Blood doping: Lance Armstrongs fall from grace explained

Posted on August 24, 2012 By Hope Gillette Health Seven-time Tour de France winner and cancer survivor, Lance Armstrong, has issued a statement indicating he is giving up the battle against charges from the U.S. Anti-Doping Agency (Shutterstock photo) For years Lance Armstrong has been fighting allegations that he used blood doping to gain an unfair advantage over competitors in the sport of cycling. The seven-time Tour de France winner and cancer survivor has issued a statement indicating he is giving up the battle against charges from the U.S. Anti-Doping Agency (USADA), an act which has led many to question his innocence. Now, the USADA will likely strip him of his seven wins, effectively marking him as guilty though it has never been proven that the cyclist was indeed involved with the use of banned substances or methods. In his statement released Thursday evening, Armstrong says, There comes a point in every mans life when he has to say, Enough is enough. For me, that time is now. I have been dealing with claims that I cheated and had an unfair advantage in winning my seven Tours since 1999. Armstrong says the toll the process has taken on his family and his professional life, as well as the lack of assistance from the federal court, has made him realize fighting such a one-sided battle is not worth it. Today I turn the page. I will no longer address this issue, regardless of the circumstances. I will commit myself to the work I began before ever winning a single Tour de France title: serving people and families affected by cancer, especially those in underserved communities, he concluded. Armstrongs announcement comes in the wake of another major athletic doping scandal: that of Melky Cabrera, the baseball star found to be using anabolic steroids.

Are all doping cases the same?

No. Melky Cabrera was banned for using testosterone to enhance his performance. According to reports on Armstrong, the cyclist is suspected of blood doping, a method of injecting drugs or oxygenated blood to enhance the oxygencarrying ability of red blood cells. Elevated blood levels, gained by using EPO or other blood doping methods give a huge advantage because oxygen-rich blood cells allow the muscles to work for

longer, and to recuperate better after an extreme effort, said former U.S. Postal Service Team doctor Prentice Steffen, who was interviewed back in 2010 when cyclist Alberto Contador tested positive for the muscle-booster clenbuterol, a drug linked to blood-doping. The World Anti-Doping Agency (WADA) defines blood doping as the use of certain techniques or substances that increase an athletes red blood cell count. This can be achieved by removing blood a few weeks before a competition and re-injecting it shortly before the race to boost oxygen levels. The blood can be the athletes or come from another compatible healthy individual. Another method of blood doping consists in injecting artificial oxygen carriers into the athletes blood stream.

What are the health effects of blood doping?

According to the World Anti-Doping Agency (WADA), blood doping revolves mainly around synthetic oxygen carriers within the blood stream known as erythropoietin (EPO). The drugs are effective when used to treat legitimate medical conditions such as anemia related to kidney disease. When used just as a performance enhancer, however, EPO can have some serious side-effects such as:

Increased risk for heart disease Increased risk of stroke Increased risk of cerebral or pulmonary embolism Increased risk of developing an autoimmune disease Increased risk of infections

Most of the medical complications come about as a result of EPO thickening the blood. Blood doping from blood transfusions is much more difficult to detect but has the same negative side-effects.

Can blood doping be detected by a test?

Yes, in 2004, blood doping tests were developed for testing during the Olympic Games, however controversy still exists as to how effective these are.

Does this mean Lance Armstrong is guilty of blood doping?

No physical evidence of blood doping has ever been brought against Lance Armstrong, despite multiple tests. While many experts see his refusal to fight the allegations further as a sign of his guilty conscience, the fact remains that he has not tested positive on any blood doping test.

Blood-doping can be done through use of synthetic oxygen carriers or through blood transfusions. (Shutterstock photo) He had a right to contest the charges. He chose not to, said World Anti -Doping Agency president John Fahey to ESPN. The simple fact is that his refusal to examine the evidence means the charges had substance in them. Under the rules, penalties can now be imposed. Armstrong argues that, The only physical evidence here is the hundreds of controls I have passed with flying colors. I made myself available around the clock and around the world. In-competition. Out of competition. Blood. Urine. Whatever they asked for I provided. What is the point of all this testing if, in the end, USADA will not stand by it? Sumber: http://www.voxxi.com/lance-armstrong-blood-doping-ban/

Report Describes How Armstrong and His Team Eluded Doping Tests

Peter Dejong/Associated Press Lance Armstrong exiting a doping control van during the 2001 Tour de France. Avoiding a drug test could be as simple as not answering a door, the report said. By IAN AUSTEN Published: October 11, 2012 386 Comments Throughout his career, Lance Armstrong always responded to doping accusations by saying he had been tested for banned substances hundreds of times and never produced a positive result. How could the worlds greatest cyclist, always in the cross hairs of doping officials, never fail a drug test if he was doping, Armstrong reasoned. Related

For an Armstrong Insider, a Passion for Cycling Gave Way to Corruption (October 12, 2012) The Lede Blog: Can a Race Among Doped Cyclists Be Fair? One Former Armstrong Teammate Says No. (October 12, 2012)

Related in Opinion

Op-Ed Contributor: A Drug to Quicken the Blood (October 12, 2012)

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Franck Fife/Agence France-Presse Getty Images Lance Armstrong undergoing a medical check-up before the start of the 2003 Tour de France. Enlarge This Image

Nico Casamassima/Agence France-Presse/Getty Images Dr. Michele Ferrari was a central figure in the doping scheme, according to the report. Enlarge This Image

Johan Bruyneel, left in 2004, was the director of Lance Armstrongs team. Readers Comments Readers shared their thoughts on this article.

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An explanation emerged Wednesday, when the United States Anti-Doping Agency released its dossier on Armstrong, citing witness testimony, financial records and laboratory results. Armstrong was centrally involved in a sprawling, sophisticated doping program, the agency said, yet he employed both cunning and farcical methods to beat the sports drug-testing system. The report also introduced new scientific evidence that the agency said suggested Armstrong was doping the last two times he competed in the Tour de France. It has been a frequent refrain of Armstrong and his representatives over the years that Lance Armstrong has never had a positive drug test, the report said. That does not mean, however, he did not dope. Nor has Armstrong apparently had nearly as many doping tests as his representatives have claimed. As part of its investigation, Usada asked Christopher J. Gore, the head of physiology at the Australian Institute of Sport, to analyze test results from 38 blood samples taken from Armstrong between February 2009 and the end of last April. Those taken during the 2009 and 2010 Tours, the report said, showed blood values whose likelihood of occurring naturally was less than one in a million, and other indications of blood doping. While Gores analysis was not a conventional antidoping test, Usada concluded that the findings build a compelling argument consistent with blood doping. The techniques Usada says were used by Armstrong and his teammates to elude positive tests were used by many cyclists, and many believe those tactics are still in use today. They often exploited weaknesses in the antidoping system, many of which still persist. The most basic technique outlined in the report, based on affidavits from some of Armstrongs former teammates, was simply running away or hiding. The most conventional way that the U.S. Postal riders beat what little out-ofcompetition testing there was, was to simply use their wits to avoid the testers, the report concluded. To facilitate out-of-competition testing, professional cyclists are required to inform their national antidoping agencies of their locations at all times. Riders who receive three warnings in an 18-month period for either not providing their

