On one hand, the incentive to cheat and win is very high. So people are constantly coming up with ingenious ways to get away with it. At the same time, anti-doping is hindered by complicated international structures, underfunding, and in the case of some countries, a deliberate blind eye.
But no country wants to expose that its athletes are doping. They may not want their athletes to dope, but they certainly don’t want the bad PR that exposing it brings.
Then there’s the physiological aspect. Human biochemistry is variable, and natural levels of various hormones can vary considerably per person. And within individuals it can vary over time. So its difficult to draw a line in the sand and say that such and such testosterone level means you’re doping. Obviously there are levels that would stick out as impossible for humans to achieve, but sophisticated dopers don’t take that much.
A big problem is micro-doping, the practice of taking relatively low doses of PEDs for a small but still potentially decisive boost. That makes it tremendously difficult to tell if someone is doping.
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