 2004)

spade2you said:


> 125ml/hr and we're on about 48h so far.


Couldn't a wide open line with a pressure infusers get a much higher flow rate? I'm not an expert, but I think medics can push over a liter an hour in cases of severe blood loss.

If an athlete did that, would the kidneys be able to keep up and filter and excrete all of that?


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## spade2you (May 12, 2009)

SilasCL said:


> Couldn't a wide open line with a pressure infusers get a much higher flow rate? I'm not an expert, but I think medics can push over a liter an hour in cases of severe blood loss.
> 
> If an athlete did that, would the kidneys be able to keep up and filter and excrete all of that?


You can push a liter in an hour or so, but how the body reacts depends a lot on the current fluid status. Most of the time when we push that much, a patient's blood pressure is dangerously low. Under normal blood pressure and fluid status, it's generally considered unsafe to infuse it that fast. It's not that hard to drink a liter in an hour, but directly into the blood stream can cause fluid overload problems potentially. 

Yes, there can be a dilutional factor in blood and urine samples, but as jnschwie noted, the body will quickly try to restore the osmotic balance sooner or later. That time will depend on many factors, but they're not going to fool the testers by saline alone. As noted in another post, testing for dilution has been around for as long as I can remember.


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## Doctor Falsetti (Sep 24, 2010)

rubbersoul said:


> I vote for spade2you. Dr. Falsetti may know how to use the internet, but he isn't a clinician


I may get my info from the internet (It is good for more then just P*rn BTW).....But where do Doctors Ashenden, Catlin, Mørkeberg and Belhage get their info from? 

None of them are referring to a "48 hour drip" they are talking about cracking open a Mickey's Big Mouth


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> I may get my info from the internet *(It is good for more then just P*rn BTW*


FALSE


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## SilasCL (Jun 14, 2004)

spade2you said:


> You can push a liter in an hour or so, but how the body reacts depends a lot on the current fluid status. Most of the time when we push that much, a patient's blood pressure is dangerously low. Under normal blood pressure and fluid status, it's generally considered unsafe to infuse it that fast. It's not that hard to drink a liter in an hour, but directly into the blood stream can cause fluid overload problems potentially.
> 
> Yes, there can be a dilutional factor in blood and urine samples, but as jnschwie noted, the body will quickly try to restore the osmotic balance sooner or later. That time will depend on many factors, but they're not going to fool the testers by saline alone. As noted in another post, testing for dilution has been around for as long as I can remember.


I would imagine that it's unsafe on healthy people, I'm just trying to establish that it's possible and used on patients with severe fluid loss.

Aren't some fluids given intravenously (normal saline, ringers lactate, and other isotonic fluids) similar to plasma so that osmotic balance isn't upset by their addition? Wouldn't these fluids take a while to be processed, and not simply escape into the cells through osmosis?


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## spade2you (May 12, 2009)

SilasCL said:


> I would imagine that it's unsafe on healthy people, I'm just trying to establish that it's possible and used on patients with severe fluid loss.
> 
> Aren't some fluids given intravenously (normal saline, ringers lactate, and other isotonic fluids) similar to plasma so that osmotic balance isn't upset by their addition? Wouldn't these fluids take a while to be processed, and not simply escape into the cells through osmosis?


Crap. Yeah, they're osmotically balanced. The day is taking its' toll on me. The body will try to compensate for the extra fluid volume and eliminate it as soon as it can. The dilutional effect is temporary. I had better get more coffee and try to wake up.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> Crap. Yeah, they're osmotically balanced. The day is taking its' toll on me. The body will try to compensate for the extra fluid volume and *eliminate it as soon as it can.* The dilutional effect is temporary. I had better get more coffee and try to wake up.


Now we know why all those riders stop for a pi$$ in the first km of the race.


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## rubbersoul (Mar 1, 2010)

Doctor Falsetti said:


> I may get my info from the internet (It is good for more then just P*rn BTW).....But where do Doctors Ashenden, Catlin, Mørkeberg and Belhage get their info from?
> 
> None of them are referring to a "48 hour drip" they are talking about cracking open a Mickey's Big Mouth


Last time I checked spending a few minutes on google didn't qualify one to be a hematologist. I may be wrong, but last time I checked the qualifications were more akin to 4 years med school followed by 5 year residency? 