whereabouts accurately or not filing the information at all can be punished as if they had had a positive drug test. Saying that the adequacy of unannounced, no -notice testing taking place in the sport of cycling remains a concern, Usada outlined several methods used by Armstrong and his teammates to circumvent the system. The simplest was pretending not to be home when the testers arrived. As long as they were in the city they had reported as their locations, the riders found they would not receive a warning for not answering the door. The agency compared the whereabouts information it received from Armstrong over the years with messages between Armstrong and Michele Ferrari, a sports medicine doctor who is also a target of the doping investigation. There were revealing discrepancies, the report said. Travel plans that Armstrong conveyed months in advance to Ferrari through training and racing diaries were submitted to Usada weeks later, sometimes the day he made the trip. While those last-minute changes did not break any rules, they frustrated the agencys testing plans. The doping agency also found that Armstrong often stayed at a remote hotel in Spain where he was virtually certain not to be tested. According to the report, Armstrong abruptly dropped out of one race after his teammate George Hincapie warned him through a text message that drug testers were at the teams hotel. Armstrong had, Hincapie said in an affidavit, just taken a solution containing olive oil and testosterone. Riders on Armstrongs team, the agency said, also kept a constant lookout for testers and relayed information about them to one another. Team officials often seemed to know when a supposedly unannounced drug test would occur. When the testers could not be avoided, Armstrong and his teammates turned to drug masking, the report said. It indicated that during the 1998 world championships, testers were diverted to other riders on the United States team while one of Armstrongs doctors smuggled a bag of saline under his raincoat, getting it past the tester and administering saline to Armstrong before Armstrong was required to provide a blood sample. The saline infusion restored Armstrongs blood values to a level that would not attract attention. The report also described how Armstrong, often in conjunction with Ferrari and the team director Johan Bruyneel, was careful to use techniques and drugs that were untraceable through tests. During his first Tour de France victory, in 1999, Armstrongs drug of choice, according to the sworn affidavits, was the blood-boosting hormone known as

EPO. At that time, there was no test for EPO, which is a cloned form of human hormone rather than a synthetic product. But when rumors began circulating about the arrival of a test for EPO, Armstrong and some of his teammates switched to withdrawing and then reinfusing their own blood. Again, it was a technique initially without a test. Ferrari discovered that when regular, if small, doses of EPO were injected directly into veins rather than under the skin, Armstrong and others could continue using the hormone without fear of a positive test result, the report said. Armstrong and his teammates also learned from Ferrari that the test for testosterone was not highly sensitive and caught only those who consumed large amounts of it or carelessly used it at times of the day when testing was likely. A test for human growth hormone, another banned substance with a following among members of the United States Postal Service team, was introduced only this year, at the London Olympics. According to the report, the drugs used by Armstrong and his teammates were generally supplied by Jos Mart, often at clandestine meetings. Better known as Pepe, Mart ostensibly worked as a trainer for Armstrongs United States Postal Service and Discovery Channel teams. But several riders told Usada that Marts training largely involved relaying information from Ferrari, who was apparently careful to give only advice rather than administer or supply drugs. Mart, who also helped with the teams blood transfusions, according to the report, sometimes sold drugs to riders on other teams. Contrary to Armstrongs repeated claim that he never tested positive, it was widely reported at the time that he tested positive for a corticosteroid during the 1999 Tour. But he was not sanctioned because the team produced a prescription from one of its doctors indicating that Armstrong had received it in a cream used to treat a saddle sore. Usada contends in the report that the prescription and its explanation were both shams. In his affidavit to Usada, Tyler Hamilton, the disgraced former Olympic champion and Armstrong teammate, said the positive test prompted a great deal of swearing from Lance and Johan. A backdated prescription, a former team employee told Usada, was created to resolve the problem. As part of its investigation, Usada said it recently obtained additional data from French officials who had retested Armstrongs samples from the 1999 Tour. For procedural reasons, those samples cannot be used to sanction Armstrong. But the Usada report indicated that advances in EPO testing since then conclusively showed that he used the hormone. The report said the retesting produced resoundingly positive values from six samples.

Armstrongs account of how often he has been tested has varied. His lawyers, according to the report, have indicated that he provided samples 500 to 600 times over 14 years. Usada said it tested Armstrong only 60 times, and it cited reports indicating that the International Cycling Union had tested him about 200 times, although Usada said many of the cycling unions tests were for a health program rather than for prohibited substances. The number of actual controls on Mr. Armstrong over the years appears to have been considerably fewer than the number claimed by Armstrong and his lawyers, Usada said. Sumber: http://www.nytimes.com/2012/10/12/sports/cycling/how-lancearmstrong-beat-cyclings-drug-tests.html?pagewanted=all

Details of Doping Scheme Armstrong as Leader

By JULIET MACUR Published: October 10, 2012 1335 Comments

Paint

To start what was deemed a new and better doping strategy, Lance Armstrong and two of his teammates on the United States Postal Service cycling squad flew on a private jet to Valencia, Spain, in June 2000, have blood extracted. In a hotel room there, two doctors and the teams manager stood by to see their plan unfold, watching the blood of their best riders drip into plastic bags. Peter Dejong/Associated Press In 2005, Lance Armstrong held up seven fingers to indicate his seventh straight win in the Tour de France. Should Doping Be Allowed? It's a constant scandal in cycling, baseball and at the Olympics. Testing doesn't eliminate the drugs. Should we just accept them? Enlarge This Image

Timothy A. Clary/Agence France-Presse Getty Images Lance Armstrong at the Clinton Global Initiative in 2010. Readers Comments Readers shared their thoughts on this article.

