Blood Doping

From ArticleWorld

Each year an athlete’s ability to perform seems to increase by leaps and bounds. Some reasons for this increase can be attributed to better training methods, better conditioning techniques, and better overall health of the athlete. While most of the situations involve one or more of the previously mentioned scenarios, some athletes always seem to take it a step further. They engage in a process called blood doping. This procedure does increase their athletic ability, but potentially may do more harm than good.

Blood doping is the practice of illicitly boosting the number of red blood cells (RBCs) in the circulation in order to enhance athletic performance. Because they carry oxygen from the lungs to the muscles, more RBCs in the blood can improve an athlete’s aerobic capacity and stamina.

Blood doping has become an integral part of sports and fair play. It enhances your performance by increasing red blood cell mass and thereby delivering more oxygen to muscle. This manipulation has gained notoriety in the sports world for what it can do for an athlete during endurance events. Special concern has been expressed that the cardiovascular system of an athlete undergoing this procedure could be in jeopardy. Still, there are athletes out there that will put themselves at risk just to experience the thrill of being number one, regardless of the circumstances.

Blood doping, often called induced erythrocythemia, is the intravenous infusion of blood to produce an increase in the blood’s oxygen carrying capacity. It is a procedure that begins with between 1 to 4 units of a person’s blood (1 unit = 450 ml of blood) being withdrawn, usually several weeks before a key competition. The blood is then centrifuged and the plasma components are immediately reinfused while the remaining red blood cells are placed in cold storage. The RBC’s are then reinfused back into the body, usually 1 to 7 days before a high endurance event. If done correctly, this process can increase the hemoglobin level and RBC count by up to 20%.

The term blood doping originally meant literally doping with blood, i.e. the transfusion of RBCs. RBCs are uniquely suited to this process because they can be concentrated, frozen and later thawed with little loss of viability or activity. There are two possible types of transfusion: homologous and autologous. In a homologous transfusion, RBCs from a compatible donor are harvested, concentrated and then transfused into the athlete’s circulation prior to competition. In an autologous transfusion, the athlete harvests his own RBCs well in advance of competition and then re-introduces them before a critical event. Both types of transfusion can be dangerous because of the risk of infection and the potential toxicity of improperly stored blood. Homologous transfusions present the additional risks of communication of infectious diseases and the possibility of a transfusion reaction.

It is also possible that blood doping could have effects opposite to those intended. A large infusion of red blood cells (and resulting increase in cellular concentration) could increase blood viscosity and bring about a decrease in cardiac output, a decrease in blood flow velocity, and a reduction in peripheral oxygen content – all of which would reduce aerobic capacity. The human heart was not designed to pump this thickened blood throughout the body and, therefore, could lead to a multitude of problems. Some of the problems that can arise from an autologous blood transfusion are phlebitis, septicemia, hyperviscosity syndrome (including intravascular clotting, heart failure and potential death), bacterial infections, and air/clot embolisms.

A more recent and more sophisticated method of analysis, which has not yet reached the level of an official standard, is to compare the levels of mature and immature RBCs in an athlete's circulation. If a high number of mature RBCs is not accompanied by a high number of immature RBCs--called reticulocytes--it suggests that the mature RBCs were artificially introduced by transfusion. EPO use can also lead to a similar RBC profile because a preponderance of mature RBCs tends to suppress the formation of reticulocytes. A measure known as the "stimulation index" or "off-score" has been proposed based on an equation involving hemoglobin and reticulocyte concentrations. A normal score is 85-95 and scores over 133 are considered evidence of doping.

A new invention by a University of Colorado at Boulder professor only adds to the controversy of blood doping. Igor Gamow, an Associate Professor of Chemical Engineering, has invented a sleep chamber that may enable endurance athletes to, in effect, train while they sleep. The chamber mimics the reduced air pressure of high altitudes and stimulates the production of red blood cells. This enables an athlete training at sea level to gain the same fitness advantage as an athlete living at high altitude. If this chamber is used correctly (six to eight hours a day for two to three weeks) the hemoglobin concentration can be boosted by more than 23%. Because the High Altitude Bed ® is legal, safe and natural; this procedure of red blood cell enhancement is called Holistic Blood Doping.

At present there is no accepted way of detecting autologous transfusions (using the athlete’s own RBCs) but research is in progress and the World Anti-Doping Agency (WADA) has promised that a test will eventually be introduced. The test method and its introduction date are to be kept secret in order to avoid tipping off doping atheletes. At the present time blood doping is a controversial issue. With the new advances in science and sports medicine, this will probably be a dilemma for years to come. Many present and future athletes will have to use their best judgment when this procedure becomes an issue in their lives. Blood doping is illegal but is also undetectable. The potential risks of such a procedure seem to outweigh any potential benefits, above and beyond the ethical issues involved. If a distinct advantage is needed in endurance events, altitude training and the altitude sleep chamber pose far fewer risks and are currently safe and legal. And, if all else fails, hard work and determination still count for something.