A recently published study in the Journal of Occupational Medicine and Toxicology suggests that WADA has opened the door to social analysis and psychological profiling to catch steroids users and users of other banned substances. The WADA-funded researchers hope to establish a reliable indicator of self-reported use of performance-enhancing drugs.

The proposed anti-doping tool would ask the athlete various questions about their own self-reported doping, hypothetical doping scenarios, and the doping behavior of other athletes. If the athlete’s responses to the questionnaire fit the psychological profile of a doper, then this might represent evidence that athlete is doping even if the athlete does not admit to doping! The research is based on the False Consensus Effect from social psychology research.

[The False Consensus Effect is] the considerable overestimation of behaviour in which a person engages, and a slight underestimation of behaviour absent from a person’s repertoire. That is, over-estimating a particular behaviour indicates that the person who makes the estimate (and overestimates the behaviour) is likely to be engage in the same act.

[...]

The ‘False Consensus Effect’ (FCE), by which people perceive their own actions as relatively common behaviour, might be exploited to gauge whether a person engages in controversial behaviour, such as performance enhancing drug (PED) use. Hypothesis: It is assumed that people’s own behaviour, owing to the FCE, affects their estimation of the prevalence of that behaviour. It is further hypothesised that a person’s estimate of PED population use is a reliable indicator of the doping behaviour of that person, in lieu of self-reports.

An athlete that thinks most of his competitors are cheating must be cheating as well. This must be what WADA would call evidence of a non-analytical positive.

The researchers repeatedly emphasize that the measurement tool is not intended to catch dopers.

The measurement tool is to be used as a research tool to gather information on prevalence of PED use but it is not intended to be a diagnostic tool for individual assessment.

[...]

The importance of the method lies in its usefulness in epidemiological studies, not in individual assessments

But elsewhere in the article, researchers state that the measurement tool can explicitly be used to gain information about the individual assessed.

We propose to use estimates to gain information about the individual who makes the estimates and not the population for which the estimates are made.

[...]

The measurement tool is not envisaged to be used to gather data on projected use, but rather, employed as an implicit self-report method. A model will be developed to give an estimation of ‘own’ use based on the projected use.

Will WADA use the “false consensus” research as the “elegant integration of biochemistry, social psychology and statistics” in order to:

(1) Obtain reliable estimates of doping behaviour; or

(2) Obtain corroborating evidence that individual athletes are doping?

Source: Comfort in big numbers: does over-estimation of doping prevalence in others indicate self-involvement? (PDF)

Stuart P. Cram, strategic marketing vice president at Thermo Fisher, reports that their company has numerous service engineers available 24 hours a day during the Beijing Olympics to maintain uninterrupted and efficient operation of the Thermo Fisher testing equipment. Chinese Anti-Doping Agency purchased several products from their company including:

• (2) Thermo Fisher DFS Sector Field gas chromatography/mass spectrometry (GC/MS) systems;
• (1) Thermo Fisher Delta V isotope ratio mass spectrometer – used to distinguish between “natural and synthetic steroids”;
• (4) Thermo Fisher triple-quadrupole TSQ Quantum Access liquid chromatography/mass spectrometry (LC/MS) systems

Agilent Technologies supplies the China Anti-Doping Agency with the majority of their steroid testing and drug detection equipment. Stephen B. Crisp, international business development manager at Agilent, states that Agilent also has technicians available 24/7 to maintain the operational status of Agilent equipment that includes 18 liquid/mass stations and 19 gas/mass stations.

• Agilent 1200 Series LC/MS units
• Agilent 6400 Series triple-quadrupole LC/MS units
• Agilent 6100 Series single-quadrupole LC/MS units
• Agilent 6300 Series ion trap LC/MS
• Agilent 7890A GC/MS units
• (8) unspecified laboratory instrumentation

Crisp also reports that different screening methods are used for different sports depending on the performance enhancing drugs most prevalent in that particular sport.

The Beijing lab will use screening methods that vary depending on the drugs athletes tend to favor in a particular competition. “Different compounds are suspected in different sports,” Crisp explains.

Phenomenex is a manufacturer of solid-phase extraction columns used in both GC/MS and LC/MS equipment. The separation columns are used to prepare samples for analysis according to Terrell Matthews, product manager for Phenomenex.