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The next month, during the Tour de France, the cyclists lay on beds with those blood bags affixed to the wall. They shivered as the cool blood re-entered their bodies. The reinfused blood would boost the riders oxygen-carrying capacity and improve stamina during the second of Armstrongs seven Tour wins. The following day, Armstrong extended his overall lead with a swift ascent of the unforgiving and seemingly unending route up Mont Ventoux. At a race in Spain that same year, Armstrong told a teammate that he had taken testosterone, a banned substance he called oil. The teammate warned Armstrong that drug-testing officials were at the team hotel, prompting Armstrong to drop out of the race to avoid being caught. In 2002, Armstrong summoned a teammate to his apartment in Girona, Spain. He told his teammate that if he wanted to continue riding for the team he would have to follow the doping program outlined by Armstrongs doctor, a known proponent of doping. The rider said that the conversation confirmed that Lance called the shots on the team, and that what Lance said went. Those accounts were revealed Wednesday in hundreds of pages of eyewitness testimony from teammates, e-mail correspondence, financial records and laboratory analyses released by the United States Anti-Doping Agency the quasi-governmental group charged with policing the use of performanceenhancing drugs in Olympic sports. During all that time, Armstrong was a hero on two wheels, a cancer survivor who was making his mark as perhaps the most dominant cyclist in history. But the evidence put forth by the antidoping agency drew a picture of Armstrong as an infamous cheat, a defiant liar and a bully who pushed others to cheat with him so he could succeed, or be vanquished. The U.S.P.S. Team doping conspiracy was professionally designed to groom and pressure athletes to use dangerous drugs, to evade detection, to ensure its secrecy and ultimately gain an unfair competitive advantage through superior doping practices, the agency said. A program organized by individuals who thought

they were above the rules and who still play a major and active role in sport today. Armstrong, who retired from cycling last year, has repeatedly denied doping. On Wednesday, his spokesman said Armstrong had no comment. When Armstrong decided in August not to contest the agencys charges that he doped, administered doping products and encouraged doping on his Tour-winning teams, he agreed to forgo an arbitration hearing at which the evidence against him would have been aired, possibly publicly. But that evidence, which the antidoping agency called overwhelming and proof of the most sophisticated sports doping program in history, came out anyway. Under the World Anti-Doping Code, the antidoping agency was required to submit its evidence against Armstrong to the International Cycling Union, which has 21 days from the receipt of the case file to appeal the matter to the Court of Arbitration for Sport. Once it makes its decision, the World Anti-Doping Agency has 21 days in which to appeal. The teammates who submitted sworn affidavits admitting their own doping and detailing Armstrongs involvement in it included some of the best cyclists of Armstrongs generation: Levi Leipheimer, Tyler Hamilton and George Hincapie, one of the most respected American riders in recent history. Other teammates who came forward with information were Frankie Andreu, Michael Barry, Tom Danielson, Floyd Landis, Stephen Swart, Christian Vande Velde, Jonathan Vaughters and David Zabriskie. Their accounts painted an eerie and complete picture of the doping on Armstrongs teams, squads that dominated the sport of cycling for nearly a decade. His goal led him to depend on EPO, testosterone and blood transfusions but also, more ruthlessly, to expect and to require that his teammates would likewise use drugs to support his goals if not their own, the agency said in its 202-page report. Enlarge This Image

Joel Saget/Agence France-Presse Getty Images Lance Armstrong, left, at a training session in 2010 for his final Tour de France. He placed 23rd in a race won by Alberto Contador, who was stripped of the title. Drug use was casual among the top riders, and some shared EPO the banned blood booster erythropoietin as if borrowing cups of sugar from a neighbor. In 2005, Hincapie on two occasions asked Armstrong, Any EPO I could borrow? and Armstrong obliged without question. In 2003, Armstrong showed up at Hincapies apartment in Spain and had his blood drawn for a future banned blood transfusion, Hincapie said, adding that he was aware that Armstrong used blood transfusions from 2001 to 2005. Kristin Armstrong, Armstrongs former wife, handed out cortisone tablets wrapped tightly in foil to the team at the 1998 world championships. Riders were given water bottles containing EPO as if they were boxed lunches. Jonathan Vaughters said the bottles were carefully labeled for them: Jonathan 5x2 meant five vials of 2,000 international units each of EPO were tucked inside. Once when Vaughters was in Armstrongs room borrowing his laptop, Armstrong injected himself with EPO and said, now that you are doing EPO too, you cant go write a book about it. Landis was asked to baby-sit the blood inside the refrigerator of Armstrongs apartment, just to make sure the electricity did not go out and the blood did not spoil. Zabriskie, a five-time national time-trial champion, recalled serenading Johan Bruyneel, the longtime team manager, with a song about EPO, to the tune of Jimi Hendrixs Purple Haze. EPO all in my veins; Lately things just dont seem the same; Actin funny, but I dont know why; Scuse me while I pass this guy. Tyler Hamilton, another teammate, said Armstrong squirted a mixture of testosterone and olive oil into Hamiltons mouth after one stage of the 1999 Tour. At the same time the drug use was nonchalant, it was also carefully orchestrated by Armstrong, team management and team staff, the antidoping agency said. Mr. Armstrong did not act alone, the agency said in its report. He acted with the help of a small army of enablers, including doping doctors, drug smugglers, and others within and outside the sport and on his team. Armstrong relied on the Italian doctor Michele Ferrari for training and doping plans, several riders said. Armstrong continued to use Ferrari even after he publicly claimed in 2004 and testified under oath in an insurance claims case that he had severed all business ties with Ferrari.

The antidoping agency noted that Armstrong had sent payments of more than $1 million to Ferrari from 1996 through 2006, based on financial documents discovered in an Italian doping investigation. Ferrari was a master at reducing the riders chances of testing positive, several cyclists said, so much so that Hincapie said he was not fearful he would test positive at the 2000 Tour because of Ferraris tricks. As an example of the extreme care the team would take to avoid positive tests, the doctor suggested that the riders inject EPO directly into their veins instead of under their skin, which would lessen the possibility that the drug would be picked up by tests. He pushed the use of hypoxic chambers, which he said also reduced the effectiveness of the EPO test. Bruyneel, Armstrongs longtime team manager, and team doctors played a key role in the doping scheme. They would often indoctrinate young riders into the doping program, the riders said. In his affidavit, Vande Velde recalled Bruyneel took over as the team director after the 1998 season and brought in the new team doctor, Luis Garcia del Moral, who was fond of giving riders injections. He would run into the room and you would quickly find a needle in your arm, Vande Velde said, adding that when he would ask questions about the treatment, del Moral would say things like I was bloated or blocked and needed vitamins. Vande Velde added that whatever he injected was always described as vitamins. In 1999, del Moral offered Vande Velde testosterone, and Vande Velde knowingly doped for the first time, using testosterone mixed in olive oil. The cyclist then discussed the program with Bruyneel because he was nervous about it. He said not to worry if I felt bad at first, that I would feel good at the end, Vande Velde said. Eventually, Armstrong confronted Vande Velde for not closely following Ferraris training program. Armstrong said his good standing on the team would be jeopardized, Vande Velde said. Feeling threatened, Vande Velde stepped up his drug use. Zabriskie was also anxious about using drugs and asked Bruyneel how safe it was to use them. He barraged him with questions: Would he be able to have children? Would it cause any physical changes? Would he grow larger ears? Bruyneels response: Everyone is doing it. The teams doctors came up with fake maladies so that riders could receive an exemption to use drugs like cortisone, several riders said. When Armstrong tested

