Turns out EPO doesn't work.

[Heisenberg]

Call off the dogs, turns out EPO is a sham and doesn't improve performance.

‘No Evidence’ EPO Boosts Cyclists’ Performance, Study - Businessweek

At all.

“'An elite cyclist runs on technique, on muscle power which is supplied by oxygen and glucose and amino acids and foods, on team tactics, on weather, on millions of things,' lead researcher Adam Cohen said in an interview. 'To assume that one of these factors, which is delivery of oxygen to tissue, is going to clinch the whole thing, is rather naïve.'"

[palincss]

So the reason so many cheating pro's do it is that they're stupid sheep?

[spopepro]

I love it!

For what it's worth, the Centre* For Human Drug Research is a contract research company, and the esteemed Adam Cohen quoted above is not listed as head researcher, nor director, but CEO. I haven't pulled up my journal search yet to see just how bad it is in person yet... but I am curious about who funded it. Maybe some doctors from some place warmer?

*English for center

[Dorman]

Nothing to see here!

Marketing is marketing you know.

[solfege]

And if this doesn't convince you that Businessweek has absolutely no claim to being a credible journalistic organization capable of distinguishing between meaningful science and absolutely ridiculous shit, nothing will.

Of course, if you didn't at least strongly suspect that in the first place...

[spopepro]

Uh... So far no evidence of this actually appearing in the brittish journal of pahrmacology...

Hmmmmm....

[spopepro]

Ok... Here's the press release: Wiley: EPO Doping in Elite Cycling: No Evidence of Benefit, But High Risk of Harm

Turns out they got the journal slightly wrong. And it turns out A. Cohen is the European editor. Journal culture sucks. Still trying to find something that might have been peer reviewed.

[spopepro]

Can't go back to 1991 using this database. But these are some of the studies referenced. I hope they got a fat check for this press release.

Do alterations of endogenous angiotensin II levels regulate erythropoietin production in humans? Full Text Available
By: Freudenthaler, S.; Benöhr, P.; Grenz, A.; Selzer, T.; Schmidt, T.; Mörike, K.; Osswald, H.; Gleiter, C.H. British Journal of Clinical Pharmacology. Oct2003, Vol. 56 Issue 4, p378. 10p. 3 Charts, 6 Graphs.
Subjects: ANGIOTENSINS; ERYTHROPOIETIN; FUROSEMIDE
Database: Academic Search Complete
 Add to folder
PDF Full Text (1.6MB)
2.
Academic Journal
Plasma erythropoietin concentrations in patients receiving intensive platinum or nonplatinum chemotherapy. Full Text Available
By: Canaparo, R.; Casale, F.; Muntoni, E.; Zara, G.P.; Della Pepa, C.; Berno, E.; Pons, N.; Fornari, G.; Eandi, M. British Journal of Clinical Pharmacology. Aug2000, Vol. 50 Issue 2, p146. 8p.
Subjects: ERYTHROPOIETIN; CANCER -- Patients; CHEMOTHERAPY
Database: Academic Search Complete
 Add to folder Times Cited in this Database: (1)
PDF Full Text (1.4MB)
3.
Academic Journal
Fenoterol stimulates human erythropoietin production via activation of the renin angiotensin system. Full Text Available
By: Freudenthaler; Schenck; Lucht; Gleiter. British Journal of Clinical Pharmacology. Oct99, Vol. 48 Issue 4. 1 Graph.
Subjects: FENOTEROL; ERYTHROPOIETIN; PHYSIOLOGY
Database: Academic Search Complete
 Add to folder
PDF Full Text (90KB)
4.
Academic Journal
Predicting the time course of haemoglobin in children treated with erythropoietin for renal anaemia. Full Text Available
By: Port; Ding; Fies; Schärer; Port. British Journal of Clinical Pharmacology. Nov98, Vol. 46 Issue 5, p461-466. 6p.
Subjects: HEMOGLOBIN; ERYTHROPOIETIN; RENAL anemia; PHYSIOLOGY
Database: Academic Search Complete
 Add to folder
PDF Full Text (2.6MB)
5.
Academic Journal
Pharmacokinetic analysis of subcutaneous erythropoietin administration with nonlinear mixed effect model including endogenous production. Full Text Available
By: Hayashi, Naoto; Kinoshita, Haruki; Yukawa, Eiji; Higuchi, Shun. British Journal of Clinical Pharmacology. Jul98, Vol. 46 Issue 1, p11-19. 9p.
Subjects: ERYTHROPOIETIN; PHARMACOKINETICS
Database: Academic Search Complete
 Add to folder
PDF Full Text (3.5MB)
6.
Academic Journal
Fenoterol increases erythropoietin concentrations during tocolysis. Full Text Available
By: Gleiter; Schreeb; Goldbach; Herzog; Cunze; Kuhn. British Journal of Clinical Pharmacology. Feb98, Vol. 45 Issue 2, p157. 3p.
Subjects: ERYTHROPOIETIN; ADRENALINE -- Receptors
Database: Academic Search Complete
 Add to folder
PDF Full Text (74KB)

