However, it is a bit surprising that the EPO microdosing was not suspected as masking method.”Of course we knew that autologous transfusions are undetectable, and we also knew that microdosing was probably being used. What I had never encountered before was the scenario that riders were using the two in tandem, during the major Tours. That was the missing piece of the puzzle.”

Masking blood doping was one of the logical possibilities considered in A Tale of Two Cyclists

“Masking:

Transfusion plus volume expansion: Very low Retic despite what looks like a low to normal Hgb without other cause for suppression.

EPO plus volume expansion: High retic normal HgB, and an effect that can overcome significant physical stress.

Transfussion plus EPO micro dose: High Hgb, low normal Retic, and an effect that can overcome significant physical stress.

Transfusion plus volume expansion with EPO micro dose: Low to normal Hgb, low normal retic, and an effect that can overcome significant physical stress.”

Remember also, that Altitude training may be a way to mask the Retic suppression that might come after discontinuation of EPO or a blood transfusion.

“Abrupt stop of EPO plus altitude: Very high Hgb, with low normal retic.”

Given the legality of Altitude training, this may be a preferred method when logistically possible. It would also explain the otherwise counterproductive use of altitude tents previously reported in the middle of grand tours. Hopefully officials pick up on this possibility as well.

Ashenden goes on to state,  ”[Microdosing] keeps the percentage of reticulocytes close to normal – not exactly normal, but close enough that we would have difficulty excluding the possibility that some other reasonable explanation could account for the subtle change we had seen.” This statement makes for an uncomfortably good description of a Retic pattern we previously analyzed at length.

In an interesting aside, Ferrari offers comments that imply a bit too much knowledge, ”
Not everyone accepts the researchers’ conclusions. Among them is Michele Ferrari, the controversial Italian sports medicine doctor whose clients have included Armstrong. “It’s a bit like playing Russian roulette,” Ferrari said in an e-mail exchange. “There is absolutely no microdose that can be taken without the risk of getting detected by out of competition controls within a 12-hour window.”” His statement does to some degree corroborate Floyd’s statement that Ferrari may have advised against EPO use once the test was developed.

One word, PRO.

For the 2010 Road season, USA Cyclin Collegiate will be trying out a new program for volunteers with an interest in journalism, publicity, communications, or PR. Here’s what we’re looking for:

-Excellent writing skills
-Ability to work on a deadline
-High level of organization
-Weekly race attendance

Every year you pay USA Cycling $30 for a collegiate cycling license ($60 if you purchase a Road or Mountain Bike license, as well), your club pays a $50 renewal fee, and you pay to promote a race through USA Cycling, as well. So where does this money go? What do we do with it? First and foremost, every USA Cycling staff member is issued a company Porsche and a Learjet on his or her first day.

So im jeremy. Im not a good writer, i like to ride bikes fast, and im working on starting a business when i graduate that will give me the flexibility to keep riding bikes for a long time. (we’ll leave this one anonymous)

Dear Dick

Dear Amy,

Thanks,
Very Virile

And my new favorite blog.
Jose has lots of toys.
A room for the toys.
A break-down of the toys needed to assemble a 13.5 toy.
A car to carry the toys.
And an analysis of toys on race day.

Yet Jose still does not have enough toys;
Here’s the problem. I have all the know-how to take on this project (it’s a perfect 6.115 Microcontroller Lab final project, in fact), but not the hardware (at least a nice oscilloscope and bench setup), or the ANT+Sport tech data, or the time really.

Just don’t pigeon whole Jose as just an engineer.
When I talk about clearing space in the bicycle room, I say that the goal is to reduce the “bottom bracket count”. When I describe the mileage on a bicycle, I’m really describing the distance that the bottom bracket has traveled (though I do include indoor “miles”).

After every ride, I go into the bathroom, stop the sink, start running warm-ish water, and squirt about 1-2 tablespoons of detergent into the water. Then, I drop in the spandex I used on the ride: jersey, tights, socks, gloves. I wash these by hand, rinse 2-3 times or until the water runs clean, squeeze (not wring!), and hang to dry. In 40% humidity, it takes about 8 hours for everything to dry. Ok maybe you can.

The blog is worth rummaging through with plenty of analysis of all things bike racing.

