Darkside_of_cycling.doc

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Errors and omissions are not intentional, Your Host & Hostess, Chief Dave "Passing Wind" & Faith "D'Sagwagon" Substances: World Anti-Doping Code:
List of prohibited substances and method
Partial list WADA, World Anti-Doping Agency 2006-2007 "Banned
Substances"
Prohibited substances and methods Classes of prohibited substances and methods o Anabolic agentso Agents with anti-oestrogenic activityo Beta-2 agonistso Cannabinoidso Glucocorticosteroidso Diuretics and other masking agentso Narcoticso Hormones and related substanceso Stimulantso Enhancement of oxygen transfero Gene dopingo Chemical and physical manipulationo Substances prohibited in particular sportso Specified substances The Prohibited List is set by the World Anti-Doping Agency (WADA)and is reviewed annually.
Most sports reference the Prohibited List in their anti-doping policies.
The Prohibited List outlines classes of substances and methods insport.
Changes to the Prohibited List usually come into effect on 1 Januaryeach calendar year.
Athletes and support persons should ensure they re-check the statusof all medications and substances in January each calendar year. TheProhibited List may be subject to change during the year.
/06) from the WADA website. Some sports may not recognise the Code. Athletes are advised tocheck their sport's anti-doping policy as some sports may differ fromthe Code's Prohibited List.
Classes of prohibited substances and methods
The classes of prohibited substances and methods on the World Anti-Doping Code 2006 Prohibited List include: Agents with anti-oestrogenic activity Diuretics and other masking agents Hormones and related substances Stimulants (excluding caffeine, pseudoephedrine, phenylephrine,phenylpropanolamine, pipradol)*.
Enhancement of oxygen transfer (blood doping; products that enhance the uptake, transport or delivery of oxygen) Chemical and physical manipulation.
* prohibited in-competition only (not prohibited out-of-competition).
Anabolic agents/Anabolic androgenic steroids
Anabolic androgenic steroids are substances that have both anabolic and androgenic properties. The anabolic effects can result in anaccelerated growth of muscle and bone. The androgenic propertiesmay effect development of the male reproductive system and thesecondary male sexual characteristics such as hairiness and deep voice. Anabolic androgenic steroids can be derived from bothendogenous (naturally produced) or exogenous (syntheticallymanufactured) sources.
Athletes may be tempted to use anabolic steroids as they can improvethe body's capacity to train and compete at the highest level byreducing fatigue associated with training and the time required torecover after physical exertion.
Steroid use also promotes the development of muscle and tissue in thebody, which can be associated with increased strength and power andmay decrease recovery time following injury.
Examples of prohibited anabolic androgenic steroids include but arenot limited to: androstenedione, boldenone, nandrolone,dehydroepiandrosterone (DHEA), stanozolol and testosterone.
The analogues of anabolic androgenic steroids are also prohibited. An analogue is a substance derived from modification or alteration of thechemical structure of another substance while retaining similarpharmacological effect.
Side effects
Side effects may include jaundice and liver damage, acne, heartproblems, euphoria, improved self-esteem, mood swings, depression,paranoia and aggression.
Effects specific to males may include the development of breast tissue,infertility and baldness.
Effects specific to females may include an increase in facial and body hair, menstrual problems, permanent deepening of the voice, foetaldamage and clitoral enlargement.
Other anabolic agents
Other anabolic agents include substances such as zeranol which are not anabolic androgenic steroids but when taken into the bloodstreammay increased lean muscle mass and reduced body fat due to theirinteraction with androgenic receptors.
Agents with anti-oestrogenic activity
Many agents with anti-oestrogenic activity are legitimately used in thehormonal treatment of breast cancers. Examples include, but are notlimited to, aromatase inhibitors and tamoxifen.
Aromatase inhibitors reduce the amount of circulating oestrogen, whereas substances like tamoxifen block the actions of oestrogen inbreast tissues by occupying the oestrogen receptors on cells.
Agents with anti-oestrogenic activity may be illegally used tocounteract undesirable side effects associated with anabolic steroiduse, such as gynaecomastia (development of breast tissue).
Side effects
Side effects may include hot flushes, gastro-intestinal disorders, fluidretention and venous thrombosis.
Substances: Beta-2 agonists
Beta-2 agonists are commonly used to treat asthma, however if takeninto the bloodstream, they may have anabolic effects. For this reasonall beta-2-agonists are prohibited with the exception of those whichare inhaled. Special note: An Abbreviated Therapeutic Use Exemption (ATUE) isrequired for the use of inhaled beta-2-agonists (formoterol, salbuterol,salmeterol and terbutaline to prevent and /or treat asthma andexercise-induced asthma/broncho-constriction). ATUE forms andfurther procedural information is on the ASADA website.
