Catch me if you can – the science

I haven’t been able to blog for a while, in part due to work constraints, but also due to working on my next book (Blood: A Very Short Introduction). Still the book will be finished by the end of this month and I should have more time to write soon.

Still I couldn’t resist commenting on the latest BBC documentary about doping - Mark Daly’s Catch Me If You Can. I was actually invited to talk about it last week on BBC2s Newsnight; I couldn’t make it as I was busy talking about my artificial blood research at a blood transfusion conference in Scotland (for the latest info see www.haemO2.com).

What I would like to do here is explore some of the science behind the allegations. First up, the least interesting part of the piece – the reporter taking EPO himself to see if he could fool the anti doping biological passport. I am growing to hate this aspect of science TV documentaries [1].  They all do it now (I blame Michael Mosley!) and, although I understand it is used to engage the viewer, it rarely adds anything to the science. In this case we know that microdosing is an issue with the biological passport. We also know that EPO can theoretically improve VO2 max and performance. Actually what we don’t know is whether in this particular case the EPO enhanced the performance. The reporter clearly expected the drug to work He also admitted feeling very different as soon as he took the EPO. One would expect a large placebo effect under these conditions and, as a non-elite athlete, there was a large room for improvement. Did the drug really work or was the effect all in the mind? What the documentary should really have done of course was a double blind crossover study with a placebo. In fact as a watching scientist I wanted the Swiss expert Carsten Lundby’s view, not on the passport data, but on whether he thought the EPO-induced haematocrit change was enough to trigger the measured VO2 max increase. Lundby is a world authority on the performance link between blood oxygen content and performance and it would have been really interesting to hear his opinion about this.

That said the journalistic scoops were really interesting. For me personally the most concerning were the allegations about Alan Wells, one of my childhood heroes. High dose anabolic steroids can clearly increase muscle mass and I would be genuinely saddened if his victories were in part due to steroid use.

But, of course, the most concerns have been raised about the Galen Rupp and Alberto Salazar allegations (hotly denied). Leaving aside the truth or otherwise of the stories what about the science? Well, unlike sprinting, anabolic steroids such as testosterone are not game changers in long distance running (especially in men). They have turned up occasionally, the “steroid in my toothpaste” excuse from Dieter Baumann being perhaps the most famous occasion. The most likely benefit is in training where they might aid recovery and allow for longer, more intense, sessions (although even that is not based on mostly anecdotal data). Likewise asthma therapies like oral corticosteroids. They can stimulate activity, but in some cases could actually be detrimental to performance. Similarly pre race IV drips should not be required for a healthy athlete.

My conclusion, albeit on a one off viewing of a one-hour TV program, is that what was exposed, even if true, was not what led to Galen Rupp’s strong performances. If he got his medals by cheating there was most likely something else going on. What the documentary did expose was a culture that might not have been averse to using a scientific approach to doping methods (and detection prevention) that really could make a significant difference in long distance running events. These include EPO and blood transfusions. That’s what Mo Farah needs to find out when he returns to America to meet with Salazar.

[1] Hypocrite alert – I have just taken part in a Channel 4 documentary where this is done. However, at least this means I can talk with authority about its limitations!