A very simple question

PTF wrote:

Coach...I never really understood what you meant when you said that EPO would not do anything for athletes who are properly trained at altitude. However, after studying Covid and the way it attacks the blood through the CD147 receptor, what you have asserted may be making sense.

There have been a couple of interesting findings:

1) EPO has shown to a candidate for supportive treatment of Covid.

https://molmed.biomedcentral.com/articles/10.1186/s10020-020-00186-y?fbclid=IwAR2Tr_XoYd0TBjGKOWllNvJT-kfmUDVMaYCiZQL0H7VYqrwbmnt14CPlR6s

2) People living at high altitudes for an extended period are less vulnerable to Covid:

https://www.ndtv.com/world-news/coronavirus-pandemic-people-living-on-higher-altitudes-lesser-vulnerable-to-covid-19-report-2238744

It looks probable that taking EPO and adapting to altitude are basically doing the same thing...namely...increasing EPO. If you said this many times and I didn't get it, my apologies. Therefore, if I am understanding correctly, taking EPO if you are properly altitude trained is redundant and will give no additional benefit.

Does this make sense?

Primo Numero Uno wrote:

This is nonsense. There is a very simple reason top athletes continue to take PED's like EPO and athletes taking these drugs to dominate the world's stage because it works.

We've heard every garbage argument for world-class athletes being clean. From Viren's goat milk, the Jamaican sprinters just being honest hard-working people, EPO not working on athletes at elevation. It is all a smokescreen of misinformation. Over and over again the top athletes continue to get popped. Over and over again they have the tone-deaf stupidity to continue to associate with dopers or agents/coaches known to push drugs on athletes.

For the longest time we were told there was no doping in Kenya but as soon as any out of competition testing started, which is minimal compared to many other countries athletes began getting popped left and right. If you talk to any elite who has traveled and trained in Kenya PED's are rampant in the training camps.

Letsrun has always verbally taken a hard anti-doping stance. But why they continue to promote a coach from a country with a tradition of cheating in sports who moved to a country to train elites, where no testing existed, is beyond me. I'm not questioning Renato's coaching credentials, he is extremely knowledgeable about running. So was Alberto. Coaches who know a lot about running and training understand that there are PED's that improve performance. A well-designed training regime is always going to be more effective with the support of PED's.

Dr EPO wrote:

PTF wrote:

Coach...I never really understood what you meant when you said that EPO would not do anything for athletes who are properly trained at altitude. However, after studying Covid and the way it attacks the blood through the CD147 receptor, what you have asserted may be making sense.

There have been a couple of interesting findings:

1) EPO has shown to a candidate for supportive treatment of Covid.

https://molmed.biomedcentral.com/articles/10.1186/s10020-020-00186-y?fbclid=IwAR2Tr_XoYd0TBjGKOWllNvJT-kfmUDVMaYCiZQL0H7VYqrwbmnt14CPlR6s

2) People living at high altitudes for an extended period are less vulnerable to Covid:

https://www.ndtv.com/world-news/coronavirus-pandemic-people-living-on-higher-altitudes-lesser-vulnerable-to-covid-19-report-2238744

It looks probable that taking EPO and adapting to altitude are basically doing the same thing...namely...increasing EPO. If you said this many times and I didn't get it, my apologies. Therefore, if I am understanding correctly, taking EPO if you are properly altitude trained is redundant and will give no additional benefit.

Does this make sense?

No, it doesn't make sense.They mainly talk about people living above 3000m/ 10000 ft.

Which top runners train at that altitude? Not in Kenya.

Furthermore in this context one must then determine the amount of EPO that is produced and the amounts that the EPO dopant supplies to the body.

Jan Stensson , Coach JS wrote:

Renato Canova wrote:

Sorry, but I don't agree in several things you say (while I agree with some of your observations).

First, you have to change your first assertion :

There is a very simple reason top athletes continue to take PED's like EPO and athletes taking these drugs to dominate the world's stage because it works.

