Last week Jakob Mørkeberg was quoted by the Danish news outlet DR Sport as saying that he had concerns about blood values posted by Lance Armstrong on the Livestrong.com website (link to external website opens in new window). The Bispebjerg Hospital anti-doping researcher has worked on many scientific studies, including a 2008 paper co-written with Belhage and Damsgaard entitled Changes in Blood Profiles during Tour de France 2007, and stated that expected trends over a three week race were not seen in the Texan’s data.
"What we know from our research is that during periods of hard activity, like in the Tour de France, we normally see a drop in these blood values. We don't see this with Armstrong," he told DR Sport.
He elaborated on this when speaking to Cyclingnews. “His blood profile contradicts what we see and what we know from international studies during the last few decades,” he said in a phone interview. “His blood values are not acting as we would expect, so that is highly unusual.” (see sidebar)
Mørkeberg has just finished a Ph. D. dissertation entitled Detection of Autologous Blood Transfusions via Analyses of Peripheral Blood Samples, and is working on a method to trace this method of doping.
His aforementioned Tour de France study catalogued seven riders in the 2007 race, revealing lower hemoglobin and lower hematocrit (percentage of red blood cells in whole blood) on day 19 when compared to their pre-Tour reading. On average hemoglobin dropped 11.5% and hematocrit fell by 12.1%, keeping in line with physiological expectations.
Armstrong's Bio Passport Critic Speaks
AS: The other thing you find strange is the reticulocyte count, that it's too low, and that's indicating that he's not producing his own red blood cells?
JM: If you look at his values during the year up to the Tour, the reticulocyte values are pretty much what you would expect, around 1%. There are analytical variations and biological variations to that parameter as for any other parameter. Then at the beginning of the Tour, it's half, .5%, which is producing half the red blood cells that you would expect. The reason why you get a decrease in your reticulocyte values is when you have an increased amount of hemoglobin. Your body does not have to produce as much as usual.
Armstrong's values at the 2009 Tour de France:
7/2, 2 days before the start of the race
Hct 42.8 Hb 14.3
7/10 3 days before the 1st rest day
Hct 41.3 Hb 14
7/11, 2 days before the 1st rest day
Hct 40.7 Hb 13.7
7/14, the day after 1st rest day
Hct 43.1 Hb 14.4
7/20, the 2nd rest day
Hct 41.7 Hb 14
7/25, one day before the last day of the race
Hct 43 Hb 14.5
5/7, 2 days before the start of the race
Hct 43.5 Hb 14.8
Hct 40 Hb 13.6
5/31, the last day of the race
Hct 38.2 Hb 13
Cyclevaughters: yeah, it's very complex how the avoid all the controls now, but it's not any new drug or anything, just the resources and planning to pull of a well devised plan
Cyclevaughters: it's why they all got dropped on stage 9 - no refill yet - then on the rest day - boom 800ml of packed cells
Rasmus Damsgaard, who defended LA in the cyclingnews article linked above, was on Astana's payroll. Here's what he had to say when he wasn't being payed to lie.
Rasmussen did have a blood transfusion during the Tour or followed an EPO cure just before the Tour. Damsgaard says the increase of 3.6% in his hematocrit value and 1,1 gram per deciliter for his hemoglobin value is 'suspect', 'physiologically impossible' and scientifically impossible to explain in another way than that Rasmussen used doping.
When the [hemoglobin] number rises during a hard race like the Tour de France it indicates that one has received a blood transfusion,” Rasmus Damsgaard explains.
“We conclude that a rise in hemoglobin by itself ought to constitute the basis for the possibility of a penalty.”
Michael Ashenden agrees.
In a pre-Tour blood screen from June 29, two days before the 2006 race began, Landis had a hematocrit level of 44.8 percent and hemoglobin level of 15.5. On July 11, 10 stages into the Tour, his hematocrit had increased to 48.2 and his hemoglobin to 16.1.
This caught the attention of Michael Ashenden, project coordinator for an Australian research consortium called Science and Industry Against Blood Doping, because the body's concentration of red blood cells naturally decreases during an exhausting competition such as the Tour de France.
“Going from 15.5 to 16.1 (in hemoglobin) is not that unusual when not competing,” Ashenden said by phone from Australia. “But it is very unusual to see an increase after a hard week of cycling. You'd expect it to be the reverse. You'd expect that to fall in a clean athlete. An increase like this in the midst of the Tour de France would be highly, highly unlikely.
USADA: "Lance Armstrongs's doping is further evidenced by the data from blood collections obtained by the UCI from Lance Armstrong in 2009 and 2010. This data is fully consistent with blood manipulation including EPO use and/or blood transfusions."