[cilantro]

This is not serious research. The paper cited is an unfocussed review done by a group of "elective students", and it shows. They cite a lot of relevant research but do not seem to have read any of it. Eg the paper by Birkeland suggests that the VO2max will increase by 7% with EPO versus placebo (abstract below). The study by Thomson suggests a gain of 12%, and also that the benefit is even greater for submaximal effort (abstract below). Both are cited in that "review", but because they have not used world class cyclists they are considered irrelevant.

That is where the logical flaw is: absence of evidence is not evidence of absence. There is no reason to think that world class cyclists do not benefit similarly.


Birkeland KI, Stray-Gundersen J, Hemmersbach P, Hallen J, Haug E, Bahr R. Effect of rhEPO administration on serum levels of sTfR and cycling performance. Med Sci Sports Exerc 2000; 32: 1238-1243.
Abstract
PURPOSE: We assessed the possibility of using soluble transferrin receptor (sTfR) as an indicator of doping with recombinant erythropoietin (rhEPO).
METHODS: A double-blind, placebo-controlled study was conducted with the administration of 5,000 U of rhEPO (N = 10) or placebo (N = 10) three times weekly (181-232 U x kg(-1) x wk-1) for 4 wk to male athletes. We measured hematocrit and the concentration of hemoglobin, sTfR, ferritin, EPO, and quantified the effects on performance by measuring time to exhaustion and maximal oxygen uptake (VO2max) on a cycle ergometer.
RESULTS: Hematocrit increased from 42.7 +/- 1.6% to 50.8 +/- 2.0% in the EPO group, and peaked 1 d after treatment was stopped. In the EPO group, there was an increase in sTfR (from 3.1 +/- 0.9 to 6.3 +/- 2.3 mg x L(-1) , P < 0.001) and in the ratio between sTfR and ferritin (sTfR-ferritin(-1)) (from 3.2 +/- 1.6 to 11.8 +/- 5.1, P < 0.001). The sTfR increase was significant after 1 wk of treatment and remained so for 1 wk posttreatment. Individual values for sTfR throughout the study period showed that 8 of 10 subjects receiving rhEPO, but none receiving placebo, had sTfR levels that exceeded the 95% confidence interval for all subjects at baseline (= 4.6 mg x L(-1)). VO2max increased from 63.6 +/- 4.5 mL x kg(-1) x min(-1) before to 68.1 +/- 5.4 mL x kg(-1) x min(-1) 2 d post rhEPO administration (7% increase, P = 0.001) in the EPO group. Hematocrit, sTfR, sTfR-ferritin(-1), and VO2max did not change in the placebo group.
CONCLUSION: Serum levels of sTfR may be used as an indirect marker of supranormal erythropoiesis up to 1 wk after the administration of rhEPO, but the effects on endurance performance outlast the increase in sTfR.


Thomsen JJ, Rentsch RL, Robach P, Calbet JA, Boushel R, Rasmussen P, Juel C, Lundby C.
Prolonged administration of recombinant human erythropoietin increases submaximal performance more than maximal aerobic capacity. Eur J Appl Physiol. 2007 Nov;101(4):481-6.

Abstract
The effects of recombinant human erythropoietin (rHuEpo) treatment on aerobic power (VO2max) are well documented, but little is known about the effects of rHuEpo on submaximal exercise performance. The present study investigated the effect on performance (ergometer cycling, 20-30 min at 80% of maximal attainable workload), and for this purpose eight subjects received either 5,000 IU rHuEpo or placebo every second day for 14 days, and subsequently a single dose of 5,000 IU/placebo weekly/10 weeks. Exercise performance was evaluated before treatment and after 4 and 11 weeks of treatment. With rHuEpo treatment VO2max increased (P<0.05) by 12.6 and 11.6% in week 4 and 11, respectively, and time-to-exhaustion (80% VO2max) was increased by 54.0 and 54.3% (P<0.05) after 4 and 11 weeks of treatment, respectively. However, when normalizing the workload to the same relative intensity (only done at time point week 11), TTE was decreased by 26.8% as compared to pre rHuEpo administration. In conclusion, in healthy non-athlete subjects rHuEpo administration prolongs submaximal exercise performance by about 54% independently of the approximately 12% increase in VO2max.

