Hematocrit just out of range - could I fail a "drug" test?

I just got blood work back from my annual physical and everything is in range except hematocrit, which is just barely out of range at 50.3% (50% is the upper limit for normal). The Dr. said it’s nothing to worry about from a health perspective as everything else looks great and it’s just barely outside of range. My hematocrit has always been on the higher end, typically 48-49%, but this is the first time it’s tested over 50.

My concern - I understand that anything over 50% is a potential problem for cycling drug tests (indicative of possible blood doping, EPO, etc.). Based on some quick web research, I found that some cyclists do have natural levels over 50 and I assume they compete without issue, but I have no idea whether they have to proactively register for an exception or how it’s handled.

I’m a fairly competitive 50+ age group guy and I know the chances of me ever being drug tested are very, very small. I’ve also only tested over 50% Hematocrit this one time, so it might just be a one-off thing. That said, it would be crushing (and potentially life altering) to “fail” a test at a race and be seen as that guy.

Does anyone know if the 50% thing even applies to amateurs and whether there is something I should do to get in front of this? I have several USAC events I’ll be doing this year and it’s stressing me out a bit. I was thinking about just reaching out to USAC to get their take, but figured I’d ask here first to see if anyone has dealt with it before.

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You should be fine. IIRC the hematocrit level test was only implemented because they didn’t have a test at the time that would detect EPO.
Even the blood passport is used to detect anomalies and then they will then do more “random” drug testing to hopefully detect any substance abuse.

There was a cyclist who naturally had a high hematocrit level who at one point had to get a dispensation to race, but unsure if he’s still racing/still needs one.

Its not a great test anyway cause you can have larger red blood cells than normal too!

I’m curious whether they do blood or urine testing if they do testing at a masters amateur race.

Update on this if anyone is curious - I reached out to USAC and referred me to USADA. The people at USADA were really helpful and said that a high hematocrit level is not a violation in any way for them. It was a UCI thing where you would not be allowed to start a race and might drive additional testing or review of past levels to determine the outcome and ability to race legally at higher levels. She wasn’t sure whether it’s still a thing with UCI. I won’t be doing any UCI events (until that pro contract comes through), so it’s basically no issue for me.


Most of the time high hematocrit values are caused by delayed/improper transportation of the sample.
I did quite a bit of research on the subject because all my last 3 blood tests came back with hematocrit values > 55%.

Turns out i’m not Bjarne Riis but my sample hasn’t been stored properly. Did a retest at a local lab and my values were down to 42%.

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Glas you had a good outcome from this. There’s a good chapter in Charly Wegelius’ book ‘Domestique’ about his battle with the UCI and naturally high hematocrit levels. He was downing pints of water before blood tests to avoid being pulled from races.

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Do any amateur events do blood tests? I didn’t think so, but I could be wrong.

Something like exogenous EPO would show in urine, but a naturally high hematocrit shouldn’t raise any alarms.

Last spring I was taking an Anatomy and Physiology II class, we tested our hematocrits in class with a centrifuge. I was (pleasantly?) surprised to see that I had a 58% reading. So I might be Bjarne Riis’ sidekick, call me “Mr 58.”

The professor confirmed it wasn’t read wrong, but I’m not sure. A few years ago, when very out of shape, the lab work at a yearly physical showed 47%. In a few weeks I will have some labs done, looking forward to what they show.

I think that there is nothing to worry about, as long as you are not taking any prohibited substances. Even if they are going to give you a drug test, you can explain everything, and it should be fine. One of my friends has taken a drug test from https://testcountry.com/pages/urine-drug-test-cups and it has shown a wrong result. However, he was able to explain everything and he didn’t have any problems.

I don’t think haemocrit is used now that they can test for EPO.

As for UCI, I rode in the Gran Fondo World Champs and doping control was only for the winners (turns out the person who won in my category for 2017 and 2018 was convicted of doping last year).
Scanning of bikes was nearly every second bike.

If my hematocrit were consistently > 50%, I’d see a hematologist.

What have you done to get it to 50?

Nothing that I know of. It’s always been near the upper end of normal. I haven’t bothered with an annual physical this year with all the covid stuff going on, but I’m curious if last year’s test was a bit of an outlier. I’ve had my v02max tested in a lab a couple times and it’s nothing impressive, so unfortunately the high hematocrit levels aren’t translating to elite aerobic performance. My understanding is that there have been plenty of world class cyclists with hematocrits in the low 40’s, so I don’t think it’s really that meaningful by itself.

Just as a point of interest. I remember reading somewhere that OVER 50% was a problem, therefore 50.9% was within bounds.

It’s not some thing to worry about at amateur level. If I’ve got it right, the haematocrit level applies to those that are subject to the biological passport. It acts as a reference level and any change from your baseline has to be explained.

I’d agree with your planned action, contact USAC, no-one else can really help you.