positive for cortisone during the 1999 Tour, Armstrong produced a backdated prescription for it, for saddle sores. Hamilton said he knew that was a lie. Riders said they felt that they needed to dope to stay at the top of the sport and stay on the team. Armstrong was instrumental in the hiring and firing of team personnel and pressured riders to stay on a doping program, the antidoping agency said. The evidence made clear, the agency said, that Armstrongs drug use was extensive, and that he also was the linchpin holding the teams doping program together. It said that is why it barred him from Olympic sports for life and stripped him of his record seven Tour victories. It was not enough that his teammates give maximum effort on the bike, he also required that they adhere to the doping program outlined for them or be replaced, the antidoping agency said in its report. He was not just a part of the doping culture on his team, he enforced and reinforced it. Sumber: http://www.nytimes.com/2012/10/11/sports/cycling/agency-detailsdoping-case-against-lance-armstrong.html?pagewanted=3&_r=0

Why Evolution Is True

Pharoahs snake in a vivarium The Argument from Tabbies

Lance Armstrong masterminds blood-doping scheme

At one time Lance Armstrong was my hero. Having beaten testicular cancer that metastasized to his brain, he came back to win the Tour de France seven times. What an inspiring story! And now its fallen apart. As most of us know from extensive reports in The New York Times and other places (see here and here, for instance), Armstrong was the mastermind of a scheme of illegal blood-doping and drug use (including testosterone), forcing his teammates to participate as well. The U.S. Anti-Doping agency has released 1000 pages of evidence and testimony against Armstrong, and the CEO of that Agency released a statement that includes the following: The evidence of the US Postal Service Pro Cycling Team-run scheme is overwhelming and is in excess of 1000 pages, and includes sworn testimony from 26 people, including 15 riders with knowledge of the US Postal Service Team (USPS Team) and its participants doping activities. The evidence also includes direct documentary evidence including financial payments, emails, scientific data

and laboratory test results that further prove the use, possession and distribution of performance enhancing drugs by Lance Armstrong and confirm the disappointing truth about the deceptive activities of the USPS Team, a team that received tens of millions of American taxpayer dollars in funding. Together these different categories of eyewitness, documentary, first-hand, scientific, direct and circumstantial evidence reveal conclusive and undeniable proof that brings to the light of day for the first time this systemic, sustained and highly professionalized team-run doping conspiracy. All of the material will be made available later this afternoon on the USADA website at www.usada.org. The New York Times quotes the USADA report: [Armstrong's] goal led him to depend on EPO, testosterone and blood transfusions but also, more ruthlessly, to expect and to require that his teammates would likewise use drugs to support his goals if not their own, the agency said in its 202-page report. . . At the same time the drug use was nonchalant, it was also carefully orchestrated by Armstrong, team management and team staff, the antidoping agency said. Mr. Armstrong did not act alone, the agency said in its report. He acted with the help of a small army of enablers, including doping doctors, drug smugglers, and others within and outside the sport and on his team. The NYT gives a lot of gory details, which include the following: Kristin Armstrong, Armstrongs former wife, handed out cortisone tablets wrapped tightly in foil to the team at the 1998 world championships. Riders were given water bottles containing EPO [the blood booster erythropoietin] as if they were boxed lunches. Jonathan Vaughters said the bottles were carefully labeled for them: Jonathan 52 meant five vials of 2,000 international units each of EPO were tucked inside. Once when Vaughters was in Armstrongs room borrowing his laptop, Armstrong injected himself with EPO and said, now that you are doing EPO too, you cant go write a book about it. And last night the NYT published a piece about how Armstrong managed to avoid getting caught, including getting tipped off about impending drug testing and using saline infusions to dilute the drugs he took. Theres no Schadenfreude here, as there would be with people who, after a time in the public eye, have fallen low without having achieved anything (Paris Hilton and the Kardashians come to mind). Armstrong did work hard, and was immensely dedicated. Its a pity that his dedication led him to the conclusion that any means justified his winning the Tour de France.

Whats immensely sadder is that Armstrong, despite all the evidence, still refuses to admit guilt. Hes forever disgraced, and has been stripped of his Tour de France titles and Olympic gold medal. Unaccountably, criminal charges against him have not proceeded, despite his actions having violated several U.S. laws. Illegal performance-enhancing use of drugs is pervasive in professional sports, especially in America. Football players take them, baseball players take them, and even racehorses are injected with them. It hasnt been a level playing field for a long time, and drug use spurs on arms races in sports in which one must go along to remain competitive. The 1000-page report on Armstrongs illegal activities has now been put up, along with supporting materials. Go here to see it if you have the stomach. Sumber:http://whyevolutionistrue.wordpress.com/2012/10/11/lancearmstrong-masterminds-blood-doping-scheme/

Blood Doping: Here are the answers for Ron Corning (and the rest of you)
By jane sadler drjane65@gmail.com 1:01 pm on October 19, 2012 | Permalink

The blood doping scandal involving famous Tour de France cyclist Lance Armstrong has become front page news in the last few weeks. There is a lot of confusion circulating (Sorry. Doctor humor) around the topic of blood doping. In fact, the other day, I heard the morning news anchor, Ron Corning ask: What is blood doping? Well, Ron Corning is not the only person confused about the subject of blood doping. Many other people are understandably confused about the athletic advantage of blood doping and the charges linked to Lance Armstrong. First, I will let you know that I continue to admire Lance Armstrong for his fight against testicular cancer and the wonderful contributions Livestrong Foundation

