Dr. Mallika Marshall: Lance Armstrong case

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January 16, 2013, 8:40 am
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(NECN) - There is so much money involved in the world of professional sports that some athletes have begun making questionable decisions - even turning to performance-enhancing drugs.

NECN's Medical Expert Dr. Mallika Marshall stopped by "The Morning Show" to shed some light on the recent case involving disgraced cyclist Lance Armstrong.

* Details of Lance Armstrong's confession to Oprah Winfrey aren't public yet - but he is accused of using a combination of performance enhancing substances - one of the techniques is "blood doping".  What exactly is that?  

Blood doping is when athletes use a hormone which is naturally produced by the kidneys and is normally used to treat anemia in people with chronic kidney disease because it stimulates red blood cell production.  Athletes use EPO to raise their red blood cell counts which can increase the amount of oxygen delivered to muscles, improving recovery and endurance.  It's been banned in competitive sports since the 1990s but the first screening test was introduced at the 2000 Summer Olympics in Sydney.

* Blood doping can also involve getting blood transfusions?

Blood transfusions are also used to increase the body's red blood cell count. Usually an athlete will store some of his blood when his hemoglobin levels are high, have it infused right before an event. This type of transfusion cannot be detected by current tests.
Both methods can have dangerous side effects because you can end up thickening the blood, which can lead to complications with circulation, at put athletes at risk for cardiovascular problems.  

* Testosterone is also on the Armstrong accusation list.

Testosterone is a naturally occurring hormone that helps regulate a number of bodily functions including muscle strength, red blood cell production and sex drive. Athletes generally use testosterone to bulk up. Testosterone can increase the risk for cardiovascular disease by both stimulating red cell production and increasing cholesterol levels. It can also cause fertility problems, mood swings, tendon rupture, and liver dysfunction.

* Armstrong is also accused of using corticosteroids - how are they different from anabolic steroids some baseball players use?

Corticosteroids are man-made drugs that resemble the natural hormone cortisol. These are different from anabolic steroids, which athletes take to increase strength. Corticosteroids work to decrease inflammation that can cause swelling and pain. They can be administered locally -- to the specific area that hurts -- or systemically through a pill or intravenously.
But the risk of side effects is high with chronic use including weight gain, sudden mood swings, blurred vision, osteoporosis and high blood pressure.

*Are corticosteroids banned substances?

According to the accusations the USADA has against Armstrong riders needed medical authorization to use cortisone. They say team doctors provided them improperly to the cyclists to increase their energy. The USADA is basing their accusations on firsthand testimony from witnesses who were aware of Armstrong's use of cortisone this way.

* How many other cyclists face similar charges to what Armstrong is accused of?

According to the US-Anti-Doping Agency, 80 percent of the Tour de France medalists between 1996 and 2010 have been "similarly tainted by doping".  They're hoping a new era will change that.

*What kind of testing do the U.S.-A.D.A. have in place?

In following the World Anti-Doping Agency regulations for testing of athletes, USADA can test athletes during competitions and any time afterward, without notice. The samples are kept for eight years, and the agency can re-test samples as screening technology for detecting banned substances, or new performance-enhancing drugs, improves.

Tags: Lance Armstrong, Cycling, health, athletes, performance-enhancing drugs , Dr. Mallika Marshall, the morning show, doping case, blood doping
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