Performance Enhancing Drugs in Cycling and Beyond [BIKE/SPLIT]

Columbian cyclist Luis Herrera once remarked:"When I saw riders with fat asses climbing cols like airplanes [at the Tour de France], I understood what was happening."

When I went to Europe with the US National Team as an amateur cyclist 25 years ago more than one Euro coach told me: "You have to take these 'B12' shots in your butt to have any chance of competing on the same level as the best riders." I was young and naive, but I wasn't about to be injected with whatever, and I doubted vitamin B12 was the whole story. I lost enthusiasm for my ambition to race pro.

Are there drugs in cycling and other endurance sports? Yes. Ultimately it's the athlete who makes the decision to cheat or not, but coaches and medical advisors empower with their knowledge and access to illegal performance enhancing techniques. An elite level athlete excels and his coach looks like a genius, when in fact the coach might just be another corrupt link in the doping process. It happens. Today there are familiar coaches and medical advisors of endurance athletes who've been implicated as administering banned ergogenic aids. They've made it through virtually unnoticed lawsuits—unscathed.

Amphetamines were the original ergogenic aid; a stimulant to get more out of the athlete on race day. Tom Simpson brought doping to public awareness when he was the first to die from stimulant induced over-exertion. It happened during stage 13 of the 1967 Tour de France on the slopes of Mt Ventoux. A memorial marks the spot.

Then came steroids and HGH (human growth hormone). More powerful muscles, faster recovery, and a more aggressive mind set. Steroids have been closely associated with testicular cancer along with many other health risks. To complicate matters for testing, other drugs can be administered to mask steroid use.

Blood doping was next; increasing oxygen carrying red blood cell count by re-infusing blood saved at an earlier date. Blood doping is undetectable unless someone else's blood is used, or if a sharp increase in hematocrit level as measured against a baseline value occurs. If the first 'clean' test is done when the athlete is already blood doped all subsequent tests will be deemed within legal limits.

The most effective performance enhancing drug of all for endurance athletes is EPO (erythropoietin), and testing for it is difficult. Some athletes on EPO will go undetected, while there are also rare false positives. It's a drug developed to help medical patients with an anemic condition, not athletes. When it first became available in the early 80s many cyclists died from EPO use. They suffered heart attacks from increased blood viscosity with lack of sufficient hydration. The performance gains from EPO are reported to be as much as 16%.

To test for blood doping or EPO use, several times a year blood samples will be taken and compared against an athlete's benchmark, looking for abrupt increases in hematocrit levels. The acceptable limit is generous (50% men, 47% women). Many athletes can use blood doping and EPO as long as they have periodic testing and don't exceed the accepted levels. The standards are difficult to enforce with some athletes' natural values equal to or exceeding the limit (usually those that live at altitude). Drug companies that manufacture EPO have begun to help with the testing process by including markers that flag samples without doubt.

Adding to the gray area of what ergogenic aids are allowed is the TUE (therapeutic use exemption), which allows athletes to use banned substances with an exemption for acceptable medical reasons. For example, an athlete can have his or her TUE registered with the UCI (Union Cyclist International) and take a steroid supplement for low testosterone production after surgery, or cortisone for a degenerating joint condition.

None of us wants to think of our sports heroes as cheaters, so the philosophical questions about doping are many. Endurance events like the Tour de France are so physically demanding that athletes need all the help they can get! Right, but the race doesn't get easier doped, the athlete just goes faster. So what if some athletes cheat—endurance sports are still entertaining. True, but I've competed against athletes that were doped and it ruins the sport for clean athletes who give it their all. What about athletes who are competing doped and haven't gotten caught? No doubt there are many, but they might be having second thoughts after the developments of the last few seasons. Careers have been ruined with multi-year suspensions, team contracts revoked, and lucrative endorsements outside sport lost. Once an athlete's integrity is questioned it's nearly impossible to regain their former status. A few athletes of note have admitted to using banned performance enhancing techniques after their career ended, but I'm sure they are the minority.

I've never participated in an age group National or World Championship for duathlon or triathlon that had drug testing and that's a shame.

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