HIF (hypoxia inducible factor) activators or stabilizers are oral compounds that act via the HIF pathway to stimulate EPO production.22This is an easier method of administration compared to rhEPO, which needs injections. In consequence, they are less visibly detectable and less painful to use. These compounds include chemical elements such as Xenon, Argon and Cobalt.22 Recently in the 2014 winter Olympic Games, Russian athletes were caught abusing HIF activators.22Normally, the HIF pathway is activated upon hypoxic conditions. Thus, the end result would be to stimulate EPO synthesis in order to restore the normal oxygen levels in the blood and to enhance angiogenesis. Giving exogenous HIF activators can imitate hypoxic conditions which leads to the
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Furthermore, excessive amounts of this agent can impair thyroid activity which can lead to the production of goiter.29The abnormal growth of the thyroid gland can be traced to several causes such as direct drug adverse reactions. Additionally, goiter can be caused by acute or chronic inflammation, by iodine deficiency or by thyroid cancer. With these conditions in mind, the exact details of the mechanism of action of cobalt needs more research to understand how exactly thyroid activity is impaired. Unfortunately, there is little data available on cobalt metabolism in athletes. Moreover, there are no current anecdotal evidence of any athletes specifically taking cobalt supplements.27This explains why these agents are not banned yet27despite the serious health concerns. However, since they can be used to enhance erythropoiesis, further caution should be made by both sports professionals considering taking HIF activators for blood doping and anti-doping
Furthermore, excessive amounts of this agent can impair thyroid activity which can lead to the production of goiter.29The abnormal growth of the thyroid gland can be traced to several causes such as direct drug adverse reactions. Additionally, goiter can be caused by acute or chronic inflammation, by iodine deficiency or by thyroid cancer. With these conditions in mind, the exact details of the mechanism of action of cobalt needs more research to understand how exactly thyroid activity is impaired. Unfortunately, there is little data available on cobalt metabolism in athletes. Moreover, there are no current anecdotal evidence of any athletes specifically taking cobalt supplements.27This explains why these agents are not banned yet27despite the serious health concerns. However, since they can be used to enhance erythropoiesis, further caution should be made by both sports professionals considering taking HIF activators for blood doping and anti-doping