Oh, I remember it well: the Olympics, Squaw Valley, 1960. The final game of the hockey tournament featured the us against Czechoslovakia. Incredibly, the Americans had knocked off the favored Canadians, and the Russians, and now only the Czechs stood between them and a gold medal. But going into the third period, the group of unheralded college players trailed the skilled Czechs by a score of 4-3. That’s when Nikolai Sologubov, the Russians’ superb defenseman, waltzed into the American dressing room and suggested that the players fortify themselves by inhaling some extra oxygen from tanks. His motive? If the Americans won, the Russians would end up with the bronze medal; if they lost, the Russians would go home empty-handed. Amazingly, the Americans scored six times in the third period for their first “miracle on ice!” Was the extra oxygen responsible?
As I recall, the next day’s newspapers were filled with stories about the ingenuity of the oxygen boost. Nobody suggested that this was in any way unfair. Performance enhancement by means other than training was not yet a big issue, even though “doping” had tainted the Olympics since 1936. Just a year earlier, German scientists had isolated the male sex hormone testosterone and had shown that it increased muscle mass and aggression. There is little doubt that German athletes used it in the 1936 Berlin Olympics along with amphetamines, stimulants that had been found to ward off fatigue. By 1955, various analogues of testosterone, collectively referred to as “anabolic steroids,” had been synthesized and made their way into the bodies of athletes clamoring for glory. It is hard to know how extensive such doping was back in those days, because urine tests for steroids were not introduced until 1973. Only in 1975 did the world’s governing sport bodies officially ban the use of anabolic steroids. That certainly didn’t mean these drugs were not being used. Detection techniques were relatively primitive, and as long as athletes didn’t use steroids just prior to competition, they got away with it.
I remember marveling at the physique of East German swimmer Kornelia Ender at the Montreal Olympics of 1976. She took home an unprecedented four gold medals. She was built more like a man and even had an unusually deep voice. Steroids? Probably. Then, in 1988, the lid was blown off when sprinter Ben Johnson was caught cheating with stanozolol, an anabolic steroid, in the 100 meters, one of the Olympics’ prime events. Since then we have looked warily on the Olympic motto of “Citius, Altius, Fortius,” or “faster, higher, stronger,” and have asked the question “with what?” It seems we have come a very long way since those American boys inhaled some extra oxygen. Now we must ask whether athletes have used growth hormone to bulk up, insulin to boost the body’s supply of glycogen, a crucial muscle fuel, or if they have injected themselves with erythropoietin (EPO) to increase their production of oxygen-carrying red blood cells.
Why the need for EPO? Why not just inhale some extra oxygen? Simple. It doesn’t work! The romanticized story of the American victory at Squaw Valley notwithstanding, red blood cells are already saturated with oxygen, and inhaling extra gas will be of no help. This was clearly shown in a landmark paper in the Journal of the American Medical Association in 1989. Researchers studied professional soccer players who breathed either room air or pure oxygen in a double-blind fashion before a period of exercise. There was no difference in performance, and the subjects were unable to identify which gas they had inhaled.
To increase the oxygen carrying capacity of the blood, the number of red blood cells needs to be increased. There are several ways to do this. Training at high altitude, where the air contains less oxygen, stimulates the body to produce more red blood cells. Living in dorms where nitrogen-rich air is pumped in to simulate the low oxygen concentration of air at high altitude also works. Then there are the shortcuts. Like “blood doping.” Athletes withdraw a couple of pints of blood and reinfuse it months later, prior to a major competition, to increase their red blood cell count. Such blood doping is illegal and is detectible. Which is why athletes began to use EPO, a hormone synthesized by the kidneys that sends a signal to the bone marrow to produce red blood cells. EPO can be made via recombinant DNA technology and is widely used to treat anemia stemming from kidney disease, chemotherapy, or blood loss. It didn’t take long for athletes to figure out that they could also avail themselves of this technology to boost performance. Nor did it take long for problems to crop up. Too many red blood cells increase the density of the blood, which in turn can lead to heart attacks or strokes. When the deaths of over a dozen cyclists were associated with the use of EPO in the early 1990s, the Olympic Committee banned the drug. The problem, though, was that injected EPO was difficult to detect, and reliable tests have only recently become available.
But some athletes may already be a step ahead. Pharmaceutical companies are working on a way to treat kidney patients by introducing the gene that codes for the production of EPO. Animal experiments are already under way. And I’m quite sure that there are athletes out there quite willing to become human guinea pigs. By the way, about those six American goals against the Czechs in the third period back in 1960? None of the four players who did the scoring had inhaled any extra oxygen! Natural adrenalin was the chemical at work.