Important to the efficient operation of GC/MS and LC/MS instruments at the Olympics are the solid-phase extraction columns that clean up and concentrate target compounds from urine for analysis, says Terrell Mathews, product manager for Phenomenex, a maker of separation columns. Sample purification steps can take 60% of a lab technician’s time and can be a significant source of lab errors, he says.

The new anti-doping lab in use at the 2008 Beijing Olympics will conduct approximately 4,500 drug tests during the Olympic games and will analyze samples for over 400 different drugs on the WADA list of banned substances in the following nine classes of performance enhancing drugs: anabolic steroids, hormones, beta-2 agonists, hormone antagonists and modulators, diuretics, stimulants, narcotics, cannabinoids, and glucocorticosteroids. Each different piece of testing equipment has a unique function in the drug testing process (“Olympics technology: Keeping ‘em Honest,” August 4).

Regardless of when or where a sample is gathered, its first stop after entering the testing lab is the Agilent 7890A gas chromatograph, which separates and detects the different components in the sample, isolating the banned substances from the normal biological molecules. The sample is vaporized with heat, and the gas enters the 7890A’s separation column. As the gas moves through the column, the different atomic weights of its component compounds cause them to travel at different speeds (the lighter ones exit the column first). By measuring the speed, amount and sequence at which the components exit the column, investigators can readily identify most substances on the banned list.

But some compounds, such as peptide hormones, are destroyed by the vaporization process, requiring use of a liquid chromatograph. Using the same principle as the gas chromatograph to separate molecules by atomic weight, the Agilent 1200 series liquid chromatograph substitutes a liquid solvent that moves through the column. The liquid solvent takes longer to separate the molecules but preserves the molecules that would otherwise be destroyed by the heat of vaporization.

“About three out of four samples are analyzed using gas chromatography, but use of liquid chromatography is increasing because many of the new compounds are destroyed by vaporization,” said Sheehan.

If either the gas- or liquid-chromatograph indicates a questionable substance is present, then the sample is submitted to the mass spectrometer, which can confirm the chemical identity of virtually any compound. The mass spectrometer measures the molecular weight of the questionable substance, producing a unique chemical fingerprint that is compared with the fingerprints of known banned substances, providing unambiguous confirmation of the gas- or liquid-chromatograph results.

The science of anti-doping is a complicated process and big business for laboratory equiipment manufacturers.

Bastianelli claims she never knowingly ingested a banned substance. She admitted to her obsession with weight control stating “I wanted to lose weight, like any girl.” She consulted with her doctor to find weight loss products that were not on the WADA banned substance list. Her doctor prescribed the drug Benfluorex. Benfluorex is an anti-diabetic drug that improves insulin sensitivity and glycemic control; as such it is often prescribed for weight loss. Benfluorex is not on the WADA banned substance list but it is structurally similar to Fenfluramine (which is listed) (“Bastianelli tests positive for diet product,” July 28).

“I’m disgusted with my trusted chemist for preparing a mix of herbs for me aimed at weight loss.

“Like always I wanted to read the list of products used and amongst them was benfluorex, which doesn’t figure among the list of banned substances.

“However, laboratory analysis demonstrated that this product contains the ingredient responsible for my positive test.

“But how could I know that?”

Today, she provided a sample of the Benfluorex product to prosecutors for analysis to support her contention that she unknowingly consumed a banned substance.

On Tuesday she said she had given the product to the prosecutor so that it could be analyzed. She expressed regret at not being able to take part in the Olympics and said she hoped to take part in the next world championships to defend her title.

Italian officials are unsympathetic. She will no longer represent Italy in the Beijing Olympics.

Italian Cycling Federation President Renato Di Rocco spoke critically of Bastianelli’s positve fenfluramine test stating that she ”committed an incredible act of naivity.”

“She was positive for flenfluramine, that is in dieting products. She’s obsessed about her weight. She only eats salad.”

Italian Olympic Committe (CONI) president Gianni Petrucci was even more “unyielding.”

“Marta Bastianelli has betrayed Coni, the (Italian Cycling) federation and the world of cycling.”

It is truly unfortunate that the complexities of WADA/IOC testing result in such mistakes by athletes.

Bastianelli and/or her physician would have to be very familiar with the pharmacology of Benfluorex and Fenfluramine to appreciate the structural similarities and the risk for an adverse analytical finding. This just emphasizes the requirement that athletes must perform thorough research into any substances that they utilize.

