[Transcript] – Straight Talk About Doping In Amateur Sports

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Podcast from:  https://bengreenfieldfitness.com/podcast/fitness-podcasts/doping-in-amateur-sports/

[00:00] Introduction

[04:45] EPO and Blood Boosting in Aerobic Sports

[08:15] Human Growth Hormone vs. Testosterone

[11:15] Can You Get Stuff Into your Bloodstream or Unknowingly Ingest Banned Drugs?

[17:00] Self-Testing

[19:30] Does Using Hormones to Enhance Performance When Hormone Levels are Clinically Low Actually Work?

[23:00] The Biological Passport System and the Use of Blood Passports

[25:30] Testosterone Ratios and Carbon Isotope Testing

[29:00] Genetic Anomalies and Androgen Insensitivity Syndrome

[34:00] Are Herbal Supplements an Alternative Form of Performance Enhancing Drugs?

[44:35] End of Podcast

Ben:  Hey folks, it’s Ben Greenfield and on the call with me today is Chris Cooper who is a professor of biochemistry at the University of Essex; and the Head of Research in Sports and Exercise Science; and he’s written a book called “Run, Swim, Throw, Cheat”.  The reason that I got Chris Cooper on a call with us today is because there was so much interest generated around my interview with age grouper triathlete Kevin Moats about drug cheating and the use of illegal performance enhancing drugs in, in this case, Ironman Triathlon that I really wanted to get someone who’s kind of an expert in the chemistry of how all of this works and really the politics of it on the call to explore some of the stuff in more detail and give you guys some good content and a better understanding of how all this works.  So, Chris, thanks for coming on the call today.

Chris:  Yeah, great.  Thanks, Ben.  Thanks for inviting me.

Ben:  So, for you specifically, what’s your background?  Why did you write this book “Run, Swim, Throw, Cheat”?

Chris:  Well, I’m a biochemist, as you said so, I look at molecules and how they interact in the body.  I mostly work with oxygen – said oxygen in biology, how you look at it, trying to solve clinical problems, but also trying to see how we can improve oxygen delivery to maybe improve sports performance.  One of my other areas is I work at making artificial blood to replace blood transfusions.  And, that’s an ongoing struggle or battle, but it’s a very interesting area.  Hopefully we’ll succeed someday.  But, that is banned.  The use of those artificial blood substitutes was banned in sports.  So, I sort of got interested in the idea that what would make something banned?  And, I didn’t think these compounds would necessarily really improve sports performance.  So, I was saying why is something banned, what’s the biochemistry?  At the same time, I started to teach drugs in sports to my undergraduate students in the university, so I thought ‘hey, why don’t I just go as a biochemist, moderately naïve to the field, I started four or five years ago, and just see what is the science, what can work, what doesn’t work, and importantly, what might happen in the future, where is the field going?’

Ben:  Gotcha.  Now, there’s a lot of different performance enhancing drugs out there and obviously you brought up blood and artificial blood transfusions, but in terms of the stuff that you see most commonly used among either professional athletes or now, perhaps among amateurs, what are some of the ones that you think are the biggest when it comes to things that people should have on their radar or be aware of when it comes to performance enhancing drugs?

Chris:  Well, basically the ones that “work” for the three categories – by “work” I say could be performance enhancing rather than “work” as in necessarily good for you.  And, the three areas are strength and power events, and then endurance, long-distance running events, and then sort of the psychology, what sort of makes you overcome the pain barriers in life, makes you not be fatigued.  In the strength power events, it won’t surprise you to know that anabolic steroids increase muscle mass, that class is the sort of most commonly used because biologically it does work, at least in the average athlete where we’re not… and certainly in female athletes there’s a very strong effect on anabolic steroids.

Ben:  So, anabolic steroid, what would be a name of an anabolic steroid?

Chris:  Testosterone is the male sex hormone- that’s the classic anabolic steroid.  Then, you’re looking at things like nandrolone [03:44] ______, all sorts of compounds that have been used medically because these drugs are… nearly every sport performance enhancing drug started off as a medicine.  So, when people discovered the male sex hormone, testosterone, they suddenly thought ‘wow, here’s a magic compound, it’ll all make us long-living and give us vitality.’  So, the drug companies in the early 40s and 50s made all sorts of derivatives of testosterone which are out there and which you can buy.  Some of them are used clinically, though rather few of them have a medical use, mostly they’re there as sort of black market drugs used for sports and bodybuilders and such like.

