The Legal Case Against Lance Armstrong: Drug Doping.

Unless you are living under a rock, you have probably heard or read that the United States Anti-Doping Agency (USADA) has stripped American cyclist Lance Armstrong of his seven Tour de France victories and all his victories and awards for the last 14 years. In the eyes of the USADA, Armstrong is a cheater.

The facts remain that Armstrong is probably the most heavily tested athlete in the world, and has submitted to over 500 official blood and urine and other types of tests. It is also a fact that never once has Armstrong failed an OFFICIAL drug test, even though there have been unofficial tests that did indicate that he took performance-enhancing drugs (PEDs). The case against Armstrong is entirely circumstantial and relies on the testimonies of convicted dopers who rode with Armstrong or on the testimonies of those who worked with him. On his radio show, conservative commentator Rush Limbaugh said there was no evidence that Armstrong used PEDs. That’s not exactly right. There is no direct evidence from drug tests that Armstrong used PEDs, but the fact remains that there is a strong circumstantial case against him. In this entry, I thought I might bring that evidence to my readers.

The investigation into Armstrong falls under the aegis of the US Food and Drug Administration and is directed by agent Jeff Novitsky. It begins when Armstrong initiated his quest to be an Olympic athlete at the age of 15 (ca 1990). He began his career as a triathlete, but switched to cycling.

In 1990, two teammates of Armstrong, Greg Stock and Erich Kaiter claim in a 20o0 lawsuit against USA Cycling that their coaches regularly administered steroids to them in 1990 and that the side effects of these steroid injections damaged their health and cut their athletic careers short. USA Cycling settled this lawsuit in 2006 by paying each rider $250,000.  Since these two athletes were teammates of Armstrong’s and strongly allege that they were given steroids by their coaches, and since Armstrong was coached by the same people, it is likely that Armstrong received at least some steroid treatments as well during this time.  Whether or not he received them knowingly or unknowingly is difficult to ascertain.

During 1990-2000, Lance Armstrong was tested more than two dozen times. His blood was sent to the UCLA laboratory of the famous antidoping scientist Donald Caitlin. Caitlin is somewhat of a legend in the anti-doping world, since he designed methods to distinguish between synthetic and natural testosterone. Caitlin also discovered the illicit drug Tetrahydrogestrinone (THG), which is an extremely potent anabolic steroid that can induce muscle growth with just a few drops under the tongue, and was distributed by the Bay Area Laboratory Co-Operative (BALCO) to many different athletes, including baseball player Barry Bonds, and sprinters Marion Jones and Tim Montgomery. Caitlin served as an expert witness in cases brought by the USADA and in federal investigations of the BALCO, which was also led by Novitsky.

In May 1999, USA Cycling sent Caitlin a formal request for test results from a cyclist who was identified only by a code. The code, however, was for a cyclist named Lance Armstrong. Of these tests, three tests, June 23, 1993, July 7, 1994, and June 4, 1996 show rather high ratios of testosterone to epitestosterone. Epitestosterone is a natural variant chemical form of testosterone. In most healthy males, the ratio testosterone to epitestosterone is around 1:1, but in athletes, this ratio can vary. For this reason, the highest ratio allowed by most regulations is 4:1, since the highest recorded ratio in a non-doping athlete is 5.25 to 1 (very rare). Taking oral testosterone or testosterone-like drugs will raise the level of testosterone but not epitestosterone. Therefore, a high testosterone to epitestosterone ratio in a blood test is almost certainly (though not always) indicative of taking anabolic steroids. Armstrong’s test ratios were 9 to 1, 7.6 to 1, and 6.5 to 1.

Why wasn’t Armstrong sanctioned at this time? Caitlin apparently retested the sampled to verify the high ratios and the second tests were normal. Thus the high levels could not be officially verified. Several drug testing experts find this very odd that three high tests for the same athlete could not be confirmed, but the simple fact remains, that Caitlin was not able to officially document high testosterone levels in Armstrong’s blood during 1990-2000. Some think that something funny is going on. Caitlin has been described by some as one of Armstrong’s greatest fans, and some have asserted, with little proof, that Caitlin would have gladly faked the test for Armstrong’s sake. This is a very weighty accusation that is being made without any evidence. It seems it is impossible to say what happened with any certainty.

The next witness is Stephanie McIlvain, who is a marketing representative for Oakley sunglasses. She provided Armstrong with all the latest eye wear and clothing from her company and was an Armstrong confidant. When Armstrong was diagnosed with stage III testicular cancer on October, 1996, McIlvain was by his bedside after his surgery 25 days later. Around this time, while sitting in a hospital conference room in Indianapolis, watching a football game, two physicians came into the room and directly asked Armstrong if he had ever used PEDs. According to the sworn testimonies of Armstrong’s former teammate, Frankie Andreu and his wife Betsy Andreu, Armstrong responded to the doctors by admitting that he had taken PEDs that the drugs he had taken were growth hormone, cortisone, anabolic steroids, testosterone, and the hormone erythropoietin (made by the kidneys, it boosts the quantity of red blood cells in the bloodstream thus increasing oxygen delivery to the tissues).

