BIOLOGICAL PASSPORT PART III

I tackled a theme not too long ago: The Biological Passport.  It is necessary to speak clearly about it because bureaucrats want to be important like some of the referees in a Football game.  The biological passport is just a parameter to consider when evaluating doping in somebody.  Please see our post when the case of Mark Fretta came to light:

21 nov. 2012

BIOLOGICAL PASSPORT AND TRIATHLON

As we can see in the Hematopathology / Automated Blood Cell Counts Am J Clin Pathol 2008;130:104-116

http://171.67.112.51/content/130/1/104.full.pdf

It is also desirable that, as with the high standardization for basic CBC parameters, a continued effort be made for the parameters (ie, RDW, IRF, MCVr, and MPV) for which results provided are still too different when produced by different analyzers. To reach these goals, cooperation between long-standing (ie, International Council for Standardization in   Haematology and the National Committee for Clinical Laboratory Standards, now the Clinical and Laboratory Standards Institute) and recent (International Society of Laboratory Hematology) organizations interested in hematologic standardization and the manufacturers is fundamental. It should be remembered that despite the essential role of automation in the modern hematology laboratory, microscopic control of pathologic samples remains indispensable, so much so that in certain cases, it alone is diagnostic.134 Moreover, knowledge of the limits of the specific analyzer in use is of paramount importance for the correct interpretation of results. These considerations require that clinical laboratories performing hematologic diagnostics have personnel with specific training and profound knowledge in laboratory hematology.

We have to find the substance to make a case; otherwise, we are not beyond a reasonable doubt.  There is a criterion in the law that says: Beyond a Reasonable Doubt.

The standard that must be met by the prosecution's evidence in a criminal prosecution: that no other logical explanation can be derived from the facts except that the defendant committed the crime, thereby overcoming the presumption that a person is innocent until proven guilty.

http://jap.physiology.org/content/99/5/1745.full

Errors of measurement for blood volume parameters: a meta-analysis

Christopher J. Gore, Will G. Hopkins, Caroline M. Burger

DISCUSSION

The most important results in the present study are the meta-analytic estimates of error of measurement of V_RBC and M_Hb, the blood parameters directly related to oxygen transport. The short-term error for V_RBC,51Cr and M_Hb,CO were ∼2.5%, whereas those for V_RBC,Evans or V_RBC,CO were about threefold greater. Over a period of 1 mo, the errors for V_RBC,51Cr and M_Hb,CO were ∼3.5%, about one-half of those for V_RBC,Evans or V_RBC,CO. The errors of measurement for M_Hb,CO, V_RBC,51Cr, and V_RBC,Evans also showed wide variation between laboratories, typically by a factor of approximately ×/÷1.6. Thus a poor laboratory assessing M_Hb,CO and a good laboratory assessing V_RBC,Evans could have similar errors of measurement (∼4%) and obtain similar precision in the estimates of effects on M_Hb and red cell volume with a given sample size, but an even greater disparity between the two methods is also possible. Unfortunately, we were unable to estimate whether V_RBC,51Cr shows substantial variation from laboratory to laboratory, owing to a paucity of data. 

We have to have the doping substance to be beyond a reasonable doubt; otherwise we speak of weak evidence due to LABORATORY ERROR.  In the biological passport we do not have the sample B to decrease the chances of errors. In the latest case of Chris Horner who won La Vuelta a España, the chances of doping are high; not because of the biological passport, but because doping is endemic from what we know of Xavi Llobet and different operaciones in Spain.

Outside Online
Tuesday, October 22, 2013

Chris Horner's Bio Passport Problem

On Sept. 25, in what appeared to be a good-faith effort at transparency, Horner released his bio passport data to the public. But the move seemed to raise more flags than it lowered. We checked in with Michael Puchowicz M.D., a sports medicine physician for the Arizona State University Health Services and author of the Veloclinic blog, to see how Horner’s bio passport numbers hold up under anlaysis. Conclusion: Not very well. Here, Puchowicz explains why:

Chris Horner’s blood values during the Vuelta better fit with the patterns that anti-doping authorities look for as signs of cheating. The first element of Horner's bio passport that raises concern is the hemoglobin concentration. Hemoglobin is the oxygen-carrying protein inside red blood cells. In endurance sports, athletes seeking an advantage have been known to use EPO or blood transfusion to increase their total hemoglobin. The biological passport tracks the hemoglobin concentration as an indirect marker of EPO use or blood transfusion. Anytime that the hemoglobin concentration is higher than expect it is an indication that EPO or a blood transfusion may have been used.

