August 1, 2006

Travelblogging: The Blood Is the Key

Hatched by Dafydd

Here's an intriguing claim.

You all remember that American Floyd Landis won this year's Tour de France in a tour de force run on the second to last day of the race, making up several minutes of time and sealing his victory. Within moments, it seemed, someone lodged the inevitable charge: that Landis had been "doping."

As proof, "the French national antidoping laboratory in Châtenay-Malabry" said that the results from a testosterone test on one of Landis' two blood samples (sample A) that day found an elevated ratio of testosterone to epitestosterone:

Landis’s personal doctor... did, however, acknowledge that the initial test found a ratio of 11 to 1 in Landis’s system. He and Landis are seeking an explanation for that high level.

“I’ve seen bodybuilders with numbers 100 to 1,” Kay said. “Although Floyd’s was elevated, it’s not off the chart or anything.”

The New York Times notes that a normal ratio is 1:1 or 2:1, and the cycling rules allow a 4:1 ratio.

However, Landis has denied all charges and called for his B sample from that same day to be tested. The lab will use a much more sophisticated test on sample B than was used in the preliminary test on sample A; the tests take several days and should be ready this coming weekend.

Now right away, there is something fishy about this. There is another drug commonly used by athletes called EPO; the big scandal that kept so many of the top cyclists out of this year's Tour (on the basis of newspaper clippings about a list found that had some names on it) was about EPO doping, not testosterone, as we discussed in our previous post on this topic.

EPO, or Erythropoietin, acts by increasing the production of red blood cells: more red corpuscles means more oxygen to the muscles, and the athlete doesn't tire as much and recovers much more quickly. EPO works its magic nearly instantaneously, boosting the rider the same day he takes it.

But with testosterone, you need a long period of use to gain any benefit at all out of it. You cannot simply pop some "Vitamin T" and feel instantly stronger.

So "the curious incident of the dog in the night-time" was that none of Floyd Landis' other blood tests, from before or after that one day, came up with anything positive at all. If he were going to risk using testosterone, why wouldn't he have used it for weeks before the race, when it might actually have done some good?

Therefore, not only are we to believe that he doped -- we're being asked to believe that he did so in a dopey manner, injecting himself with but a single, large dose of testosterone on a single day... knowing not only that it was sure to be discovered the moment the bloood test was performed but also that it wouldn't even help him in the race.

So why would he do it? It doesn't make sense on any level at all.

But along comes a spider now. A certain anonymous Dr. X , who says he works in the antidoping department of the International Cycling Union (UCI), has leaked what he terms results in a second test -- of the original sample A. This test determined:

...that some of the testosterone in [Landis'] body had come from an external source and was not produced by his system, according to a person at the International Cycling Union with knowledge of the results.

Perhaps there was testosterone added "from an external source"... but was it added to Floyd Landis -- or to Floyd Landis' blood sample?

What fascinates me is the growing insistance from the anti-American faction that there's really no need for a second set of tests to be performed on sample B at all; the sample A results are so clear and convincing (to those who don't like Landis in the first place), why bother testing any others?

Dr. Gary I. Wadler, a member of the World Anti-Doping Agency and an associate professor at New York University School of Medicine, said that the result of the carbon isotope ratio test already proved that there was synthetic testosterone in Landis’s system. He said that the test needs to be done only once, on either an A or on a B sample, particularly if the athlete’s testosterone to epitestosterone ratio is found to be high or if that elevated level is inconsistent with previous test results.

Well, no: the carbon isotope ratio test proved that there was synthetic testosterone in Landis' blood sample; it's quite a leap from there to conclude that it must have been present in Landis' system as well -- especially when it's nonsensical that any athlete would futilely inject testosterone on a single day.

More and more, I wonder what that B test will show... would someone trying to frame Landis go so far as to contaminate both of his samples from that day? And is the "sophisticated" test precise enough to be able to determine whether synthetic testosterone came from the original blood, or whether it was added later? I don't know... but I think we may find out very soon.

What are the possibilities?

  • Landis is lying and he really did inject himself with testosterone. But why, knowing it would do nothing to help him?
  • Landis is telling the truth: either the testosterone arose naturally within his system, or else someone somehow induced him to eat something that contained it. But how? Wasn't Landis suspicious?
  • Landis is telling the truth: the testosterone was injected into the sample , not the rider. But injected by whom? Who had access to Landis' blood samples -- except those working at "the French national antidoping laboratory in Châtenay-Malabry?" Including, of course, the anonymous Dr. X., who leaked to the New York Times the supposed results of the carbon isotope test.