In their testimonies, Armstrong and McIlvain deny that Armstrong said such a thing and Armstrong even denied that physicians had ever asked him such a question. However, in a phone conversation with three-time Tour de France winner Greg LeMond that was apparently secretly taped by LeMond, McIlvain admitted that Armstrong had said exactly what Betsy Andreu had recounted in her testimony. McIlvain allegedly said, “You know I was in that room. I heard it, you know.” She also added, “So many people protesting him that it is just sickening, you know.” In statements to Sports Illustrated, McIlvain said that she stands by her court testimonies.

The next stretch of witnesses are mostly former teammates of Armstrong’s. Stephen Swart was a member of the 1995 Tour de France Motorola team with Lance Armstrong. According to Swart, Armstrong instigated the use of EPO (erythropoietin) to raise their hematocrits (the percentage of blood composed of red blood cells). EPO had been banned by the International Olympic Committee in 1990. According to Swart and Andreu, who were teammates of Armstrong’s, Lance Armstrong was the leader of the cycling team and he determined which riders stayed or were replaced. According to Swart, Armstrong suggested that they all take EPO and it was the force of Armstrong’s personality that persuaded the team to take EPO.

Swat admits to using EPO while he was riding with Motorola, and he told about a small hemotological analyzer that was brought into the hotel room every night to test their hematocrits. This would tell them how much EPO to use, since too much EPO can crowd the blood with so many red blood cells that the thickened blood will spontaneously clot within the blood vessels, thus setting off a heart attack or a stroke.

A normal hematocrit for a healthy male ranges from 42 to 52. Athletes will tend to have higher hematocrits, but a hematocrit of over 50 will typically get you banned from cycling for 15 days. Swart recalls on July 17, 1995, his hematocrit was 48, but Armstrong’s hematocrit was 54-56.

Tests to detect EPO in the blood rely on differences between recombinant EPO and native EPO. Native EPO is decorated with all kinds of sugar groups, but the recombinant EPO has a very different combination of sugar groups attached to it. By detecting these aberrant forms of EPO in the blood, labs can detect EPO in a blood test. This test was developed by scientists at the French national anti-doping laboratory (LNDD) in 2000. The World Anti-Doping Agency (WADA) endorsed this test, and introduced it to detect pharmaceutical EPO, since it could distinguish exogenous EPO from the natural hormone normally present in an athlete’s urine. Swart said that he never saw Armstrong inject himself with EPO and he never saw Armstrong give anyone of the team EPO. If this is the case, then where did the EPO come from?

In the mid-1990s, Armstrong commenced his relationship with the Italian physician Michele Ferrari. Ferrari has publicly defended the use of EPO by athletes, even though he has also denied doping athletes. Armstrong officially ended his relationship with Ferrari in 2004 after Ferrari was convicted of sport fraud by an Italian court.

Nevertheless, former Armstrong teammate and convicted doper Floyd Landis, Dr. Ferrari was “matter-a-fact about” doping. According to Landis, Ferrari helped Landis transfuse his own blood to boost his performance. He said that Ferrari was professional and calculated about his work.

Landis also said that Ferrari was concerned after Armstrong’s cancer diagnosis because he thought that his doping regime might have brought on Armstrong’s cancer. According to Landis: “I remember when we were on a training ride in 2002. Lance told me that Ferrari had been paranoid that he had helped cause the cancer and become more conservative after that.”

Landis also recalls that Armstrong and his cycling team always flew on private charters because there were less stringent customs checks as private airports. However, according to Landis, in 2003, at the airport in St. Moritz, Switzerland, customs agents stopped Armstrong and searched his duffel bag. There were drugs with labels in Spanish and syringes in the duffel bag. Armstrong asked someone in the contingent to tell the customs officers that the syringes and bottles were vitamin-injecting gear. The customs officers, says Landis, “looked at us sideways but let us through.” Armstrong denies that any of this occurred.

Landis won the Tour de France in 2006, but was stripped of his victory after his testosterone to epitestosterone levels were shown to be close to 11 to 1. Landis sent emails to USA Cycling in April and May of 2011, accusing Armstrong of doping while he and Landis were members of the US Postal Service Cycling team. In May 2011, Landis filed a whistle-blower lawsuit against Armstrong under the US False Claims Act. This Act allows citizens who possess evidence that someone has defrauded the US Government to sue on behalf of the Government. Armstrong has responded by labeling Landis as “a person with zero credibility.”

Finally, Armstrong’s bike mechanic and personal assistant from 2002 to 2004, Mike Anderson recalls several instances that are potentially incriminating if true. According to Anderson, Armstrong sent him to Girona, Spain to remove all traces of his ex-wife Kristin before Armstrong arrived with his girlfriend Sheryl Crow. Anderson said that in the bathroom cabinet of this apartment was a white box labeled “ANDRO.”