Above is Horner's complete hemoglobin concentration data from his published bio passport, spanning from early 2008 to September 2013. The Vuelta values are highlighted in red.

http://www.outsideonline.com/outdoor-adventure/biking/road-biking/Chris-Horner-Bio-Passport-Raises-Doubts.html?utm_source=twitter&utm_medium=social&utm_campaign=twee

No solo se dopan los profesionales

Carlos Arribas

Si la Operación Cursa pudo ser considerada como una más por una sociedad a la que cada poco se le sobresalta con un nuevo golpe policial contra el dopaje, para el sargento Xavier Tarrés, jefe de la Unidad de Consumo de los Mossos d’Esquadra, supuso entrar en un mundo oscuro que sospechaba que existía, pero del que nadie tenía constancia documentada. Dirigiendo la investigación de una red de tráfico de sustancias dopantes con ramificaciones en Portugal, Andorra y varios hospitales catalanes, Tarrés, que comenzó su carrera como escolta de Jordi Pujol, entró de pleno en el mundo del dopaje que invade el deporte llamado aficionado o popular. Confirmó así lo que ya imaginaba, que no solo se dopan los campeones y los deportistas profesionales, sino también los participantes en las medias maratones o en las carreras populares o en las sansilvestres de fin de año, llamadas cursasen Cataluña. Por eso Tarrés bautizó a la investigación Operación Cursa.

“El producto estrella era Actovegyn, un concentrado de sangre de ternera, al que llamaban EPO de los pobres”, explicaba hace un par de años en una conferencia antidopaje. También describió la Operación Cursa como la primera desarticulación de una red que suministraba al deporte aficionado. “La lógica económica de las redes de tráfico exige también fomentar el consumo”, explica Enrique Gómez Bastida, director del departamento de inteligencia e investigación de la Agencia Española Antidopaje (AEPSAD) y que como teniente de la Guardia Civil dirigió diversas operaciones contra el dopaje, incluida la Operación Puerto. “La ganancia se consigue vendiendo EPO a corredores de San Silvestre. En todo caso, los profesionales sirven para hacer publicidad indirecta de las bondades del producto”.

Restringido antes a los gimnasios en los que adeptos al culto del cuerpo lograban kilos de calidad y forma no solo subiendo hierro sino con anabolizantes del mercado negro —muchas veces falsificados o provenientes de desvíos de pedidos de farmacias—, la masificación del running y del cicloturismo ha aumentado el espectro de productos y vendedores. En Valencia la policía bautizó una operación Master porque los clientes de la trama eran en gran número participantes en pruebas Master, categoría de veteranos de ciclismo. La Skype, llevada a medias entre los mossos del sargento Tarrés y la Policía Nacional, destapó una banda que operaba en una tienda de suplementos nutricionales de Mataró y con ramificaciones en Marruecos, Colombia y Madrid. Junto a atletas excelentes, como el campeón olímpico Rashid Ramzi, y decenas de atletas marroquíes que se ganan su sustento participando en carreras locales con premios, entre los consumidores detectados había ciclistas y runners populares, y hasta alumnos de un centro de formación de opositores a bombero en Móstoles.

There is a conversation in Spanish where the ironman competitor Xavi Llobet is asking to a drug dealer over the phone for doping substances when an undercover agent was listening to the conversation.

http://deportes.elpais.com/deportes/2013/09/27/actualidad/1380308597_086041.html

Xavier Llobet, triatleta olímpico en Atenas 2004, habla por teléfono con el exciclista del Kelme Jordi Riera Valls. Son las 9.54 del 1 de febrero de 2011. Riera tiene el teléfono pinchado dentro de una operación policial sobre dopaje. Hablan en catalán. “¿Qué pasa, crac?”, es el saludo. Tras comentar brevemente su plan de entrenamiento pasan a la farmacología.

Riera. Los Actos salen a 150.

Llobet. Vale...

R. Cada caja.

Ll. Vale.

R. ¿Lo digo bien? Sí, vale.

Ll. Vale, ¿qué más?

R. ¿Cuántas quieres?

Ll. Oh, tres. Son 350.

R. Después, el clembu a 60.

Ll. Vale.

R. Después, ¿algo más de aquello?

Ll. No, porque todo lo otro ya lo tenía, ¿no?

R. Bueno, ¡el tratamiento aquel!

Ll. Sí.

R. ¿Lo quieres hacer? Yo, yo, es que, Xavi, lo tengo, lo tienes muy... lo conté para hacer 12 pinchazos.

Ll. Pues venga.

R. O sea, seis, seis inyecciones que te las puedes ir combinando. Tienes para mucho, eh.

Ll. Vale, ¿entonces a cuánto sale esto?

R. Esto sale cada inyección unos 30 euros.

Ll. O sea, has dicho seis: seis por... tres, ¿18, no?

R. Ahí.

Ll. Vale, pues esto así. Vale. Yo ahora...

R. Así.

Ll. Cero, diez, diez, quince, quince, me llevo una, son 750 euros.

R. Vale, y aquí entran tres Actos, dos...

Ll. Dos, dos cle, clembu y seis, seis inyecciones de aquellas.

