BenGreenfield-Doping.mp3

Hey folks, it's Ben Greenfield. And on the call with me today is Chris Cooper, who is a professor of biochemistry at the University of Essex and the head of research in sports and exercise science. And he's written a book called Run, Swim, Throw, Cheat. The reason that I got Chris Cooper on a call with us today is because there was so much interest generated around my interview with age grouper triathlete Kevin Moats about drug cheating and the use of illegal performance enhancing drugs in, in this case, Ironman Triathlon, that I really wanted to get someone who was kind of an expert in the chemistry of how all of this works and really the politics of it on the call to explore some of this stuff in more detail and, and give you guys some good content and a better understanding of how all this works. Chris, thanks for coming on the call today.

Great, thanks, Ben. Thanks for inviting me.

For you specifically, what's your background? Why did you write this book Run, Swim, Throw, Cheat?

Well, I'm a biochemist, as you said, so I look at molecules and how they interact in the body. I mostly work on oxygen, oxygen and biology, partly looking at trying to solve clinical problems, but also trying to see how we could improve oxygen delivery to maybe improve sports performance. One of my other areas is I work on making artificial blood, so to replace blood transfusions. And that's an ongoing struggle or battle, but it's a very interesting area. Hopefully we'll succeed someday, but that is banned. The use of those artificial blood substitutes was banned in sport. So I sort of got involved, interested in the idea that what would make something banned? And I didn't think these compounds would necessarily really improve sports performance. So I was saying, why is something banned? What's the biochemistry? At the same time, I was starting to teach drugs in sport to my undergraduate students in the university. So I thought, oh, hey, why don't I just go as a biochemist, moderately naive to the field, it's about four or five years ago, and just see what is the science, what can work, what doesn't work, and importantly, what might happen in the future. Where is the field going?

Gotcha. Now, there's a lot of different performance enhancing drugs out there and obviously you brought up blood and artificial blood transfusions, but in terms of the stuff that you see most common, most commonly used among either professional athletes or now perhaps among amateurs, what are some of the ones that you think are the biggest when it comes to things that people should have on their radar or be aware of when it comes to performance enhancing drugs?

Well, Basically, the ones that work fall into three categories. By work I say could be performance enhancing rather than work as in necessarily any good for you. And the three areas are strength power events and then endurance long distance running events and then sort of the psychology what sort of makes you overcome the pain barrier, if you like, makes you not be fatigued. And in the strength power events, it won't surprise you to know that anabolic steroids increase muscle mass. That class is the sort of most commonly used because by and large it does work, at least in the average athlete, where we're not, and certainly in female athletes, there's a very strong effect of anabolic steroids.

So anabolic steroid that would be like what would be a name of an anabolic steroid?

Testosterone is the male sex hormone. That's the classical anabolic steroid. And then you're looking at things like nandrolone, all sorts of compounds that have been used medically because these drugs are nearly every sport performance enhancing drug started off as a medicine. So when people discovered male sex hormone testosterone, they suddenly thought, wow, here's a magic compound, it'll all make us long living and give us vitality. So that the drug companies in the really forties and fifties made all sorts of derivatives of testosterone which are out there and which we can, you can buy. And some of them are used clinically, though rather few of them have medical use. Mostly they're sort of black market drugs used for the sports people and bodybuilders and such like. So those are the kind of class of compounds. But in terms of testing, what's interesting is that in a lot of areas in drugs and sport, it's going back to sort of more almost back to the future where people started to take just testosterone. Because these more actually potent and maybe more useful derivatives are rather easy to test for now if you do it properly. So people try and use the normal body one to get away with it, so to speak.

Now, what about stuff like EPO that wouldn't be considered the same as a synthetic hormone like you just talked about?