Cannabinoids are the psychoactive chemicals in the cannabis plant.
The most active cannabinoid in cannabis is tetrahydrocannabinol(THC).
Marijuana and hashish are forms of cannabis Ingestion of cannabis is detectable via sample analysis, however theuse of hemp seed oil in cosmetics, body lotions and creams is unlikelyto absorb into the body in sufficient amounts to be detected.
Side effects
Immediate side effects of cannabinoids may include impairment ofbalance and coordination, loss of concentration, increase in heart rate, dry mouth, increased appetite, drowsiness and hallucinations andreduced ability to perform complex tasks such as driving. Prolongeduse of marijuana may result in loss of motivation and decreasedconcentration, impaired memory and learning abilities and respiratory diseases such as lung and throat cancer and chronic bronchitis.
Dependence and addiction are also risks associated with cannabis use.
Glucocorticosteroids are powerful anti-inflammatory agents. They maybe administered in a variety of ways to treat chronic inflammatoryconditions such as arthritis, asthma, inflamed joints and allergicreactions.
Side effects
When administered through the bloodstream, glucocorticosteroidshave effects on many different body systems. Possible acute sideeffects include fluid retention, hyperglycemia and mood alteration.
Potential chronic side effects include systemic infections (due to immunosuppression), musculoskeletal problems (e.g. osteoporosis,softening of the connective tissue and weakening of muscles, bonesand ligaments).
ophthalmical (eye drops) dental (topical mouth applications) nasal (nasal sprays) Other non-systemic routes of administration (respiratory or inhaled,anal, local injection, intra-articular injection) require an ATUE prior touse.
Glucocorticosteriods administered via systemic routes (orally, rectally,or by intravenous or intramuscular administration) are prohibited andtheir use requires a standard Therapeutic Use Exemption (TUE).
Diuretics increase the amount of urine produced by the body. In a medical setting diuretics are used to treat patients suffering from renaldysfunction.
Some athletes may use diuretics illegally to assist them to fall withinthe required weight categories in sports such as horse racing, judo,weightlifting and rowing.
Diuretics may also be used by some athletes to dilute their urine in anattempt to avoid detection of anabolic agents.
Side effects
The use of diuretics may induce dehydration which may causedizziness, headaches, nausea, loss of coordination and balance,cramps and kidney and heart failure.
Narcotics are commonly known as painkillers because they can mask the effects of pain. Narcotics may also produce sensations ofeuphoria, invincibility and illusions of athletic prowess beyond athleticability.
Examples of narcotics include but are not limited to: diamorphine(heroin), morphine, methadine, pethidine.
Side effects
Narcotics may be used illegally to stop the pain resulting from aninjury. However this can be dangerous as these substances merelydisguise the pain. An athlete who continues to train or compete withan injury risks further damage.
Narcotics also have other adverse effects such as loss of balance and coordination, decreased ability to concentrate, sleepiness, nausea,vomiting, respiratory depression and constipation. Prolonged use mayalso produce physical dependence, leading to addiction.
Hormones and related substances
The following substances are prohibited, including their mimetics,analogues and releasing factors: Chorionic gonadotrophin (hCG)** Human Growth Hormone
(hGH)
Human growth hormone (hGH) or somatotropin, is a glycoprotein hormone that is synthesised and secreted by cells in the anteriorpituitary gland.
hGH is known to act on many aspects of cellular metabolism and isalso necessary for skeletal growth in humans.
The major role of hGH in body growth is to stimulate the liver andother tissues to secrete insulin like growth factor (IGF-1). IGF-1stimulates production of cartilage cells, resulting in bone growth andalso plays a key role in muscle growth.
A deficiency in hGH before puberty results in growth retardation and dwarfism. Excess secretion of hGH after puberty has little effect onskeletal growth but results in a disease known as acromegaly.
In years past, growth hormone purified from cadaver pituitaries wasused to treat children with severe growth retardation. More recentlyrecombinant (artificial) hGH has lead to several other applicationsincluding treatment of growth disorders and cosmetic symptoms ofaging.
hGH may be used in sport to induce anabolic effects, reduce musclecell breakdown and reduce body fat.
Side effects
One of the most common side effects of hGH abuse is acromegaly. The onset of this disorder begins with an overgrowth of bone andconnective tissue which leads to a change in appearance such as aprotruding jaw and eyebrow bones.
