PEDs in Ultrarunning – Part Two

OK!… So part one fired a few people up yesterday and there were some excellent contributions on both our Facebook page, as well as on our website too. I refrained from saying anything yesterday as I didn’t want my personal opinions involved. I read Matt’s article thoroughly (twice) and I’ll be honest, I was certainly caught in two minds as to whether or not to publish it. However, I am a big proponent of free speech and I like to listen before drawing conclusions. Given the debate being had around this issue right now, I thought an alternative point of view was appropriate.

So today we have part two of Matt’s article. I think to set the context a little further, one of Matt’s comments in this piece is that he doesn’t agree with Savulescu (an article quoted in the first part quite a bit) on many points. Here he discusses finding that competitive edge, the definition of honesty in relation to PEDs and what a sport with PEDs might look like. Matt acknowledges that his hypothetical argument is a highly minority and unpopular one for sure, but feels that it’s a debate worth having.

Part Two – PEDs in Ultrarunning

Competition & Advantages: Finding “That Edge”

The greater question is how we want to understand ultrarunning. Some would argue that early American football—as birthed from the Ivey League colleges—had a central goal of forming upright, honest, citizen athlete-warriors who played and lived by a clear code of conduct. Others could counter and point out how Pop Warner’s underdog team from the Carlisle Indian Industrial School “bent” the rules by introducing the forward pass ( According to the RadioLab, American football has never looked back and now changes the rules continually, arguably more than any of the other major sports (

Similarly, Christopher McDougall’s recent book Natural Born Heroes speaks of the ancient Greek god Metis, who represents a mixture of prudence and shrewd cunning. Is endurance running compatible with the notion of metis that seeks every possible advantage to endure, including enhancing the body through diet or medicines? “Fat as fuel” is a popular topic currently, and it seems easy to distinguish between this legal enhancement and, say, blood doping during competition, but in reality the body’s own resources are being used for both. Blood doping can be considered external in that technical processes (IV needles, fluid bags, coolers) are employed, but if we head that direction, we need to be aware of the implicit assumptions behind our definitions.

The point here is not to bring up examples where cheating has changed the rules in sport, as though cheating is to be praised. The challenge is rather to turn our attention to consider the spirit of games, the spirit of competition that naturally leads us to want to be better and better. Will we, or should we, adjust the rules of the game around these advances?

By way of a few disclaimers: as with Torrence’s article, this essay does not address a very practical issue that make PEDs in ultrarunning doubly complicated. Namely, for better or worse, currently there is no governing body for ultrarunning (outside of the events that are coordinated with WADA) to articulate the rules of acceptable enhancement (see Logan Jones-Wilkins’ thoughtful proposal on governing bodies in ultrarunning: .

Further, I should say that I do not agree with Savulescu on many points. Savulescu’s logic in promoting PD I & II leads him to look forward rather gleefully to a (hypothetical) transhumanist future—replete with technological enhancement, bionic arms and legs, human and superhuman Olympics—that radically alters the definition of humanity that I believe in dearly. That aside, however, he offers a sound distinction between PD I & II and NPD that seems helpful to further the discussions on PEDs in ultrarunning.

The Rules of the Game Define Honesty

Disclaimers aside, as a way to draw these themes together, maybe we should step even further into the realm of controversy by considering in light of this proposal the now-classic case of cycling’s persona non grata, Lance Armstrong. Inevitably, it’s difficult to keep an even keel and remain reasonable while discussing such a controversial figure who has poured significant energy into fighting cancer while simultaneously investing in a lifetime of lies. If we can pause for a moment, however, to consider why Armstrong is such a villain (or somewhat vilified, depending on your perspective), I submit that Armstrong’s most significant, polarizing offense is not illegal doping per say but rather his nearly pathological lies for so many years. Others guilty of breaking the rules alongside Armstrong have been forgiven in the public eye. Some have served suspensions and re-joined the cycling ranks with less scandal and fanfare. Not so with Armstrong who remains a mysterious personality that many seem to find difficult to believe even after managing a few tears on Oprah. Are his apologies sincere? Is he honest at last?

