Download PDF
Int J Sports Med 2012; 33(09): 691-695
DOI: 10.1055/s-0031-1295441
Physiology & Biochemistry
© Georg Thieme Verlag KG Stuttgart · New York

Spurious Hb Mass Increases Following Exercise

C. E. Gough
1   Australian Institute of Sport, Physiology, Canberra, Australia
,
A. Eastwood
2   South Australian Sports Institute, Sport Science, Adelaide, Australia
,
P. U. Saunders
3   Australian Institute of Sport, Physiology, Belconnen, Australia
,
J. M. Anson
4   University of Canberra, Faculty of Applied Science, Australia
,
C. J. Gore
1   Australian Institute of Sport, Physiology, Canberra, Australia
› Author Affiliations
Further Information

Publication History



accepted after revision 18 October 2011

Publication Date:
15 June 2012 (online)

Also available at
    Permissions and Reprints

Abstract

Sensitivity of the Athlete Blood Passport for blood doping could be improved by including total haemoglobin mass (Hbmass), but this measure may be unreliable immediately following strenuous exercise. We examined the stability of Hbmass following ultra-endurance triathlon (3.8 km swim, 180 km bike, 42.2 km run). 26 male sub-elite triathletes, 18 Racers and 8 Controls, were tested for Hbmass using CO re-breathing, twice 1–5 days apart. Racers were measured before and 1–3 h after the triathlon. Controls did no vigorous exercise on either test day. Serum haptoglobin concentration and urine haemoglobin concentration were measured to assess intravascular haemolysis. There was a 3.2% (p<0.01) increase in Racers’ Hbmass from pre-race (976 g±14.6%, mean ±% coefficient of variation) to post-race (1 007 g±13.8%), as opposed to a  − 0.5% decrease in Controls (pre-race 900 g±13.9%, post-race 896 g±12.4%). Haptoglobin was  − 67% (p<0.01) reduced in Racers (pre-race 0.48 g / L±150%, post-race 0.16 g / L±432%), compared to  − 6% reduced in Controls (pre-race 1.08 g / L±37%, post-race 1.02 g / L±37%). Decreased serum haptoglobin concentration in Racers, which is suggestive of mild intravascular blood loss, was contrary to the apparent Hbmass increase post-race. Ultra-endurance triathlon racing may confound the accuracy of post-exercise Hbmass measures, possibly due to splenic contraction or an increased rate of CO diffusion to intramuscular myoglobin.