Because of the role that hGH plays in stimulating IGF-1 secretion, excessive use of hGH may also lead to metabolic dysfunction, includingglucose intolerance and other side effects associated with excess levelsof IGF-1.
Status in Sport
Human growth hormone is a prohibited both in and out of competitionunder the the World Anti-Doping Code 2006 Prohibited List (effectivefrom 01/01/06).
Mimetics are substances with a pharmacological effect similar to that of another substance, regardless of the fact that it has a differentchemical structure. Analogues are substances derived from themodification or alteration of the chemical structure of anothersubstance while retaining a similar pharmacological effect.
Corticotrophin is a hormone which increases levels of endogenouscorticosteroids (cortisone) in the blood. Corticotrophin has an anti-inflammatory effect, but may also used to obtain the mood elevatingeffects of corticosteroids.
Side effects
Short-term use of ACTH may cause stomach irritation and ulcers, and psychological effects such as irritability. Prolonged use may induce sideeffects including softening of connective tissue and weakening of aninjured area in muscles, bones, tendons or ligaments, osteoporosisand cataracts.
Substances: Epoetin Delta (Dynepo)
Dynepo is the trademark name for an erythropoiesis stimulatingprotein, epoetin delta. This protein, which stimulates red blood cell production by the same mechanism as human erythropoietin (EPO), ismanufactured by the US pharmaceutical company TranskaryoticTherapies (TKT).
An increase in red blood cells improves the amount of oxygen theblood can carry to the body's muscles. It may also increase the body'scapacity to buffer lactic acid.
Dynepo has legitimate clinical use in the treatment of anaemia related to chronic renal (kidney) disease - specifically for patients receiving orabout to undergo dialysis, to elevate and maintain red blood cellproduction.
Side effects
Because it is a relatively new drug, scientific and anecdotal evidence ofits side effects are not readily available. However, the drug is verysimilar to EPO, and therefore it is expected to have similar side effects.
This includes causing the blood to thicken excessively. The heart hasto work harder to pump the thicker blood and the blood is more proneto clot.
Consequently, Dynepo use could increase the risk of heart attack,stroke and clots in the lung. The risk is exacerbated by dehydration,which often occurs during endurance exercise.
Status in Sport
Dynepo is prohibited both in and out of competition under the WorldAnti-Doping Code 2006 Prohibited List (effective from 01/01/06).
Substances: Human Growth Hormone (hGH)
Human growth hormone (hGH) or somatotropin, is a glycoprotein hormone that is synthesised and secreted by cells in the anteriorpituitary gland.
hGH is known to act on many aspects of cellular metabolism and isalso necessary for skeletal growth in humans.
The major role of hGH in body growth is to stimulate the liver andother tissues to secrete insulin like growth factor (IGF-1). IGF-1stimulates production of cartilage cells, resulting in bone growth andalso plays a key role in muscle growth.
A deficiency in hGH before puberty results in growth retardation and dwarfism. Excess secretion of hGH after puberty has little effect onskeletal growth but results in a disease known as acromegaly.
In years past, growth hormone purified from cadaver pituitaries wasused to treat children with severe growth retardation. More recentlyrecombinant (artificial) hGH has lead to several other applications including treatment of growth disorders and cosmetic symptoms ofaging.
hGH may be used in sport to induce anabolic effects, reduce musclecell breakdown and reduce body fat.
Side effects
One of the most common side effects of hGH abuse is acromegaly. The onset of this disorder begins with an overgrowth of bone andconnective tissue which leads to a change in appearance such as aprotruding jaw and eyebrow bones.
Because of the role that hGH plays in stimulating IGF-1 secretion,excessive use of hGH may also lead to metabolic dysfunction, including glucose intolerance and other side effects associated with excess levelsof IGF-1.
Status in Sport
Human growth hormone is a prohibited both in and out of competition under the the World Anti-Doping Code 2006 Prohibited List (effectivefrom 01/01/06).
Insulin, normally used in the treatment of diabetes, is a naturallyoccurring hormone secreted into the blood stream to promote themetabolism of carbohydrates, fats and proteins.
Some athletes may use insulin, in conjunction with other prohibited substances in an attempt to increase muscle growth and improvemuscle definition. However, desired results are debatable, chances ofharmful side effects are great anddeaths are alleged.
Side effects
Use of insulin can cause hypoglycaemia (low blood sugar) which maycause shaking, nausea, weakness, shortness of breath, drowsiness,coma, brain damage and death.