And I leave you with:
Dear Chris Worden,.
Enjoy.

10. Continental Race King.
Sure this tire was probably not the right choice for The El Passo Puzzler but 3 punctures and a sidewall cut all in 1 race… next tire please.
9. Sram X9 shifter.
Note to self, set up the shifter so that the barrel adjuster doesn’t smack into the top tube in the event of a crash.
8. My back.
Solo at Old Pueblo on a hardtail, self explanatory really.
7. KCNC bar ends.
Soda can thin bar ends = not compatible with even minor crashes, i.e. not compatible with me and racing.
6. Seals on Fox F29.
See explanation for number 8.
5. Powertap Hub.
Really? Again?
4. Trek Madone (old version)
After riding the thing for 6 months with a chip in the chainstay a nice big squishy spot has developed. Laterally stiff yet vertically compliant.
3. Jet 9
Mine never actually broke, but I had to send it back anyway. At least the redesign has gone into production.
2. My body
Kentucky Camp Epic, Puzzler, Hospital on IV antibiotics for pneumonia, followed by Old Pueblo. Again self explanatory. All fantastic races by the way.
1. Tucson Weather
This last one is actually a bright spot. I know Tucson is supposed to be a winter training destination, but rain and snow capped mountains in the desert are just too beautiful not to enjoy.

The purpose of this guide is to help athletes and coaches develop nutrition and hydration strategies based on quality evidence. Most of the information in this guide comes from the position statements from the American College of Sports Medicine on nutrition and fluid replacement. These statements were published in 2009 and 2007. After spending some time reviewing the literature, I found that these two position statements represent the most comprehensive reviews available on this topic. They provide a good foundation to build a strategy to guide food and drink choices for endurance athletes. Also, incorporated into this guide is the 2010 review article published in Sports Medicine (O’Reilly et. al) on the topic of the effects of glycemic index on performance and metabolism.

To help illustrate how this information translates into reality, an example 150 (70kg) “typical” cyclist is used for calculations. When the recommendations seem to stretch the limits of practicality I offer suggested modified strategies.

Some important things to keep in mind when using this guide:
All recommendations will need to be tailored to your own personal needs.
Nutrition and hydration deficits will cause decreases in performance but excesses will not improve it.
Stick to familiar nutrition or hydration on race day.
Use training rides to try out new foods and drinks.
When experimenting, don’t be fooled by a particularly good or bad day. Instead, use what works most consistently.

Daily Needs

Carbohydrates, Protein, and Fat:
The endurance athlete should take in 6-10 gm/kg of carbohydrates and 1.2 – 1.7 gm/kg of protein. For a typical 70 kg (150 lb) athlete that would be about 420 – 600 gm of carbs per day and 84 – 119 grams of protein. Fat should make up 25 – 30% of the total calories. (A quick way to convert your own weight in pounds to kilograms subtract 10% then divide by 2, for example 155 lb, 155-15 = 140, 140 / 2 = 70).

For perspective of what these numbers mean, Subway claims a foot-long oven roasted chicken sandwich with cheese veggies and a bag of baked chips would get you 143 grams of carbs, 50 grams of protein, and 39 grams of fat (or 20% of total calories). Notice that eating an equivalent meal 3 times a day would get you to the lower range of carbs, quite a bit over for protein, and a little short on your fat intake.

From a realistic standpoint, tracking every gram you take in probably won’t happen. A simpler method that works out reasonably well is a 50/25/25 approach. When you sit down to eat, fill half of your plate with vegetables and fruits, a quarter with a lean protein, and the other quarter with a complex carb such as pasta or a backed potato. The extra carbs you need will come from intake during and around workouts. Rounding out this diet with “healthy” fats by cooking with olive oil, snacking on nuts, or having a fatty fish as your protein choice etc. should get you fairly close to the recommended intake.

Once every couple of weeks or so you can spot check your diet on a typical day to make sure your balance of foods is appropriate. Comparing your actual intake to the general recommendations should give you a sense of any major deficiencies.

Vitamins or supplements shouldn’t be necessary unless you have diet restrictions or are actively trying to loose weight.