Of course a self professed internet jockey can graduate top of his class as fast as he can form an opinion.


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## Doctor Falsetti (Sep 24, 2010)

rubbersoul said:


> Last time I checked spending a few minutes on google didn't qualify one to be a hematologist. I may be wrong, but last time I checked the qualifications were more akin to 4 years med school followed by 5 year residency?
> 
> Of course a self professed internet jockey can graduate top of his class as fast as he can form an opinion.


It is not my opinion you are questioning, I am just the massager 

Jakob Mørkeberg has written 10 peer-reviewed papers on blood doping within the past three years, and has completed a Master’s thesis entitled Autologous Blood Doping. His PhD dissertation was titled "Detection of Autologous Blood Transfusions via Analyses of Peripheral Blood Samples".He was involved in the running of the CSC and Astana anti-doping programmes until the end of 2008.

Bo Belhage has written 53 publications; of these, 41 are peer-reviewed, two peer-reviewed in press (pending) and 10 book chapters. He is a Doctor of Medical Science, an Associated Research Professor, and was also involved in the running of the CSC and Astana anti-doping programmes. He has been involved in science for 21 years.

I could go on but I am sure you get the picture.....


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> I could go on but I am sure you get the picture.....


You mean you could use more Google? You can do that all you want, but I don't think you're making any real points other than basic internet medicine.


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> It is not my opinion you are questioning, I am just the massager
> 
> Jakob Mørkeberg has written 10 peer-reviewed papers on blood doping within the past three years, and has completed a Master’s thesis entitled Autologous Blood Doping. His PhD dissertation was titled "Detection of Autologous Blood Transfusions via Analyses of Peripheral Blood Samples".He was involved in the running of the CSC and Astana anti-doping programmes until the end of 2008.
> 
> ...


Hang on, these guys were involved with CSC and Astana? I don't know about anyone else, but wouldn't that raise a few eyebrows??? :idea:


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> Hang on, these guys were involved with CSC and Astana? I don't know about anyone else, but wouldn't that raise a few eyebrows??? :idea:


You clearly disagree with them....but why do you think they believe this? Why do the dopers, doping doctors and WADA believe that a bag of saline can drop a riders Hct? You would think that by now Ferrari or Pepe Marti would have figured out that it is worthless. 

If your current internship does not work out there may be a spot on Radioshack next year.


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> You clearly disagree with them....but why do you think they believe this? Why do the dopers, doping doctors and WADA believe that a bag of saline can drop a riders Hct? You would think that by now Ferrari or Pepe Marti would have figured out that it is worthless.
> 
> If your current internship does not work out there may be a spot on Radioshack next year.


To be honest, the fact that they were involved with those teams during those times would lead to a lot of questions involving their integrity or a conflict of inflict to say the least.

So, if you're so awesome, why don't you enlighten us to your educational background and profession?


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## DMFT (Feb 3, 2005)

Doctor Falsetti said:


> Now we know why all those riders stop for a pi$$ in the first km of the race.


- Nahhhh, it couldn't be because they're pumped full of either coffee, nutrition products, water or just all 3.  What do pro's drink over 120k? 6 bottles on an average temp. day??? They pee all the time, you just see it once or twice during race coverage.

So from what i've read, it would safely take an hour or so to pump up with saline. NOBODY that wins a stage get's that much time at the line. Ever. 
- No less on a mountain top finish where there are NO team bus's waiting.


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## spade2you (May 12, 2009)

DMFT said:


> - Nahhhh, it couldn't be because they're pumped full of either coffee, nutrition products, water or just all 3.  What do pro's drink over 120k? 6 bottles on an average temp. day??? They pee all the time, you just see it once or twice during race coverage.
> 
> So from what i've read, it would safely take an hour or so to pump up with saline. NOBODY that wins a stage get's that much time at the line. Ever.
> - No less on a mountain top finish where there are NO team bus's waiting.


Fun fact, pissing like a race horse was coined because Lasix was used to help clear out steroids in the system. Upon learning this, testers also began testing for Lasix, among other similar drugs.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> To be honest, the fact that they were involved with those teams during those times would lead to a lot of questions involving their integrity or a conflict of inflict to say the least.
> 
> So, if you're so awesome, why don't you enlighten us to your educational background and profession?