So, those are the kind of class of compounds, but in terms of testing, what’s interesting is in a lot of areas in drugs and sports it’s going back to more… almost back to the future where people started to take just testosterone because these more actually potent and made more useful derivatives are rather easy to test for now if you do it properly.  So, people try and use the normal body one to get away with it so to speak.

Ben:  Now, what about stuff like EPO?  That wouldn’t be considered the same as like a synthetic hormone like you just talked about, right?

Chris:  Well, EPO is a synthetic hormone, yes.  Our whole hormone is the molecule that’s produced in one part of the body and has an effect somewhere else.  So, obviously they’re very attractive to inject as drugs because they will go to the part of the body where they will do the effect… they used to be travelling around the blood system and then going to the right parts.  So, EPO is a synthetic hormone, it’s a normal body compound.  When you go to altitude to train, you produce more EPO and that’s because when you go to altitude, you have a lack of oxygen in the air, less partial pressure, harder to breathe, and therefore your body says ‘okay, let’s make more red blood cells’ and it’s the red blood cells that carry the oxygen around the body.  So, you increase the levels of EPO.  What the form athletes try and do to enhance their performance at long distance aerobic events, things like the Tour de France marathon, 10,000 meter running, triathlon is to get either higher levels of red blood cells and carry even more oxygen by injecting the EPO and that’s relatively common.  I wouldn’t say it’s as common as anabolic steroids in the world because there’s a big body building community who use anabolic steroids, but certainly in elite sports EPO has been a problem – the same issue with how you can detect it or not.

Linked to EPO again there’s this back to the future thing where people, rather than using the new synthetic drugs, are just using blood and that’s because in principle you can detect EPO, but just giving yourself a blood transfusion gives you a massive boost immediately in terms of how much oxygen you can deliver.  So, that’s really the story through all the blood boosting in aerobic sports.  They work, in fact, they’re arguable more effective in those sort of events than anabolic steroids are in the power events.

Ben:  Now, if you step back and look at it, there’s this new book by Tyler Hamilton called “The Secret Race” and the stories of these Tour de France cyclists going through great measures for things like blood transfusions and the use of illegal performance enhancing drugs.  When it comes down to age groupers and amateurs, do you think that a lot of age groupers or amateurs are actually using this stuff or going through the same measures in terms of the use of any of these drugs or…?

Chris:  I should just correct you, they’re not illegal.  So, they’re banned for sports performance, but these aren’t illegal.

Ben:  Right.

Chris:  Some of them are – so, it depends on the country.  So, anabolic steroids are illegal, at least in the UK, I think in the US as well, to ship.  So, they have a class, in the UK a class C drug.  So you can’t supply them but it is not illegal to possess them or use them.  So, it’s a confusion of what’s illegal and what’s banned, but they are banned.  If you use them in elite sports, you’re banned.

So, how common they are in amateur sport, I’m not an expert in knowing how common they are.  It’s very clear that things like anabolic steroids and human growth hormone are completely endemic in large parts of the body building community for sure and human growth hormone is being increased in use because a lot of these proteins were quite difficult to get in the past and now are really fairly straightforward to get on the black market.

Ben:  And that’s something pretty different than taking testosterone, right?  Taking human growth hormone?

Chris:  Not really.  So, human growth hormone is not clinically… well, clinically you give human growth hormone to people who have a growth deficiency, usually a genetic growth deficiency, and that’s why we’ve developed human growth hormone, but in this sort of artificial, synthetic form.  But, increasing doctors, I think it’s actually more common in the US than in my part of the world, are prescribing human growth hormone because your natural levels go down, so it’s presumed to be a natural thing you would do as you get older.  So, it’s not quite in a way than testosterone and probably no more harmful, given that they both can be harmful, so I don’t think it’s some alien evil human growth hormone.  Taking large doses of anabolic steroids or large doses of human growth hormone are probably both bad for you, but it’s not worse.  It just sounds a bit different, but it’s not worse, but it’s arguably not as effective.

Ben:  I see.  So, testosterone and human growth hormone would probably be two of the ones that would be most common among amateurs or age groupers, you think?

Chris:  Yeah, I’m not an expert on amateurs, but I would say probably not testosterone.  I imagine that the age groupers are just taking the banned steroids if they’re not competing.  The question is are they competing in an elite sport or not?  Do they care about being tested?

Ben:  Right.