Right, well, EPO is a synthetic hormone, yes. But all hormone is the molecule that's produced in one part of the body and has an effect somewhere else. So obviously they're very attractive then to inject as drugs because they will go to the part of the body where they will do the do the effect. They used to be traveling around the blood system and going to the right part. So EPO is a synthetic hormone, it's a normal body compound. When you go to altitude, to train, you produce more epo. And that's because when you go to altitude, you have a lack of oxygen in the air, less partial pressure, harder to breathe, and therefore your body says, okay, let's make more red blood cells. And it's the red blood cells that carry the oxygen around the body, so, so you increase the levels of epo. What athletes try and do to enhance their performance at long distance aerobic events, things like the Tour de France Marathon, 10,000 meter running triathlon, is to get even higher levels of red blood cells and carry even more oxygen by injecting the epo. And that's relatively common. I wouldn't say it's as common as anabolic steroids in the world because there's a big bodybuilding community who use anabolic steroids. But it's a, in certainly in elite sport, EPO has been a problem and the same issue with how you can detect it or not. And linked to epo, again, there's this back to the future thing where people, rather than using the new synthetic drug, are just using blood. And that's in principle that you could detect epo, but just giving yourself a blood transfusion gives you a massive boost immediately in terms of how much oxygen you can, you can deliver. So that's the really the story for all the blood boosting. The aerobic sports, they work. In fact, they're arguably more effective than in those sort of events than anabolic steroids are in the power events.

Now, you know, if you step back and look at it, I mean, you know, there's this new book by Tyler Hamilton called the Secret Race and the stories of these Tour de France cyclists going through great measures for, you know, things like blood transfusions and the use of illegal performance enhancing drugs. When it comes down to age groupers and amateurs, do you think that a lot of age groupers or amateurs are actually using this stuff or going through the same measures in terms of the use of any of these drugs?

I should just correct you, they're not illegal, so they're banned for sports performance. But these aren't illegal. Some of them are and depends on the country. So anabolic steroids are illegal to, at least in the uk, I think in the US as well, to ship. So they're a class in our uk, class C drug. So you can't supply them, but it's not illegal to possess them or use them. So there's a confusion what's illegal and what's banned. But they are banned if you use them in elite Sport, you're banned. So how common they are in amateur sport, I'm not an expert in knowing how common they are. It's very clear that things like anabolic steroids and human growth hormone are completely endemic in large parts of the bodybuilding community, for sure. And human growth hormone has been increasingly used because of these. A lot of these proteins were quite difficult to get in the past and now are really fairly straightforward to get on the black market.

And that's something pretty different than taking testosterone, right? Taking human growth hormone?

Not really. I mean, so human growth hormone is not clinically. Well, clinically you give human growth hormone to people who have a growth deficiency, usually a genetic growth deficiency, and that's why we've developed human growth hormone in the sort of artificial synthetic form. But increasingly, doctors, I think it's actually more common in the US than in my part of the world, are prescribing human growth hormone because your natural levels go down. So it's presumed to be a natural thing that you do as you get older. So it's not quite any more weird than testosterone and probably no more harmful, given that they both can be harmful. I don't think it's an alien evil. Human growth hormone. Taking large doses of anabolic steroids or large doses of human growth hormone are probably both bad for you, but it's not worse. It just sounds a bit different, but it's not worse. So it's. But it's arguably not as effective.

I see. So testosterone and human growth hormone would probably be two of the ones that would be most common among amateurs or age groupers. You think?

Yeah. I'm not an expert on amateur, but I would say probably not testosterone. I imagine that the age group are just taking the banned steroids if they're not competing. The question is, are they competing in elite sport or not? Do they care about being tested? If they don't care about being tested, they're not. In a sport that's being tested, then testosterone is probably not the best way of increasing your muscle mass by taking steroids. So there will be other ones which you would take. And testosterone is not very easily active in a pill, so people like to take pills rather than inject if they can. So there's a variety. I mean, you just need to go wander around the various bodybuilder web pages to see that they take all sorts of mixtures of these compounds, trying to hope that they'll get a balance that will give them the benefit of the muscle mass without giving them the side effects which for males is enhanced breast growth, which is not so good, and severe acne, which I guess is less bad than enhanced breast growth, but still not nice. So, yeah, I think probably not testosterone, except the testosterone tends to be in people who are trying to avoid testing would be my guess.