Recently, the cycling press has made the high fat diet a hot topic. The concept is that you can train your body to burn more fats during exercise resulting in better endurance by sparing carbohydrate (glycogen) stores. There are some studies that support this idea. However, such an approach risks causing more harm than good because of how important carbohydrates are as a fuel source.

Pre-Race Nutrition

Ideally, a large high carb meal should be eaten 3-4 hours prior to the event. Eating 200 – 300 grams prior to events has been shown to improve performance in some studies, and 3 to 4 hours is usually enough time for the stomach to empty. To get this amount of carbs for 9 am start an athlete would need to eat the equivalent of 4-6 good sized bagels at 5 in the morning. Such a large meal might be a bit tough to eat especially so early in the morning.

The practical approach is to simply eat a large amount of carbohydrates as early you can. Adjust the size of the meal based on how much time you have before the race to avoid an upset stomach. If you need to eat close to start of the race it may also be a good idea to avoid foods high in fiber, fat, and protein. Foods high in these nutrients will slow down the rate that your stomach can empty.

When choosing pre-race carbs many experts tout the benefit of complex carbs, or low glycemic index carbs. (For simplicity complex carbs are generally starchy foods while low glycemic index carbs are can be starchy foods or foods that contain protein or fat which lower the glycemic index of the carb that they contain). The complex/low glycemic carb strategy appears to effective if your only carbohydrate intake will be the pre-race meal. Taking in sufficient carbs during the ride eliminates the performance advantage of the complex/low glycemic carbs. O’Reilly et al make the point that the type of carb doesn’t really matter as long as you can optimize the amount of carbs before and during your event.

However, I do still recommend complex carbs and low glycemic index carbs whenever possible because they tend to be in more nutritious foods. Also, in the real-world setting carb intake is often not maximized. This reality leaves open the possibility to gain some performance benefit of complex and low glycemic index pre-race carbs.

Notes:
It is ok to eat right up until the start of the event as long as your stomach can tolerate it. Studies looking at the effect of eating within an hour of an event do not show any decrease in performance. This evidence goes against the popular teaching that eating within the hour or two before an event should be avoided.

Pre-Race Hydration

Drink 5 – 7 ml/kg of water (a little less than a 24 oz water bottle) 4 hours before the event. At two hours before the event if you are not urinating clear or very light yellow (dark yellow urine can be a sign of dehydration) drink another bottle. Drinking this amount should correct any minor dehydration. If you are significantly dehydrated, more water will not necessarily help as the body can not correct deficits much faster. It is important to drink far enough in advance of the event to give your body plenty of time urinate out excess water. Avoid drinking plain water in the hour before the event as you are likely to find yourself with a full bladder just as you roll off from the start line.

Drinking fluids with salt or protein can help your body hold on to more fluid than drinking water alone. Logic would imply that this may be an effective strategy for events where drinking is difficult or for particularly hot humid days. However, hyper-hydrating has not been shown to improve performance. Attempting to hyper-hydrate with glycerol is specifically not recommended.

Although there may be no performance advantage, a sports drink is likely a better option than plain water in the hour before the start to reduce the chance of needing to urinate at the start of the race. After the race is underway the rate of urine production slows significantly making the need to urinate less of an issue.

Race Nutrition

Carbohydrates
Take in 30-60 grams (1-1.5 bananas, 1-2 gels, or 1-2 bottles of sports drink) of carbohydrate every hour during events that are greater than 1 hour. This amount represents the upper end of what most athletes can absorb during exercise. Carbs that are not absorbed can lead to abdominal discomfort and diarrhea. Experiment during training to figure out how much carb intake you can tolerate during exercises.

It is important to realize that your body can not absorb enough carbs to keep up with the demand of moderate to intense exercise. Your intake of carbs simply extends the time you have before you run out.

Although no performance advantage has been shown, I again recommend complex/low glycemic index carbs whenever possible because of the extra nutrients available in whole-foods versus a gel.

For sports drinks, concentrations of greater than 8% for drinks will empty slower from your stomach. If you stick with the mixing instructions on most drinks you will be fine.