The following can be more realistic :

There is a very simple reason SOME top athletes continue to take PED's like EPO and SOME athletes taking these drugs ARE AMONG the best in the world : because they THINK it works.

Of course I understand there are PED's that improve performances, but I'm strongly convinced EPO is not one of them, with athletes responding to altitude training in the best way..

You know Renato, we are many that admires your coaching skills and results during the years, but

this that you got for yourself about EPO and EPO`s effects is just too ridiculous.

Here you say " There is a very simple reason SOME top athletes continue to take PED`s like EPO and SOME athletes taking these drugs ARE AMONG the best in the world: because they THINK it works." . So you mean in all seriousness that EPO only has a kind of placebo effect on runners with great talent?

Renato Canova wrote:

Armstronglivs, what you say is ok, eccept the fact you continue to speak about "doping" in general way. I think that already I explained my ideas about "doping", and I never said it doesn't work : all what I say is about EPO.

The only thing we know about EPO is that, due to the ability to transport more oxygen, the recovery from fatigue becomes shorter. This is a fundamental factor in cyclism, during the big competitions with 20 stages in following days (Tour de France, Giro d'Italia, Vuelta de Espana), but is not a factor in athletics, where the ratio between number of training sessions and number of competitions is 1/100, or maximum 1/50 (100 training sessions for one competition, in the case of Marathon, sometimes, 300 training sessions for one race).

In this "panorama", athletes can decide when are ready for the next tough session, increasing the modulation between intensity and recovery looking at individual characteristics, and absolutely is not true that who is able to recover in shorter time can be also able to have the training sessions with more quality.

Therefore, the acclarated fact that EPO can help the recovery doesn't produce any variations of the final performance, if athletes are trained according their natural characteristics.

Also, it seems everybody forget that the percentage of athletes doped with blood manipulations (including EPO and BP) is less than 15% of the total, while the percentage of athletes doped with steroids is of 65% and the percentage of athletes banned for missed tests of whereabout mistakes is about 10%.

What I cant accept is that doped athletes, at very high level, in the general vision, can show that also who is not "officially" positive MUST be positive, because it's not possible that doped and not doped athletes can achieve equivalent results.

At first, there is a difference of individual talent. When we speak of Kenenisa, of Shaheen, of Haile, of Tirunesh Dibaba, of Beatrice Chepkoech, or, in other events, of Usain Bolt, or Edwin Moses, we speak of "freak of nature", who absolutely didn't need any external help for being, at their best, at the top of the world.

Secondly, there is a big difference depending on the training system. Several times we had athletes (especially Africans) wo are already of high international level, in spite of a very poor coaching and the lack of physiotherapic supports. These athletes, when finally approach a professional and well organised situation, including training camps (they finally can eat twice per day) and coaches of international level, can produce big jumps of quality (for example, 2:07 in Marathon can become 2:03, or 3'33" in 1500m can become something better than 3'30").

Compare long distances with sprint. The real money is in the sprint events : there are more opportunity to compete, are still in DL (long distances are cancelled), there are higher contracts from the Companies, there is more interest from the TV, and generally every top athlete has a very high medical support, something that doesn't happen with middle distances, where the best are Kenyan, Ethiopian and Ugandan. So said, how is that in top 100 of 100m almost 50% of the athletes had some problem with doping, while in marathon only 3 had problems (in spite of the fact that at the moment the athletes more tested are specialists of long distances, in order to have data enough for creating their Biological Passport) ? Really do you think African athletes are clever, and able to evade every control, and rich American sprinters are idiots who don't know what have to do for appearing clean ?

The problem is not that I don't know the limitation of doping : the problem is that people believing in doping as main reason of any performance don't knopw the limitation of training.

