Understanding the health threats to athletes from doping

The National Dope Testing Laboratory in collaboration with the World Anti-Doping Agency (WADA) launched the Athlete Biological Passport (ABP) on December 6, 2024, to monitor athletes' health and detect potential doping practices. The ABP involves regular collection of blood and urine samples, analyzing their haematological, endocrine, and steroidal profiles over time.

This tool acts as corroborative evidence in anti-doping violation cases and complements traditional testing by providing indirect evidence of doping, thus enhancing detection accuracy.

Doping, as defined by the National Anti-Doping Agency Rules 2021, encompasses the use of prohibited substances, presence of these substances or their metabolites in the body, evasion or refusal of testing, possession or trafficking of banned substances, administering them to others, and complicity in violations. The main objective of banning doping is to uphold sports integrity, promote fair play, and ensure a level playing field for all athletes. Ethically, doping is wrong, but the health consequences of doping are equally alarming.

Performance-enhancing drugs, despite their performance advantages, have several short-term and long-term health consequences. Ancient Greece athletes consumed herbal stimulants for performance enhancement, and the use of these substances dates back centuries. In the late 19th century, modern pharmacology introduced cocaine and strychnine.

Anabolic steroids, initially developed for medical purposes, emerged in the mid-20th century. The WADA Prohibited List categorizes substances into two types: banned at all times (both in and out of competition due to performance-enhancing or masking effects) and banned during competition (restricted during athletic events).

The health risks associated with anabolic agents, such as testosterone, include cardiovascular diseases, liver damage, hormonal imbalances, psychiatric disorders, and weakened tendons prone to injury. Peptide hormones like erythropoietin increase red blood cell production, enhancing endurance, but carry risks like thickened blood leading to blood clots, strokes, heart attacks, insulin resistance, acromegaly, and increased cancer risk.

Beta-2 agonists, which improve respiratory efficiency and muscle growth, can cause tremors, headaches, and heart rhythm disorders with prolonged use. Hormone and metabolic modulators like tamoxifen suppress blood clotting and increase endometrial cancer risk, while diuretics lead to dehydration, electrolyte imbalances, kidney damage, and cardiac arrest.

The substances banned during competitions, such as stimulants, narcotics, cannabinoids, and glucocorticoids, pose severe health risks. Stimulants increase alertness and energy but lead to addiction, high blood pressure, and mental health disorders. Narcotics reduce pain but cause respiratory depression, addiction, and organ damage. Cannabinoids impair cognitive function and respiratory health. Glucocorticoids suppress the immune system and cause osteoporosis, among other health issues.