According to papers filed in 2005, Anderson sued Armstrong for allegedly backing out of their business deal that included Armstrong helping Anderson build a bike shop. Anderson’s lawyers wrote that the substance in the while box was “androstenin or something very close to that.” This piqued the interest of Novitsky at the FDA who was sure that the substance in the white box was androstenedione, the compound that was found in baseball player Mark McGwire’s locker. The International Olympic Committee banned androstenedione in 1997. Armstrong denies ever having taken androstenedione, and without the box or testing its contents, it seems impossible to know what was ever in it.

The Anderson-Armstrong lawsuit also alleges that shortly after winning his 6th Tour de France in 2004, Anderson received a phone call from a friend of Armstrong’s that USADA drug testers had shown up at the Armstrong ranch in Dripping Springs, Texas, and Armstrong was not there. Athletes subject to random drug testing must inform the USADA of their location and missing three random tests within an 18-month period constitutes a violation.

Anderson asserts that he was involved in an attempt to fool USADA agents by keeping watch over the USADA agents in their white SUV while a friend of Armstrong’s drove Lance’s black Suburban from the airport terminal to the ranch to make it look as though Armstrong had been there all along and the USADA agents simply could not raise him for whatever reason.

The two Armstrong friends who allegedly collaborated with Anderson in this cover-up, Derek Russey and John Korioth, deny that this ever happened that and Anderson fabricated the entire tale. USADA still seems to think that Anderson is telling the truth.

Is Armstrong guilty? USADA certainly thinks so. The case is largely circumstantial, but the cumulative case is somewhat strong, but the evidence is all indirect. The testimonies are largely from athletes who are admitted dopers, which certainly taints their credibility. Landis, for example, was also found guilty of fraud. His credibility is certainly low.

However, why would Betsy Andreu lie about what she heard Armstrong say? Her tenacity about this whole thing has bought her little more than tremendous grief from Armstrong’s supporters. Her motive for lying seems low. Likewise, the conversation between LeMond and McIlvair, if it is true, would seem to corroborate the stories of Betsy Andreu and her husband.

It seems to me that at least at some point in his career, Armstrong did use PEDs. Whether he was a serial abuser is difficult to say. Whether all seven of his Tour de France victories were due to PED use is also unproven, in my opinion. It also seems to me that Armstrong has had relationships with noted dopers, such as Dr. Ferrari.

Did Ferrari help Armstrong dope? We know that he helped Landis dope, and it seems highly unlikely that Armstrong would have had a relationship with a physician such as Ferrari unless he wanted Ferrari to help him dope. Therefore, it seems likely to me that at some point in his career, Armstrong did use PEDs. When and where? I do not know and I do not think the USADA knows either. I would say that stripping him of the last 14 years of his career seems more than a little extreme. I would say that it looks to me as though they want to make an example of Armstrong.

If Armstrong truly did all he did while doping, many of the riders he beat were also doping. Thus it seems difficult to assign an unfair advantage to Armstrong during this time. Secondly, if Armstrong was a chronic serial doper, he found a certifiable way to beat the hundreds of tests he was subjected to. He has never officially tested positive for PEDs, which is a testimony to the difficulty of detecting PEDs in the blood of athletes who dope and do so smartly. It shows in some ways how far behind the detection technology lags when it comes to catching up with smart dopers.

For those interested in this subject, please read Chris Cooper’s excellent book, Run, Swim, Throw, Cheat:  The Science Behind Drugs in Sport (Oxford University Press, 2012).


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Professor of Biochemistry at Spring Arbor University (SAU) in Spring Arbor, MI. Have been at SAU since 1999. Author of The Stem Cell Epistles. Before that I was a postdoctoral research fellow at the University of Pennsylvania in Philadelphia, PA (1997-1999), and Sussex University, Falmer, UK (1994-1997). I studied Cell and Developmental Biology at UC Irvine (PhD 1994), and Microbiology at UC Davis (MA 1986, BS 1984).

5 thoughts on “The Legal Case Against Lance Armstrong: Drug Doping.”

  1. So the lies of jelous riders etc. convicted Lance Armstrong, not blood and urine samples. What a bunch of CRAP!

  2. Greg,
    I will grant you that the other riders might have been jealous of Armstrong’s success. This does not remove the fact that athletes are very adept at fooling drug testers an evading spot testers. This is the main reason why it is so difficult to convict athletes who dope.

    The people who are accusing Armstrong are not just jealous competitors, but friends of Armstrong’s who rode with him and were teammates with him. Virtually all of these cyclists admit that they doped and that Armstrong was the one who initiated doping.

    Also USADA’s investigation has shown that Armstrong lied about his association with Dr. Ferrari, since bank statements definitively show that Armstrong was interacting with a known drug doper long after he publicly said that he had dissociated himself from Ferrari. Why would Armstrong be paying money to a Italian physician who is a known doper if not to secure illegal PEDs?

    This is not crap, it is investigation and the evidence, though circumstantial is immense. Also, there were tests of Armstrong’s blood and urine that were indicative of doping, but because they were not confirmed, they cannot be officially used to ban an athlete. Because Dan Caitlin did the testing, the lack of a positive result is dubious, given his history of admiration for Armstrong. We convict people for murder and theft on the basis are far less evidence all the time.

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