Total Hemoglobin Mass-A New Parameter to Detect Blood Doping?


Medicine & Science in Sports & Exercise: December 2008 - Volume 40 - Issue 12 - pp 2112-2118
doi: 10.1249/MSS.0b013e3181820942
BASIC SCIENCES: Original Investigations

Purpose: All kinds of blood manipulations aim to increase the total hemoglobin mass (tHb-mass). To establish tHb-mass as an effective screening parameter for detecting blood doping, the knowledge of its normal variation over time is necessary. The aim of the present study, therefore, was to determine the intraindividual variance of tHb-mass in elite athletes during a training year emphasizing off, training, and race seasons at sea level.

Methods: tHb-mass and hemoglobin concentration ([Hb]) were determined in 24 endurance athletes five times during a year and were compared with a control group (n = 6). An analysis of covariance was used to test the effects of training phases, age, gender, competition level, body mass, and training volume. Three error models, based on 1) a total percentage error of measurement, 2) the combination of a typical percentage error (TE) of analytical origin with an absolute SD of biological origin, and 3) between-subject and within-subject variance components as obtained by an analysis of variance, were tested.

Results: In addition to the expected influence of performance status, the main results were that the effects of training volume (P = 0.20) and training phases (P = 0.81) on tHb-mass were not significant. We found that within-subject variations mainly have an analytical origin (TE ∼1.4%) and a very small SD (7.5 g) of biological origin.

Conclusion: tHb-mass shows very low individual oscillations during a training year (<6%), and these oscillations are below the expected changes in tHb-mass due to Herythropoetin (EPO) application or blood infusion (∼10%). The high stability of tHb-mass over a period of 1 year suggests that it should be included in an athlete's biological passport and analyzed by recently developed probabilistic inference techniques that define subject-based reference ranges.

1Department of Sports Medicine and Sports Physiology, University of Bayreuth, Bayreuth, GERMANY; 2Swiss Laboratory for Doping Analyses, University of Lausanne, Epalinges, SWITZERLAND; 3Department of Rehabilitative and Preventive Sports Medicine, University Hospital, Freiburg, GERMANY

Address for correspondence: Nicole Prommer, Ph.D., Department of Sports Medicine/Physiology, University of Bayreuth, Universitaetsstrasse 30, 95447 Bayreuth, Germany; E-mail:

Submitted for publication February 2008.

Accepted for publication June 2008.

©2008The American College of Sports Medicine