Lance, enhanced

Image by eugene via Flickr

Lance Armstrong is threatening to make history, again, when he lines up for the Tour de France this Saturday.  Given his well-documented health history, his athletic abilities seem to defy logic and, some would argue, physiology, leading to claims of doping that have so far proven to be groundless.

First, let me be perfectly clear that I don’t think Lance Armstrong is using performance-enhancing drugs.  I think he is an amazing athlete that deserves every single Tour de France yellow jersey that he’s won.  I think the guy works his ass off and reaps the rewards of his efforts. 

At the same time, however, his athletic prowess is curious to say the least, particularly when you consider his relatively less-than-stellar performance before his diagnosis of testicular cancer.  For a long time I  wondered whether Lance was using testosterone shots under the World Anti-doping Agency’s therapeutic use clause, which is basically a statement allowing the use of otherwise banned substances if there’s a medical indication for it.  Testosterone supplementation is often indicated for men following surgery for testicular cancer if they’ve had both testicles removed or if the chemotherapy and/or radiation therapy has shut down the body’s ability to produce testosterone.  Moreover, our knowledge is limited about what a truly “normal” level of any given hormone is for any individual, so someone using supplemental testosterone could, in theory, use as much of the substance as he wanted, even if it would be excessive for his own physiologic needs, as long as it fell within the gaping range of “normal”.  In light of testosterone’s positive effects on muscle mass, speed, and recovery, that could be a huge stroke of luck for an athlete with an unfortunate illness.

Turns out Lance only had one testicle removed.  Not only that, but as evidenced by his brand-new baby, the remaining one appears to be working just fine, so he probably doesn’t need testosterone shots after all.  So much for that theory.

But as I was looking into this issue, I stumbled across a 2007 article in the journal Medical Hypotheses, which describes how the removal of one testicle theoretically may have altered Lance’s physiology in such a way that he is, biologically, at an athletic advantage.  Through an extremely complicated cascade of endocrinology, the removal of one testicle may cause a relative elevation in the production of prolactin, luteinizing hormone, and follicle-stimulating hormone.  This misbalance of hormones has the potential to enhance the body’s utilization of nutrients for fuel (improving endurance) and mechanisms of recovery.  It also may promote the production of more lean muscle mass and red blood cells.  In short, his illness and its resultant hormonal aberration may have turned him into an athletic powerhouse.

While I certainly don’t recommend that aspiring male athletes lop off one of their family jewels as a means of gaining a competitive edge, it provides an interesting hypothesis of how, in addition to an enviable work ethic and natural abilities, Lance may have become the cycling deity that he is.