Wednesday, June 30, 2010

More evidence on Lance Armstrong

Sports Illustrated published a column today that discusses how the information that Floyd Landis recently provided about how riders get away with doping may change things at this year's Tour de France. For example, Floyd explained how riders combine blood transfusions with micro-doses of EPO at night to boost their red blood cell count and to keep the number of immature red blood cells within normal ranges. The blood transfusions increase the number of mature red blood cells and the EPO produces an increase in the number of immature red blood cells. Because the amount of EPO is small, the tests for EPO show normal levels after a few hours. As such, if riders are not tested in their sleeping hours then they appear to be clean.

The Sports Illustrated column gives more details about Floyd's revelations than I've seen before. For example, it says that Floyd claims that his Phonak team owned a Sysmex machine that he learned to use to monitor his blood count levels. Imagine that--Phonak provides their riders with a sophisticated medical device for blood monitoring! These guys are serious!

One interesting point that the article makes is that the rigor of the Tour de France is such that hemoglobin counts should decline over the race period. Thus, if a rider's hematocrit levels don't decline over the 3-week race period, it's an indication that he is doping. Here is a quote:

What else should testers look for, based on what they've learned from Landis? "One thing I would be looking for, based on Floyd's account," writes Ashenden, "is a steady hemoglobin value throughout the 3-week race." In other words, the inhuman rigors of a grand tour should force those values down. "It is both unnatural and highly suggestive of doping if blood values do not decline during a Tour."

Then, the column made this point:
Sort of like this profile, posted by Lance Armstrong on his LiveStrong site after last year's Tour, but subsequently taken down.

The column added a disclaimer in Armstrong's defense by saying that hematocrit levels can be skewed by dehydration and diarrhea. That disclaimer sounds pretty weak to me. It's kind of like Floyd's claim that his T/E ratio was skewed by the alcohol he drank the night before. The bottom line is that since there is no smoking gun in a fraud case, including athletes who dope, we have to rely on circumstantial evidence. The evidence in this profile looks suspicious. Combine that with all the other accusations and testimony and it doesn't look good.

So what does the profile show? I looked at it and noticed a few things that are interesting. First, Lance's values don't seem to change much over the year, including during the almost daily testing during the Tour de France. Another thing I noticed is that his hematocrit levels were lower than I expected--hovering in the low 40's. I would have expected them to be right around the magic 50 number.

I'm not sure what to make of his low 40's hematocrit levels since other articles have alleged that the UCI has given racers warning before testing them and even waited for them while having coffee breaks with team officials! Coupling those claims with the insight from Ed Burke's article that riders can easily manipulate their hematocrit numbers with 20 minutes notice, makes me less impressed with Lance's values in the low-40's.

One thing is for sure: his values were stable over the period of last year's Tour. Assuming Ashenden knows what he's talking about, this appears to be evidence Lance had more than mother nature on his side.

So what can we make of all this? Here is what I conclude. First, as in most frauds, opportunities definitely exist for smart and determined fraudsters who are professional cyclists to dope. Second, they can easily do so if they have 20 minutes to dilute their hematocrit levels and use a combination of blood transfusions and EPO micro-doses to make their blood counts look normal. Third, one more piece of evidence suggests Lance was likely doping even as recently as the 2009 Tour de France.

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