Many sports drinks make the claim that maltodextrin, an other polymers, are complex carbs. And as a complex carbs, they have an advantage in increasing your ability to take in large quantity of carbs with out slowing down stomach emptying or faster absorption. These claims are somewhat misleading as maltodextrin is an chain of glucose molecules connected end to end, i.e. a chain of simple sugars. This chain is broken easily by digestive enzymes and the process starts as soon as it hits your mouth. (Maltodextrin actually has a higher glycemic index than table sugar.)

The type of complex carbs that will not get broken down as quickly have multiple branches rather than a chain. These types of carbs will not taste sweet and are found in typically in starchy foods.

The type of carbohydrate/sugar doesn’t seem to matter from a performance standpoint as long as it is not just all fructose. Fructose by itself is not taken up as fast as glucose or glucose fructose combinations. I don’t know of any sports products that contain straight fructose. High-fructose corn syrup, which is found in soft drinks and some less expensive sports drinks, probably isn’t as bad as its current reputation as the cause of the obesity epidemic. It is actually fairly equivalent in fructose and glucose balance to sucrose (cane and beat sugar), and honey. Rice syrup contains some complex carbohydrates in addition to simple sugars.

The advantages to different carbs/sugars is mostly the sweetness/flavor and cost.

Protein
Protein intake does not immediately improve performance unless your intake of carbs is suboptimal. The original studies that showed improved performance of 4:1 carb to protein compared a suboptimal intake of carbs to carbs plus protein. Followup studies that made the total calorie intake the same between carb and carb plus protein did not show a performance advantage. However, there may still be a theoretical advantage to taking in protein during exercise as it may spare muscle breakdown and promote muscle growth after exercise. The theoretical discussion is beyond the scope of this guide.

Fats
Fats represent the largest fuel reserve in your body. It is not necessary to take in additional fat during exercise. At low intensity the majority of your energy can come from burning fat. However the rate at which you can burn fat is limited and dependent on carbohydrates. As intensity increases your body is forced to burn a higher percentage of carbs. When your body runs out of carbohydrates you not only loose your ability to sustain high intensity exercise but you also loose your ability to efficiently burn fats making even low-moderate levels difficult to sustain.

Strategies to improve fat utilization, i.e. spare carbohydrates, may provide a performance advantage. These strategies include improving aerobic fitness, intelligent pacing, and diet manipulation. Improving fitness and good pacing are logical and easy to endorse. Diet manipulation however, is difficult to recommend because of the significant potential to cause more harm than good.

Electrolytes
Electrolytes (salts) have not been shown to improve performance. Typical western diets contain plenty of electrolytes to replace anything lost during exercise.

The advantages of salt containing sports drinks are for taste, and to lessen the risk of hyponatremia. Taste is self explanatory. Hyponatremia, or low salt concentration, usually occurs in less experienced endurance athletes who drink too much plain water during an event. As exercise slows kidney function, the body looses its ability to get rid of excess water. In this state an athlete can potentially drink enough water to cause a low salt level caused by dilution. Theoretically, salt containing sports drinks decrease this risk.

Conventional wisdom is that the loss of salt and fluids causes cramping. However, replacing fluids and salts has not been shown to prevent cramping. It has been shown that improving fitness and acclimatization to hot environments reduce cramping AND excessive salty sweating. An alternate explanation may be that both cramping and excessive salty sweating are caused by over-reaching or suboptimal fitness/acclimatization.

Water
Studies show that dehydration (loosing 2% of your body-weight) leads to decrease aerobic performance. Aerobic performance continues to fall off as dehydration worsens. Anaerobic performance is less affected by dehydration.Water intake should roughly match your rate of water loss through sweat and evaporation. For endurance athletes this can range anywhere from 0.5 – 2 L per hour depending on temperature, intensity, and individual physiology.

For the hypothetical 155 lb (70kg) rider, a loss of about 1.4kg (about 3 lbs) or 1.4 liters would equal 2% dehydration. Saving a little margin of error it is probably a good idea for the average rider to note loose more than 1 liter (a little more than a 24 oz water-bottle).