(his non-profit organization) has made towards cancer research. In the past few years, total contributions have exceeded several hundred million dollars towards fighting cancer. The Livestrong Foundation web site is also a great health source for all individuals. Back to work: In general terms, blood doping is illegally improving athletic performance by increasing the bloods ability to deliver more oxygen to muscles. Blood carries oxygen to the rest of the body. With more blood, comes more oxygen. More oxygen delivered to the muscles including the heart, improves physical performance. Blood doping can take place with blood transfusions thru the athletes own blood or the use of someone elses blood (with the same blood type). Blood transfusions increase the bodys ability to improve energy because there is more available oxygen to the muscles. EPO injections (erythropoietin) can also increase red blood cell production and is another form of blood doping. EPO is a hormone produced by the kidneys and is used in medicine to treat patient with anemia related to severe kidney disease. By using EPO, athletes can produce larger than normal amounts of red blood cells. Newer techniques of blood doping involve chemicals that have the ability to increase the bodys ability to carry oxygen. These synthetic oxygen carriers are generally used in emergencies if human blood is not available or if there is not enough time to find the perfect blood type match when someone has suffered significant blood loss. Unfortunately, no test exists for blood transfusions other than a particular test that can compare differences in blood cell profiles at testing time to previous event times. In other words, similar levels of red blood cells at different test times ensure there is not too much of a variation. Stable blood profiles can be reassuring that no blood doping took place (but are not exact). Testing for EPO and synthetic oxygen carriers can be performed, but unfortunately, these chemicals quickly leaves the body, so false negatives are possible. Natural increases in red blood cells can occur when training at high altitudes but physical efforts are limited in high altitudes and training benefits are not consistent. There are dangers involved with blood doping that all athletes should be aware. Because the blood is thicker (there is more of it in the vessels), the doping individual is at risk for heart attack, stroke and blood clots. In fact, an estimated

20 European cyclists may have died as a result of blood doping over a recent 4 year period (Sports Med 2007). Many years ago, when Lance was suffering from testicular cancer, one of my patients had shared a space in the Intensive Care Unit (ICU) with him. Lance was on life support at the time and my patient was informed that Lance was not going to live to leave the hospital. What a miracle that Lance survived and what steadfast determination he had in order to return to cycling competition; but, what desperation there must be to feel you must abuse your body with unnatural additives in order to gain unfair physical advantage. Sumber: http://healthblog.dallasnews.com/2012/10/blood-doping-here-arethe-answers-for-ron-corning-and-the-rest-of-you.html/

Expert: Lance Armstrong's Blood Data Shows Signs of Doping

The readings show that during the race, LanceArmstrongs body produced fewer young blood cells than would be expected.
By Lance Williams and Matt Smith | Monday, Oct 8, 2012 | Updated 6:25 AM PST AP ADVANCE FOR WEEKEND EDITIONS, JUNE 25-26 - FILE - This July 26, 2009, file photo shows Tour de France winner Alberto Contador, of Spain, and third-placed overall American seven-time Tour de France winner Lance Armstrong, right, react on the podium after the 21st stage of the Tour de France cycling race, in Paris, France. When Armstrong came out of retirement to return to the Tour de France, organizers called the seven-time champion's decision an embarrassment for the race. Contador's decision to defend his title in the grueling three-week event despite the doping case that hangs over him could become an even bigger embarrassment for the cycling world. (AP Photo/Christophe Ena, File) advertiseme Cyclist Lance Armstrongs recent fall from grace has been portrayed in books and news accounts as a thriller featuring teammate betrayals, motorcycle drug couriers and secret blood transfusions.

But as the U.S. Anti-Doping Agency prepares to release an evidence dossier detailing its reasons for stripping the cycling star of seven Tour de France titles, the most compelling evidence might be found in dry data drawn from tests of Armstrongs blood chemistry, a world-renowned doping expert says. Michael Ashenden, an Australian scientist who helped create a test for the blooddoping substance EPO, told California Watch that an analysis of blood samples drawn in 2009, contained in an earlier court filing, suggests that Armstrong was recklessly using banned doping methods in an effort to win the Tour de France one more time. He finished third that year. The tipoff, Ashenden said in an interview and follow-up email, is found in three weeks worth of telltale readings in Armstrongs so-called biological passport, a log of blood tests sometimes used as evidence in cheating probes. The readings show that during the race, Armstrongs body produced fewer young blood cells than would be expected, Ashenden said. That suggests his system was adapting to the presence of an extra volume of blood that had been re-infused and that suggests cheating, Ashenden said. Suppressed red blood cell production is a classic signature associated with blood doping, he wrote. The body reacts to the presence of excess red cells in circulation by suppressing the bone marrows production of new cells. Armstrong has adamantly denied doping, protesting that the investigation that resulted in his lifetime ban from cycling was biased and unfair. His spokesman said the blood data amounts to no evidence at all. The rules are clear to everyone but USADA: You either pass a drug test, or you fail it, attorney Mark Fabiani wrote in an email. There is no in between. Lance Armstrong has passed every test ever given to him, including every test administered during the 2009 Tour de France. The anti-doping agency has said in court filings that during the 2009 race, Armstrongs blood chemistry was consistent with a banned performance enhancement method in which cyclists extract blood months before competition, and then re-inject it just before they race to circulate oxygen more efficiently. For California Watch, Ashenden filled in details, describing his interpretation of blood data from the 2009 Tour de France that was introduced in a July lawsuit Armstrong filed in a failed attempt to block the anti-doping agency from stripping his titles. Ashenden said that during the race, Armstrongs blood did not become thinner as the three-week event dragged on, belying the normal wear and tear of extreme exercise. Instead, his blood remained packed with oxygen-carrying cells.

The absence of a natural decline in blood concentration during a three-week race is also consistent with blood doping, Ashenden said. In February, the U.S. attorneys office in Los Angeles halted a 20 -month investigation into allegations that Armstrong had used drugs to win the Tour de France. Anti-doping agency chief Travis Tygart pledged to pick up where the Justice Department left off. The nonprofit agency later released allegations that Armstrong led a doping conspiracy involving team riders and staff. The result: a recommended lifetime ban and nullification of seven Tour de France titles. The anti-doping agency is expected to produce a dossier by this week. Already, accounts such as former Armstrong teammate Tyler Hamiltons recent book, The Secret Race: Inside the Hidden World of the Tour de France, have spurred speculation about the contents of the dossier. Hamilton described a painstakingly secretive doping program that included a motorcycle drug courier and clandestine transfusions. But in his careers twilight, Armstrong might not have been careful enough. Allowing testers to collect telltale signs of blood transfusions fails the so-called doping IQ test, Ashenden said. In a follow-up email, Fabiani, Armstrongs lawyer, contended that Ashenden was fatally biased because he had been an expert witness for a Texas sports promoter embroiled in a multi-million dollar dispute with the cyclist. SCA Promotions had sought to avoid paying Armstrong a $5 million bonus for his 2004 Tour de France win, arguing that the cyclist violated his contract by using banned drugs. Ashenden testified he believed that Armstrong had used EPO. An arbitrator ruled in Armstrongs favor. The company paid Armstrong the money, plus $2.5 million legal fees in 2007, but it may seek repayment in light of USADAs recent findings, the New York Daily News has reported. View this story on California Watch This story was produced by California Watch, a part of the nonprofit Center for Investigative Reporting. Learn more at www.californiawatch.org. Sumber: http://www.nbcbayarea.com/news/local/Armstrong_s_blood_data_shows_sig ns_of_doping__expert_says-173071991.html