Chris:  If they don’t care about being tested, they’re not in a sport that’s being tested, then testosterone is probably not the best way of increasing your muscle mass by taking steroids.  So, there will be other ones which you would take and testosterone is not very easily active in a pill.  People like to take pills rather than inject if they can.  So, there’s a variety, I mean, you just need to go wander around about body builder web pages to see that they take all sorts of mixtures of these compounds trying to hope that they’ll get a balance that will give them the benefit of muscle mass without giving them the side effects which, for males, is enhanced breast growth, which is not so good, and severe acne which is less bad than enhanced breast growth, but still not nice.  So, yeah, I think probably not testosterone, except testosterone tends to be in people who are trying to avoid testing would be my guess.

Ben:  Yeah, it’s kind of interesting because this seems like it’s a big discussion among endurance sports right now.  But, I used to be a bodybuilder and in body building this stuff was just… you’d just see it all over the place and it didn’t even shock people or surprise them to actually be using synthetic hormones or hormone replacement therapy or any of these derivatives, but it seems like it flies under the radar and is talked about a lot less in the endurance sports community probably because in so much of the competition it is banned.  But, can you accidentally get stuff into your bloodstream or unknowingly ingest some of these banned drugs from foods or common medication?

Chris:  Now this is a controversial topic, I’ve got to be slightly careful with what I say because some people have claimed to have got artificial compounds into their system by artificial ingestion.  The most famous example recently was Alberto Contador, who won the Tour de France three years ago now, and was found to have clenbuterol in his system which is a kind of a synthetic molecule.  It’s a little bit like testosterone in terms of increasing muscle mass.  It has an anabolic effect.  And, he claimed he ate contaminated cows and that was his defense.  That was not agreed with, but in the end, the Anti-doping Agency said, ‘well, you probably got it from contaminated supplements so we’ll only give you a smaller ban.’  So, there is a big debate about how easy it is to get positive tests from these compounds.

The easiest way to get a positive test is to take a nutritional supplement that is not licensed and you’re not…  So, frequently those have problems and they’re not well regulated in terms of the manufacturing and you have to bear in mind a positive drug tested sport is not just looking for a compound itself, it’s looking for the things that it converts itself into in the body.  So, you say right you’ve taken a synthetic steroid, that means you have this, what’s called a metabolizer of that, and some nutritional supplements have those contaminations of those things that they give you positive drug tests.  So, you’ll get the positive drugs test without even having the benefit.  So, I think that’s certainly was a whole scream of nandrolone and positive tests about ten years ago, which are probably at least in part due to contaminated supplements.  So, that’s….

 Ben:  You mean like multivitamins and electrolyte pills or stuff that’s a little bit more fringe than that?

Chris:  Yeah, more fringe than that.  I mean, you have to be careful.  So, some products have banned substances because this is not illegal, they have them in any… and you’ve got to check the labels.  So, ExtenZe, which is one of these compounds to enhance male sexual organs, that compound has a DHEA, which is a precursor for testosterone in the body, and that is banned, but, unless you look carefully at the label you wouldn’t know that. It’s certainly… my mind is drawing a blank on his name, but the US 400-meter Olympic champion, one of the top people, was banned for taking this compound.  And so my mind’s got a blank on who that person is, but it’s easy to find out.  So, that’s the issue that you check the labels, but your normal multivitamin is fine.  So, anything that is taking these big nutritional supplements, they take them by bodybuilders and by athletes that you really have to check the labels carefully and certainly sports teams, they get them checked.  So, the companies are supposed to check these will not have these products in them.

Ben:  Is there something you can look for in the bottle?  Are there certain certifications that would be considered to be better than others when you’re trying to figure out whether or not something might be dangerous for you taking or if you know you’re going to be tested something you should stay away from?

Chris:  Well, I think we’re not looking at dangerous here.  So, if you get small amounts of a contaminant, that won’t be dangerous.

Ben:  Well, I guess what I mean by “dangerous” is you work your butt off to cross the finish line of an Ironman triathlon and then you get DQ-ed because something that you took was not certified properly.

Chris:  Sorry to interrupt you there, I think the governing bodies will have a list of these things.  It’s up to them to tell you what you should take, but should you not take something unless you’ve been approved that it’s okay.  So, certainly with the UK Olympic team, they will have set things that they are allowed to take or they’ll make up their own sports drinks which they know are okay.  So, I think just looking off the shelf, the quality control is poor, but some companies certainly do say they’ve had them tested.  So, I think you just have to just check that out as much as you can.  I’m not an expert on each individual brand, so I can’t.  But, it certainly has been an issue and it’s impart being solved, but I think it’s…

There’s an example of this African rugby union team where they had a supplement that they had tested for in the past that it was okay, they gave it to all their players, and that batch had a problem with it and had a stimulant that it shouldn’t have had in it.  So, it’s still, in my personal view, is there is a huge overreliance on supplements in the whole sports industry, most of which aren’t really of any use and just cost money.  But, this is a multimillion dollar industry, I’m not going to stop it by just saying that over an interview, but I think most cases, silly bodybuilders don’t need to take these supplements and that’s probably controversial, but you really don’t.  You just need to take your milk protein and it’ll be fine.