So, I give you reason, but also I reverse your argument. You ask "what is the logical argument for banning EPO if altitude training works better ?". The logical argument is that very few athletes, excluding who lives in altitude because born in altitude, decide to move their life from their place to altitude (maybe in different Country), so continue to train at sea level, and in this case EPO works, giving the same effect (maybe in shorter time) of Altitude. For that reason, EPO must be banned, and who uses EPO must be banned, but this doesn't mean that taking EPO in altitude, if there is proper training, can produce the summation of the two effects.

And, again I point out, NEVER there was some research with top athletes living and training in altitude, giving them EPO for controlling the final results.

Therefore, my conclusions depends on what I see and I know (facts), the conclusions that EPO gives advantage also for top athletes living and training in altitude depends on what researchers see, but don't know, refusing to investigate clean athletes for understanding the physiological effects of proper training.

Renato Canova wrote:

Now I answer your question, basing on my experiences.

1) The goal of proper training in altitude and of the EPO assumption is the same : to increase the ability to transport oxygen.

Athletes can be "responders" or not responders to altitude training. The main effect of altitude training is to raise the total volume of blood, but this happens in different quantity depending on the athlete. Responders can increase the total volume till 25% (it means 1.5 liters of blood more compared with the normal volume, inside the circulatory system), not responders can't, and the maximal increase doesn't reach 10%.

This process lasts 5-6 months, the increase of blood volume is very slow, and this is one of the reasons because long and continue stay in altitude produces very different effects from the short periods of altitude training (also repeated), that are used by athletes normally living and training at sea level.

In the first case, the stay produces ADAPTATION, in the second case (short and repeated periods) REACTION. Reaction consists, in 80% of cases, in a superior stimulus for producing more erythrocytes, and is the first step. Adaptation consists in increasing the volume of the Red Cells (MCV), in order to reduce the viscosity, increasing the plasmatic percentage.

This process is natural, and the development from reaction to adaptation folows a well balanced road : the changes of the physiological characteristics involved in the process are concomitant and happen together, in a balanced way that allow the body to work at the best possible level with a perfect interaction.

Taking EPO, you put your body OUT of a well balanced way of working. The increase in the ability of transporting oxygen happens in very short time, and many functions of the body can be affected by changes mono directional.

One of the big mistakes is to look at the increase of Hct and Hb as main reason for the increase of Aerobic Power. This is not true : there is an individual range for the optimal action of Hb and Hct, and when we go out of the range with the level of Hct too high, this affects other functions of the body, and the PRACTICAL result is that the athlete runs slower.

The assumption of EPO doesn't have any role in the increase of the total blood volume, so, for something giving advantage, we have also something else that cannot achieve.

Again, the answer to the question is in the individual characteristics of each athletes.

I coached hundreds athletes in altitude in my career : with somebody I had amazing results, with other very little improvement. Not considering cases depending on factors out of training, like accidents, lazyness, family problems, the question is : Why ? Same coach, same training camp, same methodological system, and so big differences in the improvement.

Athletes like Nicholas Kemboi were able, in two months with me in St. Moritz (living in the same apartment, eating the same food, having the same kind of life) were able to move from 28'19" and 13'32" to 26'30" and 13'01". In the same period, and with the same group, I had a pair of athletes having PB of 7'46" and 7'49" in 3000m, who improved to 7'44" and... 7'51", in spite of serious training, because in Switzerland nobody had the possibility to escape from training or to waste time with friends in some pub : they didn't have anything else to do.

So, the real question is : Which is the physiological, basic difference between "responders" and not responders to altitude, and to the same training phylosophy ? Why something effective for one athlete is not effective for another ?

The most important "natural talent" of top athletes, speaking about the Organical talent, is to have the possibility to develop these one and half liter of blood more in their system, so depends on the "elasticity" of the circulatory system. When we have some athlete with this natural attitude, EPO assumption is not a factor for bettering the performance, on the contrary can be a "limiting factor".

Instead, for athletes not having this characteristic, EPO assumption can give advantage, and the same can happen with athletes having the "natural talent" I described above, if they train at sea level, because, without the stimulus of hypoxia, never can increase their volume of blood in the same quantity.