That's why it's so important that we get the results of the testing on sample B before leaping to the conclusion that Landis is not only crooked but also thick-headed. First let's see whether there is anything here to shoot down the "null hypothesis," that there is nothing to explain, other than skill at cycling and the refusal of race officials to consider innocence a defense.

Hatched by Dafydd on this day, August 1, 2006, at the time of 10:17 PM

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Comments

The following hissed in response by: Harold C. Hutchison

Landis is going to get stripped of the title. Just due to the ratio - which they have set at 4:1.

And if it comes out later that he was set up... well,t he French will deny it. The real question is what happens to that B sample.

The above hissed in response by: Harold C. Hutchison [TypeKey Profile Page] at August 2, 2006 6:27 AM

The following hissed in response by: Davod

They did the same thing to Armstrong (different chemical, same attack). I would fight azny atempt to strip him of the title until the B sample is tested by another laboratory. If that proves possitive so be it. If the B sample was tampered with I do not know how you could offer proof of tampering.

The above hissed in response by: Davod [TypeKey Profile Page] at August 2, 2006 7:16 AM

The following hissed in response by: JGUNS

I know a fair amount about steroids and I can tell you that the epi test is about as simplistic as it gets and there are all kinds of things that can throw off the ratio. If the testosterone was introduced to the sample AFTER it was provided, it can almost certainly be ferreted out by a more sophisticated test. At least what would happen is that the results would be so confusing that it would bring into question serious doubts as to the validity of the sample. Most athletes would not use synthetic testosterone as that would be way too easy for tests to find. They would use a drug that metabolized into a drug with testosterone like qualities- similar to THG if you remember that, and the metabolites would be recognized. For example the drug itself would have to go through steps like the stairs to a door, with the door being the ultimate final prodct. not only would the "door" be visible, but every stair to the door would be apparent. This would be extremely hard to "fake" on a sample.

The above hissed in response by: JGUNS [TypeKey Profile Page] at August 2, 2006 8:03 AM

The following hissed in response by: Big D

Oh yeah, and Landis is/was a Mennonite. No drugs, no alcohol, no caffeine.

No matter what the test reveals, there is certainly something very fishy here. Most doctors would say that testosterone does little for endurance, and certainly doesn't act over night. So taking the drug was pointless and against his upbringing.

One thing Landis has said is that he spent the entire evening before his terrific ride eating, drinking fluids, and taking naps. The previous day he did poorly because he "didn't eat enough".

I think the most likely explanation is that he ate something that caused a spike in his testosterone. Probably inadvertently, though he may have been slipped something.

Foods that raise testosterone? Oysters do this very well. Also other protein rich foods, especially those high in zinc. All the kinds of things it was likely he was eating.

The above hissed in response by: Big D [TypeKey Profile Page] at August 2, 2006 9:24 AM

The following hissed in response by: JGUNS

Just to clarify to everyone what this highly unreliable test is: in the mid 80's as chromatography — mass spectrometry (GCMS) was used as the main method of anabolic steroid analysis. This method could test for more specific steroid metabolites as well as testing the Testosterone to epitestosterone ratio (T/E). This latter method could distinguish whether a person was on Testosterone because endogenous Testosterone is produced in the testis in a 1:1 ratio with epitestosterone. Therefore, if someone were using Testosterone, this ratio would be out of balance. Due to some natural variations in this ratio it was established that a 6:1 ratio of T/E determined suspicion while a 10:1 ratio established guilt.

This method of testing, however, could be overcome by a variety of methods:

Simply co-administering a cocktail of Testosterone and epitestosterone to maintain the appropriate ratio. This cocktail would also contain other appropriate endogenous steroids since the administration of only T and e would inappropriately elevate these two hormones relative to the other endogenous steroids, thereby raising caution flags. On the other hand, the co-administration of Testosterone and epitestosterone alone, if done in smaller doses, might not be cause for suspicion.

The use of Testosterone patches or gels. These drugs have a slower release and deliver steroids in such a way as to lower peak blood concentration, perhaps allowing athletes to still pass using the 6:1 ratio as the standard. However this use, due to 5 alpha reductase activity in the skin, can lead to elevated blood DHT and the DHT may be detected in the urine.

