May 25, 2010

Cyclists Find New Way to Use an Old Doping

Tool
By IAN AUSTEN

MONTREAL — The blood-boosting hormone that was cycling’s greatest doping issue during
the 1990s may be back as the sport’s newest problem.

It has long been known that athletes can use small, carefully timed doses of the blood booster
EPO to beat urine-based drug tests yet still gain a significant performance advantage. But
research in Australia and France has found that the technique also eludes the long-range
biological passport program that was supposed to overcome conventional testing’s shortcomings.

At the World Anti-Doping Agency board meeting here earlier this month, officials
acknowledged that they had a problem when it came to the technique, known as microdosing.
Few people in the antidoping world think the loophole is unknown to cyclists, leading to concern
that EPO is making a comeback.

Cycling was transformed in the 1990s by the introduction of commercially cloned forms of EPO,
the hormone the body uses to prompt the production of red blood cells. More red cells meant
significant performance gains for cheating cyclists and ultimately brought the sport its most
damaging doping scandals, including police raids at the 1998 Tour de France.

Last week, Floyd Landis, the American stripped of his 2006 Tour title after a positive test for
testosterone, acknowledged using EPO early in the last decade and charged that several of his
teammates, notably Lance Armstrong, did the same, although Armstrong and the others
dismissed the allegations.

At first, cyclists injected themselves with large quantities of EPO to develop unnaturally high
counts of red blood cells. That had the unwanted effect of dangerously thickening their blood and
is believed to have caused several deaths.

Many antidoping scientists say the approach riders took to EPO evolved because of the
introduction of limits on levels of hematocrit, the portion of blood containing red cells, as well as
the arrival of a urine-based test for EPO in 2000.

“In 2003, the athletes started to use a new procedure together with blood doping,” said Francesca
Rossi, the director of antidoping at the International Cycling Union, the sport’s governing body.
“I know that this microdosing strategy can be difficult to detect.”
Working with doctors, cyclists discovered that carefully controlled, small doses of EPO eluded
the urine test while still raising their red cell count. Microdoses of EPO let athletes put in
superhuman hours of training without suffering the natural consequence of fatigue.

In a research paper published five years ago, Michael Ashenden, an Australian exercise
physiologist and a scientific adviser to the cycling union, and scientists at the University of
Montpellier in France injected two athletes with EPO. Ashenden said it took only about a week
for the laboratory in France to devise a dosing program that escaped detection, assuming athletes
are not required to provide urine samples in the middle of the night.

The biological passport, which cycling introduced in late 2007, attempts to overcome problems
with conventional tests by analyzing blood samples of athletes regularly for signs of unnatural,
long-term patterns that indicate manipulation.

Ashenden and the French researchers have recently repeated their earlier experiments. Somewhat
to their surprise, they found that the bodies of the test subjects adapted in a way that hides
microdosing from the passport program. For various practical reasons, the passport tests measure
only the concentration of red cells in athletes’ blood, not the total amount of red cells in their
bodies.

Microdosing, however, appears to increase users’ blood volumes significantly. So although EPO
raises users’ overall red blood cell level, its concentration stays constant because blood volume
increases.

The body’s adjustments, Ashenden said, also disguise changes to other markers in the blood that
would normally prompt an investigation under the passport program.

Ashenden said the group also found that the same benefits from EPO could be derived with
much smaller doses than used in the first experiments. (To avoid providing a how-to guide, the
group has not published its dosage information.)

Despite improvements to the urine test, Ashenden said that microdoses still evaded it, assuming
that the samples were not taken from athletes in the middle of the night. It is possible under
WADA’s rules for testers to wake up athletes, but they have been reluctant to do so because
athletes already complain that testing is intrusive.

Based on anecdotal evidence, Ashenden said he thought that cyclists were microdosing EPO
only during the spring and fall, when races generally last one or two days, and through the off-
season. Police activity, he said, makes it too risky for athletes and teams to travel with vials of
EPO during three-week events like the Tour de France.

Ashenden said he thought that transfusions of blood frozen during the off-season remained the
doping method of choice during long races. Landis, in e-mail messages to cycling and doping
officials, described participating in that practice — for which there is no effective test.
The new research has yet to be published. But Ashenden has given the group’s findings to
WADA as well as to Pat McQuaid, the cycling union’s president.

WADA officials acknowledged that there was a problem with detecting microdoses of EPO but
said they were confident that refinements to the passport system would eventually overcome it.

Ashenden is not as sanguine.“They are taking it seriously, but I don’t know the solution,” he
said.

Not everyone accepts the researchers’ conclusions. Among them is Michele Ferrari, the
controversial Italian sports medicine doctor whose clients have included Armstrong. “It’s a bit
like playing Russian roulette,” Ferrari said in an e-mail exchange. “There is absolutely no
microdose that can be taken without the risk of getting detected by out of competition controls
within a 12-hour window.”

Although she has not seen the new research, Rossi of the cycling federation said she was not
surprised that cyclists may have found a way to use EPO without detection.

“I know perfectly well that they are organizing themselves,” she said. “We are obliged to publish
what we are doing while they can study it and work underground.”