Tricks of the trade: How athletes blood dope

The science and history of an illicit process By Daniel Schwartz, CBC News Posted: Aug 24, 2012 6:35 PM ET Last Updated: Aug 25, 2012 9:02 AM ET Read 146 comments146 Related Stories The life and times of Lance Armstrong Columnists, fans divided after Lance Armstrong drops drug defence Lance Armstrong doping charges have 'substance': WADA External Links World Anti-doping Agency: Questions & answers on blood doping Science and Industry Against Blood Doping: What is blood doping? (Note:CBC does not endorse and is not responsible for the content of external links.) More Lance Armstrong IOC opens probe into Lance Armstrong's Olympic medal UCI bans Armstrong from cycling for life Armstrong out as Livestrong chairman Nike dumps Armstrong 'with great sadness' Armstrong stripped of Tour de France titles by USADA Laying claim to Armstrong's Tour de France titles UCI demands details in Armstrong case Armstrong doping charges have 'substance': WADA TIMELINE: Lance Armstrong TRADE SECRETS: How athletes blood dope

Run, Swim, Throw, Cheat-qq5-Jun 23, 201216:43 Blood doping the illicit process of increasing the amount of oxygen in the bloodstream to enhance athletic performance has a decades-long history in the athletic world but the methods for using it to cheat have changed over the years. The issue was in the news Friday after the United States Anti-Doping Agency (USADA) banned cyclist Lance Armstrong for life and requested that he be stripped of his seven Tour de France titles. The USADA's decision came after Armstrong dropped his challenges to their allegations that he took performanceenhancing drugs and engaged in blood doping. The science about blood doping is pretty straight-forward. The body uses more oxygen during exercise, perhaps 20 times the rate, during intense exercise compared to when at rest. Blood moves oxygen from the lungs to the muscles. Since oxygen doesn't dissolve readily in blood, it is carried by a protein called hemoglobin inside red blood cells. The purpose of blood doping is to increase the quantity of hemoglobin, which carries the energy-fueling oxygen, into the athlete's bloodstream. Blood doping began in the 1970s

Christiane Ayotte talks about the anti-doping lab set up at the Olympic Oval in Richmond, B.C. Oct. 21, 2009. The state-of-the-art lab was set up for the 2010 Olympic Winter Games. (Andy Clark/Reuters) A takeaway from the 1968 Summer Olympics in Mexico City, 2,240 metres above sea level, was that increasing the number of red blood cells would enhance athletic performance. Training at higher altitudes will boost the red blood cell count but hardly by Olympian amounts. A few years after the Mexico Games, and through the 1970s and 1980s athletes used transfusions to blood dope.

That method wasn't banned until 1986, after the 1984 Los Angeles Olympics, where the U.S. cycling team boasted about their use of transfusions. There are two methods of using transfusions for blood doping, plus other methods that use substitutes and hormones. For transfusions, there's the standard method, using blood from someone of the same blood type. The hemoglobin in the transfused blood increases the amount of hemoglobin in the recipient's bloodstream. That's called homologous transfusion. Another method used by athletes is transfusing their own blood, which is called autologous transfusion. Hospital patients awaiting elective surgery sometimes choose this method to avoid infections and blood type match errors. Difficulties in detection Athletes have their own blood withdrawn, preferably when their hemoglobin level is high, stores and then re-infused before a competition. The athlete's blood could also be run through a centrifuge to isolate red blood cells from blood plasma.

Russia's Viatcheslav Ekimov holds his silver medal, left, with gold medalist Tyler Hamilton, right, of the U.S., on the podium after the men's road individual time trial of the 2004 Olympic Games in Athens. The IOC stripped the medal from Hamilton in August and gave it to Ekimov. (Laurent Rebours/Associated Press) In 2006, Spanish police raided a cycling team doctor's office in Madrid and discovered 99 bags of athletes' blood allegedly being stored for later transfusion. American cyclist Tyler Hamilton, an Armstrong teammate was investigated by the IOC during the 2004 Athens Games, after his initial doping sample indicated he had tested positive for a blood transfusion but the case was dropped after his backup "B" sample was mistakenly frozen and couldn't be properly tested. The IOC stripped him of the medal in August.

It took 20 years until a successful test was developed in 2004 for homologous transfusions, which involves using another person's blood, but experts are still confounded by the use of an athlete's own blood. "No test exists to detect when an athlete has used autologous blood transfusion," according to Dr. Michael Ashenden, one of the world's top blood doping experts who played a key role in the Armstrong blood doping case. EPO becomes favored method

On Aug. 24, cycling icon Lance Armstrong was stripped of his seven Tour de France wins by the United States Anti-Doping Agency. (Mike Hutchings/Reuters) In the 1990s blood transfusions took a back seat as cheating athletes turned to a new method of blood doping. A genetically-engineered hormone that could stimulate bone marrow to produce more red blood cells was for sale. The kidneys naturally produce a hormone called erythropoietin (EPO) to do that. In the 1980s, scientists figured out how to engineer the hormone. By 2002, according to a New York Times story, EPO had become "the best-selling genetically engineered drug ever, and one of the largest-selling drugs of any kind in the world." EPO's primary medical use is for patients with anemia. It's standard for patients on dialysis to take EPO. "Athletes quickly realized that EPO injections were a quicker, neater and more convenient means to blood dope than either homologous or autologous transfusions," wrote Ashenden, who heads the Australia-based research consortium Science and Industry Against Blood Doping. "EPO tipped the sporting world upside down so that cynical doctors and drug gurus, rather than talent and training, came to dominate results," Ashenden added.