Status in Sport
Insulin is prohibited both in and out-of-competition under the WorldAnti-Doping Code 2006 Prohibited List (effective from 01/01/06). The legitimate use of insulin to treat insulin dependant diabetesrequires a Therapeutic Use Exemption (TUE) from a recognised TUECommittee. Check the TUE procedures of the relevant sports federation for furtherguidance.
Substances: Insulin-like Growth Factor - 1 (IGF-1)
IGF-1 is a naturally occurring growth factor/hormone that stimulates many processes in the body, including protein synthesis. It is thehormone through which growth hormone exerts most of its growthpromoting effects.
IGF-1 receives its name because its amino acid structure is similar tothat of insulin, it can bind to insulin receptors on the surfaces of cells and in very high quantities can produce the same effects as insulin.
However most of its effects are mediated through its own receptors.
In its naturally occurring form, IGF-1 binds to specific carrier proteinsthat transport it in the bloodstream and regulate its biological actions.
IGF-1 is legitimately produced for research purposes and is used bypharmaceutical companies to stimulate cell growth in cell cultures.
Some overseas pharmaceutical companies have also been trialing theuse of IGF-1for human therapeutic purposes; however clinical trialshave largely been discontinued because of significant side effects,although some trials are still continuing.
It has been reported that some athletes use IGF-1 in an attempt toincrease muscle bulk, reduce muscle cell breakdown and reduce bodyfat.
There is no evidence to support the belief that IGF-1 producesperformance-enhancing effects in athletes. Even if it did, it wouldrequire very large doses to achieve any potential gain. Such doses would carry the risk of significant adverse effects, includinghypoglycemia.
IGF-1 is also very expensive and is produced in strictly limitedquantities.
Side effects
Due to its insulin-like properties, IGF-1 can have potentially fatalhealth effects including: swelling of the brain, diabetic (hypoglycemic)coma, enlargement of the heart, and facial nerve paralysis.
Status in Sport
IGF-1 is a prohibited both in and out of competition under the WorldAnti-Doping Code 2006 Prohibited List (effective from 01/01/06).
Mechano Growth Factors (MGF)
MGF is derived from IGF-1 but its make-up differs from the systemicIGF-1 produced in the liver. MGF promotes muscle tissue repair.
Side effects
Yet to be determined, however may be very similar to those of IGF-1.
Human chorionic gonadotrophin (hCG)
hCG is a hormone normally produced in the placenta during pregnancy and can promote an increase in the production of natural male andfemale steroids.
In males, it stimulates the testes to produce testosterone rapidly. hCGmay be illegally used by those taking anabolic steroids to attempt tocounteract the effects of testicular damage or as a masking agent.
Side effects
Since hCG is used to stimulate testosterone production, side effectsare similar to those of anabolic steroids, although the risk ofgynaecomastia may be increased. Leutinising Hormone (LH)
Pituitary gonadotrophins are secreted from the pituitary gland andinclude hormones such as Leutinising Hormone (LH) which stimulates the testes and ovary. In females, LH stimulates ovulation; in males itis similar to hCG and can stimulate the production of testosterone.
Synthetic gonadotrophins ( e.g. tamoxifen, cyclofenil and clomiphene)have the ability to regulate gonadotrophin production or use.
Side effects
Side effects of pituitary and synthetic gonadotrophins are unknown.
Side effects are generally particular to the hormone in use.
Special note on gonadotrophins -LH and hCG are only prohibited in
males under the World Anti-Doping Code 2006 Prohibited List(effective 01/01/06).
Corticotrophin is a hormone which increases levels of endogenouscorticosteroids (cortisone) in the blood. Corticotrophin has an anti-inflammatory effect, but may also used to obtain the mood elevatingeffects of corticosteroids.
Side effects
Short-term use of ACTH may cause stomach irritation and ulcers, and psychological effects such as irritability. Prolonged use may induce sideeffects including softening of connective tissue and weakening of aninjured area in muscles, bones, tendons or ligaments, osteoporosisand cataracts.
19-Norandrostenedione is derived from the steroid hormoneandrostenedione.
Androstenedione, which is one of the two metabolites of DHEA(dehydroepiandrosterone), is the main intermediate hormone in theproduction of testosterone.
Norandrostenedione is readily metabolised (broken down) in the liverto nortestosterone, which is also known as nandrolone (durabolin) andbinds strongly to the testosterone receptors.
