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[Definitie:] "An ergogenic aid is any substance or phenomenon that enhances performance."
(Wilmore and Costill) 
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2 1 - 1 2 - 2 0 0 4 Two drugs are puzzling
By Elliott Almond
Victor Conte Jr. has boasted that his drug program eluded the authorities for three years. Even as details of the scandal surrounding Balco Laboratories have been highly publicized in the 15 months since a raid of Conte's Burlingame nutrition company, the uses for two of the substances confiscated there remain a mystery to drug testers.
According to a source with intimate knowledge of the program, one was piracetam, a prescription drug used to treat disorders of cognition and balance. Balco athletes used it to help them train longer. The other was mazindol, a prescription appetite suppressant that Conte experimented with as a stimulant.
Piracetam and mazindol are two pieces of the sophisticated regimen created by Conte, a self-taught nutritionist who is one of four Bay Area men facing federal charges of money laundering and distributing anabolic steroids. All have pleaded not guilty.
Conte, 54, was the mastermind of the Balco regimen. The program combined pharmacology with nutrition to develop a stable of fast sprinters, according to the source.
In 2003, for example, Kelli White won world titles in the 100 and 200 meters, and Dwain Chambers took the 100-meter European championship. Both participated in the Balco program, and both have since been banned for drug use.
Much of the attention on Balco has focused on athletes' use of ``the clear'' and ``the cream,'' the company's code names for the designer steroid THG and a testosterone cream. But the drug regimens Conte developed also included the blood-boosting agent EPO and medications usually used to treat diabetes and thyroid disorders. Athletes injected the human growth hormone and adrenaline and took legal dietary supplements such as amino acids, in addition to the two newly disclosed drugs.
Conte bought some of the prescription drugs from a pharmacy in Texas, authorities allege. But items also can be purchased off the Internet, the source said.
Conte began giving many of these drugs to athletes a month after the 2000 Olympics. But it was not until 2003 that some competitors, including NFL players, began taking piracetam before games or races to help them run harder and longer, according to the source. The athletes believed it helped them by increasing their count of oxygen-rich red blood cells. Oliver Rabin, the World Anti-Doping Agency's science director, said that piracetam has been found in tests but is not banned because there is no conclusive evidence that it boosts athletic performance. ``We're trying to put some rationale behind it and not necessarily rush to the conclusion that anything they are taking is, by definition, doping,'' said Rabin, a pharmacologist.
A representative of the U.S. Anti-Doping Agency declined to comment on the two drugs. But the agency's legal counsel, Travis Tygart, said, ``It's not a surprise that those who cheat on that level will look to new substances that we might not be able to test for.''
According to the source, Balco athletes experimented with mazindol as a stimulant to replace modafinil, a sleeping disorder medication that runners such as White used before races. Athletes tried mazindol during practice but never for competition.
Rabin said he had never heard of mazindol being used in connection with sports but acknowledged it could work as a stimulant. Some of the drug regimen detailed by the source was corroborated by doping calendars and other material in the case seen by the Mercury News. The calendars listed the days the different drugs were to be used.
Although the results seem impressive, some experts question the effectiveness of Balco's program because it has not undergone a peer-reviewed study.
``People tend to believe things without understanding the overall pharmacology,'' Rabin said.
Conte's basic theories came from the world of bodybuilding, where he first saw how performance-enhancing drugs worked. But the source said the athletes in Balco's program were held to strict conditions to guard against some of the health problems seen in bodybuilders: They got small doses and never more than a month's supply at a time; they submitted to monthly blood tests to check for side effects; and if they missed a blood test, they were taken off the program. Each athlete's program was customized based on body mass, gender and event.
Drug-testing officials begrudgingly acknowledge Conte's program was well-crafted to elude detection. For example, an article confiscated during the raid discussed how insulin acts as an anabolic agent when used with growth hormone. But that's not how Balco athletes were using insulin, the source said. Insulin, used to treat diabetics, is a banned substance for which there is no test. Balco athletes used it in conjunction with dextrose, whey protein isolates, creatine and other legal supplements that athletes swallowed with water. The insulin helps deliver those nutrients to muscles that are depleted after heavy weightlifting involving the legs. Athletes could recover within three hours instead of a day, the source said.
``Using insulin without the other ingredients doesn't do you any good,'' the source said. ``The nutrition was the building blocks.'' Conte said in an appearance this month on the ABC news program ``20/20'' that thwarting the authorities was ``like taking candy from a baby.''
What are sports officials planning to do about it? Dr. Don Catlin, head of the UCLA Olympic Analytical Laboratory, hopes the outcry over the Balco scandal will lead to more research funding so new tests can be developed for undetectable drugs. But he worries that once the Balco frenzy ends, authorities will become complacent.
``They will say, `We got it this time,' '' Catlin said. ``They don't have it this time. They are not close to it.''
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