To be absolutely plain: the argument I’m putting forth in no way seeks to justify Armstrong. Clearly, he broke the rules of the game. Lance won while racing “dirty.” That stated, it’s informative for us now to imagine hypothetically what it would mean if the rules back then had allowed PEDs such as PD I & II? Doubtless, Armstrong rode against fellow unclean riders in his years on top, and it is reasonable to think that his incredible training regiment earned him the victory other those fellow dirty riders. The point remains that he broke the rules and has rightly earned the consequences, but were the rules different (allowing PD I & II) his very same actions currently vilified would be admired. This may seem obvious, but such a simple point reminds us that the rules help define the critical principle of honesty.

How would this argument for PD I & II affect the mid-pack ultrarunner currently training for her or his upcoming race? What are the implications of this proposal for the elites that toe the same starting line as the rest of us? Simply put: this argument suggests allowing PD I & II for anyone who wishes to put in the effort and expense needed to experiment for gains with PD I & II. In all other areas, ultrarunning welcomes creative efforts to gain advantages for endurance and speed. Most runners take extra sodium. Most runners wear high-tech shoes, however minimal or maximal. Many runners swear by their favorite gels, drinks, carbs, fats and nutritional timing strategies. Some races allow poles while others deem that an unfair advantage. Many runners can’t wait to see their pacers somewhere on the second half of 100 mile races. Others think pacers offer no advantage. Some swear by the benefits of electro-stimulation for muscle recovery, while some low landers swear by their altitude tents. Regardless of the example, the point is that runners experiment and adopt whatever advantages they can to run faster and more easily. We could even say that such experimentation and time/money invested is actually a critical and enjoyable part of ultrarunning. I think we all know a few tech-happy runners who geek out with half a dozen GPS running watches, HR monitors, etc. The peripheral stuff of ultrarunning matters to many, and without that stuff, events such as the Adventure Gear Review expos wouldn’t exist, nor would we eagerly read articles from the elites offering “tips” for improvement.

The urge to find benefits and enhancements is normal; the question is how we chose to define acceptable, clean enhancements.

So, Practically, What Might PEDs in Ultrarunning Look Like?

Let’s entertain this even as a mere thought experiment: what if PD I & II were allowed in ultrarunning for anyone who wished to invest in such efforts? Personally, I would have little interest, as my training regiment and natural ability place me below the elite level. For me to seek out PD I & II enhancements would probably be akin to a cyclist who is 25lbs overweight yet shells out $15k to buy the perfect aero-bike to shave a few ounces off his riding weight. This is difficult to verify, but I suspect that cyclist and I both would need to invest in fitness substantially more to see real gains with PD I & II. This point may be challenged by some steroids and HGHs that encourage lean muscle mass independent of extreme training, and perhaps in weightlifting and body building there are enhancements that change that alter the spirit of the sport. Considering the endurance nature of ultrarunning, however, with the exception of some PD I recovery enhancements, I strongly doubt my fitness level is at such a level that PD II enhancements in particular would be an advantage.

For the elite runners, the advantages seem clearer. The line between 1st and 10th place in many races is a thin one, and naturally this leads to the motivation to cheat by the current rules. Detecting these cheaters as Torrence and others have noted, is a real challenge. Some say it’s impossible. Armstrong the Artful Dodger, evaded the system for years, despite around the clock attention and testing. Despite the difficulties in testing, it makes no sense to throw up our hands and give in to accept “dirty” ultrarunning. Why not work with the grain, and ask if our definition of “dirty” is worth all the hoopla? What is lost if we allow PD I & II? Why not reconsider the rules to allow for PEDs that do not take away from the spirit of our sport? Arguably, with rules that outlaw PD I & II, the system is set up to increase the temptation to cheat. No on wants that. We all want a clean sport with honesty and integrity so that we simply don’t need to worry about ethical dilemmas that can be reasonably avoided. Perhaps the best answer for this dilemma facing ultrarunning is to diffuse some of the elements in the problem itself.

All this to say, I am proposing this cautious argument in support of PD I & II in ultrarunning as a way to move past the vague definitions of “clean,” “dirty,” “cheating” in our sport. As things stand now, this argument is a long way from being implemented practically (if ever), but I do maintain that this argument is worth considering for the ultra runners interested in PEDs. For those not interested in reflecting on this, please ignore this ethics puzzle and go for that long run. At the very least, this (unpopular, minority) argument is offered as a way to further the conversation amidst fellow ultrarunners who love ultrarunning for what it does best: draw people out in to the wild places, testing the physical and mental limits of our bodies that simply love to move.