Side effects
Norandrostenedione has the same side effects as anabolic steroidsincluding psychological and physical effects such as jaundice,permanent liver damage, liver tumors, diabetes, acne (face and back),heart problems, high cholesterol levels, blood poisoning and HIV through sharing needles, depression, mood swings, violent oraggressive behaviour, paranoia.
Some of the side effects can be serious, sudden and include suddendeath.
Ephedrine is a central nervous system stimulant first produced from the ephedra plant 5000 years ago. It is often found in Chinese herbalpreparations and therefore use of these herbs can lead to a positivedrug test.
Ephedrine is a sympathomimetic agent. This means it is a stimulantwhose mechanism of action mimics adrenaline or amphetamines as itstimulates the same type of drug receptors. The effects of ephedrine,however, are much less pronounced than amphetamine.
Side effects
Side effects are common with ephedrine use. Side effects include increased heart rate, palpitations, heart irregularities, tremor,insomnia, increased sweating and trouble with heat regulation.
Ephedrine commonly causes an increase in blood pressure and mayincrease anxiety and alter judgement. Drug addiction and death arebeing more commonly reported in sport.
Plasma Expanders (PEx)
Plasma expanders are used to increase (expand) the volume of plasmain the blood. Examples include Haemaccel, Albumex, Gelofusine and more recently Dextran 70 and Hydroxy-ethyl starch (HES). They aremainly used in medicine to replace fluid in cases of severe shock, asmay occur with blood or fluid loss in surgery.
Endurance sports such as cycling and cross-country skiing do not allowathletes to compete who have high haematocrit and haemoglobinlevels in their blood. Some athletes may use plasma expanders in an attempt to reduce high hematocrit levels, while maintaining elevatedtotal blood volume.
Some athletes may use plasma expanders in an attempt to mask bloodtesting detection of erythropoietin (EPO).
Side effects
Side effects include allergic reactions and anaphylactic shock (a severeform of generalised allergic reaction that can result in death).
Artificial Oxygen Carriers
Artificial oxygen carriers are chemicals used to increase the ability to carry extra oxygen in the blood. Examples include perflurocarbons(PFCs), haemoglobin based oxygen carriers (HBOCs) and liposome(fatty membrane) encapsulated haemoglobins (LEHs).
Artificial oxygen carriers are useful when human blood is not available,the risk of blood infection is high or when time to properly undertakecross-matching donated blood with a recipient is short. Such products are still in development and although improvements are being made,more research and development is needed before these products willbe useful to humans in clinical medicine.
There are some reports of athletes using these products to increasethe oxygen carrying capacity of their blood. There is no concrete evidence to support these claims and these drugs are not in generaluse.
Side effects
Side effects significantly vary between the PFCs and the HBOCs. They can be serious, as it is difficult to measure correct doses.Side effects ofPFCs include transient fever, reduction in the platelet count, andpotential overloading of phagocyte cells. Side effects of HBOCs includehypertension, vasoconstriction, kidney damage, and iron overload.
Erythropoietin (EPO) is a peptide hormone that occurs naturally in thehuman body.
EPO is released from the kidneys and acts on the bone marrow to stimulate red blood cell production. An increase in red blood cellsimproves the amount of oxygen the blood can carry to the body'smuscles. It may also increase the body's capacity to buffer lactic acid.
Recombinant (artificially produced) EPO has a legitimate use in thetreatment of anaemia in patients with diseases such as kidney disease, HIV and some cancers. Some athletes may use recombinant EPO toimprove endurance performance or to improve recovery fromanaerobic exercise.
Side effects
Use of recombinant EPO can cause the blood to thicken excessively.
The heart has to work harder to pump the thicker blood and the bloodis more prone to clot. Consequently, EPO use can increase the risk ofheart attack, stroke and clots in the lung. The risk is exacerbated bydehydration which often occurs during endurance exercise.
Epoetin Delta (Dynepo)
Dynepo is the trademark name for an erythropoiesis stimulatingprotein, epoetin delta. This protein, which stimulates red blood cell production by the same mechanism as human erythropoietin (EPO), ismanufactured by the US pharmaceutical company TranskaryoticTherapies (TKT). An increase in red blood cells improves the amount ofoxygen the blood can carry to the body's muscles. It may also increasethe body's capacity to buffer lactic acid.
Dynepo has legitimate clinical use in the treatment of anaemia related to chronic renal (kidney) disease - specifically for patients receiving orabout to undergo dialysis, to elevate and maintain red blood cellproduction.
