067-b EPO WORKS – part 2


In my career as a team doctor of several professional cycling teams, I had to do with EPO almost every day. There was no doubt amongst the riders who used EPO, about the improvement of the cycling performance by this blood stimulating agent. Blood transfusions have the same effect as EPO. The only difference is that the effect of a blood transfusion occurs directly.  EPO is slower and starts to work during the EPO injections. Blood transfusions became popular when EPO became detectable better and better.  Cyclists who are using EPO and blood transfusions could train a lot harder and very important was that the recovery after a hard workout or race was much better and faster. Especially in stage races you could make the difference with EPO. After the first week of a stage race the whole peloton felt more and more tired while EPO riders feel fit as a fiddle. That difference was huge. It makes a big difference whether you wistfully longing for the end of the stage race or if you are still fresh and full of fighting spirit for the next day race.


The development of the world hour record does not lie. Eddy Merckx, the best cyclist of all time, improved the world record in 1972 at the high-altitude track of Mexico City. He reached a distance of 49.431 km, which was 778 meters more than his predecessor Ole Ritter in 1968. After his successful attempt Merckx said he had never suffered  so much throughout his whole cycling career.

It took until 1984 before Moser was able to improve the record of Merckx. After Moser came Obree, Boardman, Indurain and Rominger. Boardman eventually reached in 1996, on the track of Manchester, the incredible distance of 56.375 km.


Between 1937 and 1984, in  a period of 47 years, the world record was improved 11 times between 1993 and 1996, during the EPO era this record was broken 6 times. It was obvious that blood transfusions and EPO cures played an important role in that period. After Boardman’s successful attempt  the record was not attacked  for a long time. The reason was the health checks of the UCI since 1997 whereby blood was taken from which the hematocrit was determined. Cyclists with a hematocrit above 50 were not allowed to start. Not because of a positive doping test but because of the so called health risk. A high hematocrit was associated with a large or a high risk of heart attack or cerebral thrombosis. But in fact these health controls were intended to limit the EPO use.  Because EPO could no longer be used unlimitedly no new world hour record attacks were attempted.



In the time I was cycling intensively I tried  an EPO treatment twice. I wanted to experience what EPO was doing with my body. The results were astounding. I always trained alone, on my regular workout round of 106 kilometers. Often I made a time trial to compare the time with prior attempts. My best time without EPO was 3h.15min to 3h.20min.
3h.20min means an average speed of 29 kilometers per hour. I really could not go faster  and mostly in the last 15 to 20 kilometers I could not keep my pace and lost a lot of time.  During and shortly after the EPO cures I rode under 3 hours. Usually around 2h.50min. My record was even 2h.39min.
2h.50min means an average speed of 37 km per hour.
2h.39min means an average speed of 40 kilometers per hour.
For me that was the irrefutable evidence of the performance-enhancing effects of EPO.
EPO works.



So I wrote a comprehensive book about all the aspects of EPO use. My motivation for writing this book came from the many nonsense stories that were told about EPO. This book contains a few clear studies about the performance-enhancing ability of EPO. I give you two examples:


This study looked at the effects after redonation of 400 cc red blood cells.

  • 10 km running time on the track
  • the sub maximal heart rate
  • hematocrit

In  six well-trained male distance runners one unit of 400 cc blood was taken twice,  which were frozen for the purpose of giving it back again at a later moment. Eleven weeks after the second blood collection three 10 km runs happened on a track of 400 meters.

Race 1: took place before blood redonation and was intended to determine the starting times.

Race 2: took place after infusion of 100 cc of NaCl solution and was considered as the placebo treatment.

Race 3: took place after the infusion of 400 ml of own blood and aimed to establish a better performance after the return of the blood.

After redonation of blood Ht increases clearly. The running time of the 10 km also improved considerably. The sub maximal HR decreased by an average of 10 beats per minute.


An increase in the number of red blood cells, after redonation of 400 ml autologous blood, improves the performance on a 10 km race by increasing the oxygen transport to the working muscles.




After redonation of blood Ht increases more than 5 percentage points, from 42 to 47. The average Ht after blood return is 47%. After administration of a placebo, there is no significant increase in the Ht.


The running times after administration of a placebo did not improve. After redonation blood the 10 km race is run, average one minute faster. This performance enhancing effect, after the blood return, remains at least 14 days.


The performance enhancing effect of the blood redonation is also still present after the placebo treatment, which took place 9 days after the blood return.

Race 1 starting times.
Race* times after returning blood..
2 and 3 without asterix* times after administration of a placebo.


A refund of 920 ml of blood, corresponding to two units of blood, or an equivalent thereof in packed cell, to an athlete with a normal blood volume and a normal Hb causes a marked increase in the number of RBC and an increase in the Hb so that the running time over 5 miles on a treadmill can be shortened considerably.

If the refund is only a single unit of blood (460 ml), no clear positive changes in respect of the performance are observed.

Conclusion: a blood refund improves performance only when only enough blood  is given back. A quantity of 920 ml of whole blood or the equivalent of packed cells, which is 450 ml, is the minimum required amount of RBCs that is necessary for performance improvement.


The table indicates the average running times of a group of runners after repeatedly having to run five miles. They were run before and after treatment with a placebo, physiological saline, and before and after the return of an equivalent of 920 ml of whole blood in the form of packed RBCs.

The times are presented for each round, subsequent mile, half distance and a total time.

The running time on the five-mile after blood refund is  about 50 seconds faster, with notice that the time savings is greatest in the second half of the race.