EPO and blood transfusions: Injected
Until 2000 there was no viable test for EPO, which boosts red blood cell production, thus improving endurance, and was taken by Armstrong and his team-mates under programmes devised by Dr Michele Ferrari, according to Usada.
Saline solution was used to lower hematocrit levels and evade detection, while Ferrari instructed George Hincapie to inject it directly into the vein, so reducing the window of detection to 12 hours. At one stage, makeup was applied to Armstrong’s upper arm to hide bruising from an injection, the report says. After the EPO test came in, blood transfusions became more popular. Half-litres of blood were extracted, stored in fridges, then rigged up as drips on coat hangers and reinfused into riders, so replicating the effect of EPO.
Andriol: Taken orally/through patches
Tyler Hamilton describes how he saw Armstrong using a mixture of Andriol, commonly referred to as liquid testosterone, and olive oil developed by Dr Ferrari, which was to be taken orally. On at least one occasion during the 1999 Tour Armstrong squirted the “oil” into Hamilton’s mouth after a stage. The testosterone, which boosts power, could also be dispensed through patches, which were to be worn overnight. Because testosterone is naturally produced by the human body, it is difficult to detect in low doses.
Cortisone: Injected or swallowed
A steroid that reduces pain and inflammation, Cortisone is only prohibited if there is no medical need. So US Postal Service and Discovery Channel team doctors would simply provide false declarations of medical need. The Usada report claims Armstrong and his team-mates received Cortisone injections or took it in pill form. During the 1999 Tour, Armstrong tested positive for Cortisone but had no medical exemption – so the team provide a backdated prescription for Cortisone cream for saddle soreness.
Human growth hormone: Injected
Several of Armstrong’s team-mates, and officials, testify to witnessing Dr Luis García del Moral injecting human growth hormone, which as an anabolic agent increases size and power. There was no satisfactory test for HGH between 1998 and 2005 and Wada is only now close to having one.
Actovegin: Injected night before race
During the 2000 Tour, a discarded box of the anti-diabetes drug Actovegin was found in a skip. US Postal said at the time that it was used to treat road rash and Armstrong claimed never to have heard of it. But his team-mates claim it was administered the night before a race to “improve oxygen delivery to the muscles”. It is not currently banned but Usada said that the evasion of Armstrong and the team during an official French law enforcement investigation showed their willingness to lie.