Breaking Down the Doping Recipe of Pro Cycling: A Guide to Steroids, Hormones, Drips, and Blood Doping

The United States Anti-Doping Agency has released "USADA Report on Allegations Against Lance Armstrong," a 202-page document summarizing the evidence and testimonies collected during their investigation of Lance Armstrong and the United States Postal Service Team.

The document makes for some epic reading and in its source will probably only be of interest to journalists and serious cycling nerds. Fortunately, the Wall Street Journal has already started breaking it down for us.

Whether you're reading the original or a summary, you're going to come across numerous references to drugs and processes used for doping. Just what are these things? We've compiled a quick guide to the major ones:

Erythropoietin, commonly referred to as "EPO" in the USADA testimony, formed the foundation of the doping system allegedly used by Lance Armstrong, teammates, and others in professional cycling. EPO is a hormone that controls red blood cell production in the human body. By injecting additional EPO, athletes improve the oxygen-carrying capacity of their blood. This directly improves their endurance capacity.

READ MORE: Lance Armstrong's Cat-and-Mouse Game

EPO increases the hematocrit of blood, or the percentage of red blood cells per volume of blood. It also makes blood thicker and more viscous, which increases the risk of thrombosis and stroke. The use of EPO could not be detected at all until 2000. Since then, doping agencies have had the ability to differentiate between natural forms of the hormone and the presence of additional hormone.

Saline is simply sterile salt water. It is used to hydrate and rehydrate patients in hospitals, among many other things. In the context of the USADA documents, saline treatments are mentioned as a means of masking the use of EPO and blood doping techniques.

By infusing a large amount of saline directly before a drug test, doping athletes were able to temporarily lower their hematocrit levels, thus avoiding suspicion.

EPO therapy is capable of achieving the same results of "blood doping"-which traditionally has required the harvesting of red blood cells from a donor followed by a transfusion into an athlete. However, evidence collected by the USADA suggests that cyclists were using traditional transfusions of red blood cell-rich blood in addition to EPO injections.

In this case, most blood doping was autologous, meaning the red blood cells were harvested earlier in the season from the athlete that would later receive the transfusion.

In one particularly unsettling piece of testimony, USPS team member Tyler Hamilton recounts a transfusion session in a hotel during the Tour de France in 2000. "Each blood bag was placed on a hook for a picture frame or taped to the wall and we lay on the bed while the chilly blood re-entered our bodies." Hamilton said that riders "joked about whose body was absorbing the blood the fastest."

Testosterone, a type of anabolic steroid, typically conjures images of body builders or heavy-hitting baseball sluggers, not thin and lean road cyclists. Yet, there it is, peppered all over the USADA testimonies.

Really, the physiological effect is always the same, but the way in which it is used can produce different results. Testosterone and other anabolic steroids increase the muscle's ability to synthesize protein. Muscle fibers become larger and repair faster as a result. When used during weight training cycles, this can lead to massive, powerful, builds.

However for cyclists, at least according to the testimony, the focus of testosterone use was on repair. Athletes would use the steroid after hard days of racing to speed and improve recovery.

In the USADA documents, testosterone is often referred to as "oil" because members of the USPS team mixed it with olive oil for concealment. They would then squirt the mixture under their tongues after racing, sometimes even in the open.

Andriol, which is also mentioned several times, is simply a brand name for Testosterone undecanoate, the anabolic steroid strain of the hormone.

Anabolic steroids, like testosterone, are synthetic substances related to male sex hormones. Typically, when "steroids" are mentioned in reference to performance enhancing drugs, the term is meant to mean anabolic steroids.

Corticosteroids, however, are drugs synthesized from cortisol, a hormone produced in the adrenal gland. Corticosteroids have the ability to quickly and dramatically reduce swelling and inflammation, thus improving athlete recovery.

While not as common, corticosteroids are mentioned in the USADA testimonies and are identified as the cause of Lance Armstrong's first failed drug test in 1999.

The final doping technique mentioned in the USADA document is the use of growth hormone. The science on the use of growth hormone, human growth hormone, or HGH is actually inconclusive but it is widely accepted as effective in sports circles.

The most likely benefit of HGH use, which has been supported by a few scientific studies, is that it improves the ratio of lean mass in the body. Thus, using HGH helps athletes replace fat with muscle to better achieve optimal body fat ratios.

Another suspected benefit is that HGH also increases muscle mass. Though research has shown that HGH treatments alone do not increase strength, some believe that the resulting larger muscles exhibit heightened protein synthesis, thus improving their responsiveness to and recovery from workouts.

One final suspected benefit of HGH is that it may improve the connective tissues between muscles, thus decrease injury risk for athletes.

READ MORE: Return to Sender: Lance Armstrong and USPS Pro Cycling Team's EPIC FAIL

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