Key words

long distance triathlon - haematological passport - myoglobin
 

  • References

  • 1 Alexander A, Garvican LA, Burge CM, Clark SA, Plowman JS, Gore CJ. Standardising analysis of carbon monoxide rebreathing for application in anti-doping. J Sci Med Sport 2011; 14: 100-105
    CrossrefPubMedGoogle Scholar
  • 2 Bruce EN, Bruce MC. A multicompartment model of carboxyhemoglobin and carboxymyoglobin responses to inhalation of carbon monoxide. J Appl Physiol 2003; 95: 1235-1247
    CrossrefPubMedGoogle Scholar
  • 3 Burge CM, Skinner SL. Determination of hemoglobin mass and blood volume with CO: evaluation and application of a method. J Appl Physiol 1995; 79: 623-631
    PubMedGoogle Scholar
  • 4 Butcher JD. Runner’s diarrhea and other intestinal problems of athletes. Am Fam Physician 1993; 48: 623-627
    PubMedGoogle Scholar
  • 5 Eastwood A, Bourdon PC, Withers RT, Gore CJ. Longitudinal changes in haemoglobin mass and VO2max in adolescents. Eur J Appl Physiol 2009; 105: 715-721
    CrossrefPubMedGoogle Scholar
  • 6 Eastwood A, Hopkins WG, Bourdon PC, Withers RT, Gore CJ. Stability of hemoglobin mass over 100 days in active men. J Appl Physiol 2008; 104: 982-985
    CrossrefPubMedGoogle Scholar
  • 7 Fallon KE, Bishop G. Changes in erythropoiesis assessed by reticulocyte parameters during ultralong distance running. Clin J Sport Med 2002; 12: 172-178
    CrossrefPubMedGoogle Scholar
  • 8 Garvican LA, Burge CM, Cox AJ, Clark SA, Martin DT, Gore CJ. Carbon monoxide uptake kinetics of arterial, venous and capillary blood during CO rebreathing. Exp Physiol 2010; 95: 1156-1166
    CrossrefPubMedGoogle Scholar
  • 9 Garvican LA, Eastwood A, Martin DT, Ross ML, Gripper A, Gore CJ. Stability of hemoglobin mass during a 6-day UCI ProTour cycling race. Clin J Sport Med 2010; 20: 200-204
    CrossrefPubMedGoogle Scholar
  • 10 Gore CJ, Bourdon PC, Woolford SM, Ostler LM, Eastwood A, Scroop GC. Time and sample site dependency of the optimized CO-rebreathing method. Med Sci Sports Exerc 2006; 38: 1187-1193
    CrossrefPubMedGoogle Scholar
  • 11 Gore CJ, Hopkins WG, Burge CM. Errors of measurement for blood volume parameters: a meta-analysis. J Appl Physiol 2005; 99: 1745-1758
    CrossrefPubMedGoogle Scholar
  • 12 Harriss DJ, Atkinson G. Update – Ethical Standards in Sport and Exercise Science Research. Int J Sports Med 2011; 32: 819-821
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Hew-Butler T, Collins M, Bosch A, Sharwood K, Wilson G, Armstrong M, Jennings C, Swart J, Noakes T. Maintenance of plasma volume and serum sodium concentration despite body weight loss in Ironman triathletes. Clin J Sport Med 2007; 17: 116-122
    CrossrefPubMedGoogle Scholar
  • 14 Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc 2009; 41: 3-13
    PubMedGoogle Scholar
  • 15 Hoppeler H, Weibel ER. Structural and functional limits for oxygen supply to muscle. Acta Physiol Scand 2000; 168: 445-456
    CrossrefPubMedGoogle Scholar
  • 16 Margaritis I, Tessier F, Richard MJ, Marconnet P. No evidence of oxidative stress after a triathlon race in highly trained competitors. Int J Sports Med 1997; 18: 186-190
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 McCord JL, Halliwill JR. H1 and H2 receptors mediate postexercise hyperemia in sedentary and endurance exercise-trained men and women. J Appl Physiol 2006; 101: 1693-1701
    PubMedGoogle Scholar
  • 18 McDonald W. (ed.) Butterworth’s Medical Dictionary. 2 ed. London: Butterworth’s; 1984
  • 19 Miller BJ, Pate RR, Burgess W. Foot impact force and intravascular hemolysis during distance running. Int J Sports Med 1988; 9: 56-60
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Morkeberg J, Sharpe K, Belhage B, Damsgaard R, Schmidt W, Prommer N, Gore CJ, Ashenden MJ. Detecting autologous blood transfusions: a comparison of three passport approaches and four blood markers. Scand J Med Sci Sports 2011; 21: 235-243