On hot days a good strategy might be to assume a high sweat rate of 1.5 – 2 liters per hour and try to drink enough to avoid loosing more than 1 liter. Thinking about hydration in these terms, replacement fluids need to be progressive as the length of the ride increases. For example you might loose:

.75 – 1 L in 30 min
1.5 – 2 L in 1 hr
3 – 4 L in 2 hr
4.5 – 6 L in 3hr

Assuming you have about 1 liter to loose comfortably without affecting performance your minimum intake to prevent dehydration would need to be:

0 L (0 bottles) for 30 min
.5 – 1 L (1 bottle) for 1 hr
2 – 3 L (3 bottles) for 2 hr
3.5 – 5 L (6 bottles*) for 3 hr

*Notice that the 3 hr estimate of 6 bottles is a very large amount of water. Less experienced athletes should gain experience optimizing their hydration with exercise bouts in the 2 hour range to decrease the risk of hyponatremia and dehydration.

The calculations above are likely to overestimate water intake needs for longer events and for well conditioned, properly acclimatized athletes. Also, rate of sweating tends to fall off with time and as the body becomes dehydrated.

Ultimately, trial and error is needed to figure out what your body will need during any given circumstances. Spot checking yourself with pre and post-ride weights can tell you if you are drinking enough, see below.

Recovery

Carbohydrate
Carbohydrate intake should be your priority following hard rides. Within the first 30 min take in 1 – 1.5 grams/kg, about 100 grams for an average rider. Take in another 100 grams every 2 hours for the next 4 – 6 hours or until you have a main meal.

Their appears to be mixed data for the best type of carbohydrate to eat after exercise. Without a clear answer my default recommendation is again complex carbs and low glycemic index carbs.

Protein
Protein intake is also a good idea, especially if you are trying to gain muscle mass or have difficulty maintaining it. Studies do show that taking in protein after exercise may promote muscle repair and growth. For endurance athletes the ideal post-exercise intake is not entirely clear. But given that the daily intake is about 1:5 protein to carb you can probably use this a starting piont for recovery intake as well, i.e. about 20 grams of protein in the first 30 min followed by 20 grams every 2 hours until your main meal assuming you are taking in 100 grams of carbs.

Electrolytes
The typical western diet contains enough salt to replace losses during exercise.

Water
The water replacement recommendation is to drink 1 – 1.5 L for every kilogram (16-24 oz for every pound) of body weight lost during your event.

Going on the assumption that most people will not bring scale with them to events calculating your water needs is not entirely practical. Instead, start with the pre-race hydration of drinking a bottle of water immediately after the event. Drink another bottle of water every 2 hours until your urine is consistently clear or very light yellow. To check your fluid status compare your pre and post exercise weights. Every 2 pounds of weight loss equals about 1 liter or water deficit (or a little more than 1 bottle).

Recovery Drinks
If real food is not available, recovery drinks are reasonable way to make sure that you get some carbs and protein in immediately after an event. Just check the label to make sure that there is a reasonable ratio of protein and carbs. For endurance sports err on the side of more carbohydrates as their is strong evidence for the benefits of carbohydrates for recovery while the benefit of protein is still theoretical at this time.

The concept is the same as plugs for car tires. The kit includes several “ropes” that are coated in some orange stuff, and an insertion tool. All you do is load a rope on the tool, find the hole, push in the plug, pool out the tool, and that’s about it.

The idea may not be a new one. In fact, anyone who has ever found a thorn in their tire in the middle of a ride and resisted the temptation to pull it out, has already used a “plug.”

Instead, the genius is how well it works to compliment the puncture protection of latex sealants. By fixing the tire from the outside, plugs are much faster and less messy than throwing in a tube or trying to patch a tire. Your back up is no longer a thorn vulnerable tube. And because you are not breaking the seal at the bead, you don’t need to worry about tires that are difficult to re-seat.

Sure, major sidewall cuts are still going to be a tire booting suck the fun out of riding experience.

For the remaining 99% of the time, flats are now relegated to a very minor inconvenience. Not bad for less than 10 bucks.

The first is that the “experts” basically aknowledge that hemoglobin and hematocrit values are relatively easy to manipulate and explain away. So while an abnormally high level is evidence of doping normal levels aren’t great evidence of clean competition (something to keep in mind when data is used as marketing.) Instead, it looks like the Reticulocyte count is their current go to value. This is a same impression that I came away with after looking at the Armstrong data from all sides.