Benfluorex (RN: 23602-78-0)

• 2-((alpha-Methyl-m-(trifluoromethyl)phenethyl)amino)ethanol benzoate (ester)
• Ethanol, 2-(alpha-methyl-m-trifluoromethylphenethylamino)-,benzoate
• N-(2-Benzoyloxyethyl)norfenfluramine

Fenfluramine (RN: 458-24-2)

• Benzeneethanamine, N-ethyl-alpha-methyl-3-(trifluoromethyl)-(9CI)
• Phenethylamine, N-ethyl-alpha-methyl-m-(trifluoromethyl)-

The question of why and how clenbuterol appeared in Jessica Hardy’s sample remains a mystery. Was Hardy simply caught doping? Or were the “dietary supplements” used by Hardy contaminated or spiked with the banned substance clenbuterol? The supplement company Advocare was cited as one of the brands of dietary supplements used by Jessica Hardy.

Intentional doping

Why would Jessica Hardy take clenbuterol when drugs with similar performance-enhancing effects were legally available to her and all other swimmers with therapeutic use exemptions for asthma medications?

The performance enhancing effects of clenbuterol are not significantly different from those of other beta-2 agonists like albuterol, formoterol, salbutamol, salmeterol and terbutaline that are used by other Olympic swimmers. Swimming phenom Dara Torres uses the two legal beta-2 agonists (LABAs) Proventil (albuterol) and Symbicort (formoterol) and seems to be doing pretty well. Why would Hardy use an illegal drug when the legal PEDs are just as good?

Accidental doping

The quality control problems of dietary supplements are well known. Over the past several years, several reports have revealed that a significant percentage of supplements were contaminated with steroidal ingredients and/or stimulants. The U.S. Drug Enforcement Agency (DEA) recently identified 22 supplements sold over the counter that contain anabolic steroids. Last month, a British study found that 1 in 10 supplements contain ingredients banned by the World Anti-Doping Agency (WADA). A brief review of these reports did not find any evidence of dietary supplements showing cross-contamination with clenbuterol.

Most sports nutrition supplement companies have an official or unofficial disclaimer stating that their products are not intended for athletes competing in organizations subject to anti-doping procedures. The Dietary Supplement Health and Education (DSHEA) permits several products that are not permitted by WADA and other professional sports organizations. As a result, most supplement companies created products for the mass market of fitness enthusiasts, recreational athletes and bodybuilders rather than create WADA/IOC approved supplements for an infinitesimally small number of elite athletes.

Jessica Hardy publicly acknowledged using several supplements from Advocare. In fact, she endorsed the Advocare product line. Advocare listed the products used by Hardy on the “Our Endorsers” page for Jessica Hardy (which has been removed in the past week but is still cached by Google).

O₂ GOLD™
Rehydrate Electrolyte Replacement Drink
Arginine Extreme
AdvoCare® Muscle Fuel Pre-Workout Drink
Muscle Gain™ Protein Shake
Muscle Strength™
Nighttime Recovery
Post-Workout Recovery Sports Drink
Catalyst™
Amplify A.T.

Advocare is a multi-level marketing company who actively recruits professional athletes to endorse and use their products. As such, we would expect Advocare to spare no expense assuring drug-test athletes that their products contain no banned substances.

Unfortunately, Advocare ONLY obtained independent certification for ONE of the ten products used by Jessica Hardy (Advocare Muscle Fuel) by a leading supplement testing organization. The Banned Substances Control Group (BSCG) requires that each and every batch of Advocare Muscle Fuel is analyzed and certified to be free of more than 80 banned substances including clenbuterol. Failure to do so results in the immediate disqualification of the company from the BSCG program. Advocare advertises its current participation in the BSCG certification program on its website.

AdvoCare® has obtained independent certification of AdvoCare Muscle Fuel™ Pre-Workout Drink through the Banned Substances Control Group (BSCG™). With this certification you can be assured that this revolutionary performance supplement is free of substances including anabolic agents and stimulants banned by major athletic associations. In addition to the power of the AdvoCare Scientific & Medical Advisory Board and the Sports Advisory Council, the BSCG certification brings confidence that Muscle Fuel not only works but it’s safe.

The Banned Substances Control Group uses a World Anti Doping Agency accredited laboratory to analyze dietary supplements for substances banned by the International Olympic Committee (IOC), the World Anti-Doping Agency (WADA), National Collegiate Athletic Association (NCAA), National Football League (NFL), and other drug-tested sports leagues.

Is it possible that the Advocare supplements used by Jessica Hardy contained clenbuterol?