Side effects
Because it is a relatively new drug, scientific and anecdotal evidence ofits side effects are not readily available. However, the drug is verysimilar to EPO, and therefore it is expected to have similar side effects.
This includes causing the blood to thicken excessively. The heart hasto work harder to pump the thicker blood and the blood is more proneto clot. Consequently, Dynepo use could increase the risk of heartattack, stroke and clots in the lung. The risk is exacerbated bydehydration, which often occurs during endurance exercise.
Blood Doping
Blood doping is the administration of autologous, homologous or heterologous blood or red blood cell products of any origin, other thanlegitimate treatment.
Blood doping can occur when an athlete introduces additional blood totheir natural blood volume or when other synthetic related bloodproducts are used to increase red blood cell mass. An increased redblood cell mass improves that amount of oxygen the blood can carry tothe body's muscles - therefore improving endurance performance.
Side effects
Any practice that involves adding blood to the body or taking blood out can pose a serious health risk. An athlete using their own blood maybe at risk of bacterial infections and fatal reactions due to bloodmislabelling. Other complications may include blood clots, stroke,congestive heart failure, hypertension, and shock.
An athlete who uses another person's blood also risks immuneproblems, fever and viral infections. The sharing of needles or bloodcan also lead to diseases such as HIV and hepatitis.
Elevating blood volume above natural levels is a dangerous practice asthe blood becomes viscous and this causes the heart to work harder topump the blood. Viscous blood is more prone to clotting. Unnaturallyhigh red blood cell levels also increase the risk of heart attack, strokes and pulmonary embolism (lung clot). The risk is exacerbated bydehydration, which often occurs during endurance exercise.
Repoxygen is the tradename for a type of gene therapy that is claimed to induce controlled release of erythropoietin (EPO) in response to lowoxygen concentration.
EPO stimulates the production of red blood cells (RBC) therebyincreasing the amount of oxygen the blood can deliver to the muscles.
Repoxygen has been developed to treat patients with anaemia. It isactivated in response to low oxygen concentration in surrounding tissue and turned off again once systemic oxygen concentration hasbeen restored. Hence this process is said to be controlled/self-regulating and essentially mimics, in the muscle, what normally occursin the human kidney when EPO is produced naturally.
Athletes may consider using Repoxygen as a means of increasing RBCmass. However in principle, if Repoxygen acts as described, it should not raise RBC levels above normal due to it's self-regulating propertiesand therefore may be a poor choice for doping purposes.
Side effects
The self-regulation function of Repoxygen observed in laboratory research is so far unproven in human tissue. Therefore the illegitimateuse of Repoxygen may be an extremely dangerous practice.
Side effects caused by increasing RBC levels unnaturally include the blood becoming viscous and causing the heart to work harder to pumpthe blood. Viscous blood is also more prone to clotting.
Such side effects could also increase the risk of heart attack, strokeand pulmonary embolism (lung clot). The risk is exacerbated bydehydration, which often occurs during endurance exercise.
Chemical and Physical Manipulation
The following types of manipulation are prohibited:
Tampering, or attempting to tamper, in order to alter the integrity and validity of samples collected in doping controls.
These include but are not limited to intravenous infusions*,catheterisation, and urine substitution.
* Except as a legitimate acute medical treatment, intravenousinfusions are prohibited. Intravenous infusions must be administeredonly under the authority of a physician and for legitimate acute medical treatment. Only under such strict medical control areintravenous infusions permitted without a therapeutic use exemption.
No other reasons for use of intravenous infusions are acceptable.
WADA seeks to ban altitude tents for Spirit of Sport
clause
This report filed - August 9, 2006 Starting in 2007, the training program - or rather, the resting program - of many top athletes could greatly change. The World Anti-DopingAgency (WADA) is considering a proposal by its Ethical Issues ReviewPanel to ban the use of Hypoxic Altitude Simulation (HAS), commonlyknown as altitude tents, on the grounds that simulated altitude violates the "spirit of sport" clause outlined in the 2003 World Anti-Doping Code.
If WADA's Executive Committee at their September meeting approvesthe proposed ban of the use of all HAS devices, elite athletes would be prohibited at the start of the 2007 calendar year. "This is somethingthat Dick Pound (chairman of WADA) has been talking about since2000," says Rip Young, head of marketing for Colorado AltitudeTraining (CAT), the Boulder, Colorado-based company that leads themarket in HAS sales. "It's something that they've been reviewing, butthis year they've made it a priority." Who will be affected
While companies like CAT will certainly take a hit if the proposed ban isapproved, the motion will also affect athletes from all over the worldwho rely on the red blood cell boosting benefits of the "train low, sleephigh" mantra. CAT counts among its clients more than 30 riders from this year's Tour de France as well as past Ironman winners TimDeBoom and Peter Reid. British marathoner and WADA anti-dopingathlete-spokesperson Paula Radcliffe is also a strong advocate of HAS.