Point number two is that they really aren’t using the passport yet to actually sanction athletes. Yes, a couple of cases have been brought forward as sort of a pilot study of the legal system. But at the moment it appears that suspicious trends are being used as a guide for traditional doping. The likely reason is that the 3 standard deviation cutoff effectively castrates the BioPassport. Such wide cutoffs are likely to pick up only reckless or unsophisticated doping practices. An unrealistic number of data points may be necessary for the current Bayesian network to narrow the predicted range sufficiently for a 3 standard deviation cutoff to be of much legal use. Suspicious trends however, say values around 2 standard deviations or improbable trends, are much more likely to be seen and can be used to more effectively target riders for traditional testing.

The final notable item is the statement that the war on doping is being won and that (normal) Retic values are the proof.

While I agree that it is likely harder to manipulate the Retic, you need a bit of a qualifier.

An abnormaly low retic can be bumped up with small doses of EPO, and possibly propped up a bit with altitude exposure as well. Masking a high Retic on the other hand would require large RBC transfusion.  So a lack of unusually high Retic counts makes high doses of EPO unlikely. But the absence of low Retics does not necessarily rule out blood transfusions or withdrawal of large dose EPO supplementation.  

With the the above in mind, it is encouraging that the BioPass data, according to Gripper’s statements, may show an end of the era of high dose EPO use.

An alternate cynical conclusion may be that Retic is already being manipulated by means that have not been reported yet.

Either way, the likely future of anti-doping will be to develop tactics and tests to pick up EPO micro-dosing, blood transfusions, and blood volume expansion.

And so I’ve been thinking about “Going Long.”

It’s a thought that’s been rattling around in my head for some time now.

Some of the relevance is personal. I’ve now completed 8 years of higher education, 2 years of research, 2.5 years of residency. With just half a year between me and decent paycheck I’ll be taking on another 2 or more years of fellowship training because practicing anything but academic Sports-medicine would be a mistake.

Some of it is just plain wonderment about human nature or the rather the nature of some rare humans.

One such human recently made aware that there is a Tequila tree that lives on one of our local mountains. As it turns out the Tequilla tree was recently refilled for an upcomming special event. No that event is not the imminent arrival of LA for the kickoff team Radioshack training camp. Nor was the event the podium sweep of a world famous charity ride by a suspected doped Mexican team. No the special event is an unsanctioned combination hike and bike race.

Are there organizations that actually sanction these things?

The hike is estimated to be a 6 hour affair to the bike staging area. The hiking leg is followed by a 6 ish hour MTB ride. For those “that are in to that kind of thing” there is a Tequilla tree along the way. Entry is word of mouth. The only fee is for a shuttle seeing as it’s a 12 hour point to point in the desert. And the only prize, is probably something like first dibs next time you happen to be by a Tequila tree.

But the true genius of the event according to the founder is that it starts at midnight. That way you should be hitting the bike just as the blue is starting to crack across the sky. And by that time you will need every bit of motivation to actually climb aboard the bike. Unless of course, you are in so much pain that the only motivating factor is pain itself.

Bicycling magazine once wrote a good bike review. It was for a Pegoretti Marcelo, a steel racebike. They speculated that the bike was to stiff for the touring crowd and steel connoseurs. And too heavy to actually race. But they concluded that the bike was perfect for someone. To that someone they said,”We don’t know who you are, but you are a beautiful person.”

My current roadbike is an old style madone, carbon fiber sharkfin seat tube and all. My current MTB is a Niner Sir 9. Like a Marcelo a Sir 9 is not a bike that I would ever buy. Unless, I was planning On racing my first 24hr solo mtb, and my race bile was a recalled Jet.

At this point I have now ridden the stink out of the Sir9. I can honestly sat that the Jet does everything better in a faster, more comfortable… technical sense. Yet the Sir somehow is the absolute right bike for my first Solo 24 hour race.

Maybe I’m just kidding myself so that I don’t feel suckered that my proper race bike won’t be showing up untill way after Old Pueblo.

And maybe the reason that every ride I’ve done on the Sir has been at least 5 hours is because I can all of a sudden stick to a training plan.

It would be nice if one solo 24 hour aboard a steel hardtail was enough to prove one’s nature. More than likely it will just confirm that I tend to be a bit stubborn when it comes to ill-conceived ideas.

