What are the recognized mechanisms for doping?

Recognized Mechanisms for Doping in Sports

The primary mechanisms for doping in sports include anabolic agents, stimulants, hormone modulators, diuretics, blood doping, gene doping, and various performance-enhancing substances that are systematically used to artificially enhance athletic performance, often with significant health risks to athletes. 1, 2

Major Categories of Doping Substances and Methods

Anabolic Agents

• Anabolic-androgenic steroids (including testosterone and derivatives)
  • Mechanism: Increase muscle mass and strength by promoting protein synthesis
  • Health risks: Cardiovascular effects (hypertension), psychiatric disturbances, reproductive system damage, liver dysfunction 2, 3
  • Commonly detected in weightlifting, athletics, rugby, hockey, and volleyball 4
  • Signs of abuse: Rapid muscle development, unexplained hypertension, mood changes, testicular atrophy, acne, male pattern baldness 2, 3

Stimulants

• Caffeine, amphetamines, and other central nervous system stimulants
  • Mechanism: Reduce perception of fatigue, enhance endurance and cognitive function
  • More commonly found in cycling, rowing, aquatics, tennis, gymnastics, and ice hockey 4
  • Side effects: Anxiety, nausea, insomnia, tremors, tachycardia, and arrhythmias 1

Peptide Hormones and Growth Factors

• Growth hormone, erythropoietin (EPO), and related substances
  • Mechanism: Increase muscle mass, reduce body fat, increase oxygen-carrying capacity
  • Particularly prevalent in cycling, athletics, and rugby 4
  • EPO specifically increases red blood cell production, enhancing oxygen delivery

Diuretics and Masking Agents

• Used to reduce weight rapidly or mask the presence of other prohibited substances
  • More commonly detected in weight category sports: boxing, wrestling, taekwondo, judo 4
  • Also found in sports with aesthetic components like gymnastics 4
  • Mechanism: Promote rapid fluid loss to "make weight" or dilute urine to hide other substances

Blood Doping

• Blood transfusions (autologous or homologous) or erythropoiesis-stimulating agents
  • Mechanism: Increase oxygen-carrying capacity by increasing red blood cell count
  • Includes newer methods using inorganic cobalt and nickel 1
  • Primarily used in endurance sports

Hormone Antagonists and Modulators

• Selective androgen receptor modulators (SARMs), aromatase inhibitors
  • Mechanism: Modify how hormones function in the body
  • Often found in muscle-building products 1

Gene Doping

• Emerging threat involving non-therapeutic use of genes or genetic elements
  • Mechanism: Modify gene expression to enhance performance
  • Identified as a new integrity threat in sports 1

Organizational Aspects of Doping

Systematic Doping

• Institutionalized doping programs have historically existed, such as:
  • The East German doping program in athletics and swimming in the 1970s-1980s 1
  • Systematic doping in weight category sports 1
  • Forced doping within power structures by coaches or team members 1

Medical Mismanagement

• Excessive use of analgesic medication by team physicians
• Misuse of prescribed medications (pain, stimulant, sleep, anti-anxiety)
• Insufficient medical coverage during training and competition 1

Detection and Prevention

Testing Protocols

• Biological passport programs track athlete physiological parameters over time
• Sophisticated testing protocols must evolve as new substances emerge 2
• Hyphenated separation techniques like LC-MS, GC-MS, and CE-MS are used for detection 5, 6

Therapeutic Use Exemptions (TUEs)

• Official authorization allowing athletes to use otherwise prohibited substances for legitimate medical conditions
• Must meet three key criteria regarding health necessity, performance enhancement, and therapeutic alternatives 1

Health Consequences

The health risks of doping substances include:

• Cardiovascular: Hypertension, arrhythmias, increased risk of stroke
• Psychiatric: Mood disorders, aggression, dependency
• Reproductive: Testicular atrophy, menstrual irregularities, virilization in women
• Growth: Premature closure of growth plates in adolescents
• Liver dysfunction and other organ damage 2, 3

Emerging Trends

• New supplements containing various prohibited substances continue to appear on the market 1
• Contamination of supplements with banned substances is common (15-25% in various studies) 1
• Inadvertent doping through contaminated supplements or traditional medicines 1
• The principle of "strict liability" means athletes are responsible even for unintentional doping 1

Doping remains a significant threat to both the integrity of sports and the health of athletes, with methods becoming increasingly sophisticated as detection techniques advance.