Ferritin and Triathlon II

http://www.cmaj.ca/content/early/2012/07/09/cmaj.110950.full.pdf

Reading the article helps to understand even more Ferritin as a marker for many purposes.  I do not see why Ferritin is not used to unmask doping.  It is not possible to have a high level of Ferritin, above 100, if it is not obtained by transfusions or IV iron.  In 1999, over 45% of riders displayed ferritin values above 300 ng/ml and one fourth levels over 500 ng/ml. http://bjsm.bmj.com/content/38/6/704.full  After being tested for the first time in 1999, the Ferritin level in the peloton decreased a year later but the decrement was not significant.  The older the rider, the greater the quantity of iron, most likely related to transfusions from what we know now.  Ferritin can be elevated for medical reason, in the case of an inflammatory process but it will never reach values above 200; unless somebody is really sick or receiving Total Parental Nutrition (TPN).

The graphic below shows the year the cyclist is born and the average of the Ferritin level for the specific group.

The study done and published:  Br J Sports Med 2004;38:704-708 doi:10.1136/bjsm.2003.006635.  The authors timidly mentioned the fact that transfusions were taking place already among the members of the peloton.  It takes years to increase Ferritin with oral iron and IV iron is necessary at least three times a year to keep Ferritin close to 100 when having a well-educated athlete.  If we need to give IV iron every two months, it means that the triathlete needs a better education.  It means that there are problems with nutrition in general and many people doped in these conditions (give transfusions).  At the same time, we need the proper nutrition to increase red blood cells and hemoglobin.  Eufemiano Fuentes says that he was “treating anemia” when he was in front of the judge for “La Operación Puerto.”  Education is the solution to our problems!