Ben:  Now, what if you wanted to check yourself?  What if you wanted to test yourself and see whatever?  There’s lots of people out there who’ve got five to ten different bottles of supplements in their fridge.  Is there a way to see, before you actually get pulled aside by some governing body of sport after a race or after an event, is there a way you can self-test?  Are there tests that you can order and look at it for yourself?

Chris:  You can’t self-test of the order of testing that is done for anti-doping agencies and they will tend not to do tests for people of samples.  They might test supplements, I suppose, but they don’t test samples of people for obvious reasons.  People will say ‘I’m now clean, now I’ll go and compete.’

I think that the official bodies don’t do tests of individuals, but of supplements, I think you have to… the manufacturers should be able to get the tests done broadly and say what’s on the label because that’s their job.  I don’t think trying to self-test is, I think it’s not cheap, I’m not sure how you would do it in that sense.  So, I think that you have to…  Some manufacturers aren’t very clear that they have it, that they do not contain these materials, and I think that needs to be…  It’s been historically a problem.

Ben:  Yeah, so from that standpoint, you just need to be careful digging around in the bargain bin of your local supplements outlet.

Chris:  [18:00] ______ of your local thing, and if in doubt, don’t take it.  But, if you’re at any level where you’re really competing in an elite sport, you will have people who will be advising you.  So, I’m not sure at the level that you’re talking about are levels that are actually drug tested.  So, I think a lot of amateur sports is not drug tested.

Ben:  Well, the original inspiration to get you on the call is that they’re not drug testing for a lot of the type of people that listen to this show, they’re doing Ironman triathlon and if…

Chris:  I imagine [18:35] ______.  I can see why that would be….  Yeah, okay.

Ben:  Yeah, I mean, you put a year of your life in your training and to getting ready for a big race, and lots of money into travel to the race, and register for it and everything.  I think a lot of people want to make sure they’re covering their bases because they are testing for age groupers now and we recently had a guy on the show who got a ban for something I wanted to ask you about now and that’s hormone replacement therapy.  So, big time obviously you know it’s being used for clinically low hormone levels in lots of people, especially in the anti-aging community or in guys or girls who are experiencing some of the deleterious effects of aging or loss of hormones.  Now, when being used for clinically low hormone levels, can these type of hormones also enhance performance?

Chris:  So, that’s a really interesting question.  It’s, I think, probably not clear to be sure what you mean by ‘enhance performance in clinically low.’  So, if…  Because it depends on what you mean by…  These are age events.  So, if you say an age event is people over 60 or 50, then they have lower levels of testosterone and human growth hormone, not by that much, but low.  So, what’s the normal?  So, if you give something that puts you to a level that’s normal for a young person, is that cheating or not?  And I don’t know the answer to that question.  Actually, that’s a question that the sports bodies need to decide really and that would be whether you get a therapeutic-use exemption.  But, it’s entirely feasible that you could take a testosterone replacement or anabolic steroids when you’re in your 50s that would improve your performance by putting you up to the high level of the normal, it seems to me possible.

I think it hasn’t been… Those trials, clinically and experimentally, are quite hard to do.  You’re taking people saying they’re from a slightly reduced, below-normal, going to the higher range of normal, does that improve your performance?  I would guess it has a chance to do it, but I would say the science hasn’t been done in that specific way.  It’s mostly been done going from either very low to normal, where it clearly works, or normal to super normal, where it also potentially works.  So, I think it’s difficult to know the exact effect or how the body when you’re 60 or 50 responds to the low testosterone levels, it might not have as big of an effect there.

So, I think it’s difficult to be precise, but I think there is an issue.  If you’re saying if some people don’t want to take hormone replacement therapy, because it’s not a standard clinical practice, you know.  I’m not sure whether you’re allowed to bill for it in the US; I don’t think in the UK, you won’t get it on the National Health Service.  So, if somebody wanted to do that, others don’t want to do it, then are they at an advantage and are you forcing people to take steroids in order to compete fairly, then you’ve got to ask that ethical question really.