The T/E ratio is flawed due to the fact that very little is known about individual variation based on diet, gender, training, etc. In addition, there are several scenarios that will raise the T/E ratio without the accused actually taking Tstosterone. As a result, several cases have been thrown out due to inconclusive evidence that drugs were used. For example, diet can throw it off, medicine (including pain medication), alcohol and also EXERCISE can cause big swings.
What I found interesting is that this test was administered at leg 17, one of the most intense parts of the race. Not only did that seem to be a strange place to test Landis, but the organizers of the test HAD TO KNOW that testosterone production would be at its peak during this time. After all, this is an old test that is used only as a minimal basic screening test at this point. My understanding is that Landis has some injuries, so he could be taking medicine for that as well.

The whole thing seems carefully orchestrated to me.

The above hissed in response by: JGUNS [TypeKey Profile Page] at August 2, 2006 10:50 AM

The following hissed in response by: ironwalker

It is my understanding that testosterone must be used over a period of time to achieve benefit. Thus, Landis taking testosterone for a one day benefit was worthless and does not make sense. No benefit = no motive = strong defense for Landis. Fishy indeed.

Yet I read that a forensic toxicologist expert (Dr. David Black in Miami Herald by Michelle Kaufman) asserts that taking testosterone would immediately improve recovery time and induce a feeling of well-being, energy and aggression creating advantage for the days ride. Interesting hypothesis.

Is there any evidence to support this assertion of immediate benefit?

See: http://news.pajamasmedia.com/2006/07/29/9909951_Toxicologist_say.shtml


The above hissed in response by: ironwalker [TypeKey Profile Page] at August 2, 2006 12:53 PM

The following hissed in response by: Big D

Er now,

I just saw a news report that Landis drank two beers and four shots of whiskey the night before his ride.

http://online.wsj.com/public/article/SB115444904804023475-b3Yk05K97EtFKvdjhAVAvcCleyE_20060831.html?mod=tff_main_tff_top

This has been shown in some studies to result in elevated testosterone. Who would have guessed that?

So I was wrong about the who Mennonite thing, but right about it being something he ate or drank.

The above hissed in response by: Big D [TypeKey Profile Page] at August 2, 2006 3:05 PM

The following hissed in response by: ironwalker

What we know to date is that only once during the race, out of at least six tests, was Landis's T/E ratio 4/1 or higher. If the evidence is testosterone must be used over a period of time to achieve a long-term benefit, Landis received no unfair advantage by taking testosterone for a short-term one day benefit. Landis then had no motive to “intentionally” take testosterone and the probability of mistake or sabotage or tampering rises considerably and should be investigated.

If Landis received no unfair advantage he should be considered the true winner notwithstanding a technical code violation.

If the evidence shows taking testosterone immediately improves recovery time and energy thus creating unfair advantage, Landis had a motive to “intentionally” take testosterone.

If Landis received an unfair advantage he should be disqualified by the doping code violation as he is not the true winner.

The above hissed in response by: ironwalker [TypeKey Profile Page] at August 3, 2006 12:25 AM

The following hissed in response by: JGUNS

Ironwalker, there is nothing to suggest that a one day application of testosterone would have any real impact on the recovery process. I saw this written up as an explanation for Landis' one day application and it is laughable. There are far more effective and legal things he could do without the huge risk of taking testosterone.

The above hissed in response by: JGUNS [TypeKey Profile Page] at August 3, 2006 7:54 AM

The following hissed in response by: rightonq

You guys all have some great comments. I have no knowledge to add, but my minimal involvement in the athletic world may give me some insight.

First, I agree with JGUNS, who knows much more about the subject than I, that it is probably more likely that Landis could have used a different drug which has a resulting effect of a high testosterone level at some point.

Second, athletes at this level are doing everything they can in concert with physiology experts to get some kind of advantage. How to train better, better bike position, better supplements, etc. I don't believe that the testing can keep up with the rate of change in science to provide a boost to a cyclist's endurance and recovery. I'm not saying that all cyclists dope, but I am saying that all cyclists are doing everything they can right up to the gray area of what is legal to stay competitive.

If you look at Basso and Ullrich, those guys were oxygenating their own blood through high-altitude exercising and then saving it for a later race. Is that legal? It's their own blood that was not tampered with.

Third, I doubt the sample was tampered with, although I guess it's possible. I think it's more likely that someone tampered with Landis himself. These guys are constantly subjected to physical test, nutritional milk shakes, injections, etc. He may have no idea if something illegal was purposefully put into his body.

Last, I know of very few cyclists who once a test came back positive sat up and said "oops, you caught me." 9 out of 10 say no way and I just have a feeling that most are lying.

I hope Landis proves to be right in this case, but I don't hold out much hope. I hoped the same for Tyler Hamilton a couple of years ago and instead of looking better near the end of his 2-year ban, it looks like he's facing a possible lifetime ban.

