The old standby—extracting red-blood-cell-rich plasma pre-Tour, storing it, and then transfusing it before key stages. It’s one of the most potent cheats available and the hardest to detect.
In Lance Armstrong’s Oprah confession, he admitted to using erythropoietin, which boosts red-blood-cell counts. It’s still popular in the peloton, because it can be taken in small, nearly undetectable doses and is flushed from the bloodstream by drinking large quantities of water.
Early adopters will experiment with banned hypoxia-inducible-factor (HIF) regulators, naturally occurring proteins that help oxygen-depleted muscles perform better. FibroGen, a Bay Area company, began late-stage testing of an HIF pill for anemia in December 2012.
Telmisartan, a drug used to treat high blood pressure, has avoided the WADA list. But we wonder why. A 2012 study in Journal of Strength Conditioning Research found that telmisartan increases endurance and a reliance on fat burning during exercise, like the popular but easily detected drug GW1516.
Used in conjunction with GW1516, Aicar works to raise the amount of fat available to muscle tissue. The result: Riders can train harder and increase their endurance. But unlike with GW1516, Aicar works on metabolic pathways instead of genes—and is far harder to detect with testing.