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I'm a mediocre runner who can bat above his average when I train hard. A man of extremes, I do enjoy everything life offers and consider it an absolute pleasure just to be able to put one foot in front of the other and let my mind wander somewhere different.

11 thoughts on “PEDs in Ultrarunning – Part Two

  1. So I front up and next years TNF 100, “Hey Tom, I have been on EPO the last 3 months and taking testosterone once a week. It’s all natural man, my body makes this stuff. My Haematocrit is now 60 and I have an alarm that wakes me up to prevent death in the middle of the night. My acne is crazy bad but never mind I’m ripped and recover faster now you see. I also just had a Bong to ward off the pain and help me enjoy the race more, stops me getting nauseous too. Can you play some Regge at the start for me? I am in start group 3 and planning on getting a Silver Buckle. Last year I gave my all and was a few hours short. You don’t mind do you Tom??”.

    STILL, great to stimulate debate, I acknowledge the Author has issues with the classification suggested. I have some doubts about the medical-physiology assumptions though. I don’t know if many of us want to be in the one sport that allows use of PEDs even if there is a Prof Singer style way of making it sound ethically sound.

    Good work Dan and Brave work Matt. Hats off to you.

    1. Thanks Adrian – this is a touchy one for sure. I have my own very personal and strong opinions on the matter for sure.

  2. I’ll be blatantly honest on my opinion here. This is just one of the most terrible blog posts on this subject I have ever read. The author’s overall ignorance on the subject matter is pretty astounding – and I’m not just saying that because I disagree with the thesis of the argument (which I do). For example the author states “Personally, I would have little interest, as my training regiment and natural ability place me below the elite level. For me to seek out PD I & II enhancements would probably be akin to a cyclist who is 25lbs overweight yet shells out $15k to buy the perfect aero-bike to shave a few ounces off his riding weight.” SERIOUSLY? Spending $15k for a perfect aero-bike DOES NOT PUT YOUR HEALTH AT SERIOUS RISK! Taking steroids, and blood doping does! Do you not understand that distinction and difference? And the term is “regimen” not “regiment”. Here’s another example: ‘For the elite runners, the advantages seem clearer. The line between 1st and 10th place in many races is a thin one, and naturally this leads to the motivation to cheat by the current rules.” Wrong again, clearly you don’t follow finishing times of elite Ultra Runners in big races. Go look up finishing times. The line is not thin, it’s rather large. I just can’t take these opinions seriously. Credibility is completely lost on me.

  3. I suspect I’m with the majority of the readers here, and speak from a complete amateur mid -packer’s point of view, though I love the sport. I don’t want to be involved in a sport where it is considered okay to take anabolic steroids, drug transfusions and EPO to enhance one’s performance. I don’t need a medical degree to tell me that this would be totally unnatural treatment of my body – and most of the reason I do this sport in the first place is to be healthy And I don’t see how an argument for making some of the clearly dangerous and unethical drugs legal enhances the debate at all. I don’t think the line is all that blurred and I don’t think the grey areas that grey – people know when they are breaking the rules, and everyone should understand what they are putting into their bodies. There is a difference between having a cup of coffee and ingesting large quantities of caffeine. And when I start using needles to inject substances into my blood supply I’ll know for sure I have gone too far. And I think that the fact it is hard to detect is certainly no justification for turning a blind eye let alone embracing it. Make the rules, enforce them as best as possible and revise if and when required as the debate evolves. I get that enforcement is really hard and that seems to be the biggest problem with the credibility of athletics today. Those who are supposed to inspire us are doing the opposite and Lance Armstrong represents the very worst of all of them and should go away. The numbers I am seeing from these recent surveys and the current scandalous reports in Athletics and marathon running make my stomach turn. I will never cheat. But I will drink a cup of coffee before I go running if I feel like it – and I’ll have a clear conscience when I do it. If I was trying win a podium place or win a prize then I would make sure to be extra mindful of the limits for caffeine in case there was some risk of going over. For now, as I look at my results I will note that up to 10% of those in front of me are cheating, and be totally clear in my own conscience.

    1. Absolutely. And where detection falls short, culture can help, or even go farther. Meaning creating and reinforcing a culture where cheating is detested and abhorred and clean running is celebrated can go a long way in preventing unethical behavior. What took over cycling was a culture of doping and cheating that was cultivated to the point it became the norm. I don’t think what the author suggest here would do anything but push it farther toward what we would want to avoid.

