Performance Enhancing Drugs

13 July 2008

Interview with

Professor Chris Cooper, University of Essex

We've seen the news stories in previous Olympic tournaments where athletes have been caught using performance enhancing drugs, such as steroids, to increase their chances of winning their event. But how much of a boost is this really giving them? We've got Dr Chris Cooper from the University of Essex with us now to tell us more.

Chris - What sorts of things to people jam into themselves in order to boost performance?

Olympic runners

Chris C - All sorts of things. If you look at what Dwain Chambers, the current hot topic - he was taking at least seven or eight different compounds. He was taking insulin which diabetics take. He was taking testosterone, he was taking this thing called The Clear which is this magic compound developed in San Francisco to not be detected by the drugs testing agencies. He was taking thyroid hormone precursors. They take all sorts of things, some of which work and some of which may or may not work.

Chris - So if I wanted to performance enhance myself what agents would work in me?

Chris C - If you're unfit lots of things will work actually. The difficulty is if you're the super elite athlete. There are three general classes of performance enhancing drugs. There's anabolic steroids that you've probably heard of, the things that build up your muscle mass. There's the things that boost your aerobic sports so the steroids help you for strength events. The compounds that help you in aerobic sports increase the amount of oxygen you can deliver: basically increase the number of red blood cells in your body. Then there's the stimulants, things like amphetamines, cocaine, modafinil and those are a bit less clear whether they work or not.

Chris - Do you think they're more of a psychological effect because a lot of people say that a lot of winning a race is 90% psychology, don't they?

Chris C - Yeah, they are a psychological effect. Psychology is a branch of biochemistry, I'm a biochemist so they're neuropsychology. Yes, whether the drug is directly working on the brain or the athlete actually thinks they're getting an edge is an interesting question.

Chris - You think it might give them a sort of psychological angle because they feel more confident. Winners win races, don't they? There's this sort of winning streak phenomenon where people feel a confidence boost when they win once and this makes them win again.

Chris C - Sure. There's clearly examples of people being given placebos. Even in the Tour de France which is sort of the drug cocktail par excellence some of the people have said I didn't want to give him this super cocktail of stimulants and they gave him a sugar solution and he won the race. It's a combination of things really.

Chris - Looking at the agents that you can put into your body, at the biochemical level how do they actually work?

Chris C - There's been a lot of work on this recently. It's an ongoing area. The steroids, the anabolic steroids, it seems that they work by increasing you ability to improve your muscle mass after you've don't the exercise. It used to be thought they let you exercise longer and harder when you're doing your weights. Now it's thought that they mostly work on the remodelling after the exercise. That's probably how the steroids work. The compounds that increase your oxygen capacity work by increasing your amount of erithropoetin. This is what's called EPO. That controls your number of red blood cells so you just basically increase your number of red blood cells.

Chris - If you go and do what some people used to do which is run up a mountain so that you have altitude training on your side, how does that work? Is that the same phenomenon?

Chris C - Yeah, the key is not to run up a mountain. It is to go up the mountain and don't run there. You go to the mountain and when you're there your body adapts to having lower oxygen because there's less oxygen up a mountain. It makes more red blood cells. The problem with that is you can't train so well up the mountain so the current idea is to live high, train low. You go up the mountain on the cable car, leave it there and come down to the bottom for your training.

Chris - I did read somewhere someone had bought the equivalent of an oxygen tent for their bed so they could simulate oxygen levels at say, halfway up Everest for sleeping. Then they would get out of their bed during the day and exercise at sea level. This was supposed to do the same thing as going up a mountain.

Chris C - Yeah. They're very common, easily bought, not that expensive and not illegal. In the days of East Germany they used to have whole gymnasiums that were at low oxygen where the athletes just lived.

Chris - How can science also help athletes to do things in a legitimate way?

Chris C - At the University we do a number of things trying to mimic the effects that the drug might have. There are things like trying to hyperventilate before you exercise which changes your blood pH and means you can run 400m better. That's a sort of extreme version which is quite difficult. Other things to get you stimulated as equivalent of taking stimulants so you should try to train to have the same chemical effect. Then there are legal drugs that you could add.

Chris - Tell us a bit more about that. If I was to start training now what would be a good regimen for me and what sorts of equipment could I use to make sure I was effectively training the most efficiently?

Chris C - That would just depend completely on what sport you were going to do. If you were going to be a Paula Radcliffe or you were going to be Linford Christie. What you would do would depend completely on that. If you were doing a power event you would be in the gym most of the time especially in the off-season in the Winter. If you were doing the long-distance event you would be running long distances. Then of course you would have the nutrition team and the sports science team there working as well.

Mrinal Shah, New York - I wanted to know if there are any naturally derived (or if there are only synthetic) steroids. Also, if there are any natural steroids would it be possible for an athlete to get them in his daily diet? Would that disqualify him from any sporting events?

Chris C - That's a really interesting question. There are natural steroids. Testosterone is a natural steroid and obviously men have more of that than women do. It's illegal to take testosterone because it's not part of your normal diet. You can't get a diet equivalent to fail a drugs test. It's difficult to take a steroid in any normal diet to have an effect because they don't work orally. You have to inject the, Then it's obvious you're doing the cheating. Where it's a more grey area is in some of the metabolites the body makes from these artificial compounds which are also illegal because the agencies say that means you've taken the metabolites. There's a concern that if you exercise very hard on certain diets you might make small amounts of these metabolites naturally. Then it's a question of what level the drug company sets those out. It's difficult to take the natural compound to fail a drugs test. The bodies make it that way. They don't want to fail people for that.

Mario - What's the fastest a human could run, theoretically. What's the fastest a human could sprint at with the aid of all the latest blood and drug enhancements?

Chris C - The cynical answer is to say we know that because we have Tim Montgomery as an example of somebody but then he'd been beaten by Usain Bolt. I think it's quite a difficult question to answer. The world record now is 9.72 [men's 100m] and no evidence that's been done illegally. You can sort of extrapolate form that where you might get. I think increasingly we're going to see genetic anomalies, people who've got a genetic aberration that makes them perform better and that's going to be what makes the difference. A classic example was a Finnish cross-country skier who had a naturally active EPO system. He made in his body large amounts of red blood cells because he had a gene defect. It wasn't a defect, of course.  I think you'll see these step changes by people who happened to have had a mutation. It's difficult to therefore extrapolate.

Chris - In this week's British Medical Journal there's an editorial by Dominic Wells who's at Imperial College. He's saying we're all worried about drugs and things but how long is it going to be before people will start doping themselves with genes? We know that certain genes definitely can enhance performance. How long will it be before people can come up with ways to switch on or add genes to their muscles to make them more genetically fit, if you like?

Chris C - I'm sure people are thinking about this. If you read a scientific paper and say that can help you in sport - and people who publish these papers which are all done for medical reasons suddenly get hoards of people, usually body builders saying how can I do this? It's difficult but it's surprising that just changing one gene or up-regulating one gene seems to have an effect on human performance. I was surprised but certainly if any of you have gone YouTube-ing you can see this picture of this mouse that's had one extra gene put into its muscle and it's running on the treadmill. It's going forever and ever like a sort of Duracell® mouse. I think it's clear that the World Anti-Doping Agency have conferences trying to test for this. I think it's going to be difficult, I think it will be hard to do it because we can't even do it in medicine yet.

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