Schmidt, W. F., Volzke, C., Wachsmuth, N., Wolfarth, B. Schmidt-Trucksass, A., Steinacker, J., Treff, G., Stray-Gundersen, J., Eastwood, A., & Prommer, N. (2011). Variation of hemoglobin mass in elite endurance athletes. Medicine and Science in Sports and Exercise, 43(5). Supplement abstract 2352.

"The administration of erythropoietic agents and blood transfusions by elite endurance athletes is designed to augment the total mass of hemoglobin (Bb-mass) in order to increase the oxygen transport capacity of the blood. Monitoring Hb-mass, therefore, might be a reasonable method to detect blood manipulations independently of their cause. Two prerequisites, however, are that Hb-mass remains constant during long time periods and that possible confounding factors are known."

This study determined the variation of Hb-mass in elite athletes over at least one year and to identify possible confounding factors. Elite endurance athletes (M = 141; F = 56) in Nordic ski sports, swimming, triathlon, rowing, and cycling served as Ss. Hb-mass was monitored approximately four times over a period of one to two years using the optimized CO re-breathing method. Venous blood samples were taken to determine Hb-concentration, hematocrit, and reticulocyte count.

Hb-mass was strongly affected by gender (males were much higher), body mass (bigger athletes had larger mass values), and altitude (mass was increased immediately after return from altitude). It was also significantly affected by age (it increased up to 22 years), training (mass increased with a training volume >20 hours per week), season (it was higher in the competition season), and illness or injury (it decreased over periods greater than two weeks).

Implication. When the confounding factors of altitude, illness/injury, and age are excluded, Hb-mass remains very stable in elite endurance athletes and shows a lower variation than all blood parameters currently considered in an athlete's biological blood passport. Regular monitoring of Hb-mass could be used to detect blood manipulations.

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