Whatever the case, 24 hours should be long enough to reach a point where every last bit of thought will be needed just to push a pedal.

And isn’t that all that anyone could really be looking for?

Whatever the case, here’s to Going Long.

Why is a persistent low normal Retic important?

Reticulocytes are a marker of Red Blood Cell production. There are normal swings in Retic. However, a persistently high or low Retic is an indication that the body is trying to compensate for a persistent deficit or surplus of Red Blood Cells (Hgb mass/oxygen carrying capacity).

An unusually low or persistently low Retic indicates artificially manipulated surplus of RBCs. It can be a marker of exogenous EPO (during the washout period) or of blood transfusion.

The main natural factors that affect Retic are training status and altitude exposure.

Training typically causes an initial increase in Retic followed by a slight decrease over the course of the season.

Altitude exposure results in a potentially greater rise in Retic followed by a greater fall before returning to baseline over a shorter period of time. (Note that altitude studies show a range of effects on Retic from no response to effects lasting 1 or 2 weeks after return from altitude, an interesting discussion for another day.)

Even when Hgb and OFF score are within normal limits, it is still worthwhile to look at Retic. Because it is not affected by volume status, Retic may sometimes be a marker of manipulation even when Hgb is well within the normal range. (scroll down until you see a box of data)

.

This chart shows the average Retic for three periods, Pre – Grand Tour, 4/30 through the Giro, and 6/16 through the Tour.

Is the low normal Retic the cumulative effect of a long season?

The modest drop from Pre-GT to the Giro is consistent with a training effect.  The larger drop during from the Giro to the Tour is less easily explained by a simple training effect.

.

Next the Giro and Tour trends are compared.

Is the drop the result of riding a Grand Tour?

This comparison is difficult to make because the Retic is at the opposite end of the spectrum at the start of each tour, Giro 1.3, Tour 0.5. Ultimately, this comparison does not explain the Tour values.

.

Finally, this last chart shows a possible predicted  effect of altitude exposure.

Can a response to altitude account for the Retic?

Since Lance Armstrong is known for responsiveness to altitude, an effort was made to find best fit data from a group of “responders.” The Toluca 2000 data (Ashenden et al.) was gathered from a group of track cyclists who where followed over the course of a 25 day altitude camp, and two weeks after returning from altitude. This data was chosen for this article chosen because the group shows good responsiveness to altitude. Retic initially rises modestly above baseline then falls to a low point 1 week after return from altitude.

The composite chart above was constructed by superimposing the Toluca data over Armstrong’s taking care to line up altitude exposure. The Toluca curve required a significant downward adjustemnt to all the points so that the low points match up (Toluca baseline was 1.3) The idea behind the composite chart here is to get a sense if the trends might be consistent with those previously seen in response to altitude exposure.

What becomes evident from the composite prediction is that a rise in Retic between the end of the Giro and 6/16 may have been missed. The low Retic at 6/16 may be consistent with the fall after an initial peak. Similarly, the low point at 1 week after altitude exposure may be consistent with the low point after altitude exposure. Overal, assuming that the Retic did in fact trend up before falling you end up with a somewhat akward but plausible fit.

The explanation becomes less convincing when the Retic stays flat after reaching its low. The Retic does show a recovery, but it comes a week later than expected and is followed by another drop. In the end, altitude could be used to account for the initial drop in Retic, but it is not a solid explanation for a persistent low normal Retic.

Taking into account training status, the effect of a Grand Tour, and altitude exposure the analysis fails to fully explain the persistently low normal retic from 6/16 through the Tour. While other factors may be at play they probably have less of an impact. There is also the possibility of a synergistic effect, but it would be difficult to find data that supports this argument while excluding the possibility of manipulation at the same time.

In this series an attempt was made to aproach both sides of the discussion with a healthy scepticism. The result of this aproach was not a black and white answer. Instead, what is left are some unusual values that have not been adequately explained by the natural factors considered. Manipulation is not a conclusion that should be drawn lightly or without substantial proof. However, it should not be completely taboo and out of bounds either to discuss. Given cycling’s history, doping is simply a possibility that needs to be considered whenever results are otherwise difficult to explain.