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Mark Sisson on Steroids in Sports

June 23, 2006 03:01 PM

When you see Mark's experience in enforcing performance drugs in sports you will understand why I think his point of view is important to present. With his permission I am posting the letter he wrote me on the subject. A special point of relevance to all of us who are seeking a healthy lifeway is the discussion of the health consequences of training and performing at the elite level; it is the antithesis of healthy living.

Art,

I have followed with great interest your discussion and analysis of purported steroid use and home-run distributions. In a recent post, you asked about the incidence of false positives in sports drug-testing and you wondered how that might factor into the equation. I’ve given great deal of thought to that and related issues over the past 15 years and now feel compelled to add my two cents to your discussion – but on a much grander scale. At the risk of sounding a bit brazen, I would suggest to you and your audience that sport would be better off allowing athletes to make their own personal decisions regarding the use of so-called “banned substances” and leaving the federations and the IOC out of it entirely. (Even the term “banned substance” has a negative connotation, since most of these substances are actually drugs that were developed to enhance health in the general population). Bottom line: the whole notion of drug-testing in sports is far more complex than even the media make it out to be.

First, I should tell you that I was the Anti-doping Commissioner of the International Triathlon Union (ITU) – a relatively new sport within the Olympic Family – for nearly 13 years. I had to act as “prosecutor” on many doping cases (doping = drugs in sport). Prior to that, I helped write the first set of “anti-doping” rules for triathlon in 1988. Before that, I was an elite marathoner (2:18) and triathlete (4th Place Ironman Hawaii) in the ‘70s and ‘80s, so I have accumulated a fair amount of “inside information” regarding drugs in sport at the Olympic level. I also own a supplement company and have done extensive research on performance enhancement in pursuit of natural, legal alternatives.

There are three main points I want to make here: first, that it is impossible to fairly police and adjudicate drugs in sport; second, that the notion of a “level playing field” is a farce and, finally, that the performance requirements set by the federations at the elite level of sport almost demand access to certain “banned substances” in order to assure the health and vitality of the athlete throughout his or her career and – more importantly – into his or her life after competition.

1. Impossible to fairly police and adjudicate. Most people think that a positive test is conclusive proof of guilt, but the reality is that almost all these tests are nothing more than GC/MS (http://www.scientific.org/tutorials/articles/gcms.html for a good description) quantitative analyses that look for parts per billion of certain metabolites in the urine. They are not black and white indicators of guilt. They are wavy lines on a graph subject to interpretation by scientists with varying degrees of expertise. In many cases a “threshold level” is established below which you are “clean” but above which you are “guilty.” Test results will vary significantly from one “accredited” lab to another. You can test positive in one lab and, conceivably, have another lab exonerate you using a portion of the very same sample. I have presided over cases where an athlete tested positive for metabolites of nandrolone (a once-popular steroid) at levels of 4 or 5 parts per billion when the cut-off was 2.5 or 3. Even at such disputably low levels, athletes are presumed guilty. Some labs have proven that these metabolites can occur in the body from having consumed certain types of meat or from other foods or are even endogenously produced. In my opinion, the threshold levels have always been too low, so a handful of innocent athletes get severely penalized, while others who are dirty but are not tested get cleared to compete and keep whatever money or medal they win.

In the old days if you ate a poppyseed muffin before a race, your urine could easily show above-threshold levels of metabolites of opium and you could be disqualified. It actually happened to a triathlete who was later cleared. There are other similar “false positives” we had to be on the lookout for.

A T/E (testosterone to epitestosterone) higher than 6:1 was considered evidence of a doping violation, yet we had cases of women who scored a T/E of 20, not because testosterone was present in high amounts, but because the epitestosterone was extremely low as a result of birth control pills. In other cases, elite athletes’ normal testosterone levels were high enough to exceed the limit, but they were allowed to compete when they showed proof of genetic abnormality.

In other cases, athletes who have been diagnosed with asthma (now nearing 25% of the elite athlete population – don’t get me started) and who have properly notified the IOC and have a “therapeutic use exemption” on file can use salbutamol, salmeterol and similar “anabolic-property” drugs which are otherwise banned. But god forbid you are an athlete from a developing nation with asthma whose team physician failed to properly file your papers. Same condition, but now you can be severely penalized for the ignorance of your coaches or doctors.

There are known cases of sabotage where ex-wives have tainted supplements (or even toothpaste) to cause a positive test, and where athletes in races have consumed tainted drinks offered by unscrupulous coaches or fans of rival competitors.

Even when you do get a fairly reliable test result from the lab, a good lawyer can throw doubt on the integrity of the collection process, the chain of custody or a number of other factors, enough to get a truly guilty athlete off on a technicality. All these factors combined lead me to the conclusion that it is impossible to fairly police or adjudicate doping in sport.

