Doping in Sports

• 9/20/06
• Floyd Landis becomes
the first Tour de
France winner to have
his title revoked for
doping
 Doping at a glance
• Discuss some of the common doping agents abused
by athletes
• Anabolic steroids
• Other anabolics
• Stimulants
• Blood doping
• Discuss strategies for obtaining desired effects
without doping
 Testosterone
• 2007 Christian Moreni arrested at Tour de
France

• 2007 Mattias Kessler

• 2007 Brazilian defender Marcao, suspended
four months after testing positive for
finasteride. (Masking agent)
 Testosterone
• 1996 Dean Capobianco, Australian 100m
champion, tests positive for anabolic steroid
stanozol

• Blames red meat

• 1996 Dieter Baumann 1500m and 5000m
• Blames positive testosterone test on
spiked toothpaste
 Testosterone
• April 2006 Justin
Gatlin Olympic gold
sprinter-facing 8 year
ban

• August 2007 Chicago

Bears fullback
Obafemi
Ayanbadejo-4 game
suspension
 Testosterone

• 1998 Dennis Mitchell 400m relay gold

medalist and 4 time US champion

• Had sex four times the previous night and

a lot of beer
 Testosterone effects

• Increases Lean muscle mass

• Increases red blood cell volume
• Decreases Body Fat
Testosterone side effects

• Acne
• Testicular
suppression

• Coronary Artery
Disease
 Bay Area Lab
Cooperative
• Victor Conte
• Bassist, Nutritional Consultant, Convict
• Produced designer androgens
• custom-developed for elite professional
athletes to evade doping detection
Detecting Testosterone

• Testosterone and EpiTestosterone are

produced in equal amounts from a precursor

• If the Ratio of Testosterone:EpiTestosterone

is greater than 1:1, doping is suspected

• Cutoff is 4:1
• RadioImmunoAssay
Increasing Testosterone
• Testosterone increases in response to:
• Intervals
• Strength training
• Testosterone decreases in response to
• Low Intensity Endurance training (L.I.E.)
 Insulin

• One of the major hormones for controlling

blood sugar

• Non functional in diabetics

• Synthetic insulin used to have a “C-peptide,”
not in recombinant insulin
• Insulin as a drug of abuse in body
building
Br. J. Sports Med., Aug 2003; 37: 356 - 357.
 What it does

• Insulin is anabolic at large doses.

• Imports amino acids into cells to speed
recovery and muscle building

• Imports glucose into muscle cells to be

stored as glycogen
 Side Effects
• Too much can cause low blood sugar, change
in mental status and coma

• Fat deposition at injection site

• Can only be used in cases of glycogen
depletion

• Adiposity
• Bodybuilders find it easy to obtain insulin
to help them in training

• BMJ 1997;314:1280 (26 April)

 What else to do
• Glycogen depletion
• Replace calories as high glycemic
carbohydrate

• Incorporate protein into recovery mix

• 1g/kg carbohydrate + 0.3g/kg protein
 Growth Hormone

• Anabolic hormone
• Secreted in pulses, the largest pulse happens
in the first 1 hour of sleep
 GH Effects
• Increases recovery (acute)
• Increased amino acid uptake into muscle
• Increased glycogen through glucose uptake
• Increases Energy (chronic)
• Stimulates fatty acid release from adipose
tissue

• Increases sensitivity to fatty acid release

• 6/06: Diamondback pitcher Jason Grimsley
possessed a season's worth of hGH, federal
indictment
• 9/07: Washington Redskins tackle Jon
Jensen:"very naive and foolish" to think that
NFL players aren't using human growth
hormone.

• "maybe 15, 20%" of the league's players use

illegal performance-enhancing substances.
• Wade Wilson, Dallas Cowboys QB
Braces and a six pack
 Growth hormone (GH)
• GH deficiency
replacement
• Pituitary disorder
• GH a potential treatment for:
• frailty
• osteoporosis
• morbid obesity
• Increases recovery (acute)
What it does
• Increased amino acid uptake into muscle
• Increased glycogen through glucose uptake
• Increases Energy (chronic)
• Stimulates fatty acid release from adipose
tissue

• Increases sensitivity to fatty acid release

• Increases lean muscle mass
 Side Effects
• Cancer
• Bony Changes
• Jaw and Forehead
• Long bones if still growing
• Coronary artery disease
• Cardiomyopathy
 2005
1992
 What else to do
• Restful sleep
• Avoid pre-bedtime snacks containing fat or
carbohydrate