Ben:  Yeah, this stuff is pretty easy to get in America.  I mean, you just go to a doctor who’s basically like an endocrinologist and if you complain of the right set of symptoms, they will pretty much prescribe you testosterone.

Chris:  Oh, okay.  Sure, if you lie, yeah, I mean that’s fine.  I guess it’s sort of a libido thing I guess.  We had Viagra for a long time, so why do you want testosterone?  But I guess it’s the view that you lose the desire as well.  But, yeah.  I think you’re right.  I imagine it’s relatively easy to do, the same way that any musician could get beta-blockers to get over stage fright.  You know, beta-blockers which are banned in sports, are widely used by musicians and they just say I would be stressed by not performing well.  So, it’s easy to get these things, but then you’ve got to be aware of, as you said, whether they’re banned or not banned.  I think it’s a live question – how much should it be debated amongst age groupers.  I don’t know, but it’s very interesting point that you brought up.  But, I don’t particularly because I was focusing of course on this sort of headline sports in my book, I don’t really address it, but I think I’m going to add it to my blog now.  You’ve inspired me to look into this in a bit more detail.  Great!

Ben:  Yeah, it’s kind of a big issue now.  And, you know, you obviously, in your book, talk about this and the testing and kind of this whole biological passport system, even though it’s a little bit different I think in the way that it manifests for an age grouper or an amateur athlete, can you explain how the biological passport system actually works?  And, the other kind of follow-up thing I’m interested in is how they account for, if there are, significant normal hormone fluctuations in people?

Chris:  Right.  So, first thing about biological passport is that there are supposed to be different parts to it and what it does is it tracks your normal body’s physiology and metabolites and just says, ‘okay, had there been a big change in your hormone levels or something else going on in the body, you must have been doping.’   So, it’s not testing for the doping itself.  That’s the rationale behind the biological passport.

The only passport that’s been approved for use is the blood passport.  The blood component tests, essentially, for rather simple things.  It tests for the young red blood cells and the total amount of red blood cells, essentially the amount of hemoglobin, the red protein in the body.  And, by testing for those, if you get dramatic changes in those, it’s almost certainly the case that there’s been a blood transfusion or you’ve been taking EPO because you don’t get those fluctuations naturally.  Though what you do is you track it per individual which is why you have a passport.  So, you track the normal body’s fluctuations and then that is part of your passport and uses a quite complicated tool called basin statistics to look at how you’re going and if that was an anomalous reading then.  So, the normal fluctuations should be corrected for, but as I said, it’s only so far used and shown to be used and allowed to be used for blood passports.  It’s not for the hormonal levels, the natural steroid level, the natural growth hormone levels, they’ve not managed to get a validated test in place.  So, you can’t be tested positive by that method.

Ben:  Now, how does the test work when they’re looking at the use of testosterone, just because I know that there’s a lot of talk about ratios?

Chris:  Sure, because the amount of testosterone that you excrete is variable, just looking for a straight amount of testosterone, because it’s a normal body hormone, that’s too variable to use as a way of testing.  So, what they’ve historically done, and this is the crude test they still do is what’s called Testosterone/Epitestosterone ratio.  And, in the body, normally that ratio is about 1, but if you take synthetic testosterone, you have more testosterone than epitestosterone which is an inactive form the body makes and therefore it goes higher.  At above a certain level, four to one, it depends on historically where it is coming down, but mostly set at 4:1, it triggers a possible positive test.

You also then, certainly in the elite sport, do what’s called a carbon isotope ratio test and that tells you whether you’ve got synthetic testosterone in the body.  So, that’s a more expensive test and it’s not done routinely.

So, there are really these two different tests.  The general test do appear to have more of testosterone than the normal testosterone in the body and there are some ways of getting around that test.  But, what is much harder to get around, essentially pretty impossible to get around if you’re using synthetic testosterone, is the what’s called the carbon isotope ratio because most synthetic testosterone comes from a plant source, not from an animal source, and it turns out that because the plants live in a different area than animals, it tends to have a different Carbon-13 amount than the animal ones.  So, it’s a quite complicated story, but you can tell the source even though it looks like the same molecule, you can tell whether it has come from a plant or come from a human being.  So, that’s the test, that’s the expensive test, but the first test is like a screening before that.

Ben:  So you could get this Testosterone/Epitestosterone ratio, you could potentially even test within limits for that but somebody could still have massive amounts of circulating synthetic testosterone if they were tested via a carbon isotope test?