The above hissed in response by: rightonq [TypeKey Profile Page] at August 3, 2006 8:52 AM

The following hissed in response by: ironwalker

Recent reports suggest the French lab used a technique called mass spectrometry that can detect exogenous testosterone in body. If true and the evidence shows exogenous testosterone, alcohol or other potential causes (food, medication) would be ruled out. Alcohol and food intake doesn't create exogenous testosterone in the body. Yet experts assert that errors are common in the tests and sabotage or tampering cannot be conclusively ruled out. It seems to me the controlling issues are:

1. Evidence of testosterone immediate benefits creating unfair advantage;
2. Mens rea (intent) of Landis;
3. Error rate of mass spectrometry testosterone testing;
4. Proper testing procedures;
5. Chain of custody of evidence;
6. Evidence of mistake, sabotage or tampering.

Final result may turn on the legal standard of proof and which side has the burden of proof. Landis needs great legal counsel, experts and investigators to fight to keep his title and career.

Question: who has the burden of proof and what is the legal standard?

The above hissed in response by: ironwalker [TypeKey Profile Page] at August 3, 2006 9:05 AM

The following hissed in response by: Maetenloch

I've taken testosterone and other anabolic steroids before, and I can assure you from personal experience that testosterone when taken in the right form does in fact have near immediate positive effects. Most injectible testosterone is actually test with an ester attached. This causes the test molecule to be slowly released from the oil injected into a muscle. Depending on the length of the ester, the half life of test levels can vary from 3 days to 21 days. On the other hand there is testosterone suspension which is just unmodified testosterone dissolved in water. When it's injected, testosterone blood levels peak within an hour or two and it has a half life of about 4 hours. Test suspension is what's used in androgel patches for men on testosterone replacement therapy.

While some of the benefits of extra testosterone like increased muscle mass and resulting strength take days to weeks to become apparent, there are other beneficial effects which are pretty immediate. These include increased strength via effects on the central nervous system, increased
intensity and ability to push through pain, as well as quicker recovery after a workout. Personally when I've taken even a short ester version of test, I can usually "feel" it within a day or so. Usually I feel energized and unfazed by the usual aggravations of life. In the gym I notice that I can suddenly lift more weight and can do extra sets without feeling any more tired, and can do my next workout a day earlier than I would have.

What I suspect happened was that Landis was using test suspension in a patch or gel form in a low enough dose that his T/E ratio would still be under 6-to-1. Somehow he must have messed up his dose which is why his ratio jumped to 11-to-1. The IRMS test just confirms that he had exogenous testosterone in his body. While it would be nice to believe in all kinds of conspiracy theories, the simplest explanation is that Landis was using test, was careless, and got caught. I can't say I blame him too much for this. He's an outstanding athlete - he was just looking for a slight edge over other the outstanding athletes. He pushed the edge a little too far and got caught. And I'm pretty sure that if the blood of the other contestants was scrutinized as closely as Floyd's, you'd find evidence of doping as well. And this is just for compounds that tests currently exist for. I won't even get into compounds like HGH, IGF-LR3, and other exotic substances that are undetectible for the moment.

The above hissed in response by: Maetenloch [TypeKey Profile Page] at August 3, 2006 10:46 AM

The following hissed in response by: ironwalker

Assuming Sample B is positive, and no evidence of funny business by lab, it appears Landis has two defenses:

1. Use of testosterone was not intended to enhance sport performance;
2. Landis bore no fault or negligence for the offense.

Landis needs clear and convincing evidence that he did not use testosterone to gain a competitive advantage and raise doubts about questions of fault or negligence. Landis should argue that the doping offense was technical and caused by others and therefore the appropriate sanction is a warning and reprimand, no period of ineligibility and no disqualification of results or forfeiture of prize money.

In order to establish “No Fault or Negligence” Landis must establish that he did not know or suspect, and could not reasonably have known or suspected even with the exercise of utmost caution, that he had used or been administered with the prohibited substance.

If Landis can establish, on the balance of probabilities, that the use of testosterone was not intended to enhance sport performance, his discipline may be reduced to a warning and reprimand and no period of ineligibility. Thus, a significant issue is whether Landis can establish on the balance of probabilities that his use of testosterone was not intended to enhance his sport performance.

Is there clear and convincing evidence that taking testosterone immediately improves recovery time and energy and as a result enhances sport performance for a bike race?

Personal experiments and research does not meet the clear and convincing evidence legal standard. What does the science say, if anything?

The above hissed in response by: ironwalker [TypeKey Profile Page] at August 3, 2006 6:04 PM

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