You don’t have to be a professional athlete to care about blood doping. The practice is most commonly used in professional sports and competitions to give athletes an unfair advantage. The most notable example has to be Lance Armstrong, who was once revered as the greatest cyclist in history. Sadly, it turned out he had been engaging in blood doping for years, so he was stripped of all of his titles and banned from competitive cycling. This practice doesn’t just affect athletes; it affects spectators who assume they’re seeing athletes’ true capabilities.
What is Blood Doping?
Blood doping involves boosting red blood cell counts in the blood to enhance athletic performance. During aerobic activities, oxygen is transported from the lungs to the muscles. Maximum aerobic capacity, or VO2 max, determines how much oxygen is ultimately delivered. It depends on cardiac output, hemoglobin mass and oxygen extraction. Nothing can be done to enhance cardiac output or oxygen extraction, but hemoglobin mass can be enhanced as blood volume and hemoglobin concentration directly affect it. Put simply, red blood cell counts in hemoglobin can be boosted artificially, and that’s the goal with blood doping.
Methods of Blood Doping
The primary goal in this illegal practice is increasing red blood cell, or RBC, levels in the blood. However, another form involves increasing levels of human growth hormone HGH. The most common forms of doping include:
EPO/HIF Stabilizer Injections – EPO erythropoietin is a glycoprotein hormone that increases the activity of hemocyoblasts, which are RBC stem cells. In so doing, it gives the blood a greater capacity for carrying oxygen. EPO erythropoietin was originally developed to treat anemia and other conditions triggered by chemotherapy and radiation therapy for treating cancer. EPO also helps to stimulate wound healing. Hypoxia inducible factor, or HJF, stabilizers are sometimes used in conjunction with EPO, as they activate the activity of the hormone.
- Blood Transfusions – Blood transfusions in doping may be autologous, meaning the person uses their own blood, or homologous, meaning they use another person’s blood. In the latter case, the blood must be the same type. A few weeks prior to competing, an athlete withdraws one to four units of blood. It is then centrifuged to separate its components. The red blood cells are stored and typically frozen, which minimizes the amount of RBCs that are lost. The stored red blood cells are reinfused about one to seven days prior to competition.
- Blood Substitutes – Blood substitutes, or synthetic oxygen carriers, are artificially engineered oxygen carriers. They are typically a type of polymerized hemoglobin solution, but hemoglobin-based oxygen carriers and perfluorocarbons, or PFCs, may also be used. Blood substitutes are legitimately used in many situations, including when human blood is unavailable, when there’s not enough time to find the right blood type or when there’s a high risk of blood infection.
- Human Growth Hormone HGH – The effectiveness of human growth hormone, or HGH, is still unproved. Still, its use in sports and competitions has been banned since the early 1990s. It is believed to help reduce body fat and increase muscle mass and strength, and it may also enhance the body’s ability to repair itself. It appears to enhance testosterone levels as well and may help testosterone work more effectively. HGH is most commonly taken as a supplement, but it may also be injected into the body. Many consider HGH to be akin to using steroids.
Tests for Blood Doping
Due to the unfair advantage blood doping provides, its use has largely been banned. To enforce these bans, tests have been developed, and they are administered to athletes prior to competition. The most common examples include:
- Transfusions – There is currently no test to directly check for autologous transfusions, but indirect methods exist. The most common is what’s known as the Athlete Passport, which involves comparing current blood samples to previous ones. Homologous transfusions, which involve using another person’s blood, are readily detectable through testing.
- EPO Injections – Blood and urine tests can detect the presence of synthetic EPO. However, EPO only remains detectable for a short period of time, but its effects continue much longer. The testing window is quite brief, and thus far there’s no reliable way around this issue.
- Blood Substitutes – Tests can easily detect the presence of blood substitutes, or synthetic oxygen carriers, so athletes are often tested for the most common types prior to competing.
- HGH – HGH levels can be checked with simple blood tests, so the use of this drug is fairly easy to discover. However, again, it is unclear just how effective HGH is when it comes to athletic competition.
Risks of Blood Doping
When engaged in regularly, doping can increase levels of red blood cells to the point where the blood thickens substantially. The heart then has to work much harder to pump it around the body. Thickened blood due to doping increases the risk of blood clots, stroke and heart attack.
Transfusions–especially homologous transfusions–expose athletes to potentially tainted blood. As a result, they may contract hepatitis B, hepatitis C or HIV from engaging in the practice. If transfusions are used regularly, a buildup of iron may occur, which can cause health problems. Further, improperly stored blood or improperly administered transfusions may result in bacterial infections and acute lung injuries. Additional potential side effects include fever, hives, rashes and allergic reactions.
EPO injections may increase endurance, but they come with substantial risks. These include hyperkalemia, a dangerously elevated level of plasma potassium, flu-like symptoms and high blood pressure.
Finally, blood substitutes, or synthetic oxygen carriers, increase the risk of heart attack, heart disease, stroke and blood clots.
History of Blood Doping
Exact dates are unknown, but it is widely believed that doping first started during the 1950s. Prior to becoming illegal, it was primarily used by mid- and long-distance runners. The first widely publicized case happened at the 1980 Summer Olympics in Moscow, when Kaarlo Maaninka won five medals in the 5 and 10 kilometer races after using transfusions. However, the practice wasn’t banned at the time.
At the 1984 Summer Olympics in L.A., cyclist Pat McDonough was discovered to have used blood doping. As it happens, around one-third of the U.S. cycling team was using transfusions, and they came away with nine medals.
Without question, the most famous blood doper is Lance Armstrong. The athlete broke many people’s hearts upon revealing to Oprah that he had been engaging in the practice for years. He was stripped of all seven of his Tour de France titles and was banned for life from competitive cycling.
Should Doping be Banned?
Most people agree that doping should be banned. It gives an unfair advantage to those who engage in it. Arguing that all athletes should do it is not viable, as the practice carries significant risks. Further, those who watch sports competitions should be secure in the knowledge that athletes are using their own natural abilities. If their endurance, strength, aerobic capacity or other attributes have been unfairly enhanced, the spirit of sportsmanship is shattered. This is why steroids are banned too, and it should stay that way. With any luck, a single test that checks for all common blood doping methods will be developed soon.