EPO and Blood Doping in Sports

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When it comes to finding an athletic edge, athletes will try just about anything from using the latest training and recovery techniques, modifying diets and hydration, training at altitude and using sports psychology techniques in hopes of finding the ideal performance formula. Unfortunately, many athletes try to take this to a level that is extreme, and in some cases dangerous. Some strategies to enhance performance are controversial, and many sporting organizations have banned specific practices among competitive and professional athletes.

One such method of gaining a performance edge is altering the body's ability to use, produce and carry oxygen to the working muscles. This practice is most commonly associated with endurance athletes, and cyclists have been those most in the spotlight for a technique called 'blood doping.'

What Is Blood Doping?

Blood doping is a method of increasing athletic performance by artificially increasing an athlete's red blood cell (RBC) count. Because red blood cells carry oxygen to the muscles, having a higher RBC count can dramatically improve an athlete’s aerobic capacity and delay fatigue. Athletes looking for a way to boost their RBC initially turned to blood transfusions, where an athlete stored and re-infused his or her own RBCs or the RBCs of someone with the same blood type. This practice is banned in professional sports.

What Is Erythropoietin (EPO)?

One means of artificially boosting RBC counts involves a drug that has been the target of accusation and speculation among the professional cycling world for more than a decade.

Erythropoietin (EPO) is a naturally-occurring hormone, produced by the kidneys, that stimulates the production of red blood cells. This hormone can also be manufactured and injected into the skin or directly into the bloodstream (intravenously). EPO may be used in medical practice to bring patient's RBC into normal levels.

The use of artificial EPO as a means of increasing athletic performance first showed up 1980s and has been linked with drug-use scandals in professional cycling. Despite the creation of an EPO detection test in 2000, some claim that EPO doping is still widespread in pro sports.

EPO abuse in cycling made the news when Floyd Landis, the 2006 Tour de France winner who was stripped of his title after testing positive for doping, confessed to years of using performance-enhancing drugs. His confession also accused 17 other riders including Lance Armstrong of doping.

In May of 2011, 60 Minutes aired an interview with former U.S. Postal Team Rider, Tyler Hamilton in which Hamilton said he injected EPO along with Lance and other teammates, "many, many times."

Is Erythropoietin (EPO) Dangerous?

Yes, EPO has its dangers. EPO injections thicken the blood, which increases the strain on the heart. This is particularly dangerous when the heart rate slows down, such as during sleep. The increased thickness, or viscosity, of the blood increases the risk of blood clots, heart attacks, and strokes. According to the book The death of Marco Pantani by Matt Rendell, some cyclists reportedly set an alarm each night to wake up and cycle on a trainer for ten minutes to jump-start their circulation and reduce the possible health risks of using EPO.

EPO is on the banned substances list in professional cycling, and riders are regularly tested to detect its presence. However, as the drug detection methods improve, so do the methods used to avoid detection. This and many other banned methods of boosting athletic performance are under constant scrutiny by sporting agencies. 

The cycling world has been in the spotlight for many years and many hope that the next generation of cyclists will return to less risky methods of performance enhancement that include nutrition, training, and sports psychology techniques and skills.

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Article Sources
  • The World Anti-Doping Agency (WADA). Questions & Answers on EPO Detection.
  • The World Anti-Doping Agency (WADA). WADA Internatioal Standards.