Chris:  Yeah, yeah.  That’s exactly… that’s what people try and do.  How successful they are I think is not clear, but anti-doping agencies, as you would obvious from looking at the USADA case against Lance Armstrong, do not now just use testing, they use a lot of detective work as well.  And so, what you will get is sometimes you’ll get targeted testing for some and therefore you will have a strong suspicion that person is doping and therefore you will go for the carbon isotope ratio test on that person.  So, I think when it gets to elite sport, it’s a lot of this cat and mouse game at the moment.  You wouldn’t expect to see sort of thing in the routine testing done for age group sport that you said.  I’d be surprised if you did routinely carbon isotope ratio testing, you mostly do the t-ratio.

Ben:  Now, what about people who are just genetically different.  And, I know there’s not a lot of people out there like this, but I heard of this story about this skier back in the 60s who had really, really, super high hemoglobin levels from literally a genetic mutation and then of course you also have the rare track and field athlete that shows up who’s basically like a male with female genitalia with like the androgen syndrome.  I mean, in terms of those type of genetic anomalies, are those pretty common and what goes on with those under the current system of testing?

Chris:  Right.  So, the first person you mentioned is a classic example that everyone quotes – the guy called Eero Mantyranta who was a Finnish cross country skier who won lots of gold medals and you’re right, exactly that, he had a natural mutation that meant he had large numbers of red blood cells.  His EPO system went haywire.  We don’t know how that, and you can track that to his family, it was inherited, that he was the one who ended up winning the gold medals.  That system would cause concern, but probably would not with somebody like that, they would trigger a concern because the high number of red blood cells, but they would not fail the blood passport test because that high number would constantly always be there.  I bet they get the scientists want to have a go and look at them and explore what was going on, but they shouldn’t fail a test.  That seems to be a relatively rare example, that individual.

The second case you said is a much more sensitive issue about the border between males and females.  Of course there is a big dynamic range to improve female performance and this is why anabolic steroids are so much more effective in females because we know that females are essentially the same kind of human beings as males, but we know that they won’t win the 100-meters men’s race because they do not have the power and therefore anything that could make a female more like a male, example giving them the male sex hormone, will improve their performance much more than would be with a male.  So, if they have that genetic, they could well have a performance enhancement effect.

The example you gave, I don’t think so about it. What you’re talking about is people with androgen insensitivity syndrome I think and you implied that they were male with female genitalia.  Those people would consider themselves female because if they don’t respond to testosterone, which is what androgen insensitivity syndrome means that they are XY so they have an X, the female…  XY is a male person, XX and his X chromosome, you have two X chromosomes you’re generally female; an X chromosome and a Y chromosome, generally male.  You could be XY and therefore you could be producing testosterone but your body doesn’t respond to it during development and therefore, although you will end up being sterile, you mostly appear female, and those people consider themselves female.  Now, what’s interesting whether there’s a borderline when that gives you a performance enhancement.  Now, the last time that was tested for was in the Atlanta Olympics where they did pick up, I think, six or seven athletes who had AIS, but because the testosterone… they were not responding to the testosterone they had, they were allowed to compete.  The percentage of elite athletes with AIS seems to be a little bit higher in the populations.  So, it’s just possible that there is, on the range of female performance, there are more people who are, if you like… these genetics are slightly more male.  But, they would be, if they’re not responding to the testosterone and it’s a clinical case, then they are allowed to compete.

We still have cases of females who appear to have higher testosterone and then there’s an issue.  The famous case from that was Caster Semenya a South African 100-meter runner who is clear to compete now but was initially there was concern because she had high testosterone levels.  So, it’s going to be a complicated area.  I mean, sex is not by the rules in the real world and it’s also not just a biological question about what you consider your sex, it’s almost a sociological, psychological question.  But, there is this gray area which needs to be treated with a lot of sensitivity.

Ben:  Yeah, and honestly, I guess, when it comes down to it, it’s not a huge, huge problem, right.  I mean, there’s not a ton of people walking around with genetic anomalies?

Chris:  No, but it’s a big area in doping where people are trying to do genetic doping which I think, if they are trying, they’re failing at the moment.  But, that is an area that people look at and think ‘wow, I can do this to turn a man into that Finnish cross country skier with lots of EPO he can be really good.’ ‘Change his genes or I can turn a woman slightly more like a man, give her some hormones that would improve her genetically change her makeup.’  So, in that sense, it’s of interest to the dopers, but I think it’s very difficult to make that work practically.  But, there will be elite athletes will be genetically different, you know.  Usain Bolt will be genetically different, but it probably won’t be one gene.  So it won’t be obvious.  It would be some combination that it’s very difficult to tease out.