  4. Interesting backlash to an open, honest evaluation of the ethics of PED’s in sport. Dr. Moffit, would you mind explaining how blood doping or steroids (when used under proper medical supervision, as suggested by the author) would “put your health at serious risk”? The outrage about the safety of PED’s is probably a slight over-exaggerating to be honest.

    The other question about being “natural” presents an interesting conversation. Does the issue with being “unnatural” or enhancing performance? Does restoring low levels of T3 and testosterone in aging men and women to restore homeostasis count as “performance enhancing”? Is supplementing with a vitamin/mineral in an athlete who is deficient count as performance enhancing?

    Pete Clark “I don’t want to be involved in a sport where it is considered okay to take anabolic steroids, drug transfusions and EPO to enhance one’s performance.” I’m afraid you already are. At the elite, professional level, this type of behavior is common place. It is easy to manipulate drug screening tests, and cycle on and off “PED’s” to ensure you are “clean” when it counts.

    I think we’re too quick to jump at these being “unethical”. Why are they unethical? Safety? Performance enhancement? Unfair advantage? By having an open mind, and open discussion, we can explore the topic. It’s a polarizing, controversial topic, and many on either side are so worried about being right, they don’t want to the the middle ground.

    “There is a difference between having a cup of coffee and ingesting large quantities of caffeine.” Not necessarily. There is substantial literature to suggest that habitual caffeine users require a much larger dose to experience the same ergogenic effect as non-habitual users. Essentially, larger quantities of caffeine would equate to a cup of coffee from a purely physiological perspective. Moreover, it could argue that in habitual users, not having large amounts of caffeine, would hinder performance such that they would be putting themselves at a disadvantage.

    ” And when I start using needles to inject substances into my blood supply I’ll know for sure I have gone too far.” A valid concern. However, you got into the sport to be healthy. You don’t have sponsorships, money, your (very short) career riding on your performance. I think the perspective shifts when these are at stake.

    “Those who are supposed to inspire us are doing the opposite and Lance Armstrong represents the very worst of all of them and should go away” Why? Because he got caught? Or he lied? What about the 10 other athletes who openly admitted to doping the same time he was? Why is he vilified? Doping doesn’t allow you to sit on your backside and coast to victory. He had to work incredibly hard to get to the top (and stay there) of an extremely competitive and elite group, most of which where on similar doping regimen.

    Well it’s cheating! Well, how?

    Dr. Julia Moffit, opinions will certainly differ on such a controversial topic, but respect should remain. I think the idea behind this was to stimulate a healthy debate, rather than condemn the author.

    1. Thanks for the comments guys. While I don’t feel qualified to answer some of the more technical medical questions, what I will say is that I wanted these articles to open the minds somewhat of people. I love to have conventional thinking challenged, which is why I decided to publish the series. To encourage debate and further things if possible. All I ask is that people be considered and respectful in their responses too. Thanks all.

    2. I would absolutely love to comment on how blood doping and use of AAS in individuals with normal physiology could harm their health. First of allw ith regard to blood doping, individuals with normal Hb/Hct levels – blood doping can elevate these values causing an increase in the viscosity of the blood, therefore increasing risk for stroke and thromboembolic events. AAS abuse casues testicular atrophy (hypogonadism), increased cancer risk especially liver (remember Lyle Alzedo?) and breast for women, anemia, osteoporosis…..shall I go on? These health risks are extremely well-documented in large volumes in the scientific and medical literature. Go to Pub Med and search you will see literally hundreds of papers documenting these effects. Advocating for freely allowing PEDs in healthy individuals is negligently promoting putting one’s health at risk. There’s a difference in “free speech” and using one’s position to advocate someone put their health at risk! This author is getting close to that line so I’m not sure why this blog would want to promote this author’s ideas but they are not in any way grounded in the scientific literature whatsoever.

      1. Hi Julia,

        Thanks for commenting so passionately on this! This is what I wanted, debate and for the average person to understand a little more. I’ll also start by saying I am vehemently against the taking of banned drugs in anyway shape or form. I’ve been pretty vocal about that on this website in the past too. But when Matthew contacted me, it made me think and challenged my thinking too. I should also add that I’ve had some long conversations with Matthew in the background on these articles too and I also know his position on the matter, which is not what it might seem from the article. he is merely proposing an alternative point of view – whether that is right or wrong is for people to judge. I know you have made that decision, but many others won’t and are unclear on the matter, as our survey indicates – this is why Matthew got in touch with me.