Stop to think all human beings are the same. The physiological principle are the same, but the level of every apparatus is individual, exactly like the level of intelligence : some is a genius, and this means is "out of the average", in any human activity, and there is no reason because we can't think these "geniuses" can exist also among the best endurance athletes.

2- Following what I explained before, I'm sure the best athletes I coached were "responders" to altitude, and for that reason couldn't have had any gain from EPO. At the same time, I'm sure that the athletes not able to improve too much with training only, had some physiological limiting factor that could be overtaked with EPO (that, of course, I never gave them, so this is my speculation looking at my experience after years and different athletes).

Athletes able to improve very quickly in direction of Aerobic Power have a great organic talent, and in my opinion can't benefit from EPO. How is it possible, for example, to explain the quick improvement of Eric Kiptanui, who never ran distances longer than 1500m in 3'37" till August 2017 (he was the pacer of Ronald Kwemoi), and, when Ronald had a stress fracture and he had to find a new role for himself, in 6 months won Berlin running 58'42" against a terrible wind in the last 10 km ? This is possible only because the athlete has a level of natural talent in the aerobic direction that was not discovered before, but makes him a "freak of nature" in that direction.

Don't look at the fact that antidoping authorities put some substance in the list. If a substance gives some advantage to some kind of individuals, of course they have to put that substance in the blacklist, but this doesn't mean that the effect can be the same for every athlete, exactly like any medicine when we are sick : what works for somebody doesn't work for somebody else, and doctors often are controversial in their prognosis, because medicine is not an exact science.

3-I don't think more recovery can make athletes enable to train harder for longer. In my opinion, the final goal of training is to support the possibility to increase the VOLUME OF THE QUALITY, and the only way for reaching that goal is to increase the modulation during the specific period, that means about the last 3 months of training before the top competitions. Under methodological point of view, the problem is how to increase the intensity inside the extension, and this cannot be done, if we think that the recovery must be the same. So, for giving an example, if 5 months before the main race I look for 3 hard session per week, but any session reaches the 90% of the individual effort, when I start the Specific Period I have to reach the 105% of effort, if I want to move my limits, and of course I have to recover, after a session like this, for 4-5 days.

You don't become able to do more repetitions because of EPO, but because understand the difference between Internal Load (used during the Fundamental Period) and External Load (used during the Specific Period), as volume, intensity and recovery.

For example, if I want to prepare the ability to recover, looking at the various rounds athletes have to face in big Championships, I use sometimes "special blocks", consisting in a day with tough specific training in the morning and in the afternoon. For making this effective, we need to be fresh, so the two days before this training are very easy, and you need to recover very well AFTER, so the two days after any Special Block are again very easy. The total volume of the week, therefore, is not high, but there is a peak of intensity never used before. If the recovery is correct, using the supercompensation, the athlete start the next week at a level a little bit higher than before, and in this system EPO can't have any role.

Renato Canova wrote:

Now I answer your question, basing on my experiences.

1) The goal of proper training in altitude and of the EPO assumption is the same : to increase the ability to transport oxygen.

Athletes can be "responders" or not responders to altitude training. The main effect of altitude training is to raise the total volume of blood, but this happens in different quantity depending on the athlete. Responders can increase the total volume till 25% (it means 1.5 liters of blood more compared with the normal volume, inside the circulatory system), not responders can't, and the maximal increase doesn't reach 10%.

This process lasts 5-6 months, the increase of blood volume is very slow, and this is one of the reasons because long and continue stay in altitude produces very different effects from the short periods of altitude training (also repeated), that are used by athletes normally living and training at sea level.

In the first case, the stay produces ADAPTATION, in the second case (short and repeated periods) REACTION. Reaction consists, in 80% of cases, in a superior stimulus for producing more erythrocytes, and is the first step. Adaptation consists in increasing the volume of the Red Cells (MCV), in order to reduce the viscosity, increasing the plasmatic percentage.

