Tag Archives: EPO

What you need to know about sports doping

The use of performance-enhancing drugs has been a serious issue in competitive sports for some time. Notably, the American cyclist Lance Armstrong was found to have “doped” during the years he won seven consecutive Tour de France races and, as a consequence, was stripped of those titles. With the Olympics underway, sports doping is something we are sure to hear even more about. The purpose of this column, which was published in my Health & Fitness column in the Aiken Standard this week, is to explain what is meant by sports doping and describe how a few commonly used substances work to improve performance.
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The use of performance-enhancing substances, also known as sports doping, is nothing new. Sports organizations around the world have launched a concerted effort to catch and penalize athletes, coaches, trainers, and physicians who use or promote the use of banned drugs and techniques to unfairly improve performance. Athletes are tested randomly, and those who are found guilty can be disqualified from events, have previously awarded wins and medals revoked, and even be banned from competing in future events.

The specific substance an athlete might use depends largely on the sport. Endurance athletes may use substances that improve oxygen delivery to the muscle, allowing them to exercise at a higher intensity for a longer time. Oxygen is transported through the blood by red blood cells (RBCs). Increasing the number of RBCs is called “blood doping.” Traditionally, this required an athlete to remove a unit of blood and then reinfuse that blood later, closer to the event. The body replaced the donated RBCs, so the reinfused blood carried extra oxygen to the muscle and improved performance.

There is a newer way for athletes to get the same result without having to donate, store, and reinfuse blood. After a blood donation, the blood oxygen level is lower than normal, causing the release of a hormone called EPO, short for erythropoietin. EPO causes an increase in RBC production. EPO can also be produced as a prescription drug that has the same effect. In fact, most cases of blood doping involve EPO administration rather than RBC reinfusion.

Athletes in events that depend primarily on strength and power need to develop a high level of muscle mass. Anabolic steroids like testosterone have been used for decades to build muscle. This works since testosterone promotes protein synthesis, the key step in muscle hypertrophy. Growth hormone (GH) is another natural hormone that, as its name suggests, promotes muscle growth. Both testosterone and GH can be injected to enhance the response to resistance training. Hormone precursors such as androstenedione or “andro,” which was famously used by the baseball player Mark McGuire when he broke the single season home run record, can also be used to achieve the same effect.

Knowing that the penalties for sports doping can be severe, why would an athlete take the risk and use performance-enhancing drugs? Athletes train year-round, usually for decades, to compete on an elite level. After this much training, additional gains in strength, speed, and endurance can be difficult to achieve. Considering that in most elite-level competition the difference between winning and losing can be as small as a few seconds or inches, depending on the event. Some athletes feel that the only way to gain an edge over the competition is to use performance-enhancing drugs.

Athletic competitions like the Olympics are a celebration of human strength, power, endurance, and skill. Hopefully, cases of sports doping in the news won’t overshadow the incredible accomplishments of so many athletes who succeed because of their talent, training, and dedication. We should be inspired, not made suspicious, by their performance.


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Should you exercise after donating blood?

January is National Blood Donor Month, a chance to acknowledge the contributions of those who donate blood and raise awareness about the importance of blood donation. The effect of blood donation on exercise is the topic of my Health & Fitness column in the Aiken Standard this week.

Donating blood is one of the simplest ways you can help others who have been injured, undergo surgery, or who are being treated for conditions like cancer or blood clotting disorders. According to the American Red Cross, over 9 million Americans donate blood each year, but that is a fraction of those who are eligible.

Donated blood contains red blood cells that carry oxygen, platelets that are important for blood clotting, and plasma, the liquid component that also contains factors used to treat clotting disorders. Whole blood can used to replace what is lost due to injuries and surgery or can be separated into individual components, so one pint of blood can be used help multiple people.

A typical blood donation involves the removal of 450 ml, or about one pint, of blood. Since this is only about one-tenth of an adult’s blood volume, it is safe for those who meet the age, weight, and other health criteria to donate. After donation, the plasma portion of your blood, which is mostly water, is replaced by your body within 24 hours, but it can take 4–6 weeks to completely replace the red blood cells.

Blood donors are usually instructed to avoid strenuous activity for 24–48 hours. Donors may feel symptoms of low blood pressure, such as dizziness or lightheadedness. Vigorous activity can make this more likely, and staying hydrated can help reduce these symptoms. Since the red blood cells are responsible for carrying oxygen to your tissues, including your muscles, donating blood may limit your ability to exercise, especially if it is intense.

Research, including a study done in our lab at USC Aiken, shows that donating a pint of blood can decrease peak aerobic power, a key measure of fitness, for up to 3 weeks in healthy young adults. Athletes and others who are engaged in vigorous training may need to take it easy for a few days after donating.

The effect of blood donation on exercise makes sense when you think of it as the opposite of blood doping, the technique used by some endurance athletes to boost performance. Blood doping is accomplished by infusing either whole blood, usually that the athlete “donated” to themselves, or injecting erythropoietin (EPO), the natural hormone that stimulates the body to produce more red blood cells. Both have a similar effect: a higher number of red blood cells delivers more oxygen to the muscles, allowing the athletes to run, cycle, and ski faster and longer without fatigue.

Blood doping is illegal and athletes who get caught are fined, suspended, or even banned from their sport. You may remember that Lance Armstrong, the celebrated American cyclist, lost both fame and fortune after his doping scandal became public. This is something we are certain to hear about again as the winter Olympics get underway next month and athletes are looking for ways to improve their chances of winning a gold medal.

In contrast to blood doping, blood donation is legal and encouraged! The great many benefits of blood donation far outweigh the potential effects on exercise performance, which are unlikely to disrupt most people’s exercise programs.

There is still time to celebrate National Blood Donor Month by visiting a local blood center. Or, if you prefer, you can celebrate the Olympics by doing the opposite of blood doping—donating blood!