Wednesday, November 18, 2009

Bike Pure - And Why the Athletes Must Speak

I had a great anti-doping heart-to-heart with BikePure earlier this afternoon. I wish I had $1,000,000 so I could donate part of it to support BP and propagate their message...I don't, but I'm still trying to help by contributing to BP the details of my sordid affair with EPO and doping in general. I hope other cyclists who've taken similarly misguided paths will consider working with BikePure to drive the grassroots fight against doping - which has to start with free, open dialogue and a realistic assessment of what the hell has been going on not just in cycling, but in sport in general with regards to the use of performance enhancing drugs and illegal methods of preparation.

I believe that it is vitally important for athletes who've doped and are seeking redemption to tell the truth about what they did, what they gained by doping, and perhaps most importantly, what they may have lost. Doping is something that pays almost immediate dividends, but apart from perhaps the monies spent on actual doping products or medical supervision, it doesn't reveal its full cost in terms of harming the well-being of the athlete and his sport until much later - and usually only after the wheels have come off. Scientific studies and research, including as the work done by Birekeland KI, Stray-Gundersen J, Hemmersbach P, et al. Effect of rhEPO administration on serum levels of sTfr and cycling performance. Med Sci Sport Exerc 2000; 32:1238-43, have confirmed that EPO can improve athletic performance in as little as four weeks, but there is little data or even informed discussion of the long-term adverse effects of EPO use on the physical and mental health of athletes. Patrick Mignon of France's CESAMES - the Research Center on Mental Health, Psychotropics, and Society - writes:

"If the knowledge of the physiological effects of doping has progressed, this is not the case for that about the long term consequences of doping on the state of health of former athletes, whose physical dependency might be one of the characteristics. This calls for the appropriated apparatuses for observation that could link the careers of athletes to their health history (wounds, consumption of psychoactive substances, recourse to mental health) and quantitative studies (combination of grids for questionnaires, elaboration of questionnaires aimed at targeted groups or at the general population). The analysis of the pharmacological effects of a substance is not enough. To it must be added the sociological analysis of dependency as a dependency on a life style that supposes the involvement in the career of top level athlete. This must be carried out through the analysis of the organization of time and of the relations between an athlete and the actors in charge of them. The analysis of high level sports as a life style thus leads back to a reflection risk behavior, to analyze the question of drugs i sports as both an aspect of this life style and a way of managing the exit from the world of sports..." [Editor's note: The Research Center on Mental Health, Psychotropics and Society (CESAMES) is a mixed research unit of France's Centre National de la Recherche Scientifique (CNRS) and the University René Descartes Paris 5.]

Though I've had some opportunity to speak on the dangers of doping and retell my own story as a warning to others, I hope that over time I will be able to play a more active role in the anti-doping movement, especially with regards to educating young athletes on the full spectrum of risks they face by involving themselves in doping.

More on the Birkeland study:

"BIRKELAND, K. I., J. STRAY-GUNDERSEN, P. HEMMERSBACH, J. HALLEN, E. HAUG, and R. BAHR. Effect of rhEPO administration on serum levels of sTfR and cycling performance. Med. Sci. Sports Exerc., Vol. 32, No. 7, pp. 1238-1243, 2000.

Purpose: We assessed the possibility of using soluble transferrin receptor (sTfR) as an indicator of doping with recombinant erythropoietin (rhEPO).

Methods: A double-blind, placebo-controlled study was conducted with the administration of 5000 U of rhEPO (N = 10) or placebo (N = 10) three times weekly (181-232 U[middle dot]kg-1[middle dot]wk-1) for 4 wk to male athletes. We measured hematocrit and the concentration of hemoglobin, sTfR, ferritin, EPO, and quantified the effects on performance by measuring time to exhaustion and maximal oxygen uptake ( O2max) on a cycle ergometer.

Results: Hematocrit increased from 42.7 /- 1.6% to 50.8 /- 2.0% in the EPO group, and peaked 1 d after treatment was stopped. In the EPO group, there was an increase in sTfR (from 3.1 /- 0.9 to 6.3 /- 2.3 mg[middle dot]L-1, P < 0.001) and in the ratio between sTfR and ferritin (sTfR[middle dot]ferritin-1) (from 3.2 /- 1.6 to 11.8 /- 5.1, P < 0.001). The sTfR increase was significant after 1 wk of treatment and remained so for 1 wk posttreatment. Individual values for sTfR throughout the study period showed that 8 of 10 subjects receiving rhEPO, but none receiving placebo, had sTfR levels that exceeded the 95% confidence interval for all subjects at baseline (= 4.6 mg[middle dot]L-1). O2max increased from 63.6 /- 4.5 mL[middle dot]kg-1[middle dot]min-1 before to 68.1 /- 5.4 mL[middle dot]kg-1[middle dot]min-1 2 d post rhEPO administration (7% increase, P = 0.001) in the EPO group. Hematocrit, sTfR, sTfR[middle dot]ferritin-1, and O2max did not change in the placebo group."

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