This process is natural, and the development from reaction to adaptation folows a well balanced road : the changes of the physiological characteristics involved in the process are concomitant and happen together, in a balanced way that allow the body to work at the best possible level with a perfect interaction.

Taking EPO, you put your body OUT of a well balanced way of working. The increase in the ability of transporting oxygen happens in very short time, and many functions of the body can be affected by changes mono directional.

One of the big mistakes is to look at the increase of Hct and Hb as main reason for the increase of Aerobic Power. This is not true : there is an individual range for the optimal action of Hb and Hct, and when we go out of the range with the level of Hct too high, this affects other functions of the body, and the PRACTICAL result is that the athlete runs slower.

The assumption of EPO doesn't have any role in the increase of the total blood volume, so, for something giving advantage, we have also something else that cannot achieve.

Again, the answer to the question is in the individual characteristics of each athletes.

I coached hundreds athletes in altitude in my career : with somebody I had amazing results, with other very little improvement. Not considering cases depending on factors out of training, like accidents, lazyness, family problems, the question is : Why ? Same coach, same training camp, same methodological system, and so big differences in the improvement.

Athletes like Nicholas Kemboi were able, in two months with me in St. Moritz (living in the same apartment, eating the same food, having the same kind of life) were able to move from 28'19" and 13'32" to 26'30" and 13'01". In the same period, and with the same group, I had a pair of athletes having PB of 7'46" and 7'49" in 3000m, who improved to 7'44" and... 7'51", in spite of serious training, because in Switzerland nobody had the possibility to escape from training or to waste time with friends in some pub : they didn't have anything else to do.

So, the real question is : Which is the physiological, basic difference between "responders" and not responders to altitude, and to the same training phylosophy ? Why something effective for one athlete is not effective for another ?

The most important "natural talent" of top athletes, speaking about the Organical talent, is to have the possibility to develop these one and half liter of blood more in their system, so depends on the "elasticity" of the circulatory system. When we have some athlete with this natural attitude, EPO assumption is not a factor for bettering the performance, on the contrary can be a "limiting factor".

Instead, for athletes not having this characteristic, EPO assumption can give advantage, and the same can happen with athletes having the "natural talent" I described above, if they train at sea level, because, without the stimulus of hypoxia, never can increase their volume of blood in the same quantity.

Stop to think all human beings are the same. The physiological principle are the same, but the level of every apparatus is individual, exactly like the level of intelligence : some is a genius, and this means is "out of the average", in any human activity, and there is no reason because we can't think these "geniuses" can exist also among the best endurance athletes.

2- Following what I explained before, I'm sure the best athletes I coached were "responders" to altitude, and for that reason couldn't have had any gain from EPO. At the same time, I'm sure that the athletes not able to improve too much with training only, had some physiological limiting factor that could be overtaked with EPO (that, of course, I never gave them, so this is my speculation looking at my experience after years and different athletes).

Athletes able to improve very quickly in direction of Aerobic Power have a great organic talent, and in my opinion can't benefit from EPO. How is it possible, for example, to explain the quick improvement of Eric Kiptanui, who never ran distances longer than 1500m in 3'37" till August 2017 (he was the pacer of Ronald Kwemoi), and, when Ronald had a stress fracture and he had to find a new role for himself, in 6 months won Berlin running 58'42" against a terrible wind in the last 10 km ? This is possible only because the athlete has a level of natural talent in the aerobic direction that was not discovered before, but makes him a "freak of nature" in that direction.

Don't look at the fact that antidoping authorities put some substance in the list. If a substance gives some advantage to some kind of individuals, of course they have to put that substance in the blacklist, but this doesn't mean that the effect can be the same for every athlete, exactly like any medicine when we are sick : what works for somebody doesn't work for somebody else, and doctors often are controversial in their prognosis, because medicine is not an exact science.

