How Accurate Are PED Tests?

Written by: Daniel J. Zeman

One of the toughest questions to answer is: “How accurate are Performance Enhancing Drug (PED) tests?” In other words, is it possible to pass a PED test but still be taking PED’s? The question is uniquely difficult to answer on two levels.

The first level is that most people who ask me the question have already made up their mind regarding the athlete’s guilt or innocence.  Their hope is my answer will help them defend their belief.  As an aside, I find it odd that most people who ask the question are only interested in defending their athlete’s integrity, but have little regard for the integrity of athletes outside of their passionate interests.

The second and more difficult level is that it depends upon the person’s understanding of the limitations surrounding the basic science behind PED testing.  This is critical because today’s athlete no longer uses a one-dimensional PED that can easily be identified and thus, the athlete could easily be found 100% guilty.

The basic science behind PED testing is an attempt to identify an “unethical” drug that has been proven to create a cause and effect relationship between the use of the drug and enhanced athletic performance.  Ironically, this basic science approach to identifying a cause and effect relationship has also been used to create a multitude of “ethical” performance enhancing training programs.

Photo Courtesy of Daniel Zeman

One of the original questions endurance athletes asked was: “Should I train for longer time periods at a lower intensity or shorter time periods at a higher intensity?” To answer the question it was necessary to design a study that controlled the training intensities of athletes across a defined period of time and then compare the cause and effect relationship between the two training programs.  Specifically, the athlete’s maximal level of oxygen consumption (VO2) and anaerobic threshold (AT) were measured both pre and post training and then used for comparison. This type of testing has been repeated numerous times across large sample sizes and continues to be accepted as credible performance-driven research.

The next significant performance question endurance athletes asked was: “What are the benefits of the use of nutritional supplements?”  To answer this question, the research combined the original VO2 testing and the ingestion of nutritional supplements (carbohydrates, proteins, vitamins) to determine a possible cause and effect relationship.  Results from these studies allowed endurance athletes to improve performance if they incorporated nutritional supplements before, during and after training bouts.  These types of supplement studies allow endurance athletes the ability to “ethically” gain additional performance enhancement outside of the benefits that are directly associated with the gains from their intense training program.  The inherent debate with all PED’s is in defining which supplements are considered “ethical”.

Another significant finding for all of these studies is they have provided great insight into the heart’s response to training, the range of VO2 max scores, the range of red blood cell count, the expected gains in muscle mass with strength training, the effect carbohydrate loading has on performance, the effect interval training has on blood lactate levels and the relationship between VO2 and effort. In addition, numerous other studies take into consideration technology, psychological states and gender.

As previously mentioned, an individual who is unfamiliar with the basic science behind cause and effect research can easily be confused as to how an athlete who is using PED’s can pass a PED test.  In essence, the burden of proof relies on the testing community as it must: decide which PED’s have been proven to enhance athletic performance; fund the testing research; keep up-to-date with the ever-changing “unethical” PED programs; be committed to removing PED’s from all sports regardless of the committee’s personal bias and still guarantee the athlete confidentiality regarding their testing results.

The following three examples offer some insight into the struggles of the testing community as athletes are willing to:

