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How dangerous is doping?

EPO kills - there are several noted instances of inexplicable heart attacks in young cyclists obviously linked to EPO use. EPO can clog the blood. Users can need to wake themselves several times a night to exercise, get the blood flowing and prevent clots.

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Why is EPO dangerous?
The reason that EPO, and transfusion blood doping, is dangerous is because of increased blood viscosity. Basically, whole blood consists of red blood cells and plasma (water, proteins, etc.). The percentage of whole blood that is occupied by the red blood cells is referred to as, the hematocrit. A low hematocrit means dilute (thin) blood, and a high hematocrit mean concentrated (thick) blood. Above a certain hematocrit level whole blood can sludge and clog capillaries. If this happens in the brain it results in a stroke. In the heart, a heart attack. Unfortunately, this has happened to several elite athletes who have used EPO.

EPO use is especially dangerous to athletes who exercise over prolonged periods. A well-conditioned endurance athlete is more dehydration resistant than a sedentary individual. The body accomplishes this by several methods, but one key component is to “hold on” to more water at rest. Circulating whole blood is one location in which this occurs and, thus, can function as a water reservoir. During demanding exercise, as fluid losses mount, water is shifted out of the blood stream (hematocrit rises). If one is already starting with an artificially elevated hematocrit then you can begin to see the problem -- it is a short trip to the critical “sludge zone”.

Additional dangers of EPO include sudden death during sleep, which has killed approximately 18 pro cyclists in the past fifteen years, and the development of antibodies directed against EPO. In this later circumstance the individual develops anemia as a result of the body’s reaction against repeated EPO injections.

http://www.rice.edu/~jenky/sports/epo.html

Testosterone, if taken as a one-off thing the night before, would not be the least bit dangerous.

But it would not help performance either.

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Originally Posted by Albany-12303

Testosterone, if taken as a one-off thing the night before, would not be the least bit dangerous.

But it would not help performance either.

But taken in other ways it could have unwanted side effects.

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Originally Posted by BeeTL

The article linked above seems to indicate that elevated hematocrit increases the potential for heart attack/stroke during extended/endurance exercise.

I wonder if those risks are similar for those who raise their hematocrit through other means like altitude training?

I'm guessing there is a question of degree at play here, but as I'm not an expert, I won't try to defend my guess.

It's my understanding that the body won't allow the red blood count to get to dangerous levels by 'natural' means (altitude training).

Pure red blood cell aplasia. Extremely rare, but a potential side effect of the epo drugs. It remains on the market because of the risk benefit ratio. This applies to those in renal failure and on chemo so weak they can't function. It it were indicated for performance enhancement, it would not be in any way worth the risk, however small.

http://www.emedicine.com/med/topic1967.htm

Who was the young Dutch rider who died in the early 90s due to his EPO use?

And what was Delgado suspected of having taken during his '88 tour win?

Johannes Draaijer, 27 years old, died in 1990 after finishing 20th in the 1989 TdF

delgado tested positive for probenicide, which was used to maskt the presecne of anabolic steroids, it was on the IOC banned list, but not the UCI.

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Originally Posted by BeeTL

There have been many posts that put forth the idea that every pro dopes. Also, the risks associated with EPO overdosing have been covered pretty well, as have been the challenges associated with keeping up with the dopers from a testing perspective.

So then assuming a pro is seeing a qualified Doctor and staying within "normal range" on each of the substances being tested for, what are the dangers to the rider himself? Beyond the obvious competitive advantage, is the "optimized" rider potentially "healthier" than the clean rider?

Normal range or allowable range? They are totally different things.

Also remember a lot of banned substances are banned not because of what they do but because they mask something else. One can use drugs to enhance performance with minimal risk, but once the process starts the guys want the maximum boost and that means pushing it to the limit. In the end that means risk and lots of it. If for no other reason because they will try untested drugs because they are untested, or to be more accurate because they either are not yet on the list or because there is not yet a test.

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Originally Posted by Smoothie104

Johannes Draaijer, 27 years old, died in 1990 after finishing 20th in the 1989 TdF

I can remember his wife being interviewed about Johannes' death. In the late 80s there was a slew of Dutch riders dying and she wanted to warn others. She asked why Italian riders weren't falling off their bikes dead..

I wonder what drug(s) made Manzano collapse. If even he knows.
Judging by the things he said... I don't think the health of some riders is really taken into account. If the team thinks that some drug will make them faster, they will give it to the rider. They don't necessarily know what the side effects might be... particularily for a pro athlete in competition. And they will dangerously mix drugs.

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Originally Posted by EURO

Do they attempt to counteract the EPO with blood-thinners like Coumadin (sp?) once the competition is over?

Any substance when abused, can kill.

It seems as if the dopers have figured EPO out and don't die much anymore from it (or use it because of the new testing?). Micro-dosing changed EPO usage. Additionally, many of the earlier deaths were pros using EPO without the benefit of knowledgeable doctors or those who forgot to wake up hourly and exercise (apparently fixed by micro-dosing). The EPO tests would prevent those who couldn't afford doctors from experimenting with EPO and those with doctors are monitored close enough to prevent short term problems. I have not heard of any long term effects of EPO use from medical trials (but EPO is only a couple of decades old).

The anti-doping effort combined with learning from the rare deaths (relatively) has kept doping pretty safe. Dopers might accept shortening their lives to win but few are stupid enough to accept death before they win in pursuit of that win.

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Do they attempt to counteract the EPO with blood-thinners like Coumadin (sp?) once the competition is over?

The only thinning product I'm aware of them using is water.

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Originally Posted by EURO

The only thinning product I'm aware of them using is water.

That is how they have gotten away with going over 50% for a decade now, isn't it? An IV of water just before the test.