3-I don't think more recovery can make athletes enable to train harder for longer. In my opinion, the final goal of training is to support the possibility to increase the VOLUME OF THE QUALITY, and the only way for reaching that goal is to increase the modulation during the specific period, that means about the last 3 months of training before the top competitions. Under methodological point of view, the problem is how to increase the intensity inside the extension, and this cannot be done, if we think that the recovery must be the same. So, for giving an example, if 5 months before the main race I look for 3 hard session per week, but any session reaches the 90% of the individual effort, when I start the Specific Period I have to reach the 105% of effort, if I want to move my limits, and of course I have to recover, after a session like this, for 4-5 days.

You don't become able to do more repetitions because of EPO, but because understand the difference between Internal Load (used during the Fundamental Period) and External Load (used during the Specific Period), as volume, intensity and recovery.

For example, if I want to prepare the ability to recover, looking at the various rounds athletes have to face in big Championships, I use sometimes "special blocks", consisting in a day with tough specific training in the morning and in the afternoon. For making this effective, we need to be fresh, so the two days before this training are very easy, and you need to recover very well AFTER, so the two days after any Special Block are again very easy. The total volume of the week, therefore, is not high, but there is a peak of intensity never used before. If the recovery is correct, using the supercompensation, the athlete start the next week at a level a little bit higher than before, and in this system EPO can't have any role.

Armstronglivs wrote:

Renato, I appreciate the comprehensiveness of your response and the effort you have taken to explain your thinking in a language that you are not native to.

However, I am not sure that you fully addressed my question relating to what source of information beyond your own experiences are you relying upon when you conclude that EPO/blood doping will not increase the endurance of the best altitude-trained athletes. As another commenter above has pointed out, there has been no direct scientific research of top elites on that point.

I fully understand you when you say that athletes will be different "responders" - and that will apply to training as much as to doping. On that, something I would like to clarify with you is do you consider each athlete will have an inherent aerobic "ceiling" that they will be unable to exceed, whether it is by training or doping? Are you further saying that altitude training may enable them to better achieve that ceiling than through doping? I appreciate that your experience has led you to conclude that the benefits of altitude training may be greater than many might think, but it seems to me there remains an area of inquiry that is unresolved, which is the actual measured effect of EPO/blood doping on the best altitude-trained athletes. I don't see that we can get a conclusive answer to that question without research on the effects of EPO that includes those athletes (which obviously they would not consent to participating in). So far, I understand the research suggests there will likely be benefits to some athletes and perhaps more so those at sea-level.

If I also understood correctly your additional comments about training, you emphasised the importance of a programme that focussed on the degree of effort involved, with rest and recovery periods, and you maintain that EPO would not assist that process. My point about that is not to differ with your description of the training process but to suggest that EPO might enable this to be performed at a higher rate, through increased endurance and recovery. Would it not be to the advantage to the athlete in training if their capacity at 90% effort, say, was able to be achieved at either a faster pace or for a longer period - because those two factors are crucial to higher race performance?

Lastly, in your comments you have emphasised the value of highly-focussed altitude training, as we have discussed above, but I don't see how that necessarily relates to the performances by Houlihan and Schweizer you identified at the beginning of the thread - unless their training followed that method. If they didn't, it is quite possible they used some other means to achieve an increase in aerobic endurance consistent with altitude training; they took a "short-cut", in other words.

rekrunner wrote:

Dr EPO wrote:

Mr Canova, could you please clarify why 1.5 L of more blood in the system makes the runner

stronger when it comes to aerob power? A logical thought would be that the new red blood cells

that are formed would be diluted in an increased total volume and therefore not as effective as if they were allowed to operate in an unchanged total volym? I guess this increased volume is some kind of natural balance seeking in the body? But then I think it's most truly that when EPO is added in this state, the density of red blood cells still increases. We will never now what happens for sure for obvious reasons, it will stay as more or less qualified speculations.

A higher volume of blood means more red blood cells available, without increased viscosity.

Adding more red blood cells in that state trades off any additional marginal benefit of more red blood cells, with the increased viscosity reducing the blood flow.