Yeah, it's kind of interesting because this seems like it's a big discussion among endurance sports right now. But I used to be a bodybuilder and in bodybuilding, this stuff was just like, you just see it all over the place and it didn't even shock people or surprise them to actually be using synthetic hormones or hormone replacement therapy or any of these derivatives. But it seems like it flies under the radar and is talked about a lot less in the endurance sports community, probably because so much of the competition is banned.

But.

But can you accidentally get stuff into your bloodstream or unknowingly ingest some of these banned drugs from foods or common medications?

Now this is a controversial topic and I'm going to be slightly careful what I say because some people have claimed to have got artificial compounds into their system by artificial ingestion. And the most famous example recently was Alberto Contador, who won the Tour de France three years ago now and was found to have clenbuterol in his system, which is a kind of a synthetic molecule, was a little bit like testosterone in terms of increasing muscle mass. It has an anabolic effect. And he claimed he ate it from contaminated cows. And that was his defense. That was not agreed with. But then in the end the antidote agent said, well, you probably got it from contaminant supplement, so we'll only give you a smaller ban. So there is a big debate about how easy it is to get positive tests from these compounds. The easiest way to get a positive test is to take a nutritional supplement that is not licensed and you're not. So they are frequently those have problems and they're not well regulated in terms of the manufacturing. And you have to bear in mind a positive drugs test in sport is not just looking for a compound itself, it's looking for the things that it converts itself into in the body. So you say, right, you've taken synthetic steroid, that means you have this, what's called a metabolite of that and some nutritional supplements have those contaminations of those things that give you positive drugs tests, which. So you'll, you'll get the positive drugs test without even having the benefit. So I think that's certainly was a whole stream of nandrolone positive tests about 10 years ago. Which were probably at least in part due to contaminated supplements. So that's the.

You mean like multivitamins and electrolyte pills or stuff? That's a little bit more fringe than that.

Yeah, more fringe than that. I mean you have to be careful. So some products have banned substances because these are illegal. They have them and you've got to check the label. So Extensis, which is one of these compounds to enhance male sexual organs for male sexual organs. That compound has a DHEA, which is a precursor for testosterone in the body and that's banned. But unless you look carefully on the label, you wouldn't know that. And certainly, oh, my mind's gone blank on his name. But the US 400 meter Olympic champion or certainly one of their top people was banned for taking this compound. Sorry, my mind's gone blank on who that person is, but it's easy to find out. So that's the issue that you check the labels. But your normal multivitamin is fine. So anything that is, it's these things taking these big nutritional supplements that are taken by bodybuilders and by athletes that you have to really check the labels carefully. And certainly sports teams, they get them checked. So the companies are supposed to check these will not have these, these, these products in them. But if you just buy.

Is there something you can look for in the bottle? Like are there certain certifications that would be considered to be better than others when, when you're trying to figure out whether or not something might be kind of dangerous for you to be taking or, you know, if you know you're going to be tested, something you should stay away from?

Well, I think we're not looking at dangerous here. So if you get small amounts of a contaminant, that won't be dangerous?

Well, I guess what I mean by dangerous is like, you know, you work your butt off to cross the finish line of an Ironman triathlon and then you get DQ'd because something that you took was not certified properly.

Sorry, I interrupted you there. I think the governing bodies will have lists of these things. It's up to them to tell you what you should take, but you should not take something unless you've been approved that it, that it's okay. So certainly with the UK Olympic team, they will have set things that they are allowed to take or they'll make up their own sports drinks which they know are okay. So I think just looking off the shelf, the quality control is poor. But some companies certainly do say they've had them tested. So I Think, you know, and you have to just check that out as much as you can. I'm not an expert on each individual brand, so I can't. But it's, it certainly has been an issue and it's in part being solved and resolved. But I think it's some kind. I mean, there's an example of the South African rugby union team where they had a supplement that they had tested for in the past that it was okay, they gave it to all their players and that batch had a problem with it, had a stimulant and it shouldn't have had in it. So it's still, you know, my personal view is that a huge over reliance on supplements in the whole sports industry, most of which aren't really of any use and just cost money, but this is a multimillion dollar industry. I'm not going to stop it by just saying that over an interview, but I think most cases, certainly bodybuilders don't need to take nutritional supplements and that's probably controversial, but you really don't. You just need to. Taking milk protein will be fine.