R. ¿Dos clembus quieres o uno?

Ll. Uno, uno, uno, uno, uno, sí pon uno, pero después ya es menos. Después son seis... Bueno 700, 700.

R. El clembu cada caja cuesta 60, pero van más.

Ll. Pues 700, al final son 700 euros. Justos.

R. Vale, espera, tres Actos, un clemb...

Ll. Y seis de aquellas que me has dicho.

R. Y seis de aquellas, que entonces serán aquellos tratamientos para los males que uno era el Testo. Que después te tengo que explicar cómo se tiene que hacer.

Ll. Vale.

R. Esto lo tendré esta semana quizá.

Ll. Bueno, y con lo otro también, ¿no?

R. Sííííí y lo otro tío, que tienes Andriol, y tienes de todo ahí.

Ll. Vale, entonces.

R. Y, y un huevo de Aire.

Ll. Vale, pues yo ahora lo preparo y te lo doy ahora aquí cuando...

R. Tres Actos, un clemb y seis inyecciones de aquellas. Ah, y te he guardado una cosa...

Ll. Sí.

R. Y quiero que lo pruebes esto, bueno, eh, es muy caro.

Ll. Mmm.

R. Pero compraron muchos y dijo, ostras, y cada uno, uno de nosotros se queda...

Ll. Mmm.

R. ... Dos ampollas. Una me la he quedado yo y la otra... te, te la daré a ti de regalo.

Ll. ¡Hostia! Vale, vale, guay, perfecto.

R. Y una de estas es como cuatro HMG.

Being devil´s advocate in the Horner´s case regarding doping, I will show you what people do to their bodies.  We should know the routines done to lose weight by limiting water in fighters.  This routine changes drastically the hematocrit and red blood cells percentage in a matter of 24 hours.

http://www.fourhourworkweek.com/blog/2013/05/06/how-to-cut-weight-ufc/

STRATEGICALLY DECREASE WATER CONSUMPTION

Routine to lose 20-30 pounds.

Dropping weight fast is all about manipulating your water and sodium levels.

For a fighter who wants to cut weight quickly and safely, here’s how much water he would consume in the 5 days leading up to his weigh-in:

Sunday – 2 gallons
Monday – 1 gallon
Tuesday – 1 gallon
Wednesday – .5 gallons
Thursday – .25 gallons
Friday – No water till after weigh-in at 5PM.

As you can see, the amount of water starts high with two gallons and decreases with each day till he’s drinking hardly any water on Thursday and Friday.

This is to ensure their body gets into “flushing mode.”

By drinking lots of water early on, the fighter’s body will down-regulate aldosterone, a hormone that acts to conserve sodium and secrete potassium.

And when he suddenly reduces the amount of water he drinks in the middle and end of the week, his body will still be in flushing mode, meaning he’ll hit the bathroom to pee a lot even though he’s hardly drinking any water.

What happens when you excrete more fluid than you take in? Bingo! Rapid weight loss.

DON’T EAT MORE THAN 50 GRAMS OF CARBS PER DAY

Since one gram of carbohydrate pulls 2.7 grams of water into the body, it’s important for fighters to keep their carb intake low.

By doing this, they also deplete muscle glycogen (a source of energy) and keep their body in “flush mode”.

DON’T EAT FRUIT, SUGAR, OR STARCHES

These are carbs that should be avoided entirely while cutting.

EAT MEALS THAT CONTAIN A LOT OF PROTEIN AND FAT

Fighters have to eat something. Since they’re avoiding carbs, Dr. Berardi advises them to load up on high-quality protein like meats, eggs or a vegetarian sources of protein. It’s also the perfect opportunity to eat lots of leafy vegetables (like spinach) and cruciferous vegetables (like broccoli and cauliflower).

Georges St Pierre normally has his meals prepared by a private chef so he doesn’t even have to think about this stuff or make decisions. Recommended reading: here’s an entire article detailing GSP’s training diet.

DON’T EAT SALT

Since the body likes to hold on to sodium (which will hold on to water), dropping salt helps the fighter’s body flush water out.

CONSIDER A NATURAL DIURETIC

This step isn’t always necessary, but it can help when you’re getting down to the wire and still need to lose water. Opt for a natural diuretic like dandelion root, but wait until the last 2 days to use it.

TAKE HOT BATHS

We sweat a lot in hot environments. However, we sweat the most in hot, humid environments. Since hot water offers both heat and 100% humidity, fighters lose water quickly by taking hot baths and fully submerging everything but their nose for 10 minutes at a time.

SIT IN THE SAUNA

This is the “finishing touch” to flush the last few pounds of water and is only used on the last few days leading up to the weigh-in.

Does the weight loss routine look like the tour de France?  It is not precisely, but it should be known by the “experts” on the Biological Passport to learn more about inter individual variations.  As I said, if Horner doped or not, it will not be answered by the Biological Passport.  The chances are high because doping is endemic and not because he was caught by the Biological Passport.