It appears you missed, or ignored, the "Anti-Doping" part. They were part of the team that ran the internal testing program.....until it became clear that the conflicts of interest were too large and they withdraw their participation. 

Of course it is easier to insult me, question my education, and trumpet your supposed credentials be perhaps a better thing to do would be to explain why so many experts on the subject are wrong? 

I ask this question out of legitimate interest, not as an insult or an attempt to bait you. It is widespread belief and practice and I am interested in understanding why all of these people are wrong?


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> It appears you missed, or ignored, the "Anti-Doping" part.


As did Astana and CSC, eh?


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> As did Astana and CSC, eh?


Most likely not. 

So I guess you are not going to answer my question......


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## spade2you (May 12, 2009)

Doctor Falsetti said:


> Most likely not.


What do you mean "most likely"? They either did or they didn't. If you were wise, you would have not disclosed that they were even working with Astana, who is under suspicion at the moment and had a problem or two while these authors were running the anti-doping program.


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## Doctor Falsetti (Sep 24, 2010)

spade2you said:


> What do you mean "most likely"? They either did or they didn't. If you were wise, you would have not disclosed that they were even working with Astana, who is under suspicion at the moment and had a problem or two while these authors were running the anti-doping program.


Given their history it is a good assumption that Astana and CSC did as much as possible to get around the anti-doping part

He was hired by Astana *after* Vino and Kash as part of a mandate from the UCI. They had been working for CSC for a while. His main role was as an observer of Damsgaard. 
He left when he felt the conflict of interest had become too great he fired Damsgaard and ended his involvement. 
http://www.cyclingnews.com/news/damsgaard-faces-criticism-over-anti-doping-programme

let us know when you can get around to explain why they are wrong. Certainly it is easier to dance around the question.


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## DMFT (Feb 3, 2005)

Doctor Falsetti said:


> let us know when you can get around to explain why they are wrong. Certainly it is easier to dance around the question.



- How about showing "proof" they're "right"? M.A. at the least has a vested interest in being "right" right? He'd look like a quack if he showed "proof" he was wrong afterall......

Good Dr's have ego's too ya know "Dr. F"


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## Doctor Falsetti (Sep 24, 2010)

DMFT said:


> - How about showing "proof" they're "right"? M.A. at the least has a vested interest in being "right" right? He'd look like a quack if he showed "proof" he was wrong afterall......
> 
> Good Dr's have ego's too ya know "Dr. F"


This thread has multiple statements from multiple doctors, not just Ashenden, who are experts in the field. I can add many more if you like as it has been a pretty active concern since the launch of the Biopassport. 

A poster is saying all of these doctors are wrong. So far the only explanations offered are attacks on the doctors, questions about my education, a critic of Google, but no explanation or supporting evidence. Spade claims to be a doctor so I am legitimately interested in hearing why these guys are all wrong and the saline bags are a waste of time.


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## worst_shot_ever (Jul 27, 2009)

This is a good thread. The ad hominum arguments concerning Dr F take away from that, IMHO. There are at least sources that seem to say that some doping atheletes and their doctors/coconspirators/monitors seem to believe that it is possible to alter blood levels in a way designed to cheat the tests through infusion of saline. Perhaps it takes too much inside-medicinal baseball to explain why that belief is flawed, but it's a valid, reasonable question to ask.

That said, did anyone see the article published about the big meeting at Interpol?? Geez, my take away was that the US federal investigation is a lot further along and concrete than I imagined it was. I'll look for the link -- it's a must read for those following the saga.

Edit: It's an AP piece. May deserve it's own thread. Here's a link: http://hosted.ap.org/dynamic/stories/C/CYC_ARMSTRONG_DOPING?SITE=TNMEM&SECTION=HOME&TEMPLATE=DEFAULT


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## heathb (Nov 1, 2008)

Just from my personal experience as a MedTech running a night shift hospital lab. We run an H&H on patients that come into ER and 8 hours later during morning rounds. 

I routinely see 1 gram drop in Hgb and up to 3% drops in HCT after being started on saline. As several days progress a person that arrives in ER with a 14g Hgb/39% Hct is often 11 Hgb/33 Hct, with no signs of a GI bleed. The body of an athlete however probably compensates much better than a sick person with limited mobility.

