Human Limits

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

Photo of Michael J. Joyner, M.D.

Who’s Doping Now?

For most of us when I say doping you say Lance Armstrong, or Barry Bonds, or Roger Clemmons or Marion Jones.   However, what about the rest of the world and our individual and collective drive for improved performance?  Here are a few thoughts on the topic and questions for all of us.


Doping With Tylenol?

A number of recent studies show that acetaminophen (Tylenol) can improve cycling performance.  This includes repeated sprints, exercise in the heat, and a self-paced time trial:


“Using acetaminophen, participants cycled at a higher mean power output, with an increased heart rate and blood lactate, but without changes in perceived pain or exertion. Consequently, completion time was significantly faster. These findings support the notion that exercise is regulated by pain perception, and increased pain tolerance can improve exercise capacity.”


Is this doping?  Should Tylenol be banned? You can tell a similar story and ask the same questions about caffeine.


What About Middle Age?

A recent piece in the Velo News tells the story of a late 50s recreational cyclist with clinical testosterone deficiency who went on testosterone replacement therapy for a number of issues including osteoporosis.  The athlete in question self-reported and asked for a therapeutic exemption so he could keep competing in local races.  The exemption denied because he did not have a clearly defined endocrine problem.  You can also make the case that Viagra like drugs might improve performance in some people especially at altitude.  What does this mean for master athletes who take these compounds for other reasons?


For women there is at least some evidence that hormone replacement therapy (HRT) improves exercise capacity but the data are far from clear cut.  What about the aging news anchor who uses botox to keep her job?


Is any of this doping when the drugs in question are used for legitimate medical purposes?  Search the internet for anti-aging clinics and you will find all sorts of outfits offering unproven (usually hormonal) therapies purported to slow the aging process.  Recently, some elite younger athletes have been tweaking their thyroids levels.  Where does the “legitimate medical purposes” justification end and doping or snake oil sales begin?


Academic Doping?

For the twenty somethings reading this article the idea of academic doping – using ADHD drugs obtained on the black market to do better on a test is old news.  This practice appears to be pervasive on college and even high school campuses.  It also appears to be drifting into the rest of the world where decision making and concentration are critical.


There are all sorts of drugs that enhance or might enhance cognition and more are in the pipeline.  Who gets them and when is it fair to use them?  Is this just another potential edge for the children of the well-off?  In a world of high stakes testing for admission to an elite school or academic program should these substances be banned and test takers subject to doping control?  The discussion in the cognitive enhancement world mirrors in many ways the sports doping discussion:


“Drugs developed to treat cognitive impairments are proving popular with healthy college students seeking to boost their focus and productivity. Concerned observers have called these practices a form of cheating akin to athletes’ use of steroids, with some proposing testing students’ urine to deter “academic doping.” The ease with which critics analogize the academic enterprise to competitive sport, and the impulse to crack down on students using study drugs, reflect the same social influences and trends that spur demand for these interventions-our hyper-competitive culture, the commodification of education, and our attraction to technological quick-fixes. Rather than focusing on the technologies that are being put to troubling uses, we would be better served reforming the culture that makes these practices attractive.”


Are We All Dopers?

All of us are surrounded by performance enhancing choices beyond the things like the drugs or nutraceuticals we can inject or put in our mouths.  The pervasive invasion of technology into almost every aspect of life offers even more opportunities for performance enhancement.  In the end, what does it mean to be human in the 21st century:


  1. What happens when things like Tommy John surgery are used to pre-emptively improve pitching performance before an injury?
  2. Who draws what lines about what is ethical and fair?
  3. Should we even strive for a level playing field?
  4. What does it mean to be a human in a world where almost every imaginable activity might be subject to high tech performance enhancing strategies?


In the end is there any value left in the lone individual struggling against his or her own limits, or is all about return on investment thinking where the individual is just part of a supply chain leading to a more desirable outcome?

2 Responses to “Who’s Doping Now?”

  1. November 14th, 2013 at 11:22 am

    Bill Schrage says:

    Interesting viewpoints. I would propose doping psych drugs will not boost mental performance, unless you’ve got a defect/disease. Of course, perhaps elite athletes have their own mental baseline that differs from Joe the plumber.
    I wondered if there is any insight into the “culture of doping” in the military context? Aren’t military regimes constantly trying to outperform their enemy-what makes a fair war?

  2. November 15th, 2013 at 8:43 am

    Krista says:

    “The aging news anchor who uses botox to keep her new anchor job?” Definitely doping! That stuff needs to be banned for sure. Those faces scare me.

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