EPO: Are the results permanent?



gntlmn

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Jul 28, 2003
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I'm wondering if a rider who builds up his red blood cell count and O2 uptake with EPO will have a permanent, positive increase in performance. How long does it take before the drug wears off and the blood counts go back down, if they do?
 
Originally posted by gntlmn
I'm wondering if a rider who builds up his red blood cell count and O2 uptake with EPO will have a permanent, positive increase in performance. How long does it take before the drug wears off and the blood counts go back down, if they do?

The increased Red Blood count is not permenent. The duration varies from person to person. There is a loading dose and a maintenance dose required.

However the risk of a heart attack during activity or more likely while sleeping is an ever permenent risk.

Its also possible to with realising buy fake.

It just depends on where a cyclists priorities are i guess.
 
Originally posted by gntlmn
I'm wondering if a rider who builds up his red blood cell count and O2 uptake with EPO will have a permanent, positive increase in performance. How long does it take before the drug wears off and the blood counts go back down, if they do?

Due to wear and tear, the average red cell lasts about 90 days in humans. If you stopped taking EPO, the high red cell count would gradually taper off over that period.
 
Originally posted by mitosis
Due to wear and tear, the average red cell lasts about 90 days in humans. If you stopped taking EPO, the high red cell count would gradually taper off over that period.

Now I understand why it's so easy to cheat with EPO, at least from the point of view that it still has enhancing effects up to 90 days after you take it, according to this.
 
Its very difficult to catch someone. Its also possible to increase your red blood cell count through high altitude training.
 
Or by blood doping - taking some of your own blood several months before a big event then reinjecting it shortly before the race.
 
Originally posted by mitosis
Or by blood doping - taking some of your own blood several months before a big event then reinjecting it shortly before the race.

And this type of cheating has now come back in to vogue because
EPO is now detectable.

In the 1970's - blood transfusions were the vogue (it wasn't illegal at the time).
Lasse Viren the Finnish long distance rider was alleged to have
had quantities of blood transfused out of his body - and the same
blood was stored and then transfused back in to him just before
major competition.

This type of activity is largely undectable - where as performance
enhancers which are chemical based, may well leave a trace.
 
Originally posted by steve007
Its very difficult to catch someone. Its also possible to increase your red blood cell count through high altitude training.

Actually, the high altitude training is well known and acceptable as a form of training, not doping, although it's effects are similar to EPO in that it raises improves red blood cell count. I don't think you have the heart attack risk that EPO poses, however, and I don't know exactly why. I suppose that EPO can raise the count into a risky level, but that the altitude training does not. Sleeping in hypoxic (low oxygen) tents is popular now, although it's not always comfortable. I wonder if riders take these on the tours.
 
Detecting EPO use is anything but a cut and dry matter and requires several tests to confirm a positive result.

The synthetic EPO peptide differs only very slightly from natural EPO. While the synthetic markers can be detected in the blood, the test is only reliable if the injection occurred in the previous 6-12 hours. Obviously, this test is of very limited value, especially in that the positive benefits of EPO are greatest some 3 weeks after the injection. This renders David Millar's alleged use timed to fit perfectly into the mountain stages of the TDF.

Since EPO raises one's hematocrit, an initial positive test for EPO use is flagged with a hematocrit of >50 and a reticulocyte count of >2.4. An initial positive is confirmed with a very sensitive urine test that assays for certain markers of synthetic EPO.
 
Originally posted by limerickman
And this type of cheating has now come back in to vogue because
EPO is now detectable.

In the 1970's - blood transfusions were the vogue (it wasn't illegal at the time).
Lasse Viren the Finnish long distance rider was alleged to have
had quantities of blood transfused out of his body - and the same
blood was stored and then transfused back in to him just before
major competition.

This type of activity is largely undectable - where as performance
enhancers which are chemical based, may well leave a trace.

I think one of the risks on this drawing your own blood and then putting it back in method is the iron level that results; it becomes too high because you reinsert the iron from the old blood back into your system. I suppose EPO is safer than this old method which doesn't seem to be used anymore.
 
Too much iron is not a good thing, but I don't think the iron level in the body is relevant unless it is in the iron pool (i.e. not yet used). Iron in the form of rbcs (hemoglobin) does not present a toxicity problem.

EPO injection are tidy little sub-q injections, whereas old fashioned blood doping requires an IV set and refrigeration for all that blood. It's just a wee bit more obvious!
 
Originally posted by Ted B
Detecting EPO use is anything but a cut and dry matter and requires several tests to confirm a positive result.