Italian Alex Schwazer, a gold medalist at the Beijing Olympics, tested positive for EPO at the London Olympics. Schwazer cools himself during the 50 km race walk at the 2007 world championships in Japan. (David Guttenfelder/Associated Press) Not until the Sydney Olympics in 2000 did officials have a method to detect athletes using the engineered hormone EPO to cheat. Italy's Alex Schwazer, a race walking gold medalist in 2008, was kicked off the team at the 2012 Olympics after testing positive for EPO. Another method of blood doping is using blood substitutes, called hemoglobinbased oxygen carriers (HBOC) and Perfluorocarbons. HBOCs were developed for use in emergencies or on the battlefield when blood is not available for transfusion, or testing for blood type is not an option. The World Anti-Doping Agency implemented a test for synthetic oxygen in 2004.

Sumber:
doping.html

http://www.cbc.ca/news/health/story/2012/08/24/f-blood-

Body Work: The science of blood doping

Red blood cells carry oxygen through the bloodstream, so increasing their numbers ups the amount of oxygen delivered to the muscles.
BY STEPHEN PRESCOTT AND ADAM COHEN | Published: October 23, 2012 Adam's journal Earlier this month, the U.S. Anti-Doping Agency released a report laying out evidence that Lance Armstrong was at the center of a sophisticated cheating ring that helped him win seven Tour de France cycling titles.

Blood doping refers to any illicit method of boosting the levels of red blood cells in an athlete's bloodstream. Top cyclists have been accused of blood doping in the past and again recently. Thinkstock photo. Photos.com Armstrong was cast out Monday by his sport, formally stripped of his seven titles and banned for life for his involvement. According to the report, the key to this performance-enhancing conspiracy was blood doping. This is a term that the media throws around a lot, but what does it actually mean? How does it help enhance athletes' performances? And is it dangerous? Dr. Prescott prescribes Blood doping refers to any illicit method of boosting the levels of red blood cells in an athlete's bloodstream. This process allows muscles to work more

efficiently, giving dopers an advantage over non-doping competitors, but it carries cardiovascular health risks. Red blood cells carry oxygen through the bloodstream, so increasing their numbers ups the amount of oxygen delivered to the muscles. This results in less fatigue and more efficient performances, particularly in endurance events such as long-distance running and cycling. Endurance athletes can naturally boost their bodies' red blood cell counts by training at high altitude. The lower air pressure and diminished oxygen content of the air cause the body to generate extra red blood cells, bumping up the hematocrit (the percentage of blood composed of red blood cells) up a few percentage points. Athletes, though, can get a bigger boost through two other prohibited methods, both of which Armstrong purportedly used. Injections with erythropoietin (EPO), a naturally occurring hormone that biotech companies have made in large amounts for treatment of anemia in cancer and AIDS, stimulate the body to produce more red blood cells. The body metabolizes the hormone in four days, making it difficult to detect via testing. But the hormones' performance-boosting effects last for weeks. Transfusions with a person's own blood can also bump up red blood cell counts. Using this approach, athletes draw and store their own blood during training, then re-inject red blood cells taken from the blood (they can be separated out using a centrifuge) before the competition. In the interim, the body has produced more red blood cells, so that the re-injected red cells create a higher volume of these oxygen carriers. Other than looking for unnaturally high hematocrit, there currently is no accepted test to detect for transfusions with an athlete's own blood. But other circumstantial evidence such as the presence in blood of plastic additives found in I.V. bags has helped authorities sniff out this method of blood doping in the past. The effects of blood doping are short-lived; when the body senses the unnatural levels of red cells in the blood, it attempts to return things to normal by not replacing the extra cells as they die. So that means that athletes who want to maintain the benefits of doping will engage in repeated cycles. Ethics aside, doping carries health risks. The hard work of pushing unnaturally thickened blood through the veins increases the probability of cardiovascular events such as strokes or heart attacks, as well as kidney damage. Although doping may cut a few minutes from athletes' race times, it can also cut years from their lives. Prescott, a physician and medical researcher, is president of the Oklahoma Medical Research Foundation. Cohen is a marathoner and OMRF's senior vice president and general counsel.

Sumber: doping/article/3721402

http://newsok.com/body-work-the-science-of-blood-

Here's The 'Insurmountable Evidence' That Made Nike Cut Ties With Lance Armstrong
Tony Manfred | Oct. 17, 2012, 8:59 AM | 17,134 | 13 Spencer Platt/Getty Images Nike has severed ties with Lance Armstrong a week after the USADA released a damning report alleging that he doped his way through seven Tour de France victories. The report called the doping operation which involved blood doping, EPO use, and testosterone use the most sophisticated in the history of the sport. In addition, it painted Armstrong as the driving force behind the program. Nike is typically loyal to its athletes, but it called this USADA evidence "seemingly insurmountable" in a statement this morning. Below is a year-by-year breakdown of the USADA's report against Armstrong. Along with general doping allegations, the witnesses in the report allege that Armstrong lied his way out of a failed test at the 1999 Tour de France, pressured his teammate to engage in more intense blood doping in 2002, and had a longstanding relationship with an Italian doctor who has since been banned from the sport for life. 1998 The report starts with a 1998 race in Spain where Armstrong's teammate Jonathan Vaughters alleges that Armstrong injected himself with EPO (a type of performance-enhancing drug) in front of him and was open about his performance enhancing drug use. In all, seven witnesses testified about performance-enhancing drug use on Armstrong's US Postal Service team, including four riders and a team employee admitting to using EPO, testosterone, human growth hormone and cortisone. 1999

In 1999, the report alleges that Armstrong's US Postal Service team ousted the team doctor Pedro Celaya because he "had not been aggressive enough for Armstrong in providing banned products." That year, Armstrong allegedly "got serious" with Italian doping doctor Michele Ferrari. In one instance, the wife of USPS rider Frankie Andreau says she, Armstrong, and Armstrong's wife met Ferrari on the side of the road outside Milan, and Armstrong met with Ferrari alone for an hour. Tyler Hamilton, Armstrong's training partner in 1999, told the USADA that Ferrari injected him with EPO that year. During the 1999 Tour de France, Armstrong tested positive for a cortisone that he didn't have medical authorization to use. A cover-up allegedly ensued: "Emma OReilly was in the room giving Armstrong a massage when Armstrong and team officials fabricated a story to cover the positive test. Armstrong and the team officials agreed to have Dr. del Moral backdate a prescription for cortisone cream for Armstrong which they would claim had been prescribed in advance of the Tour to treat a saddle sore. OReilly understood from Armstrong, however, that the positive had not come from a topical cream but had really come about from a cortisone injection Armstrong received around the time of the Route du Sud a few weeks earlier. After the meeting between Armstrong and the team officials concluded, Armstrong told OReilly, 'Now, Emma, you know enough to bring me down.'" The report alleges that the team was delivered EPO during the 1999 Tour by a skilled, drug-smuggling motorcyclist that they called "Motoman." Tyler Hamilton says riders took testosterone via a olive-oil based solution that was sprayed in their mouths in 1999 as well. 2000 When they started testing for EPO in 2000, the team moved on to blood doping, Hamilton alleges. He says he, Armstrong, and Livingston went to Valencia, Spain and had blood extracted and later re-infused to boost their performance. Armstrong's teammate George Hincapie alleges that Armstrong also used testosterone in 2000, and dropped out of an unnamed race in Spain after Hincapie warned him that there would be drug testing. Hamilton says the riders were re-infused with blood during the 2000 Tour at a hotel room, and they joked about whose body was absorbing the blood the fastest. 2001

