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Examples of performance-enhancing drugs include steroids such as cortisone, as well as natural substances such as the athlete's own blood. Using their own blood to enhance their performance, athletes perform what is known as "blood packing", that is, taking around 2 pints of blood from the body 2 weeks prior to the meet, or match that they are training for, and keeping it stored. The night before the big match, they re-inject the blood back into their bloodstream, thereby having 50% more red blood cells, and enabling them to perform better. This method of performance enhancement is almost impossible to detect, unless it is actually witnessed. After the athlete is done with his or her sport for the day, the two pints are taken out once again and disposed of.
At present there is no accepted method for detecting autologous transfusions (that is, using the athlete’s own RBCs) but research is in progress and the World Anti-Doping Agency (WADA) has promised that a test will eventually be introduced. The test method and its introduction date are to be kept secret in order to avoid tipping off doping athletes. The assay under development may be a measure of 2,3-bisphosphoglycerate (2,3-BPG) levels in an athlete's red blood cells. Because 2,3-BPG is degraded over time, the stored blood used in autologous transfusions will have less 2,3-BPG than fresh blood. A 2,3-BPG concentration lower than normal may therefore be an indication of autologous transfusion...There are many negative effects to blood doping. The simple act of increasing the number of RBCs in the blood stream makes blood thicker. This can also make it clot more readily. This has shown an increase in the chances of heart attack, stroke and pulmonary embolism. This has been seen in cases where there is too much blood reintroduced into the blood stream. .