    CrossrefPubMedGoogle Scholar
  • 21 Neubauer O, Konig D, Wagner KH. Recovery after an Ironman triathlon: sustained inflammatory responses and muscular stress. Eur J Appl Physiol 2008; 104: 417-426
    CrossrefPubMedGoogle Scholar
  • 22 O’Toole ML, Hiller WD, Roalstad MS, Douglas PS. Hemolysis during triathlon races: its relation to race distance. Med Sci Sports Exerc 1988; 20: 272-275
    PubMedGoogle Scholar
  • 23 Pottgiesser T, Umhau M, Ahlgrim C, Ruthardt S, Roecker K, Schumacher YO. Hb mass measurement suitable to screen for illicit autologous blood transfusions. Med Sci Sports Exerc 2007; 39: 1748-1756
    PubMedGoogle Scholar
  • 24 Prommer N, Ehrmann U, Schmidt W, Steinacker JM, Radermacher P, Muth CM. Total haemoglobin mass and spleen contraction: a study on competitive apnea divers, non-diving athletes and untrained control subjects. Eur J Appl Physiol 2007; 101: 753-759
    CrossrefPubMedGoogle Scholar
  • 25 Prommer N, Schmidt W. Loss of CO from the intravascular bed and its impact on the optimised CO-rebreathing method. Eur J Appl Physiol 2007; 100: 383-391
    CrossrefPubMedGoogle Scholar
  • 26 Prommer N, Sottas PE, Schoch C, Schumacher YO, Schmidt W. Total hemoglobin mass – a new parameter to detect blood doping?. Med Sci Sports Exerc 2008; 40: 2112-2118
    CrossrefPubMedGoogle Scholar
  • 27 Robertson JD, Maughan RJ, Davidson RJ. Faecal blood loss in response to exercise. Br Med J (Clin Res Ed) 1987; 295: 303-305
    CrossrefPubMedGoogle Scholar
  • 28 Schmidt W, Prommer N. The optimised CO-rebreathing method: a new tool to determine total haemoglobin mass routinely. Eur J Appl Physiol 2005; 95: 486-495
    CrossrefPubMedGoogle Scholar
  • 29 Schumacher YO, Pottgiesser T, Ahlgrim C, Ruthardt S, Dickhuth HH, Roecker K. Haemoglobin mass in cyclists during stage racing. Int J Sports Med 2008; 29: 372-378
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Schumacher YO, Wenning M, Robinson N, Sottas PE, Ruecker G, Pottgiesser T. Diurnal and exercise-related variability of haemoglobin and reticulocytes in athletes. Int J Sports Med 2010; 31: 225-230
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Selby GB, Eichner ER. Endurance swimming, intravascular hemolysis, anemia, and iron depletion. New perspective on athlete’s anemia. Am J Med 1986; 81: 791-794
    CrossrefPubMedGoogle Scholar
  • 32 Sottas PE, Robinson N, Saugy M. The athlete’s biological passport and indirect markers of blood doping. Handb Exp Pharmacol 2010; 195: 305-326
    PubMedGoogle Scholar
  • 33 Stewart IB, McKenzie DC. The human spleen during physiological stress. Sports Med 2002; 32: 361-369
    CrossrefPubMedGoogle Scholar
  • 34 Stewart IB, Warburton DE, Hodges AN, Lyster DM, McKenzie DC. Cardiovascular and splenic responses to exercise in humans. J Appl Physiol 2003; 94: 1619-1626
    PubMedGoogle Scholar
  • 35 Suzuki K, Peake J, Nosaka K, Okutsu M, Abbiss CR, Surriano R, Bishop D, Quod MJ, Lee H, Martin DT, Laursen PB. Changes in markers of muscle damage, inflammation and HSP70 after an Ironman Triathlon race. Eur J Appl Physiol 2006; 98: 525-534
    CrossrefPubMedGoogle Scholar
  • 36 Telford RD, Sly GJ, Hahn AG, Cunningham RB, Bryant C, Smith JA. Footstrike is the major cause of hemolysis during running. J Appl Physiol 2003; 94: 38-42
    CrossrefPubMedGoogle Scholar
  • 37 Weight LM, Byrne MJ, Jacobs P. Haemolytic effects of exercise. Clin Sci 1991; 81: 147-152
    PubMedGoogle Scholar
  • 38 Withers RT, Gore CJ, Mackay MH, Berry MN. Some aspects of metabolism following a 35 km road run. Eur J Appl Physiol 1991; 63: 436-443
    CrossrefPubMedGoogle Scholar
  • 39 World Anti-Doping Agency. Athlete Biological Passport Operating Guidelines and Compilation of Required Eelements. In: The World Anti-Doping Code. 2010
    Google Scholar