Now, what if you wanted to check yourself? What if you wanted to test yourself and see, you know, whatever. There's lots of people out there who've got five to 10 different bottles of supplements in their fridge. And I mean, is there a way to see before you actually get pulled aside by some governing body of sport after a race or after an event, is there a way that you can self test? I mean, are there tests that you can order and look at yourself?

You can't self test of the order of testing that is done for anti doping agents. And they, they will tend not to do tests for people of samples. They might test supplements, I suppose, but they don't test samples for people for obvious reasons. People will say, I'm now clean, now I'll go and compete. So I think the official bodies don't do tests of individuals but of supplements. I think the manufacturers should be able to get the tests done broadly and say what's on the labels? That's their job. I don't think try to self test it. I think it's not cheap. I'm not sure how you would do it in that sense. So I think that you have to. Some manufacturers are very clear that they have it, they do not contain these materials and I think that needs to be. But it's been historically a problem.

Yeah. So from that standpoint, you just need to be careful digging around in the bargain bin of your local supplements outlet.

Of Your local thing and if in doubt, don't take it. But if you're at any level where you're really competing in elite sport, you will have people who be advising you. So I mean, I'm not sure if the level you're talking about is levels that are drug tested. So I think you have to. A lot of amateur sports, you know, or semi professional is not, is not, you know, it's not drug tested.

Well, the original inspiration to kind of get you on the call is that they're now drug testing for a lot, A lot of the type of people that listen to this show. They're doing like Ironman triathlon. You know.

I can see why that would be. Yeah, okay.

Yeah. I mean, you put a year of your life and your training into getting ready for a big race and lots of money to travel to the race and register for it and everything. And you know, I think a lot of people want to make sure that they're covering their bases because they are testing for age groupers now. And we recently had a guy on the show who got a ban for something I wanted to ask you about now, and that's hormone replacement therapy. So, you know, big time. Obviously, as you know, it's being used for clinically low hormone levels in lots of people, you know, especially like in the anti aging community or in, you know, guys or girls who are experiencing some of the deleterious effects of aging or loss of hormones. Now, when being used for clinically low hormone levels, can these type of hormones also enhance performance?

So that's a really interesting question. It's, I think probably not clear to be sure what you mean by enhanced performance and clinically low. So if, because it depends what you mean by if it's an age event. So if you say an age event is people over 60 or over 50, then they have lower levels of testosterone and human growth hormone, but not by that much. But so what's the normal? So if you give something that puts you to a level that's normal for a young person, is that cheating or not? And I don't know the answer to that question, actually. That's a question that the sports bodies need to decide really. And that would be whether you get a therapeutic, as you say, whether you get a therapeutic use exemption. But it's entirely feasible that you could take a testosterone replacement or anabolic steroids when you're in your 50s that would improve your performance by putting you up to the high level of the normal. It seems to me possible. I think it hasn't been those trials clinically and experimentally are quite hard to do. You're taking people saying from the slightly reduced below normal, going to the high range of normal. Does that improve performance? I would guess it has a chance to do it, but I would say the science hasn't been done in that specific way. It's mostly been done going from either very low to normal, where it clearly works, or normal to super normal, where it also potentially works. So I think it's difficult to know the exact effect or how the body, when you're 60 or 50, responds to those low testosterone levels. It might not have as big an effect there. So I think it's difficulty precise. But I think there is an issue. I mean, I think if you're saying some people don't want to take hormone replacement therapy because it's not a standard clinical practice, I'm not sure whether you're allowed to bill for it in the us. I think in the uk, you won't get it on the National Health Service. So if somebody wants to do that and others don't want to do it, then are they at an advantage and are you forcing people to take steroids who in order to compete fairly? So then you've got to ask that ethical question. Really?

