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EPO and Blood Doping in Sports

EPO is a Method of Blood Doping Recently Linked to Professional Cycling

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Updated May 28, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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What Is Blood Doping?

Blood doping is a method of increasing athletic performance by artificially increasing an athlete's red blood cell (RBC) count. Because red blood cells carry oxygen to the muscles, having a higher RBC count can dramatically improve an athlete’s aerobic capacity and delay fatigue. Athletes looking for a way to boost their RBC initially turned to blood transfusions, where an athlete stored and re-infused his or her own RBCs or the RBCs of someone with the same blood type. This practice is banned in professional sports.

What Is Erythropoietin (EPO)?

The most recent means of artificially boosting RBC counts involves a drug that has been the target of accusation and speculation among the professional cycling world for more than a decade.

Erythropoietin (EPO) is a naturally-occurring hormone, produced by the kidneys, that stimulates the production of red blood cells. This hormone can also be manufactured and injected into the skin or directly into the blood stream (intravenously). EPO may be used in medical practice to bring patient's RBC into normal levels.

The use of artificial EPO as a means of increasing athletic performance first showed up 1980s and has recently been linked with drug-use scandals in professional cycling. Despite the creation of an EPO detection test in 2000, some claim that EPO doping is still widespread in pro sports.

EPO abuse in cycling made the news when Floyd Landis, the 2006 Tour de France winner who was stripped of his title after testing positive for doping, confessed to years of using performance-enhancing drugs. His confession also accused 17 other riders -- including Lance Armstrong -- of doping.

In May of 2011, 60 Minutes aired an interview with former U.S. Postal Team Rider, Tyler Hamilton in which Hamilton said he injected EPO along with Lance and other teammates, "many, many times."

Is Erythropoietin (EPO) Dangerous?

Yes, EPO has its dangers. EPO injections thicken the blood, which increases the strain on the heart. This is particularly dangerous when the heart rate slows down, such as during sleep. The increased thickness, or viscosity, of the blood increases the risk of blood clots, heart attacks, and strokes. According to the book "The death of Marco Pantani" by Matt Rendell, some cyclists reportedly set an alarm each night to wake up and cycle on a trainer for ten minutes to jump-start their circulation and reduce the possible health risks of using EPO.

EPO is on the banned substances list in professional cycling, and riders are regularly tested to detect its presence. However, as the drug detection methods improve, so do the methods used to avoid detection.

Sources:

The World Anti-Doping Agency (WADA). Questions & Answers on EPO Detection. Last accessed May 2010.

The World Anti-Doping Agency (WADA). WADA Internatioal Standards. Last accessed May 2010.

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