[vertical_doug]

I recall in the early 80's, the experts told us steroids didn't do anything. Funny how the track and field women's 100,200,400,800 records are all unbreakable from that era.

[Too Tall]

Well done Cilantro.

[Bobqzz]

I recall in the early 80's, the experts told us steroids didn't do anything. Funny how the track and field women's 100,200,400,800 records are all unbreakable from that era.

Yes, this went all the way back to at least the early 1970s. Many doctors and legitimate researchers said there was no evidence steroids did anything. All one had to do was look around the gym to know that the effects were very, very obvious. Turns out the test protocols were basically giving college students who did some mild circuit training steroids.

Of course when you make a ludicrous claim like that, then say "steroids are dangerous" people will dismiss the warnings as coming from a non-credible source.

[MarkC]

The physiology literature is weak for these types of studies. Partly because doing the study properly would be unethical and would not get past internal review boards in most countries. Partly because the people that could do the studies well are off doing other things. You know, treating sick people and developing drugs instead of studying the effect of illegal EPO use in sport** So you get a lot of semi-quantitative, semi-anecdotal reports and a lot of conflicting data. Not to say that doesn't happen in other areas but when N is small and the time period is short the variance will usually be high.


** I think it was in Tyler's book where the comment was made that the "doping doctors" are not geniuses. They are greedy fucks who were not making it in legit medical practice. It's a miracle so few guys were killed and it'll be years before we know the true long term extent of extended PED usage on riders health.

[GAAP]

.. There is no reason to think that world class cyclists do not benefit similarly.
.

Why not? Seems to me someone who is currently rockin a world class V02 max might benefit much differently from EPO. I'd guess a world class athlete who is already bumping the edge of the maximum constraints of the system is not seeing 12% gains in V02 max.

Now I'm not defending or disparaging the merits of the folks who conducted this study, so don't go all Lance Armstrong dog-pile one me.

[GrantM]

That is where the logical flaw is: absence of evidence is not evidence of absence.

bingo.

-g

[Michael Roy]

That is where the logical flaw is: absence of evidence is not evidence of absence.

You mean, if a cyclist passes a drug test it doesn't prove he didn't dope?

[cilantro]

Why not? Seems to me someone who is currently rockin a world class V02 max might benefit much differently from EPO. I'd guess a world class athlete who is already bumping the edge of the maximum constraints of the system is not seeing 12% gains in V02 max.

Fair point, I should have said that the benefit is unlikely to be zero. 7 to 12% is huge, even 3% would probably matter in a pro race.
The trial you want is this: randomize pro teams between epo injections and placebo, let them race for 3 years, and count the wins (or UCI points). It's not feasible.

@Michael Roy: no, I meant that the lack of studies of the effect of epo in top cyclists does not mean that epo has no effect.
(but you were just kidding me, right?)

[Michael Roy]

@Michael Roy: no, I meant that the lack of studies of the effect of epo in top cyclists does not mean that epo has no effect.
(but you were just kidding me, right?)

Right. Should have added this:

[ElvisMerckx]

This explains why so many other pros were able to stay within and hour of _______ ___________ at the Tour -- EPO was holding him back. Yeesh, just imagine his winning margins without EPO.

[solfege]

Why not? Seems to me someone who is currently rockin a world class V02 max might benefit much differently from EPO. I'd guess a world class athlete who is already bumping the edge of the maximum constraints of the system is not seeing 12% gains in V02 max.

Now I'm not defending or disparaging the merits of the folks who conducted this study, so don't go all Lance Armstrong dog-pile one me.

If you read Vaughters stuff on Twitter where he discusses these questions, the point that O2 vector doping affects people very differently comes up in nearly every discussion. Yes, it's well known that the payoff is different for different individuals. It's also well-known that the payoff for many individuals is very considerable and that the overall effect of EPO usages is to distort competition to an extremely high degree. The hysterical thing about this 'research' is that the various ADAs as well as they various people who were involved in doping / training athletes with or without these substances know this, and not simply by anecdote but as a result of pretty careful and extensive study including shit tons of physiological data.

The pretense that there's no evidence about this stuff is just laughable.