Yeah. This stuff is pretty easy to get in America. I mean, you go to a doctor who's basically like an endocrinologist and if you complain of the right set of symptoms, they will pretty much prescribe you testosterone.

Sure. If you lie. Yeah. I mean, that's fine. I guess it's the sort of the libido thing. I guess we have Viagra for a long time, so why do you want testosterone? But I guess it's the view that you lose the desire as well. But yeah, so I think you're right. I imagine it's relatively easy to do in the same way that any musician could get beta blockers to go over stage fright beta blockers, which are banned in sport, widely used by musicians, and they just say, look, I would be stressed by not performing well. So it is easy to get these things. But then you've got to be aware of where you sit, as you say, whether they're banned or not banned. And I think it's a live question how much it'll be debated amongst age groupers. I don't know. I mean, it's a very interesting point that you're. You brought up, but I don't particularly, because it's a. You know, I was focusing, of course, on the sort of headline sports in my book, I don't really address it, but I think I'm going to add it to my blog now. You've inspired me to look into this in a bit more detail. Right?

Yeah, it's kind of a big issue now. And you know, you obviously in your book talk about this and the testing and you know, kind of this whole biological passport system, even though it's a little bit different, I think in the way that it manifests for like a, like an age grouper or an amateur athlete. Can you explain how the biological passport system actually works? And the other kind of follow up thing I'm interested in is how they account for if they are significant, like normal hormone fluctuations in people.

Right. So first thing you know about the biological passport is that there are different, supposed to be different parts to it. And what it, what it does is it tracks your normal body's physiology and metabolites and just says, okay, is there been a big change in your hormone levels or something else going on in the body? You must have been doping. So it's not testing for the doping itself. That's the rationale behind the biological passport. The only passport that's been approved for use is the blood passport. The blood component tests essentially for rather simple things. It tests for the young red blood cells and the total amount of red blood cells, essentially the amount of haemoglobin, the red protein in the body. And by testing for those, if you get dramatic changes in those, it's almost certainly the case that there's been a blood transfusion or you've been taking EPO because you don't get those fluctuations naturally. But what you do is you track it for individual, which is why you have a passport. So you track the normal body's fluctuations and then that is part of your passport and uses a quite complicated tool called Bayesian statistics to look at how you're going. And then it says that was anomalous reading then, so the normal fluctuations should be corrected for. But as I say, it's only so far used and shown to use and be allowed to be used for blood passports. It's not for the hormonal levels, the natural steroid levels, the natural growth hormone levels. They've not managed to get a validated test in place. You can't be tested positive by that method.

Now how does the test work when they're looking at the use of testosterone? Just because I know that there's a lot of talk about ratios.

Sure. So because the amount of testosterone that you excrete is variable Just looking for a straight amount of testosterone because it's a normal body hormone that's too variable to use as a way of testing. So what they've historically done, and this is the crude test they still do, is what's called testosterone, epitestosterone ratio. And in the body, normally that ratio is about one, but if you take synthetic testosterone, you have more testosterone than epitestosterone, which is an inactive form the body makes, and therefore it goes higher and above a certain level. Four to one depends on historically where it is. It's currently now mostly set at 4 to 1. It triggers a possible positive test. You also then certainly in the elite sport, do what's called a carbon isotope ratio test, and that tells you whether you've got synthetic testosterone in the body. So that's a more expensive test and it's not done routinely. So there are really these two different tests. The test, the general test that you appear to have more of testosterone than the normal testosterone in the body. And there are some ways of getting around that test, but the one is much harder to get around, essentially pretty impossible to get around if you're using synthetic testosterone, is the. What's called the carbon isotope ratio, because most synthetic testosterone comes from a plant source, not from an animal source. And it turns out that because the plants live in a different area than animals, it tends to have a different carbon 13amount to the animal one. So it's a quite complicated story, but you can tell the source, even though it looks like the same molecul, you can tell whether it's come from a plant or come from a human being. So that's the test, that's the expensive test. But the first test is like a screening before that.