Michele Ferrari visited the USPS camp at the beginning of 2001, and his services were offered to any rider who wanted them for $15,000, says rider George Hincapie. Also in 2001, Vaughters went out on a bike ride with Armstrong where Lance "demonstrated a detailed knowledge of the EPO test" and told him how to skirt a positive test. He added that he had sources in the testing world who told him how it works. At the 2001 Tour du Suisse, Armstrong allegedly told his teammates that he had tested positive for EPO, but Armstrong had a conversation with UCI and told his teammates "everything was going to be okay." Floyd Landis alleges that Armstrong told him he made a "financial agreement" with UCI to keep the test hidden. 2002 In 2002, the report says Armstrong become good friends and training partners with Floyd Landis. Landis alleges that they both shared doping advice and drugs. "Armstrong also describes how much he enjoyed Landis boyish antics, gregarious personality and love for the American rock band ZZ Top." Landis had keys to his apartment. The USADA says it has evidence that $150,000 went from Armstrong to Ferrari during 2002, even though Ferrari was under investigation for doping. After the 2002 Tour de France, Christan Vande Velde alleges that Armstrong threatened to kick him off the team if he didn't step up his doping program: "Armstrong told Vande Velde that if he wanted to continue to ride for the Postal Service team he 'would have to use what Dr. Ferrari had been telling [Vande Velde] to use and would have to follow Dr. Ferraris program to the letter.' "Vande Velde said, '[T]he conversation left me with no question that I was in the doghouse and that the only way forward with Armstrongs team was to get fully on Dr. Ferraris doping program.'" Vande Velde obliged. 2003 Armstrong paid Ferrari $475,000 in 2003, according to records.

Landis was hurt during 2003, but when Armstrong went out of town he asked him to stay at his apartment and keep an eye on his blood-doping equipment. "Landis agreed to babysit the blood," the report says. Both Landis and Hincapie say Armstrong blood-doped in 2003, and every other Tour de France from 2001 to 2005. Landis says Armstrong gave him a box of six pre-measured syringes of EPO after he got two liters of blood taken out in 2003. 2004 Armstrong allegedly continued to work with Ferrari, and on the day before the 2004 Tour de France he wired him $100,000, according to records. Landis alleges that he saw Armstrong on a massage table with a testosterone patch on his shoulder. During the 2004 Tour, both Landis and Hincapie allege that the entire team got blood transfusions after a stage of the race on the team bus. In late 2004, Dr. Ferrari was convicted of sporting fraud for advising a group of Italian riders about EPO and other drugs. Armstrong publicly broke off his relationship with him. 2005 More of the same. Hincapie alleges that Armstrong gave him EPO following his seventh-straight Tour de France win. Also in 2005, the USADA says Armstrong's supposedly-finished relationship with Dr. Ferrari was "business as usual." The two met in Italy, and Armstrong wired him $100,000 according to records. 2009 The USADA says Armstrong retained a professional relationship with Ferrari by soliciting advise from him through his son Stefano. Here's an example of an email exchange ("Schumi" is Ferrari): On November 4, 2009, Stefano inquires, Schumi asks if youd like [t]o continue the cooperation for next year too if so, then it [w]ould be good to start thinking about some specifics already (gym + [s]ome bike). On November 15, 2009, Armstrong is looking ahead to the next years Tour, and he writes: Yes, lets continue . . . what we have started. Im curious to know what Schumi [t]hinks for 2010 and what we need to do differently in terms of training. . .

Stefano responds, Great! Schumi says its obviously a [T]our for light climbers.. . . The USADA says the chances that Armstrong's blood levels during the 2009 Tour occurred naturally were "less than one in a million." Read more: http://www.businessinsider.com/nike-fired-lance-armstrong-evidence2012-10#ixzz2CUTkHSdB Sumber: http://www.businessinsider.com/nike-fired-lance-armstrongevidence-2012-10

Published: October 11, 2012

Evidence From the Investigation Into Alleged Doping by Lance Armstrong

Details from the investigation of Lance Armstrong by the United States AntiDoping Agency based on testimony, largely from teammates. Armstrong has denied doping. Related Article

Won tour De France Armstrong sleeps in a tent that simulates high-altitude conditions during competition to help mask EPO. Team members are supplied EPO by a team trainer. After his Tour victory, the team director sends a teammate to Armstrongs apartment to ensure there is no drug evidence there. Armstrong supplies EPO to teammates.

Bought machinery to help monitor blood values to assure they remained at acceptable levels. After a stage in the Tour de France, blood transfusions are given to the team members on the team bus ride back to the hotel. Armstrong receives small doses of EPO to help mask the effect of blood transfusions on his blood values. Transfusions continue, and Armstrong supplies teammates with EPO. Still no testing for blood doping. Armstrong starts to personally enforce the team doping program. He supplies testosterone to teammates. No tests for blood transfusions are in place. Armstrong drops out of a race in Spain when warned of a test. He had just taken testosterone. Armstrong tests positive for a corticosteroid. A doctor backdates a prescription for it claiming Armstrong had saddle sores. Team begins blood doping in part because a new test emerges for EPO. Smaller doses of EPO will now be used to help avoid positive tests. An Armstrong assistant, nicknamed Motoman, followed the team on a motorcycle during Tour de France stages carrying EPO. Records of some payments made from Armstrong to Ferrari, who consulted on the team doping programs. At World Championships, Armstrong receives saline to lower his red blood cell level in advance of a possible test. The drugs were transported by team staff; administered by a team doctor. Dr. Michele Ferrari Evading positive tests Administration or transportation of drugs Blood doping Human growth hormone

Corticosteroid Testosterone EPO $100,000 $110,000 $475,000 $150,000 2005 2004 2003 2002 2001 2000 1999 1998

Sumber: http://www.nytimes.com/interactive/20 12/10/11/sports/cycling/dopingagencys-evidence.html