Human Limits

Exploring performance and health with Michael J. Joyner, M.D.

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Tour de France: Time for a Doping Update

With the Tour de France set to start at the end of June, Major League Baseball in mid-season and international track and field winding up it, seems like a good time to review a few developments in the world of doping.  Where to start?



The big doping news in baseball center around reports (starting last winter) that a Miami “clinic” was providing performance enhancing drugs to a number of high profile players.   Major League Baseball has obtained the records from the clinic and is considering action including the suspension of a large number of players.  The take home messages from this story include:

  • Drug testing, both the tests and the way they are administered, remain beatable.
  • High profile cases are frequently more about paper and financial trails than testing.
  • Baseball seems to be taking this more seriously than in the past.


Track & Field

In April there were reports that some high profile distance runners were being treated with thyroid hormone “replacement” therapy.  Here is a link to a thoughtful analysis by the Science of Sport blog.  It raises a number of questions about therapeutic exemptions for athletes with real medical conditions.  The other big issue here is that if heavy training and competition alters key hormone levels should the athletes be permitted to use supplemental doses to get their levels back to “normal”.   This is a slippery slope and could lead to a situation where upper limits of normal for hormone levels and hematocrit are established and “doping” up to that level is allowed.  Perhaps the biological playing field would be level but what about individual variation and the challenge of working with what you have?  At some level this might already be happening with the use of low dose doping programs designed to fly under the testing radar.  For those of you wanting a deeper dive on this topic the links above are excellent and cover a lot of ground.



A colleague sent me a link to a Velo News (the bible of Cycling) article on a new analysis of power outputs on iconic Tour de France mountain climbs.  The data come from a number of top cyclists over the last ~30 years and provides a color coded index of suspicion related to who might have been doping on what climb when.   The idea is that if you know a rider’s power output in watts/kg you can make reasonable estimates of oxygen consumption and that some of these power outputs would require people to be working at VO2max for prolonged periods of time, at altitude, at the end of long rides with multiple climbs.  This is a collection of circumstances that seems physiologically unlikely at best.   The article is an interesting read and here is a link to the full analysis being published as a one time magazine and also a podcast interview with the author.



At one level the news is depressing and it appears that doping goes on more or less unchecked with ever more sophisticated “work arounds” to beat the testing.  At another level perhaps the testing, analysis and detective work are getting good enough to keep the lid on things to some extent.  This has been likened to having enough speed limit enforcement on the highways to keep most drivers close to the speed limit.  Perhaps this is the best we can hope for given the money and fame at stake in professional sports.



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