So you could get this testosterone epitestosterone ratio. You could potentially even test within limits for that. But somebody could still have massive amounts of circulating synthetic testosterone if they were tested via, like, a carbon isotope test.

Yeah, Yes. I mean, that's exactly. That's what people try and do. How successful they are, I think, is not clear. But the anti doping agencies, as you would obvious from looking at the USADA case against Lance Armstrong, do not now just use testing. They use a lot of detective work as well. And so what you will get is sometimes you'll get targeted testing for somebody, and therefore you will have a strong suspicion that person is doping. And therefore you will go for, you know, the carbon isotope ratio test on that person. So I think there's. It's. It's when you get to elite Sport, It's a lot of a sort of cat and mouse game at the moment. So. But in the that you wouldn't expect to see that in the sort of routine testing done for age group sport that you said you'd be surprised if you did routinely carbon isotope ratio testing. You mostly do the T ratio.

Now what about people who are just genetically different? And I know there's not a lot of people out there like this, but like I heard this story about like this skier back in the 60s who had really, really super high hemoglobin levels from literally like a genetic mutation. And then of course you also have, you know, the rare track and field athlete that shows up who's basically like a male with female genitalia with like the androgen. I mean in terms of those type of genetic anomalies, are those pretty common and what kind of goes on with those under the current system of testing?

Right. So the first person you met is a classic example that everyone quotes, a guy called IRO Manti Ranta, who was a Finnish cross country skier who won lots of gold medals. And you're right, exactly that he had a natural mutation that meant he had large numbers of red blood cells. His EPO system went sort of haywire. We don't know how that. And you could track that to his family. It was inherited. He was the one who ended up winning the gold medals. That system would cause concern, but probably would not. If somebody was like that, they would trigger a concern because of the high number of red blood cells, but they would not fail the blood passport test because that high number would be constant. It would always be there. I bet they get the scientists want to have a go and look at them and explore what was going on, but they shouldn't fail a test that seems to be a relatively rare example that individual. And it's much the second case you say is much more sensitive issue about the border between males and females. And of course there is a big dynamic range to improve female performance. And this is why anabolic steroids are so much more effective in females, because we know that females are essentially the same kind of human beings as males, but we know they are not, you know, they won't win 100 meters men's race because they do not have the power. And therefore anything that could make a female more like a male, for example, give them a male sex hormone will improve their performance much more than would be with a male. So if they have that genetically, it could well have a performance enhancement effect. The example you gave I Don't think so relevant. What you're talking about was people with androgen insensitivity syndrome. I think, and you implied they were male with female genitalia, those people would consider themselves female because if they don't respond to testosterone, which is what androgen insensitivity syndrome mean is that they are xy. So they have an X. You know, the female XY is a male person, xx. On his sex chromosomes you have one X chromosome, sorry, two X chromosomes. You're generally female. An X chromosome and a Y chromosome, generally male. You could be XY and therefore you could be producing the testosterone, but your body doesn't respond to it during development and therefore, although you will end up being sterile, you mostly appear female and those people consider themselves female. Now what's interesting is whether there's a borderline when that gives you a performance enhancement. Now the last time that was tested for was in the Atlanta Olympics where they did pick up, I think six or seven athletes who had AIs. But because the testosterone, they were not responding to the testosterone they had, they were allowed to compete. The percentage of elite athletes with AIs seems to be a little bit higher than the population. So it's just possible that there is, you know, on the range of female performance there are more people who are, if you like these genetically, slightly more male. But they would be, if they're not responding to testosterone and it's clinical case, then they are allowed to compete. We still have cases of females who appear to have higher testosterone. And then there's an issue and that, I mean the famous case for that was Caster Semenya, The South African 800 meter runner who is cleared to compete now but was initially there was concern because she had high testosterone levels. So it's going to be a complicated area. I mean sex is not either or in the real world. And it's also not just a biological question about what you consider your sex. It's almost a sociological psychological question. But there is this gray area which needs to be treated with a lot of sensitivity.

Yeah. And honestly, I guess when it comes down to it, it's not a huge, huge problem. Right. I mean there's not a ton of people walking around with genetic anomalies.