The synthetic EPO peptide differs only very slightly from natural EPO. While the synthetic markers can be detected in the blood, the test is only reliable if the injection occurred in the previous 6-12 hours. Obviously, this test is of very limited value, especially in that the positive benefits of EPO are greatest some 3 weeks after the injection. This renders David Millar's alleged use timed to fit perfectly into the mountain stages of the TDF.

Since EPO raises one's hematocrit, an initial positive test for EPO use is flagged with a hematocrit of >50 and a reticulocyte count of >2.4. An initial positive is confirmed with a very sensitive urine test that assays for certain markers of synthetic EPO.

Very interesting. I hope they discover more lingering effects of this drug so that they can reliably detect it at the 3 week mark instead of having to rely on catching the rider with the goods red handed, as they mostly did with Millar.

We're only 6 days from the Tour now. This means EPO takers have probably already done their deeds.

Another question on this is whether the injections would give you a greater result if you take it every day up to the 3 weeks prior mark and then cut off use. It seems like it would based on your explanation because it goes out of your system in 6-12 hours.

The thing that doesn't make sense to me on this is how the results are peaking at the 3 weeks point even though there is no apparent test for the presence of EPO at that point. Doesn't it seem likely that there must be some trace of it's presence if it is giving it's maximum enhancement at that point? Let's hope that they develop a better test.
 
If the EPO injection did what you wanted it to do three weeks down the road, you will have elevated hematocrit levels, which are easy enough to detect (if they trip the legal threshold) followed by a confirmation via the sensitive urine assay.
 
Originally posted by Ted B
If the EPO injection did what you wanted it to do three weeks down the road, you will have elevated hematocrit levels, which are easy enough to detect (if they trip the legal threshold) followed by a confirmation via the sensitive urine assay.

Ahh. So you are saying that the blood test is only reliable at the 6 to 12 hour mark for synthetic markers, but the urine test will still be reliable at the 3 week mark? How is it then that they can still cheat it? I suppose the riders are particularly concerned with making sure their hematocrit levels are not elevated above the acceptable levels so that they can continue to deny EPO use.
 
Originally posted by gntlmn
Ahh. So you are saying that the blood test is only reliable at the 6 to 12 hour mark for synthetic markers, but the urine test will still be reliable at the 3 week mark?

AFAIK, yes...however I believe the urine test (slower + expensive) is only used as a followup to an abnormally high hematocrit (quick and easy).


How is it then that they can still cheat it? I suppose the riders are particularly concerned with making sure their hematocrit levels are not elevated above the acceptable levels so that they can continue to deny EPO use.

I would suppose so.
 
Originally posted by Ted B
AFAIK, yes...however I believe the urine test (slower + expensive) is only used as a followup to an abnormally high hematocrit (quick and easy).

Now this I would like to see quantified. How much does it cost to administer these complicated urine tests to positively identify whether or not a rider has taken EPO in the last 90 days? Is this cost so high when considered against the public suspicion that this drug is being used regularly in the sport? How difficult would it be to just test every single Tour rider with these urinalyses regardless of hematocrit levels?

I suppose these answers will indicate that indeed it is difficult and extremely expensive because otherwise, it seems they would be doing it right now. But it would be interesting to see the answers to these questions. The more people know about the difficulties and costs, the more likely someone will come up with an idea that works.
 
Actual EPO is detectable for around 72 hours. Its the effect of EPO which is detectable in a blood sample, generally by presence of young red blood cells.
 
Originally posted by steve007
Actual EPO is detectable for around 72 hours. Its the effect of EPO which is detectable in a blood sample, generally by presence of young red blood cells.

Oh. Now the picture gets clearer. These young red blood cells appear immediately under the influence of the additional enzyme that EPO provides, and they don't reach full size until the 3 week mark, at which point the effects are maximized. That's the part I didn't understand above about the red blood cells having to grow. Is that what's happenning?
 
Incidentally, some of the new drugs available are not detectable except during exertion. So why top end cyclists are risking using stuff like eprex i dont know.
 
Originally posted by gntlmn
Oh. Now the picture gets clearer. These young red blood cells appear immediately under the influence of the additional enzyme that EPO provides, and they don't reach full size until the 3 week mark, at which point the effects are maximized. That's the part I didn't understand above about the red blood cells having to grow. Is that what's happenning?

Peak varies from person to person, but generally by 3 weeks after the loading dose another smaller maintenance dose is required. But it varies from person to person exactly how often and how much should be taken. Getting it right is crucial. ;)