What altitude simulators do
HAS allows athletes at any altitude to experience the same endurance-boosting effects of those who live and train in mountainous areas. Thebenefit of high-altitude training comes from the scarcity of oxygen available at higher climes, a condition that prompts the body toproduce more oxygen-carrying red blood cells. Altitude simulationallows athletes to recover high but train at sea-level, where a relativeabundance of oxygen lets competitors work out longer and harder,resulting in greater physiological gains.
Passivity' of the process deemed unsportsmanlike
The crux of the review panel's argument is what it deems the "passivity" of the HAS process. While the panel admits thattechnological and methodical advances are inherent and important tofurthering sport, it believes there is a clear distinction between thoseadvances that are "passive" and those that are "active." The panel takes no issue with advances that require the active engagement oftechnology by athletes, such as the use of a fiberglass pole vault orstreamlined swimsuit, but the WADA board has concerns withadvances that benefit an athlete without requiring action on his or her part. Utilizing HAS, writes the review panel in their findings, involveslittle more than "entering a room or tent, donning a mask and flippinga switch." Rising opposition to the ban
Since WADA's review panel proposed the ban in May, members of theacademic community as well as individual athletes and businesseshave voiced their opposition to the proposition. In a signed letter toWADA, 76 members of the international scientific community led by Dr. Benjamin Levine argued that, "'Recovery' from training, in all itsmyriad manifestations, is one of the most important aspects of trainingand biologically is definitely NOT passive." The letter continues to pointout that manipulating athletes' recovery environments is not a new technique and cite air conditioning, saunas and hot tubs as examplesof "passive" recovery.
While several members of the the scientific community have criticizedthe panel's findings, legal advocates have also raised red flagsconcerning the logic behind the ban. "My husband and I have beeninvolved in sport and doping control for several years," says Duke University law professor and former professional 800-meter runnerDoriane Lambelet-Coleman. "We care a lot about the integrity of theprogram, and we thought the way they went about [defining the ?spiritof sport'] failed to provide clarity." In a signed letter to Dick Pound, Coleman, her husband, and two other Duke law professors expressed unease over the danger of banningHAS, writing, "If ?spirit of sport' is going to be a standard for banninga substance or method, it must be defined in a way that permits fairand consistent application." The Duke colleagues also took issue withthe panel's definition of "passivity," arguing that the term is too broad and could possibly encompass many things that WADA would not wantto prohibit such as electronic muscle stimulation, massage and evenicing.
WADA deflects criticism, says it's merely encouraging
debate
Frederic Donze, manager of media relations at WADA, says that theorganization is not leading the charge against HAS but rather merelyattempting to encourage conversation. "The discussion about hypoxicsimulation has been an old one and has been going on for quite some time," says Donze. "We are facilitating the process, and it is our roleas the organization against doping to do so." Donze was unable tocomment further on specific criticism leveled against the panel'sfindings, although he did confirm that WADA officials have received alarge amount of feedback, both public and private, from their stakeholders concerning the proposed ban. While Coleman and herDuke colleagues believe they have succeeded in highlighting flaws inthe panel's findings, she remains unsure that their voices will beheard.
"Formally, WADA is required to listen, or at least consider the views of their stakeholders," says Coleman. "In the past, sometimes they havedone that and sometimes they have not." Altitude tents - Friend or foe? Will they soon be banned for use by
competitive athletes? Possibly, but I would contend that it is not likely.
Despite (or perhaps in spite) the fact that many high-profile athletes
have used the tents, such as swimmer Ed Moses, soccer star David
Beckham, and, reportedly, cyclist Lance Armstrong, the ethics
committee of the World Anti-Doping Agency says athletes who raise
their red blood cell count by using tents that simulate high-altitude
conditions or hyperbaric chambers are getting an artificial boost and
WADA may decide to make it a banned practice.
