I've been unable to get anyone to comment on the record regarding Jakob Moerkeberg's statements about Armstrong's Tour blood values, so I went to the source himself.
Andy Shen: How did this story come about? Did you approach the newspaper, or did they approach you?
Jakob Moerkeberg: There was a journalist from Denmark’s Radio that approached me, called me last Tuesday. He asked if I had seen the results posted on Armstrong's website, and I had. Then he asked me how I interpreted the data, and I told him what I saw, and he asked me if I was willing to say that on television.
AS: So you didn't initiate it? The typical criticism is, "He must need a grant, he's trying to make a name for himself."
JM: In 2007, when Michael Rasmussen also posted his values, there was another journalist who approached me. I took a stance on that also.
AS: So you were known as a blood researcher who was willing to take a stand publicly.
AS: Can you tell me about your background?
JM: I'm an exercise physiologist, Copenhagen University graduating 2006, and I have just written up my PhD and submitted it one week ago, the PhD is about detecting autologous blood transfusions in an anti-doping context.
AS: And you have published with Damsgaard and Ashenden.
AS: Are you on the bio passport board? Do you have access to that information?
AS: Were you able to look at other values from the Tour?
JM: I've only seen Bradley Wiggins' values.
AS: Some have said that Wiggins' values are also suspicious. Do you agree with that?
JM: He hasn't published as many values, but his values are not following a pattern that you would expect from a physiological point of view.
AS: Part of what you find suspicious about Armstrong’s values is that the hematocrit stays very steady, with a couple of spikes in the middle?
JM: Yes. Usually I'm referring to the hemoglobin concentration, because that is what's used nowadays. People are more and more interpreting hemoglobin concentrations instead of hematocrit because of analytical reasons. So what I see is that his first value is the same as his last value, and when you look at those individual values during the race, it's going down in the beginning, then after the rest day the values increase, then they go down again, and then on the second rest day it increases again. I am well aware of the analytical and biological variations in the hemoglobin concentration, that is why I have emphasized that the important point when interpreting these values is that the last value is not lower than the first.
AS: Is hematocrit and hemoglobin somewhat interchangeable?
JM: Yes, there is a good correlation between those two parameters.
AS: The other thing you find strange is the reticulocyte count, that it's too low, and that's indicating that he's not producing his own red blood cells?
JM: If you look at his values during the year up to the Tour, the reticulocyte values are pretty much what you would expect, around 1%. There are analytical variations and biological variations to that parameter as for any other parameter. Then at the beginning of the Tour, it's half, .5%, which is producing half the red blood cells that you would expect. The reason why you get a decrease in your reticulocyte values is when you have an increased amount of hemoglobin. Your body does not have to produce as much as usual.
AS: What's the margin of error on these numbers? Is a .3 in hemoglobin fluctuation significant?
JM: It's not significant. That's why I'm not going into detail with every single number. I'm just saying that the first value and the last value are almost equal, and that the decrease you would expect is beyond the margin of variance for those numbers. That's the take home message.
AS: Michael Ashenden talked about a signal to noise ratio, there has to be enough of a fluctuation to be significant. Are these fluctuations beyond the range of 'noise'?
JM: The variations are within the noise, but that is if you're not doing anything. If you're not doing strenuous exercise, you wouldn't expect these values to change. You would expect these small variations that you see, but the reason I'm saying these values are suspicious is that he's doing strenuous exercise, and then you would expect to see a decrease, as you see in his values during the Giro. That's what's suspicious.
AS: So the important values to you are the beginning and the end, not the fluctuations in the middle?
JM: I would prefer not to get into details about the variations in the middle.
AS: Of course, now I'm going to ask you a question about the variations in the middle. Jonathan Vaughters and Frankie Andreu, in that famous IM session, referred to a 'rest day blood refill'. Also, Sinkewitz said he got his transfusions on rest days. Is it significant that the spikes in the middle occur after the rest days.
JM: Prefer not to comment on that.
AS: What kind of a spike in the numbers would you expect to see from a typical unit of transfusion?
JM: 0.8 grams per deciliter. For half a liter of blood, an increase in the hemoglobin concentration of 0.8 g/dL.
AS: There's also a spike in the off score before the Tour, is that something significant?
JM: If you apply it to the cutoff that they use, no.
AS: If you look at the graph, it's a big spike. It doesn't trigger a sanction, but is it something that triggers suspicion?
JM: It is a big spike, but what you have to take into consideration is that the previous value was at the end of the Giro, where his values decreased as expected.
AS: Damsgaard says this is just speculative, he hasn't criticized this on specific points. How do you view his statement?
JM: I really don't want to comment on that.
AS: Hans Erik Heier says the hemoglobin values are too low and couldn't have been manipulated.
JM: I can't follow that assumption. I am not saying these values are suspicious because they are high. That is the whole point. I am talking about a lack of relative low values for that specific athlete, which you would expect from a physiological point of view at the end of the Tour.
AS: Damsgaard also talked about the rights of the cyclist. Do you think it's correct for us to discuss this at all? The blood passport does allow for a lot of speculation, and the rider may not have sufficient recourse...
JM: I would like to emphasize that the passport does NOT allow for a lot of speculation, because the values are NOT publicized. I think there is a good reason for that and in my opinion that is the way it should be. Another thing is, when you as an athlete choose by yourself to publish your values - then it's free for people to comment on them. This was his own decision. If you're not ready for that scrutiny, you shouldn't publish your values. If a journalist comes to me, it's because I've done work in this area, and want my opinion as a scientist. If he has got a problem with people commenting on his values, he shouldn't have chosen to publish them. When he does that, it's an open forum, it's public, and if something looks strange it would be wrong for me not to say that, when I was asked. If I didn’t say his values looked suspicious, I would dismiss the scientific literature, which I have based my comments on.
AS: When a rider publishes his results, in a way, he's saying he must be clean because he's being transparent. So, in your opinion, he should be able to withstand some criticism.
AS: So if I were to come to you with Wiggins' numbers, you would say the same thing? Suspicious?
JM: I have seen no exact values, but the pattern on the graph I have seen does not follow the expected pattern.
AS: Bjarne Riis ended Saxo Bank's internal testing program, saying that the bio passport alone is sufficient. Do you think the bio passport is doing its job?
JM: Yes, definitely. I think it's a step in the right direction. I won't say it's perfect, but the bio passport has decreased the amount of doping you can do without being caught. It has decreased the allowed fluctuations you can have. I think it's on the right track.
AS: So doping might still exist, but not to the magnitude it used to be at? People might be cheating, but just not as much, so it might be easier for clean athletes to compete?
JM: Difficult to say, but I hope so.
AS: Have you been contacted by any members of the US media?
JM: The Associated Press contacted me.