In the absence of independent, third-party certification of 9 of the 10 Advocare products used by Hardy, clenbuterol cross-contamination is possible although unlikely. Clenbuterol contamination of dietary supplements is not known to be a problem; also it seems extremely unlikely that a company recruiting so many elite athletes would intentionally spike their supplements with banned substances. So, there is a good chance that Advocare is being unfairly maligned with Jessica Hardy’s misfortunes.

Advocare has strongly denied implications that any of their products ever contained clenbuterol or have caused Jessica Hardy or any other athlete to test positive for a banned substance due to ingesting their supplements.

Contrary to any false and misleading reports, AdvoCare products contain no ingredients banned by the United States Anti-Doping Agency (USADA) or the World Anti-Doping Agency (WADA) which monitor Olympic and amateur sports, or by the NCAA, NFL, MLB, NBA, NHL, MLS, or NASCAR. AdvoCare is aware of recent information about AdvoCare and some of the company’s athletic endorsers in regard to our products and remains completely confident that all of our products contain only approved substances.

In the company’s 15-year history, AdvoCare products have never tested positive for banned substances of any kind with any of our athletic endorsers.

The good news is that there should be plenty of evidence (in the form of product lab anaylses) available in the foreseeable future that will fully exonerate either Jessica Hardy or Advocare.

WADA gave notice to cyclists competing at the 2008 Tour de France that they were now able to detect the performance enhancing drug Mircera (methoxy polyethylene glycol-epoetin beta), a third generation version of erythropoietin (EPO) belonging to the category of drugs known as Continuous Erythropoeitin Receptor Activators (CERA).

Doping experts concerned with the fairness of the doping protocols administered by WADA-accredited labs were quick to raise questions about the new CERA doping detection methods (“Larry: New CERA test, looking at Hamilton’s HBT,” July 20).

The TdF news concerning the detection of CERA has raised a lot of questions, including legal questions. How is it that AFLD can use a “secret” test, one that is not referenced in any of the WADA rules? How can we know that the lab’s test is valid? If there are no WADA rules for the test, how can the lab determine that the results of the test are sufficient to prove an AAF?

The folks at Trust But Verify (TBV) offer an excellent primer on unaccredited WADA anti-doping methods used to detect adverse analytical findings (AAFs). TBV, citing precedent from the Tyler Hamilton case, explains why it is legal for WADA-accredited labs to use “secret” and “unaccredited” testing methods in some cases.

[I]t is not necessary for WADA to approve a lab method before the method can be used to prove an AAF.

The panel also ruled that a WADA lab CAN use an unaccredited test method to prove an AAF, so long as the lab can prove two things. First, the lab must prove that the unaccredited test method was conducted “in accordance with the scientific community’s practices and procedures.” Second, the lab must prove that it “satisfied itself as to the validity of the [unaccredited] method before using it.” If the lab can satisfy this two-pronged burden of proof, then (according to the Hamilton decision) the lab gets the benefit of the presumption under WADA Code 3.2.1. If the lab cannot satisfy this burden, then the lab method in question cannot be used, and the AAF against the athlete must be dismissed.

The reasoning in the Hamilton case was based on the panel’s assumption that sometimes WADA labs must use unaccredited test methods. New forms of doping arise all the time, but the formal lab accreditation process is relatively slow (the method at issue in the Hamilton case was not formally validated until more than a year after the lab’s finding of the Hamilton AAF). If labs are going to detect new performance-enhancing drugs (PEDs), they may have to do so with new (and thus unaccredited) test methods. But since accreditation is an important step in making sure that test methods are “fit for purpose”, the panel reasoned that the validity of unaccredited test methods must be defended by the lab and ultimately ruled upon by the arbitration panel.

This means that AFLD may still be required to scientifically validate the new CERA test in the cases of Miguel Beltran, Moises Duenas Nevado, Riccardo Ricco and any other cyclists who accused of allegedly using Mirecera during the 2008 Tour de France.

Steroid and doping expert Dr. John Hoberman of the University of Texas wrote an article about the Festina scandal at the 1998 Tour de France for me almost ten years ago. Hoberman thought that the public had finally accepted that the Tour de France during a “definitive outing of the Tour as a virtual pharmacy on wheels.”

The Tour debacle has finally made it acceptable to say in public and without provocation what many have known for a long time, namely, that long-distance cycling has been the most consistently drug-soaked sport of the twentieth century. 