No, but it's the big area in doping that people are trying to do. Genetic doping, which I think they probably, if they are trying, they're failing at the moment. But that is an area people look at and think, wow, I could do this to give, turn a man into that finished cross country skier with Lots of ep. He could be really good, change his genes, or I could turn a woman slightly more like a man, give her some hormones that would improve, you know, genetically change her makeup. So that is of interest to the dopers. But I think it's very difficult to make that work practically. But everybody who, you know, there will be elite athletes will be genetically different. You know, you say fault will be genetically different, but it probably won't be one gene. So it won't be obvious. It'll be some combination that is very difficult to tease out.

Interesting. Now I'm curious to hear your thoughts about this as a biochemist, but there's a lot of stuff out there that's not straight up synthetic hormone replacement. There's lots of herbs and compounds like that that people take as a nutrition supplement. I mean, you're just talking about epo. I, there was a recent study on the use of echinacea, for example, to enhance epo. And then there's all this other stuff like tribulus and nettles and maca and all these different herbal formulations that people are using to, for example, boost testosterone. Do you think any of this stuff comes close to the banned performance enhancing drugs like the use of blood transfusions or synthetic hormones?

I can sort of answer that in one question. If it did, it would be banned, right? Because if you could genuinely raise your testosterone levels hugely with these compounds, they would be banned. Right? And there's no interest in these compounds from the antidote agencies. Some of the examples you talked about, I mean, things like maca and I guess Tribalis is another one. There's really no evidence that they have any effect on changing testosterone levels in animal studies or in human studies. Just because I knew you were going to ask me this question, because you kindly warned me, I went to look again at the scientific literature and this is a huge difference if you compare doing a Google search versus doing say a Google Scholar search or a search on PubMed. So I would encourage people who want to know this to first of all do their Google search and say maca, that improves my testosterone and then go to Google Scholar and search for maca in Google Scholar and maca and testosterone and try and find a published peer reviewed scientific paper showing that maca increases your testosterone levels. And I couldn't find one. So they're probably not doing you too much harm though. You've got to be careful. Some of these, some of these herbal medicines have strong potent compounds in them. I mean, pharmaceutical companies, you know, this whole industry is Trying to get these compounds out and purify them. So you have to be careful when you take them. But the idea that you can magically get anywhere near what you would take from taking synthetic testosterone, I think there is no evidence at all in those kind of compounds. So I think my answer would be almost certainly not. I'm just trying to think of an example. I can't think of an example actually of one of those that does what they say on the label actually. So you need to look carefully at the label because different countries have different labeling regulations. You certainly couldn't say in this country and in the UK that MACA would increase your testosterone levels. And I'm not sure if you'd have to say that in the U.S. but I think there are different labeling restrictions but there's no evidence to do it.

Yeah, that's a good point that you make that this stuff probably would be banned if it had a really significant effect. At the same time, I was just curious because I know a lot of these agencies like usada, they're not like God, they really have some limited power when it comes to being able to know everything and see everything. And I was just curious if they're just focusing on the stuff that kind of flies at the top of the radar.

Well, they're not God, but It took me 10 minutes to see that these things, there was no scientific evidence. It's not difficult to find find that there's no evidence for these things. It's difficult to do the experiments, of course, so. And because they tend to be negative, you know, I can't get funding to say I'm going to study this compound that in animals has not been shown to have any effect on testosterone, but I want to study it in humans. And the funding body will say, well I'm not going to give you money for that, go and go away and save somebody's lives instead make you artificial blood. So I think it's difficult to do the proper studies. But those that have been, it's fairly easy to find out. And I don't think what if something was really secret going on, it would be looked at properly and probably someone would get the money to check it properly. It's not impossible. I mean, some just say good positive drugs come out of the herbal medicine industry. I have them historically and there are certainly companies searching for exotic plants. Many of our drugs have come from exotic plants. So it's not a negative, but it's the over exaggerated claims on the labels that are generally not justified.