Ben:  Interesting.  Now, I’m curious to hear your thoughts about this as a biochemist, but there’s a lot of stuff out there that’s not straight up synthetic hormone replacement, like there’s lots of herbs and compounds like that that people take as a nutrition supplement.  I mean, you were just talking about EPO, there was a recent study on the use of echinacea, for example, to enhance EPO and then there’s all this other stuff like tribulis, and nettles, and maca, and all these different herbal formulations that people are using to, for example, boost testosterone.  Do you think any of this stuff comes close to the banned performance enhancing drugs like the use of blood transfusions or synthetic hormones?

Chris:  I can sort of answer that in one question – if it did, it would be banned.  Because if you can generally raise your testosterone levels hugely with these compounds, they would be banned, right.  So, there’s no interest in these compounds from the anti-doping agencies.  Some of the examples you talked about, things like maca and tribulis is another one, there’s really no evidence that they have any effect on changing testosterone levels in animal studies or in human studies.

So, just because I knew you were going to ask me this question because you kindly warned me, I went to look again at the scientific literature and there’s a huge difference if you compare doing a Google search versus doing a Google Scholar search or a search on PubMed.  So, I would encourage people to want to know this.  First of all, do their Google search and say maca that improves my testosterone and then go to Google Scholar and search for maca in Google Scholar on maca and testosterone and try and find a published peer reviewed scientific paper showing that maca increases your testosterone levels and, you know, I couldn’t find one.  So, they’re probably not doing you too much harm, but you’ve got to be careful.  Some of these herbal medicines have strong potent compounds in them.  The whole pharmaceutical company industry is trying to get these compounds out and purify them, so you have to be careful when you take them.  But, the idea that you can magically get anywhere near what you would take from taking synthetic testosterone I think there is no evidence at all in those kinds of compounds.  So I think, my answer would be almost certainly not, I’m just trying to think of an example.  I can’t think of an example of one of those that does what they say on the label actually.  So, you need to look carefully at the label because different companies have different labelling regulations.  You certainly couldn’t say, in this country and the UK, that maca would increase your testosterone levels.  I’m not sure for the answer in the US, but I think they have different labelling restrictions, but there’s no evidence to it.

Ben:  Yeah, that’s a good point that you make that this stuff probably would be banned if it had a really significant effect, but at the same time, I was just curious because a lot of these agencies, like USADA, they’re not like God, they really have some limited power when it comes to being able to know everything and see everything.  I was just curious if they’re just focusing on the stuff that kind of flies at the top of the radar.

Chris:  They’re not God, but it took me ten minutes to see that these things have no… there’s no scientific evidence.  It’s not difficult to find that there’s no evidence for these things.  It’s difficult to do the experiments of course and because they tend to be negative, I can’t get funding to say I’m going to study this compound, but in animals it has not been shown to have any effect on testosterone, but I want to study it in humans and the funding body will say, ‘well I’m not going to give you money for that.  Go away and save somebody’s life instead and make your artificial blood.’

So, I think it’s difficult to do the proper studies.  But, those that have been, it’s fairly easy to find out and I don’t think what’s going on, it would be looked at properly and probably someone would get the money to check it properly.  It’s not impossible.  Good positive drugs come out of herbal medicine industry that have been historically and there are certainly searching for exotic plants, many of our drugs have come from exotic plants.  So, it’s not a negative, it’s the over exaggerated claims from on the labels that are generally not justified.

Ben:  So, what do you think is the solution to the problem of drug cheating in sports?  You know, I know it sounds like you’re going to turn out a blog post or something about amateur and age grouper use of banned drugs, but as far as even on a more macro level just doping in sports in general, do you think that there is a good solution?

Chris:  Yeah, so I do blog on runswimthrowcheat.com if anyone wants to see if I get around to write this blog, which hopefully I will do in a few days, but the question about is there a solution, I would say sort of flip that back to do and say do you think people are going to carry on breaking the law?  Will there still be criminals?  So, it’s cheating.  People will try and cheat.  Are you going to try to stop people cheating?  This is like if they think it works, they will cheat.  If they think it works and they won’t get caught, they will cheat.