        I am a big proponent of free speech and I spent a good day deliberating whether to publish these articles or not due to my own personal stance. But this website is not always about my own personal opinion and I deemed the articles worthy enough of putting out there. I knew there would be people that would violently disagree with them, but I do think it’s important to show the many thousands who read these articles and don’t comment the different sides of the debate/argument to make their own minds up, even if the majority I’m sure would disagree with some of the propositions Matthew has discussed. I hope that answers your query and I’d like to thank-you for adding in your valuable opinions also. Cheers, Dan

  5. I applaud the author for his attempt to change the direction of discussion around PEDs. While I agree with the comments that taking anabolic steroids or EPO pose real verified health risks, (although so does “sharing the road” if you ask me) not all banned substances pose these risks. I think it detracts from the author’s point that he focuses on the groups of PEDs that are the most obviously abused in sport, while ignoring the NPD group, which contains most of what I would call the gray areas relating to PED use in ultra running.

    Marijuana is a good example. Recent changes in rules have made it allowable in training, and WADA raised the levels allowable in blood during competition as well, to reflect it’s growing acceptance in many parts of the world as a benign or even beneficial drug. Ian’s survey includes Marijuana in it as a PED, not explaining the difference between use in training and use in competition. It is almost guaranteed that some of the 9% of responders who admitted to “cheating” did not actually violate any of the rules against PED use put forth by the WADA.

    Then there is the issue of TUEs. if you followed the BBC accusations against the Nike Oregon Project you heard about a whole bunch of elite marathoners, all on asthma medication, Prednisone and thyroid hormone, through the use of TUEs. Are they not cheating? What am I to do if I am a middle aged man on hormone replacement therapy competing in a backyard ultra event with no drug policy? There is no avenue for exemptions. But there is also no drug policy, am I cheating?

    Thanks Matt for sharing your thoughts!

  6. I will bring forward one empirical reality- athletic performance is exponential, meaning that the high-performance tail of the performance distribution is described using exponential functions (a brief overview is given here: So although some results margins may appear to be “thin” from a time perspective, they are actually large from a performance perspective.

    What the exponential performance curve is describing (as it concerns the athletic ability of current humans) is the probabalistic (stochastic) nature of the combination of intrinsic (physiological and psychological) and extrinsic (training, extrinsic motivation, circumstance, etc.) factors that lead to elite performance. PDI and PDII attempt to change the intrinsic part whereas high tech instruments (shoes, bikes, suits, rackets, etc.) and superior training regimens, for example, attempt to alter the extrinsic part. When such are pursued in an environment where some approaches (e.g. PDI and PDII) are disallowed by the rules, some athletes who break the rules will exhibit performances further down the “exponential tail” of the high-performance distribution. As a result the natural exponential distribution will be perturbed and will no longer reflect (in detail) the true stochastic nature of un-doped human performance excellence. However, in an environment where things such as PDI and PDII are uniformly allowed and utilized by elite and sub-elite athletes, a new, self-similar, exponential distribution will obtain and the same exponential differences, now within a uniform population of doped and artificially-enhanced elite athletes, will result. By allowing such “known to be dangerous” doping we will actually have nothing different than what we have now, except we will have faster, longer, higher… results. We, the athletic community, gain nothing from a competition perspective- it is no more exciting or inspiring or ethereal.

    It is argued here (and in one comment above) that the dangers associated with allowing PDI and PDII far outweigh any perceived and artificial “improvement” in athletic performance. Staying away from the obvious gray areas (low caffeine use, over-the-counter NSAIDs, etc.), it seems reasonable to suggest that an enforced anti-doping posture by the athletic community is a much better end result than some dystopic vision with such allowed PDI and PDII activities- a vision that was hilariously satirized on Saturday Night Live years ago:

    It is not clear that allowing PDI and PDII would provide any benefits to the athletic community as it concerns elite competition. Such PDI and PDII assisted “performances” would appear to be superior, but, in fact, they are actually performances from a different human population- a doped and artificially enhanced one and therefore cannot and should not be compared with unassisted performances.

    In the end the burden of rules, testing, and enforcement are the price we will pay to ensure a healthy, honest, and exciting athletic community.

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