Challenge of False-Positive Erythropoietin Abuse Detection in Blood Flow Restricted Resistance Trained Athletes: A Potential Doping Dilemma in Sports

The comparable structure and metabolic processes of Erythropoietin and Recombinant Erythropoietin improve athlete’s aerobic capabilities, causing inaccurate positive results in anti-doping tests. Currently, athletes who train using the Blood Flow Restriction technique can achieve a similar level of natural erythropoietin increase without resorting to doping. The practice of Blood Flow Restricted Resistance Training and Blood Flow Restricted aerobic training creates a condition of local hypoxia, leading to lower oxygen levels and the build-up of cellular Hypoxia-inducible factor 1-alpha. In addition, this would stimulate the production of erythropoietin and increase the concentration of red blood cells. As a result of the inherent rise in systemic erythropoietin levels, athletes who train with blood flow restriction may be wrongly identified as doping users during less dependable anti-doping procedures. This misjudgement can have negative impacts on the athlete’s physical and mental health, ultimately hindering their performance.