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Doping in Sports

Doping in Sports. Michael J. Ross, MD Sports Medicine Physician, Rothman Institute Medical Director, The Performance Lab. August 24, 2012. August 25,2012. 9/20/06 Floyd Landis becomes the first Tour de France winner to have his title revoked for doping. Doping at a glance.

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Doping in Sports

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  1. Doping in Sports • Michael J. Ross, MD • Sports Medicine Physician, Rothman Institute • Medical Director, The Performance Lab

  2. August 24, 2012

  3. August 25,2012

  4. 9/20/06 • Floyd Landis becomes the first Tour de France winner to have his title revoked for doping

  5. Doping at a glance • Discuss some of the common doping agents abused by athletes • Anabolic steroids • Other anabolics • Stimulants • Blood doping • Discuss strategies for obtaining desired effects without doping

  6. Testosterone • 2007 Christian Moreni arrested at Tour de France • 2007 Mattias Kessler • 2007 Brazilian defender Marcao, suspended four months after testing positive for finasteride. (Masking agent)

  7. Testosterone • 1996 Dean Capobianco, Australian 100m champion, tests positive for anabolic steroid stanozol • Blames red meat • 1996 Dieter Baumann 1500m and 5000m • Blames positive testosterone test on spiked toothpaste

  8. Testosterone • April 2006 Justin Gatlin Olympic gold sprinter-facing 8 year ban • August 2007 Chicago Bears fullback Obafemi Ayanbadejo-4 game suspension

  9. Testosterone • 1998 Dennis Mitchell 400m relay gold medalist and 4 time US champion • Had sex four times the previous night and a lot of beer

  10. Testosterone effects • Increases Lean muscle mass • Increases red blood cell volume • Decreases Body Fat

  11. Testosterone side effects • Acne • Testicular suppression • Coronary Artery Disease

  12. Bay Area Lab Cooperative • Victor Conte • Bassist, Nutritional Consultant, Convict • Produced designer androgens • custom-developed for elite professional athletes to evade doping detection

  13. Detecting Testosterone • Testosterone and EpiTestosterone are produced in equal amounts from a precursor • If the Ratio of Testosterone:EpiTestosterone is greater than 1:1, doping is suspected • Cutoff is 4:1 • RadioImmunoAssay

  14. Increasing Testosterone • Testosterone increases in response to: • Intervals • Strength training • Testosterone decreases in response to • Low Intensity Endurance training (L.I.E.)

  15. Insulin • One of the major hormones for controlling blood sugar • Non functional in diabetics • Synthetic insulin used to have a “C-peptide,” not in recombinant insulin

  16. Insulin as a drug of abuse in body buildingBr. J. Sports Med., Aug 2003; 37: 356 - 357.

  17. What it does • Insulin is anabolic at large doses. • Imports amino acids into cells to speed recovery and muscle building • Imports glucose into muscle cells to be stored as glycogen

  18. Side Effects • Too much can cause low blood sugar, change in mental status and coma • Fat deposition at injection site • Can only be used in cases of glycogen depletion • Adiposity

  19. Bodybuilders find it easy to obtain insulin to help them in training • BMJ 1997;314:1280 (26 April)

  20. What else to do • Glycogen depletion • Replace calories as high glycemic carbohydrate • Incorporate protein into recovery mix • 1g/kg carbohydrate + 0.3g/kg protein

  21. Growth Hormone • Anabolic hormone • Secreted in pulses, the largest pulse happens in the first 1 hour of sleep

  22. GH Effects • Increases recovery (acute) • Increased amino acid uptake into muscle • Increased glycogen through glucose uptake • Increases Energy (chronic) • Stimulates fatty acid release from adipose tissue • Increases sensitivity to fatty acid release

  23. 6/06: Diamondback pitcher Jason Grimsley possessed a season's worth of hGH, federal indictment

  24. 9/07: Washington Redskins tackle Jon Jensen:"very naive and foolish" to think that NFL players aren't using human growth hormone. • "maybe 15, 20%" of the league's players use illegal performance-enhancing substances.

  25. Wade Wilson, Dallas Cowboys QB

  26. Braces and a six pack

  27. Growth hormone (GH) replacement • GH deficiency • Pituitary disorder • GH a potential treatment for: • frailty • osteoporosis • morbid obesity • cardiac failure

  28. What it does • Increases recovery (acute) • Increased amino acid uptake into muscle • Increased glycogen through glucose uptake • Increases Energy (chronic) • Stimulates fatty acid release from adipose tissue • Increases sensitivity to fatty acid release • Increases lean muscle mass

  29. Side Effects • Cancer • Bony Changes • Jaw and Forehead • Long bones if still growing • Coronary artery disease • Cardiomyopathy

  30. 2005 1992

  31. What else to do • Restful sleep • Avoid pre-bedtime snacks containing fat or carbohydrate • Encourage training intensity, while discouraging training volume without intensity • Arginine as “secretogogue”

  32. Glucocorticoids • Catabolic hormone • Release glucose and fat • Stress steroids

  33. What it does • Increased energy from release of sugar and fat

  34. Side Effects • Muscle breakdown • Central obesity • Moon facies • Osteopenia • Adrenal suppression

  35. What else to do • Caffeine for fatty acid release • Maximize glycogen “supercompensation”

  36. Stimulants • Increase alertness and (perceived) energy • Mimics effects of adrenaline • Cocaine • Amphetamine • Phenylpropanolamine • Ephedrine

  37. VO2max= HR x SV x (A-V)02

  38. 2005 Mariano Puerta, French Open finalist • Traces of cardiac stimulant in blood • Claimed it was from his wife’s menstrual pain medication when he drank her water

  39. 1999 Javier Sotomayor, Olympic high jump gold medalist and world record holder, tests positive for cocaine at Pan Am Games • Fidel Castro blames it on a CIA conspiracy

  40. NCAA reports an increase in positive stimulant (and cocaine) tests since 2001-2002 • 58.3% of collegiate hockey players admit to stimulant (ephedrine, pseudoephedrine, amphetamin) use • Current Sports Medicine Reports, September,2004

  41. April 2004: Track sprinter Torri Edwards tests positive for Nikethamide-2 year ban. “Accidentally” taken in an over the counter medication • 2003 100m and 200m sprinter Kelli White tests positive for Modafinil • 1998 Dennis Mitchell 400m relay gold medlaist tests positive for testosterone

  42. Cory Stringer All-pro offensive linemandied from combination of ephedra and heat illness • 2003 Steve Belcher dies of heat stroke while using ephedrine • 2007 800m freestyle world champion Oussama Mellouli banned for 18 months

  43. Ephedra: What it does • Increases time to exhaustion • Increases cardiac output • Increases liver and muscle glycogen release • Bronchial dilatation • Appetite suppressant

  44. Side Effects • Pre-disposition for heat illness • Appetite suppressant • Insomnia (affects GH) • Tachycardia, arrhythmias and heart disease • Mental status changes • Fatigue depression and lethargy

  45. What else to do • Caffeine 4-5mg/kg + pseudoephedrine 1mg/kg • Minimizes side effects, maximizes ergogenic effect

  46. Blood • Muscles perform best when they can use oxygen and glucose to make energy. • Red blood cells transport oxygen from the lungs to the muscles

  47. VO2= HR x SV x (A-V)02

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