Now, not everyone will and some people don’t believe in cheating and they don’t think it’s correct.  So, that’s not particularly different in sport than in society at large.  But, what you can do in sport is it’s a slightly more controlled environment and I think where things could go badly out of control in a sport, it’s when you get it sort of institutionalized cheating and we’ve seen that arise in a number of times over the years and then you’ve got a really distorted sport and there’s a huge pressure from athletes to really dope themselves to have any chance of competing.  The classic example of that was the East German program where there was a very systematic doping, mostly of anabolic, steroids.  Highly effective especially with female athletes, many of whom had long-term health problems because of that.

Arguably the second area was the Tour de France where teams were, I have to be slightly careful about what I say, but this is even before the Lance Armstrong issue, teams were clearly had a doping culture where they didn’t think they were going to get caught and they carried on doing it.  There have been a number of fluctuations in the cycling community and I think now there is a much cleaner cycling because of what’s happened in the past.  It has not yet cleared up its act completely, but it’s along the way at the moment it’s pretty good at the moment.

But, that issue where everyone is able to dope and knows they can dope and there’s lots of money going into doping, they can do it more effectively.  So if you look at the programs that some of the teams, the Festina team, I don’t want to just pick on Lance Armstrong, and so the Festina team beforehand, look at them.  Look at Lance Armstrong’s team.  They’re very, very scientific and there’s lots of work going into them, therefore they can be quite effective.

So, I think breaking that up and trying to get it back to the individual cheat is helpful, but you’ll never stop a single individual trying to cheat and I think if you think you can, you’re deluding yourself in the same way as you’re going to…  You know, we have arguably a war on drugs in sport.  In the US it’s a big thing, you have a war on drugs.  So, your war on drugs in the US, which is all illegal and banned, I’m assuming you still have recreational drugs in the US, so you know, you can’t eradicate these problems completely, but you can certainly in a smaller environment of sport and contain the environment with things like detective work, the testing, the biological passport, you can control it to a certain extent and limit it and you always have to ask the question what should we ban or not.  I think that’s also an interesting question that should be revisited from time to time.  Should we ban this stuff and should we not?  And it’s… should this whole area be okay or not?  That is also an interesting question too to explore, in the same way as you do with of course recreational drugs in society, we have a current debate between your states and your federal government over cannabis I think in the US that should prove interesting the future.

Ben:  Yeah.  They actually just legalized recreational use of marijuana here in my home state, interestingly, in Washington.

Chris:  The local government police won’t, really interesting idea.  I had no idea.

Ben:  It’s still illegal federally, but on a state level it’s legal for use.  So, it’s an interesting scenario.  Anyways though, we’re running short on time, but your book “Run, Swim, Throw, Cheat: The Science Behind Drugs in Sport” I’m going to link to that in the show notes.  You got a very cool blog as well as a book that’s jam packed with really useful information for people who want to know more about this.  I mean, really what we’ve done today is ask a bunch of questions and kind of scratch the surface of the issue, but I’d recommend you check out Chris’ book and also listen to the previous interview that we did entitled The Real Truth about Age Group Drug TestingMy interview with Kevin Moats.  And then leave your comments and feedback in the show notes over in the comments sections at bengreenfieldfitness.com and I’d love to point you in the direction of some answers to your questions or hear what you have to think about the issue of banned performance enhancing drug use in pro sports or in amateur sports.  So, Dr. Cooper, thanks for coming on the call today.

Chris:  Thank you ever so much!



As you know if you listened to or read the transcript of the episode “The Real Truth About Age Group Drug Testing, Doping In Triathlon and the Kevin Moats Story“, the use of drugs and cheating (whether accidental or intentional) is a growing issue in amateur and age grouper sports.

But there are lots of unanswered questions, and you may be feeling a bit left behind when a conversation turns to doping in amateur sports, or even concerned about the potential of a supplement you're taking being “laced” with a banned substance,so in today's audio interview with University of Essex biochemistry professor Chris Cooper, author of the book “Run, Swim, Throw, Cheat: The Science Behind Drugs in Sport“, you'll find out…

-When it comes to banned performance enhancing drugs, which ones are the most common, and how they work…

-Whether many amateurs or age groupers, such as amateur cyclists, swimmers, triathletes, etc. use banned performance enhancing drugs, knowingly or otherwise…

-If you can “accidentally” get some of this stuff in your bloodstream or unknowingly ingest it from foods or common medications…

-If hormone replacement therapy gives an unfair performance advantage…

-Do herbal methods, like tribulis, maca, etc. come close to synthetic hormones for enhancing testosterone or EPO….

-How the “biological passport” system works…

-And much more…


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