• Encourage training intensity, while

discouraging training volume without
intensity

• Arginine as “secretogogue”
 Glucocorticoids

• Catabolic hormone
• Release glucose and fat
• Stress steroids
 What it does

• Increased energy from release of sugar and

fat
 Side Effects
• Muscle breakdown
• Central obesity
• Moon facies
• Osteopenia
• Adrenal suppression
 What else to do

• Caffeine for fatty acid release

• Maximize glycogen “supercompensation”
 Stimulants
• Increase alertness and (perceived) energy
• Mimics effects of adrenaline
• Cocaine
• Amphetamine
• Phenylpropanolamine
• Ephedrine
•
VO2max= HR x SV x (A-V)02
• 2005 Mariano Puerta, French Open finalist
• Traces of cardiac stimulant in blood
• Claimed it was from his wife’s menstrual
pain medication when he drank her water
• 1999 Javier Sotomayor, Olympic high jump
gold medalist and world record holder, tests
positive for cocaine at Pan Am Games

• Fidel Castro blames it on a CIA conspiracy

• NCAA reports an increase in positive
stimulant (and cocaine) tests since 2001-2002

• 58.3% of collegiate hockey players admit to

stimulant (ephedrine, pseudoephedrine,
amphetamin) use

• Current Sports Medicine Reports, September,2004

• April 2004: Track sprinter Torri Edwards
tests positive for Nikethamide-2 year ban.
“Accidentally” taken in an over the counter
medication

• 2003 100m and 200m sprinter Kelli White

tests positive for Modafinil

• 1998 Dennis Mitchell 400m relay gold

medlaist tests positive for testosterone
• Cory Stringer All-pro offensive linemandied
from combination of ephedra and heat illness

• 2003 Steve Belcher dies of heat stroke while

using ephedrine

• 2007 800m freestyle world champion

Oussama Mellouli banned for 18 months
Ephedra: What it does
• Increases time to exhaustion
• Increases cardiac output
• Increases liver and muscle glycogen release
• Bronchial dilatation
• Appetite suppressant
 Side Effects
• Pre-disposition for heat illness
• Appetite suppressant
• Insomnia (affects GH)
• Tachycardia, arrhythmias and heart disease
• Mental status changes
• Fatigue depression and lethargy
 What else to do

• Caffeine 4-5mg/kg + pseudoephedrine

1mg/kg

• Minimizes side effects, maximizes

ergogenic effect
 Blood

• Muscles perform best when they can use

oxygen and glucose to make energy.

• Red blood cells transport oxygen from the

lungs to the muscles
•
VO2= HR x SV x ( A-V)02
 Operation Puerto
• Spanish police raid a lab/office of Madrid
based hematologist, Eufamanio Fuentes

• Multiple high-end athletes implicated in his

blood doping ring

• Spanish soccer
• Tennis
• Cycling
• Extra blood increases aerobic/endurance
potential
• 1984 Ed Burke, PhD and US Cycling
Federation coaches admit to providing
homologous and autologous blood
transfusions to US Olympic Cycling Team

• US wins gold in the Road Race and medals

for the first time since 1912

• Who wins, where were the 1984 Olympics

held?
 Alexi Grewal
First gold medal
in road cycling
since 1912

Alexi had just

finished a 2
week
suspension
for ephedrine
• Erythropoetin
• 12-15% increase in power
• Decreased lactate accumulation
Mar;86(5):442-9
Eur J Appl Physiol. 2002

• 7% increase in VO2max MSSE 2000 Jul;32(7)

• rEPO v Aranesp
• CERA
• EPO changed everything...All of a sudden
whole teams were ragingly fast; all of a
sudden i was struggling to make the time
limits...I’d be on climbs, working as hard as I’d
ever worked, and right alongside me would
be these big-assed guys, and they’d be
chatting like we were on the flats!

• Andy Hampsten, winner Tour of Italy

• Fleche Wallone, 1994: three riders from
Gewiss team rode away from the pack

• After the race, team doctor Michele Ferrari

was asked about EPO use

• “I don’t prescribe the stuff, but you can buy

EPO in Switzerland without a prescription”

• “EPO is not dangerous; it’s the abuse that is.

It’s also dangerous to drink 10 liters of
orange juice”
• Late 1980’s and early 1990’s Dutch cyclists
keep dying in their sleep

• Blood is too thick and clots develop with the

slow heart rate

• Risk of blood borne diseases

• Ricco: septic after transfusion
 EPO Dosing

• WADA spent millions of dollars over years

• Ferrari took 5 minutes
• Microdosing not detected by Blood Passport
Eur J Appl Physiol 2011 Sep;111(9)
 What else to do

• Altitude training
• Altitude tents
• Hypoxic training
• Beware the athletes
• Know what is being used
• Know what training/dietary alternatives to
offer