Thursday, February 3, 2011

Tour of California

According to the local media, the Tour of California organization has dropped a provision that excluded riders who are subject to a pending doping investigation, prompting speculation that Lance Armstrong may enter the race. The Texan, who is under investigation by US authorities for activities relating to his Postal Service years, has quietly withdrawn from cycling after the Tour Down Under where he faced a barrage of doping-related questioning. A re-appearance with a more upbeat exit cannot be ruled out.

Lance had earlier canceled plans to race triathlon on the Ironman circuit. He was due to start Ironman New Zealand after the Tour Down Under, in order to secure a spot for the world championships in Kona, HI in October. He had been training on the big island last year and even challenged Chris Lieto, former second place finisher to an informal time trial there. He must have figured if I can beat second place Chris on the bike, I will win for sure.

However, after last year's stunning win by Chris McCormack Lance must have realized that his chances were close to non-existent. Lance, as we all know, does not enter races unless he thinks he can win them.

Ironman races are decided on the run portion of the event. Even if Lance were to ride a stunning TT and gain 20 minutes, chances are a runner like Chris McCormack or Craig Alexander would find him rather easily in the marathon. Winning times for that segment have now dropped well below the 3 hr mark. Based on Lance's previous marathon results it would be surprising if he could run a 3 hr marathon in Ironman. So there is a very real chance that -like Chris- he would just make the top 10- a nightmare of epic proportions for a seven time Tour de France winner.

A further interesting note regarding the Tour of California is that the AEG organization will hand over doping investigations to WADA.  USADA apparently pushed for testing to be done by an independent agency, and not UCI and its potential conflict of interest.

WADA would like to begin testing next week for the May 15-22 race and AEG has asked the teams for a list of 12 riders by the weekend. Even so, AEG does not want to exclude riders who are not on the list from entering at the last moment. If Lance were to stage such a last minute entry nobody would have the guts to stop him.

But on to the interesting question of early testing. WADA thinks doping will happen in the months leading up to event. Surely longer term remedies such as growth hormone, anabolic steroids, etc. take several weeks to show an effect and that effect lasts for months. These compounds work mainly through building muscle and promoting muscle adaptations that do not happen overnight.

Last year riders were first tested 10 days before the start of the race. Given that the event lasts for a week that left the door wide open for most forms of doping, including what is probably the most effective form of doping, blood doping in all its incarnations.

Blood doping relies on extra red blood cells to carry oxygen. Since performance is largely limited by cardiovascular performance -which in turn means the capacity to deliver oxygen- blood doping is probably the most effective form of doping. I say probably because my background in drug development tells me that the only way to be sure a drug is efficacious is to see how it performs in a double-blind, placebo-controlled trial. To the best of my knowledge no such testing has ever happened. So even though blood doping makes total sense, and should enhance performance, we won't know unless we test it.

In any case, blood doping is not only (rumored to be) most efficacious, it is also virtually undetectable if done properly. The best way to catch blood doping is to find the athlete in flagrante delicto and the chances of that happening are insignificant to say the least.

Red blood cells survive for a long time. The value one finds in the literature is 120 days, or nearly four months. Of course there are cells of all ages in a random sample so one cannot expect the cells gathered to last for that long when re-infused later. Furthermore, storage does affect life expectancy and even properly stored cells will not survive as long as they would in vivo. But in all likelihood a transfusion 10 days out will guarantee extra cells for the 20 days needed and then some. Such an autologous transfusion would be undetectable.

There is a lot of talk about biological passports and even dating red cells, but as a practical matter these methods are not going to achieve much. If statistical methods gain traction it would open a whole new can of worms, and one lawyers would love to tackle. Then lawyers would indeed wreck the sport as McQuaid so miraculously predicted.

EPO is even better when there is extra time. rhEPO's half life is less than half a day (4-13 hrs) so it is undetectable after just a day. But its effect lasts for months as new cells will be formed that will easily survive for 3-4 months. As you can see, this is a no-win situation.

The irony is that there is a very simple and very effective way to stop blood doping. Simply set a limit on the hematocrit. Unfortunately that means switching to a method that favors science and abandons the magic-inspired forbidden substances rules that WADA holds so dear. If you think WADA likes science think again.

WADA prefers to use the latest science to uphold a pre-scientific set of beliefs. This is no different from religious groups using science to enforce religion as described in the Feynman incident where orthodox Jews asked him whether nuclear energy was fire, so they would know if it was allowed on the Shabbat.

Measuring hematocrit is simple and easy to do. Rumor has it athletes who engage in blood doping use it to check their outcomes. It thus appears that the groups using doping are indeed far ahead of the regulators in their adoption of scientific thinking and the scientific method.

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