So what do you think is the solution to the problem of drug cheating in sports? You know, I know that it sounds like maybe you're going to turn out a blog post or something about amateur and age grouper use of banned drugs, but as far as kind of like even on a more macro level, just doping in sports in general, do you think that there is a good solution?

Yes, I do blog on runswimthrowcheat.com if anyone wants to see if I get around to writing this blog, which hopefully I will do in a few days. But the question about is there a solution? I would say sort of flip that back to you to say, do you think people are going to carry on breaking the law? Will there still be criminals? So it's cheating. So people will try and cheat and try to stop people cheating. This is like, if they think it works, they will cheat. If they think it works and they won't get caught, they will cheat. Now not everyone will. And you know, some people don't believe in cheating and they don't think it's correct. So that's not particularly different in sport than in society at large. But what you can do in sport is a slightly more controlled environment. And I think where things can go badly out of control in a sport is when you get a sort of institutionalized cheating. And we've seen that arise in a number of times over the years. And then you've got a really distorted sport and there's a huge pressure from athletes to really dope themselves to have any chance of competing. A classic example of that was the East German program where there was a very systematic doping, mostly of anabolic steroids, highly effective, especially with female athletes, many of whom had long term health problems because of that. Arguably the second area was Tour de France where teams were. I have to be slightly careful what I say, but this is even before the Lance Armstrong issue. Teams were clearly had a doping culture where they didn't think they were going to get caught and they carried on doing it. And there have been a number of fluctuations in the cycling community and I think now there's been, I think now, you know, there is a much cleaner cycling because of what's happened in the past. It's not, has not yet cleared up its act completely, but it's, you know, along the way at the moment. It's pretty good at the moment. But that issue, when everyone is able to dope and knows they can dope and there's lots of money going to doping, they could do it more effectively. So if you look at the programs that some of the teams, people like Rich, the Festina team. I don't want to just pick on Lance Armstrong to the Festina team beforehand. Look at them. What, Lance Armstrong's team. They're very, very scientific and there's lots of work going into them. Therefore, they can be quite effective. So I think breaking that kind of up and trying to get it back to the individual cheat is helpful, but you'll never stop a single individual trying to cheat. I think, you know, if you think you can, you're deluding yourself in the same way as you're going to. I mean, you know, you. We have a. Arguably, we have a war on drugs in sport. Yeah. I mean, in the US Is a big thing. You have a war on drugs. So your war on drugs in the US which is all illegal and banned. I'm assuming you still have recreational drugs in the U.S. so, you know, it's. You can't solve these problems completely, but you can, certainly in a small environment of sport and contain the environment with things like the detective work, the testing, the biological passport, you can control it to a certain extent and limit it. And you always have to ask the question, what should we ban or not? And I think that's a question that is also an interesting question that should be revisited from time to time. Should we ban this stuff and should we not? And it's should this whole area be okay or not? And that is also an interesting question to explore in the same way as you do with, of course, recreational drugs in society. You'd have a current debate between your states and your federal government over cannabis. I think in the US that should prove interesting in the future.

Yeah, they actually just legalized recreational use of marijuana here in my home state, interestingly, in Washington.

But the local government police won't. It's a really interesting idea. I have no idea.

Yeah, it's still illegal federally, but on a state level it's legal for use. So it's an interesting scenario. Anyways, though, we're running short on time. But your book, Run, Swim, Throw, Cheat, the Science behind Drugs in Sport. I'm gonna link to that in the show. Note, you've got a very cool blog as well as a book, the Jam Packed with really useful information for people who want to know more about this. I mean, really what we've done today is ask a bunch of questions and kind of scratch the surfaces of the issue. But I'd recommend you check out Chris's book and also listen to the previous interview that we did. Entitled the Real Truth About Age Group Drug Testing, my interview with Kevin Moats. And then leave your comments and your feedback in the show notes over in the comments section@bengreenfieldfitness.com and I'd love to point you in the direction of some answers to your questions or hear what you have to think about the issue of banned performance enhancing drug use in pro sports or in amateur sports. Dr. Cooper, thanks for coming on the call today.

Thank you ever so much.