Unfortunately, we still have not come to terms with an acknowledgement of the scope of doping in cycling. We continue to entertain incredulous stories that doping in the sport is limited to certain generations of riders or specific geographical areas. We still believe in fairy tales that tell us a dope-free Tour de France is possible. It is not. So what should be done about doping in cycling?

We could continue to put our faith in anti-doping efforts. But the history of drug testing in competitive sports over the past 30 years or so has taught us that doping technology is always far ahead of doping detection. We can ignore history and pretend that things will be different this year or next year – or the year after that.

Hoberman puts forward an argument articulated by Hans Halter in the German newspaper Der Spiegel. The admittedly unpopular argument is to accept doping in such extreme sports such as cycling or, more accurately, to “quitely ignore” the pervasive and universal doping in the Tour de France (“A Pharmacy on Wheels – The Tour De France Doping Scandal,” November 15, 1998).

As one unblinkered observer put it at the height of the furor: “For as long as the Tour has existed, since 1903, its participants have been doping themselves. No dope, no hope. The Tour, in fact, is only possible because — not despite the fact — there is doping. For 60 years this was allowed. For the past 30 years it has been officially prohibited. Yet the fact remains: great cyclists have been doping themselves, then as now.”

[...]

There is, in fact, a case to be made for quietly ignoring the virtually universal doping that goes on in this “extreme sport,” an argument that accepts and even embraces the medically extreme and potentially fatal character of the ordeal itself. It is an argument that is (from its own perspective) properly contemptuous of medical humanitarianism and fastidious concerns about sportsmanship in the traditional (and here outmoded) sense of the term. This argument was boldly launched into the midst of the Tour madness by the German journalist, physician, and cycling fan Hans Halter, who presented it with the precisely correct doses of principled defiance and ironic pathos that this philosophy of “sport” requires. “No one can seriously expect,” Halter wrote, “that these extreme athletes, tortured by tropical heat and freezing cold, by rain and storm, should renounce all of the palliatives that are available to them.” Indeed, no one can, for those who accept the ordeal must concede to the martyrs at least a measure of relief. What the Tour scandal tells us is that modern society does not even know how to begin to draw the line.

Hoberman’s essay is still one of the most insightful articles into the doping culture in professional cycling that I have read. It hits uncomfortably close to the truth about the nature of “extreme sports.”

Power blogger Michael Arrington of TechCrunch has been called one of the most powerful and influential figures on the internet by TIME Magazine, Wired Magazine and Forbes. Arrington recently identified the secret pharmaceutical weapon that is the “drug of choice” for Silicon Valley’s entrepreneurs and executives – modafinil more commonly known by the trade name Provigil (“How Many Silicon Valley Startup Executives Are Hopped Up On Provigil?,” July 15).

But since the main effect of Provigil is to keep you awake and able to concentrate, a lot of people who get their hands on it use it to be able to work longer hours, even though it has not been deemed safe for that kind of use.

Recreational Provigil user testimonials are all over the web. Not only are people able to work with little or no sleep, the drug has the advantage of spurring weight loss and some users report a general mood enhancing side effect. The U.S. military has also reportedly tested it on helicopter and F117 pilots to see if they remain effective for up to 88 hours without sleep.

There are few side effects to Provigil compared to stimulants and it is supposedly not habit forming. That, of course, doesn’t mean it’s safe to take it just to be able to stay awake for 20 hours a day.

What’s so funny is that entrepreneurs apparently aren’t interested in typical drugs – instead they find the one that gives them a mental and stamina advantage. Perhaps some enterprising venture capitalist will start requiring founders of their companies to get a prescription in order to close on an investment.

Michael Arrington post on Provigil, while not an endorsement of the performance enhancing drug for entrepreneurial doping, is expected to have a considerable impact. After all, TIME, Wired and Forbes feel Arrington is influential for a very good reason (“TechCrunch Blogger Michael Arrington Can Generate Buzz … and Cash,” June 22, 2007).

To the world outside Silicon Valley’s tight-knit community of startups, venture capitalists, and angel investors, TechCrunch is just another mouthy blog. But to entrepreneurs in the white-hot consumer Internet boom — known to many as Web 2.0 — Arrington has become a power broker…

[...]

VCs and entrepreneurs read Arrington for the same reason they pay attention to any top journalist or columnist: He’s smart, sourced up, and ahead of the curve. “He has more information than any of us,” says David Hornik… Arrington breaks news… well ahead of the mainstream media.