As far as Contador being taking out of the game for using this minuscule amount of questionable substance, I think we're going a little overboard. I think it's great to catch the blood dopers, but WADA's list of banned substances reads like the Library of Congress catalog. I would be banned based off my asthma drugs.


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## Doctor Falsetti (Sep 24, 2010)

worst_shot_ever said:


> That said, did anyone see the article published about the big meeting at Interpol?? Geez, my take away was that the US federal investigation is a lot further along and concrete than I imagined it was. I'll look for the link -- it's a must read for those following the saga.
> 
> Edit: It's an AP piece. May deserve it's own thread. Here's a link: http://hosted.ap.org/dynamic/stories/C/CYC_ARMSTRONG_DOPING?SITE=TNMEM&SECTION=HOME&TEMPLATE=DEFAULT


Very interesting article, it deserves it's own thread. 

It appears as if the investigation is much broader then is publicly known. This is good..... if this turns out to be only about one rider doping I will be pi$$ed. They really need to go after the traffickers, financiers, and enablers. Taking out a Ferrari, Martinelli, or Marti will do a lot more then banning a one rider for life.


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## heathb (Nov 1, 2008)

Doctor Falsetti said:


> Very interesting article, it deserves it's own thread.
> 
> It appears as if the investigation is much broader then is publicly known. This is good..... if this turns out to be only about one rider doping I will be pi$$ed. They really need to go after the traffickers, financiers, and enablers. Taking out a Ferrari, Martinelli, or Marti will do a lot more then banning a one rider for life.


Yeah it does look like they're doing a lot of work, lets remember there's a recession and they have to look busy to keep their jobs. 

When they're being this secretive it usually means they have nothing, they're just hoping to pull in a few more paychecks before the Teabaggers shut this operation down.


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## adimiro (Jun 28, 2007)

IMHO as someone with an MD after their name:

(1) THe degree of intravascular volume does affect the measured Hematocrit volume.

(2) This fact even has a designated medical terminology called:

(a) Hemodilution...when the Hct is lowered (without evidence of bleeding)...95% of the time, the cause is intravenous fluid administration.
(b) Hemoconcentration...when the Hct is falsely elevated...95% of the time due to a dehydrated state.

The duration and magnitude of hematocrit (Hct) changes is dependent on many concurrent factors, but in its most simplied explantion, YES...acute IV fluid administration will lower the measured Hct.


Hope my credentials are sufficient to appease this tough forum crowd.


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## wiz525 (Dec 31, 2007)

spade- are you a physician? I thought you said you were a pharmacist? Not that it really matters as pharmacists know quite a lot about pharmacology and physiology, you're just coming off MD-ish in this thread. and since you asked, i am not an MD. I have a PhD in genetics, so i stay clear of hardcore PK/PD discussions!


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## tinkerbeast (Jul 24, 2009)

DMFT said:


> - How about showing "proof" they're "right"? M.A. at the least has a vested interest in being "right" right? He'd look like a quack if he showed "proof" he was wrong afterall......
> 
> Good Dr's have ego's too ya know "Dr. F"


its obvious you know nothing of the process of peer-review


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## DMFT (Feb 3, 2005)

Doctor Falsetti said:


> Very interesting article, it deserves it's own thread.
> 
> It appears as if the investigation is much broader then is publicly known. This is good..... if this turns out to be only about one rider doping I will be pi$$ed. They really need to go after the traffickers, financiers, and enablers. Taking out a Ferrari, Martinelli, or Marti will do a lot more then banning a one rider for life.



Completely agree. It does sound like multiple Countries are working together on this. For once anyway's.

When will Spain cave and "really" do something?


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## DMFT (Feb 3, 2005)

tinkerbeast said:


> its obvious you know nothing of the process of peer-review


Maybe more like a sham peer review in the case of the samples from 99 and some of LNDD's past processes.....


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## Doctor Falsetti (Sep 24, 2010)

DMFT said:


> Maybe more like a sham peer review in the case of the samples from 99 ..


Good point, I doubt the Vrijman report would survive any peer review process.


