Of the 189 medical checkups performed at the start of the Tour, the average hematocrit was 44.8% and the average haemoglobin was 14.9g/dl. As the Tour progressed, there were 107 additional blood controls carried out before July 13, which showed averages of 43.3% for hematocrit and 14.6g/dl for haemoglobin. During the last week of the Tour, 80 blood controls were performed, and the average hematocrit and haemoglobin were 42.3% and 14.1g/dl respectively.
That’s because the stuff top teams are using is not EPO or a drug that increases red cell count.
“What’s that?”
“Oh him, Him-o-goblin.”
For real though, guess the counter-control measures are effective eh? My guess is they are using Olean. . .you know like a bag of Fat Free Doritos while cruising the Alps :-%
Why do you doubt it?
Safe to say it has been replaced by something more effective.
Because CERA use would look like rhEPO use - high Hct and Hb
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“First results from a phase II clinical study with CERA (Continuous Erythropoiesis Receptor Activator) in dialysis patients with chronic renal anaemia have shown that Roche’s innovative new chemical entity delivers potent and sustained stimulation of red blood cell formation at dosing intervals of up to once every three weeks.1 CERA effectively increased haemoglobin at all studied doses”
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how about CERA: continuous erythropoesis receptor activator aka super EPO?
More potent (which is really irrelevent…), and has a longer lasting effect than EPO…but, has the same physiologic effect (raising HgB). Now you can argue that the blood tests are easily fooled by getting saline infusions immediately before them (although the immediate spot tests done after races, with no prep period would be difficult to cheat…), but otherwise a Hct of 43 is a pretty good argument against that person using EPO or any other erythropoetic agent.
Scott Martin
I think it works by improving the speed at which O2 attaches then leaves RBC so it wouldn’t raise HCT.
<<<
How would that help? Isn’t the vol of O2 carried to the muscles the critical factor? How would the speed of O2 attachment carry more O2 to the muscles . . . maybe let each RBC ‘work harder’ and do the work of two?
(FWIW Francois . . . serious physio question, not intended as a debate volley. I think we spent enough time on the subject yesterday)
You are sustaining the cells in this case for cancer patient who is being ravaged by chemo. The haemoglobin will be decreased as a result of treatment therefore an increase would be a bonus.
Not real sure how this would cross-over into the cycling/athlete world though.
Were you replying to me? That’s not how Roche was using the word “sustained”. The point they’re trying to make is that you can give CERA once every 3 weeks and have a sustained increase in RBC output over those 3 weeks, rather than a transient burst around the time of CERA administration.
EPO/CERA increase red cell production. In an anemic cancer patient this increase will bring the patient back towards normal Hct/Hb levels. In a healthy person it will lead to higher than normal Hct/Hb.
The Big “O” wrote: Perfluourocarbons?
Darn, beat me to it…
Why do you doubt it?
First because no such substances are commercially available. While that doesn’t mean they can’t be had, they are not available in quantities that would be needed to use over a prolonged period.
Second, they don’t work. PFC’s are only usefull if used with supplemental oxygen. PFC’s work because they are tremendous solvents. They can absorb a huge amount of oxygen, provided there is oxygen available. Plasma is capable of absorbing all the oxygen that is available at atmospheric concentrations, so PFC’s provide no benefit. PFC’s are advantagous when you also provide supplemental oxygen as they continue to absorb oxygen well beyond the point where plasma is saturated.
Hemoglobin substitutes are even less likely as they are very difficult to produce. If they become commercially available (something that is likely in the next few years), production will ramp up to where volumes will be available. At the moment though, I find it very hard to believe you could obtain adequate quantities (I know of one product in phase 3 trials now).
Hemoglobin substitutes are very inneficient compared to blood. They have very short half-lives compared to blood, and all of the ones studied so far have significant side effects.
HBOC’s (hemoglobin based oxygen carriers) have potential use in emergent cases where blood is not available, or for religous reasons not an option. As of yet no HBOC has been developed that would offer an athlete a performance advantage.
Now I’m sure there will be lots of people, that despite all of this, will remain convinced that the peleton is on some secret, unpublushed, supper blood substitute. Any product that could safely be used in athletes, provide a significant clinical effect, and be available in quantities for a reasonable cost, would be worth billions of dollars. It seems fairly unlikely that such a product would be developed in secret, and the potential profits ignored, just so a few cyclists could go a little faster in a bike race.
Scott Martin
I would imagine that the intention for an athlete would be to see an effective burst that plateaus for a limited time and then returns to normal seeing as how maintaining such a level would have less than desirable effects.
“. . .delivers rapid and sustained increases in haemoglobin levels when given once every three weeks to multiple myeloma cancer patients.” Perhaps it’s isn’t a burst but sounds fairly close. Again, this is on less than normal hct/hb patients so when administered to an athlete with a higher than normal hct/hb it could render different results.
Stupid question but do you think an athlete at altitude for a marked amount of time would be able to utilize the higher oxygen levels in combination?
So they’re clean now? 
What about substances that increse the capacity of O2 to associate at alveolar level and dissociate at muscle level?
A decrease by 2.5% does not mean anything, statistically and physiologically. On the contraire: I find this result very troublesome. There are more means to enhance metabolic performance than through RBC-count on the cellular and molecular level. One of limiter is oxygen and its delivery and alone on that level you can do so much more than just boost the hematocrit. You just have to look at the average hematocrit levels of the peloton as a new “baseline” from where you can work from (and that baseline is only there because the “rules” say so). I am pretty sure they have moved on…as has research in this field.
Hemoglobin is saturated with O2, but does it unload all of it at muscle level?
Here’s the million dollar question I have, wise one:
Is it likely that the dopers still hit the EPO in the early/pre-season to allow better recovery (like a certain recently suspended US cyclist)?
Any product that could safely be used in athletes,
Who says it is “safe”?
provide a significant effect and be available in quantities for a reasonable cost, would be worth billions of dollars. It seems fairly unlikely that such a product would be developed in secret, and the potential profits ignored, >just so a few cyclists could go a little faster in a bike race.
Do you know how long it takes to develop a drug and get it to the market? Ever heard of pre-clinical studies?