Commenters on the TechCrunch post were quick to share their experiences with Provigil as well as their criticisms of the irresponsibility of Arrington’s post. Cephalon, the manufacturer of Provigil, quickly sent Arrington an email clarifying the medical indications of Provigil. In response, Michael Arrington felt obligated to modify the original post:

i made a few modifications to the post. i guess I thought most (all) people would just assume that it’s sort of idiotic to take prescription medication without talking to a doctor.

Michael Arrington needs to be careful when he steps outside the comfort zone of business and technology news and into the societal hysteria on doping – whether it is sports doping, academic doping, or corporate doping. Then the discussion becomes a little less rational.

I am always willing to give athletes the benefit of a doubt especially given the lack of fair and reliable doping protocols administered under WADA. But, the statements Vroemen offers in his defense are weak, misleading and wrong.

Simon Vroemen claims that Dianabol would be “counterproductive” for a middle distance runner because it primarily increases muscle mass without a significant increase in strength; furthermore, Vroeman claims Dianabol remains detectable in doping tests for up to nine months after ingested making it unsuitable for any athlete competing in a drug tested competition (“A small trace with large consequences?,” July 11).

The compound, named metandienone, increases muscle weight and volume (not so much strenth) and is therefore popular in the body building scene. As a steeple chase runner, one would probably only be disadvantaged by its consequences. It appears to be traceable up to 9 months in your urine and is hence unlikely to be used consciously by sportsmen as a performance-enhancing substance.

These statements are innacurate. Dianabol can lead to significant increases in strength; anabolic steroids are particularly beneficial for endurance athletes (as seen in the number of positive steroid tests for middle distance runners and cyclists) since heavy endurance training tends to significantly suppress endogenous testosterone production. Anabolic steroids do not automatically transform an athlete’s physique into that of a bodybuilder; body size while on steroids is more heavily dependent on variables such as caloric intake versus expenditure and training specificity.

Vroemen also claims that Dianabol is detectable for up to nine months after ingestion. This is false. The metabolites are practically undetectable after 1-2 weeks.

Disgraced former Tour de France winner Jan Ullrich is to pay out a million euro fine to end a fraud case which German prosecutors have been investigating, Focus news magazine reported on its Web site Saturday.

Prosecutors accused the 1997 Tour de France winner of taking performance-enhancing drugs, leading under German law to fraud charges against the 34-year-old on the basis he deceived the public, sponsors and his team.

The United States does not have laws that specifically criminalize doping in sports. However, the Anabolic Steroid Control Act of 1990, passed as a direct result of doping scandals in sports, criminalizes the non-medical uses of anabolic-androgenic steroids. One of the primary objectives for the act has been to combat “cheating” in sports although it has been largely ineffective for this purpose. Instead, the federal government has had some recent success using perjury laws to prosecute athletes who use steroids. Maybe sports fraud prosecutions will join perjury as an additional way of making examples out of “immoral” athletes.

Among his clients, Mr. Heredia identified 12 athletes who had won a combined 26 Olympic medals and 21 world championships. Four of the 12 athletes, including Ms. Jones, had been named and barred from competition for illicit drug use. Eight of the 12 — notably, the sprinter Maurice Greene — have never been previously linked to performance-enhancing drugs.

Angel Heredia is a Mexican national who lived in Laredo, Texas and utilized his family connections in Mexico to obtain steroids and other pharmaceuticals for athletes. Heredia explains how easy it is for athletes to use steroids and other performance-enhancing drugs and avoid detection.

He said he used family connections to pharmacies and labs in Mexico to help his business. For years, Mr. Heredia said, he helped his clients flout the rules and easily avoided detection. Substances like human growth hormone and the blood booster erythropoietin, or EPO, are still virtually impossible to detect, and “it is still easy to use testosterone” with fast-acting creams, he said.

“You combine all these things — boom! — you get amazing results,” Mr. Heredia said.

Angel Heredia is the government’s star witness in the perjury trial against track coach Trevor Graham; Heredia said he will reveal names of dozens of elite athletes should he testify publicly against Graham. Graham’s attorneys in turn have stated they will reveal names of elite athletes who were clients of Heredia in order to discredit Heredia.

Coach Graham is the coach who anonymously sent a syringe filled with tetrahydrogestrinone (THG) to Don Catlin starting a chain of events that lead to the BALCO steroid scandal and fallout resulting from it. Now Trevor Graham’s glass house is being demolished sending glass fragments at former guests.