2. The notion of a level playing field is a farce. The IOC and many professional leagues suggest that banning doping in sports will create a “level playing field”, meaning that all athletes should have access – or not – to the same advantages and disadvantages. Art’s exceptional analysis of home-run distribution notwithstanding, there are clearly advantages to be had from the use of certain substances specifically within certain sports. Take the use of EPO in cycling and running. EPO (Erythropoetin) is a natural hormone produced by the body. EPO stimulates the production of red blood cells, whose level in the blood is measured by hematocrit. Red blood cells contain the hemoglobin that carries oxygen to muscles where fuel can be burned. The more oxygen you deliver to the muscles, the more energy output you derive from those muscles. So having more red blood cells is a good thing and is a primary goal of many endurance athletes. Hard training raises EPO and hematocrit, but drug companies also make artificial EPO which does the same thing without training (intended medical use is for recovery from chemotherapy which destroys RBCs). Artificial EPO is banned. Now here’s the irony: research confirms that if you train at sea level and sleep at 14,000 feet, your body makes red blood cells at an impressive rate and amount. Several companies have developed expensive “altitude chambers” for home use where you can now train at sea level and then retire to your room for the night, simulating an altitude of 14,000 feet or higher. The end result is that you have, within the letter of the law, manipulated your own EPO to artificially raise hematocrit, yet using artificial EPO to do the same thing is punishable by a 2-year suspension. Talk to an endurance athlete from a developing nation with $2 to his name about THAT level playing field.

In the early days of EPO testing, the cycling federation would measure the hematocrit of every cyclist before a race. If your hematocrit was above 52%, you were not allowed to race and were presumed to have doped. However, there were instances of cyclists from high-mountain regions in South America who had normally high hematocrits (from training AND living at 14,000 feet or higher). Some were not allowed to race because they had achieved a high hematocrit naturally. Meanwhile, others who used artifical EPO to get from, say, 44% to 51% raced without penalty. Talk to those South Americans about a level playing field.

There are many other idiosyncrasies. Within the IOC, 2 cups of coffee is OK, but 8 cups is illegal. Marijuana will get you suspended by some federations, but not by others. Creatine, one of the best natural performance enhancing substances is legal in track and field, while beta-blockers, which have no effect on performance, were not. My point is that the concept of a level playing field is a nice idea, but one that has not been realized in Olympic sport.

3. The performance requirements set by the federations at the elite level of sport almost demand access to certain “banned substances” in order to assure the health and vitality of the athlete throughout his or her career and – more importantly – into his or her life after competition. As I write this, Mike Quarry has just died at 55 from “pugilistic dementia”, the same fate that took his brother Jerry at age 52. World class athletes tend to die significantly younger than you would predict from heart disease, cancer, diabetes and early-onset dementia. They also typically suffer premature joint deterioration from the years of pounding, and most endurance athletes look like hell from the years of oxidative damage that has overwhelmed their feeble antioxidant systems. Most people don’t realize it, but training at the elite level is actually the antithesis of a healthy lifestyle. The definition of peak fitness means that you are constantly at or near a state of physical breakdown. As a peak performer on a world stage, you have done more work than anyone else, but you have paid a price. It is again ironic that the professional leagues and the IOC, the ones who dangle that carrot of millions of dollars in salary or gold-medalist endorsements are the same ones who actually created this overtrained, injured and beat-up army of young people. They don’t care. These organizations then deny the athletes the very same drugs and even some natural “health-enhancing” substances that the rest of society can easily receive whenever they feel the least bit uncomfortable.

I had to disqualify and suspend a kid from competition for 90 days because he had a head cold the night before his national championships. His dad had gone to the drugstore and gotten him some Sudafed so he could breathe while he slept. His urine test was positive when he won the race the next day. He forfeited his winnings and he had to sit out the World Championships as a result. I felt terrible, but the rules required that we do it.

I had to suspend a talented and promising young Mexican triathlete because his vitamins contained a tiny amount of a little-known stimulant legal over-the-counter in Mexico. His doctor had prescribed vitamins for him because he had been chronically overtraining and yet had little or no access to decent training foods.

These days many athletes avoid taking high-potency multi-vitamins out of fear that contaminants in their supplements could destroy their careers. Yet these same athletes have nutrient requirements that exceed the RDAs by a factor of 10 or 20 in some cases. It has been said many times that world class athletes will do anything to win – even if it means risking their lives. If that’s the case, then don’t let them train so hard that they destroy their health and then deny them the very tools they need to recover!

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I could go on, but you get my drift. I believe that with proper supervision, athletes could be healthier and have longer careers (not to mention longer and more productive post-competition lives) using many of these “banned substances.” And perhaps the biggest assumption I will make here is that the public just doesn’t care. Professional sport has become theater. All the public wants is a good show and an occasional world record.

I welcome your feedback.

Mark Sisson

· Sports

Comments

Posted by: adamsn03 at June 24, 2006 7:49 AM

Posted by: Chris H at June 23, 2006 5:04 PM

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