1. Use a drug that mainstream researchers would not believe to be worth the potential health risk of ingesting – It is common knowledge that the East German swimmers used anabolic steroids to improve performance.  At that time, most researchers could not believe swimmers would voluntarily take such high levels of steroids given the potential for disastrous health consequences; therefore, little research was done on the connection between steroids and superior swim times.  Even if the belief existed, the researchers would have been forced to give “unethically” high levels of anabolic steroids to a group of elite swimmers and then compare their swim times to another group who was given a placebo.  Eventually the catalyst for looking deeper into steroid usage was driven by the disturbing number of female swimmers who showed obvious secondary male sexual characteristics and was not that they showed superior swim times.  The final admittance of anabolic steroids was provided by the East German coaches some twenty years after the wide spread usage began.
2. Use a drug that does not cause any suspicion because it does not exceed the levels which are found in clean athletes – Early research had shown a positive relationship between hematocrit levels (red blood cell count) and levels of cardio-vascular endurance. It also showed healthy males had hematocrit levels between 42-46% while elite endurance athletes had hematocrit levels between 46-48%.  In addition, it showed that hydration states influenced hematocrit levels by altering the thickness of their blood.  This research was the reason for the widespread, yet still very dangerous, practice of blood doping as a means of increasing the number of red blood cells.  Prior to 1990 athletes who chose to use blood doping as a performance enhancement needed to manually remove and then later infuse their blood back into their body.  This cumbersome process became unnecessary in 1990 when AMGEN introduced the drug EPO to clinically treat anemia (low red blood cell count).  The major problem with EPO was it did not contain a marker that could be used when performing PED testing.  In an effort to curtail the use of EPO, a best-guess hematocrit level of 50% became the marker to determine its usage.  Unfortunately, this marker allowed athletes to continually use EPO as long as their hematocrit level did not exceed the 50% marker; in essence, allowing the athlete to pass the PED test and still be using EPO.
3. Use a drug that has yet to have published research showing a cause and effect relationship – Professional baseball provides the best example of this during its now acknowledged steroid era and its assault on the home run records.  Research has clearly shown the cause and effect relationship between steroid use and increases in lean body mass (LBM).  However, an increase in LBM had not been shown to directly enhance the ability to hit home runs as it was considered a hand-eye skill and not a strength task.  Once again, it is unethical for the research community to design a study that attempts to determine if a cause and effect relationship exists between steroid use and the ability to hit home runs as it would involve giving an unethical dosage of steroids to a large number of professional baseball players.  In this scenario, players could suggest their legendary number of home runs was due to a variety of other advances because there was no research showing steroid use directly enhanced the skill of hitting a baseball.

These examples point out some of the difficulties facing the research community as it attempts to continually fight the battle against the unethical use of PED’s.  The good news is that the professional baseball steroid scandal does offer insight into how the research community can make a further connection between PED usage and enhanced performance.  Quite simply, to compare and contrast an athlete’s legendary increase in performance (home runs) across a relatively short period of time (a single season) given similar training conditions should raise suspicion.  This practice should not be confused with a failure to accept a continued improvement in athletic performance because performance records are going to be broken due to ethical training regimens.  Record setting athletes should be applauded for their commitment to their sports and not be falsely judged.  However, regardless of the sport, once athletes stop using PED’s they have difficulty returning to the level of performance achieved during their times of PED usage. Case in point, the assault on the home run record in baseball has vanished since the players stopped taking steroids.  The same can be said about cyclists, runners and swimmers.

Further difficulties for the research community are due to the fact that each sport has its own physiological demands and thus, its own preferred PED.  For example, those that involve a single-day event mean the athlete must be in peak condition on a specific date for only a specific amount of time, while multiple-day events mean the athlete must be able to optimally recover from the previous day’s expenditures.  A possible PED red flag for single-day strength events would be when an older athlete’s level of lean body mass has drastically increased since earlier periods of competition.  For those athletes whose event involve sustained endurance tasks, a red flag would include the ability to maintain power outputs that overwhelmingly exceed work efficiencies given the highest range of VO2 scores.  While neither of these red flags should be used to condemn the athlete, the red flags should enlighten and motivate the research committee to devise new PED testing procedures.

The disturbing news for sports fans is that today’s exorbitant salaries in sports provide a significant financial enticement to take PED’s.  The financial rewards are substantial enough that it is naive to believe that athletes, and those who provide them with PED’s, are not extremely motivated to create inventive methods for passing PED testing.  Even more disturbing is that the athlete’s short-term motivation to take PED’s exceeds the potential for tragic long-term health consequences.  Ironically, it is neither the athletes or the fans who have been the most successful at battling PED usage, but it is the court system as it is generally considered illegal to buy, sell, provide or transport PED’s.

About The Author:

Dan Zeman is an Exercise Physiologist with thirty years experience in the health, fitness and sports medicine arena’s. He has worked with a wide variety of professional and recreational athletes including members of the Minnesota Vikings and Minnesota Timberwolves, as well as three-time Tour De France winner Greg LeMond. He has done research looking at the Aerobic Capacities of Wheelchair athletes, the amputee athlete and the professional mountain biker racer. Dan has appeared on radio, television, and newspaper segments including a year on a KARE 11 segment entitled Fitness Friday. He is currently writing a book regarding the effects of Aging and Automation on Americans and is also heavily involved with the health and fitness industry’s new computerized approach to making a healthier America.

Tags: #cycling, #Doping, #EPO, #greg lemond, #PEDs, #Performance Enhancing Drugs, #Tour de France