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## Gatorback (Jul 11, 2009)

> "American taxpayer money is being squandered on a European trip for FDA investigators to dredge up old allegations that have already been thoroughly examined and completely discredited," he said. "All of Lance's samples were clean when they were first provided and tested, and no amount of tax-money-wasting European meetings can change that fundamental fact."/QUOTE]
> 
> These statements tell me Armstrong's people are scared. They are attacking the process before it is even complete. That is telling.


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## terzo rene (Mar 23, 2002)

After all the credentials talk I have to add this link:
http://en.wikipedia.org/wiki/Argument_from_authority


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## davidka (Dec 12, 2001)

Doctor Falsetti said:


> Very interesting article, it deserves it's own thread.
> 
> It appears as if the investigation is much broader then is publicly known. This is good..... if this turns out to be only about one rider doping I will be pi$$ed. They really need to go after the traffickers, financiers, and enablers. Taking out a Ferrari, Martinelli, or Marti will do a lot more then banning a one rider for life.


Unfortunately the only ones to go after are the users. The drugs are all legal when used medically. EPO is practically a medical miracle to patients that actually need it. This varies with each country of course but theres a rule that applies to illegal goods, get rid of the customer and the dealer goes away by himself.

This has been a very informative thread. One question I have for the doctors that have shared their knowledge of the drug's half life is this; With Bert claiming the clenbuterol was in steak, is it important to the contamination story that the meat was or wasn't cooked? I have to think that this heat would have some effect on the supposed concentrations of the substance in the meat as well as it's having to pass through a digestive system from there.


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## den bakker (Nov 13, 2004)

terzo rene said:


> After all the credentials talk I have to add this link:
> https://en.wikipedia.org/wiki/Argument_from_authority


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## Gatorback (Jul 11, 2009)

davidka said:


> Unfortunately the only ones to go after are the users. The drugs are all legal when used medically. EPO is practically a medical miracle to patients that actually need it. This varies with each country of course but theres a rule that applies to illegal goods, get rid of the customer and the dealer goes away by himself.


That is simply not true. In fact, most law enforcement agencies spend their time going after the big fish--the suppliers and the distributors--instead of the end users.


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## spade2you (May 12, 2009)

davidka said:


> This has been a very informative thread. One question I have for the doctors that have shared their knowledge of the drug's half life is this; With Bert claiming the clenbuterol was in steak, is it important to the contamination story that the meat was or wasn't cooked? I have to think that this heat would have some effect on the supposed concentrations of the substance in the meat as well as it's having to pass through a digestive system from there.


That's a good question. Cooking could potentially destroy some of the drug. I would guess that it should be somewhat heat stable, given that China had a problem with it a while back. Then again, ya never know how well the Chinese were cooking the meats.

On a side note, I think if AC really got it from a steak, I would have thought farmers would have quickly acted to try to cover their own tracks ASAP. If he's telling the truth, the evidence is probably long gone.


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## davidka (Dec 12, 2001)

Gatorback said:


> That is simply not true. In fact, most law enforcement agencies spend their time going after the big fish--the suppliers and the distributors--instead of the end users.


I know that but this is why they are unsuccessful at slowing down the drug trade. Big siezures make headlines but they don't seem to make much progress. Get rid of the customer and the dealer loses his purpose.


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## Big-foot (Dec 14, 2002)

From the source....



spade2you said:


> That would depend on how much the cow had, how much it weighs, and how long before slaughter, I guess. Then it would depend on tissue concentration, how much steak AC ate, how long to the test, and planetary alignment.


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## orange_julius (Jan 24, 2003)

heathb said:


> As far as Contador being taking out of the game for using this minuscule amount of questionable substance, I think we're going a little overboard. I think it's great to catch the blood dopers, but WADA's list of banned substances reads like the Library of Congress catalog. I would be banned based off my asthma drugs.


No you won't be. Unless you are too lazy to apply for a TUE (Therapeutic Use Exemption). Ever wonder why half the peloton is on TUE for one reason or another?


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## worst_shot_ever (Jul 27, 2009)

Not to mention that there is both direct and circumstantial evidence that Contador is a blood doper.


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## jms (Jan 9, 2008)

*Lol!*



Big-foot said:


> From the source....


LOL. I loved the wristband. Well played sir.


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