The ban will be considered at a meeting of the WADA executive committee this weekend. The World Anti-Doping Agency (WADA),which has standardized the bans on performance-enhancing drugs insports, will take on the trickier issue of artificially induced altitudeconditions. The issue at hand is more about ethics than about anything else it seems. The questions being asked by WADA are more along thelines of if the effects of an illegal drug can be simulated in a naturalenvironment, is it ethical to use artificial means to reproduce thatenvironment? But is that a means for banning a technologicaladvance? "They're putting too much energy into an aspect of sport that is not going to change anything. They should be putting more energy intodetecting genetic doping or real blood doping," said Dave Wood. "I think WADA's position is out to lunch. It's a tool you can use, but you don't just sit down in a room and all of a sudden your performance isenhanced. You have to use it properly, and there's a trade-off offatigue and stress of being in a low-oxygen environment. It's not liketaking EPO, not even close." I agree, and unlike most controversies, where athletes have used medical substances to enhance their performance, the battle over thealtitude tent stems from technology built specifically for elitecompetition. The tents and similar technologies, such as nitrogenhouses, either remove oxygen or decrease the concentration of oxygen. Like thin mountain air, the gaseous concoction can inducephysiological changes that increase an athlete's endurance, expertssay. However, there is no scientific consensus on the cause of theextent of the benefits.
Critics oppose the technology because its effects are very similar tothose obtained by using the banned substance EPO. A naturally occurring hormone, EPO is sometimes injected to boost performance inendurance sports. At an altitude of about 8,000 feet or higher, anathlete's body will start to release more EPO, creating the same effect.
Blood Doping In Cycling
By Chad Asplund, MD Sep 22, 2004, 03:26 Recent reports regarding inconsistencies in the blood testing results ofTyler Hamilton have continued to fuel the speculation that all successful cyclists are doped. Two of Hamilton's blood samples fromAugust 19th to September 18th showed "mixed-blood cells" accordingto the Union Cycliste International (UCI), thus raising the suspicionabout doping. To date, erythropoietin (EPO) has been the mostcommonly used performance enhancer in cycling.
EPO is a hormone naturally produced by the kidneys when oxygensupply is low. Thus natural EPO concentrations in the blood increasewhen a cyclist is anemic, has been training at altitude, or has been exposed to pollution or second-hand cigarette smoke. EPO acts as asignal for the bone marrow to increase the rate at which red bloodcells are made and released into the circulation (this can be measuredas the reticulocyte count). The increase in number of red blood cells leads to an increased oxygen supply to the tissues throughout thebody. This oxygen rich blood then acts as a signal to the kidneys tostop producing EPO keeping the hematocrit within the normal range.
It is documented that the endurance process is improved in athletes with an increased red blood cell level, and thus an increased oxygencarrying capacity. This occurs whether the red blood cells areincreased via transfusion, or artificially with r-EPO. Improvements inperformance are greatest about three weeks after r-EPO injection.
EPO is rapidly cleared from the blood stream, meaning that EPO usethree or four days before a urine screen may go undetected. Athletesand trainers have learned to manipulate EPO regimens to dodge drugtests. In response, alternative detection methods have been focused on abnormally high hematocrit levels. In Geneva in 1997, the UCIimplemented an upper level of normal for hematocrit of 50%, and 2.4for the reticulocyte count. Those cyclists testing higher than theselevels are then subjected to the more accurate French urine test, which is an indirect test that looks for specific biomechanical propertiesof synthetic EPO using sophisticated laboratory techniques (gelelectrophoresis).
A new development in doping has been the increased prevalence of auto-transfusion (drawing blood from yourself, and replacing it at alater time in an attempt to boost your oxygen carrying capacity). Fearof being caught for EPO use, and awareness of the difficulty of testing for auto-transfusion, has driven athletes to self-transfusion. In preparation for the Sydney Olympics, Australian officials did researchquantifying mixed red blood cell populations via the flow cytometrictechnique used to detect minute differences between fetal andmaternal blood cells in pregnant women. This method is accurate in detecting the small amount of mixed blood cells that would result froman auto-transfusion. Using more specific antigen testing, authoritiescan more specifically hone in on blood types, exposing those who mayhave been doped. The half-life of transfused red blood cells is 55 days, meaning that this test could possibly detect doping from up to 2months prior to the test. This testing is very accurate with a falsepositive rate of less than 5%.
In Hamilton's case, if the ultra-sensitive flow cytometry techniquecould detect cells from a blood transfusion for up to 55 days, it couldbe assumed that the doping tests done following the Tour de Franceand Athens Olympics would also have shown "mixed blood cells". Thefact that he has never had a positive (or non-negative) test in the last 10 years is in his favor. We should withhold any further judgmentregarding the test results until all the results have been disclosed andall the information is known.

Source: http://www.mtpspin.ca/tipscontent/faith/darkside_of_cycling.pdf