The Untold and Insanely Weird Story of A-Rod’s Doping Habits

And why MLB quietly banned EPO, cycling’s drug of choice


By Tim Elfrink and Gus Garcia-Roberts
Illustration by Trenton Duerksen


Eccentric, exacting, and self-destructive—Alex Rodriguez is baseball’s Howard Hughes. He didn’t just shoot steroids or rub on cream like his predecessors, he took his banned substances intravenously while breathing from an oxygen tank, or while laying in a hyperbaric chamber in his Manhattan basement with little dogs yapping around him. He exchanged drugs for money in a bathroom of a Miami Starbucks, and allowed a twitchy, uneducated biochemist named Anthony Bosch to draw his blood in the men’s room of a chic nightclub. (Bosch, who Rodriguez kept on a six-figure annual retainer, promptly lost the vial of blood on the club’s dance floor.)

We reported a lot of his bizarre behavior in our new book Blood Sport: Alex Rodriguez, Biogenesis, and the Quest to End Baseball’s Steroid Era. But there are a whole bunch of details — including allegations concerning the true extent of Rodriguez’s relationship with a pseudo-scientist named Victor Conte—that came too late to meet the book’s deadline. This new information was provided by Bosch himself, who became Major League Baseball’s chief witness against his former employer. His sworn testimony was confidential, but a person with knowledge of the proceedings provided us with a detailed account of Bosch’s testimony. It is both revealing and devastating—and, unreported until now, his account has led Major League Baseball to finally ban a notorious doping agent. Not insignificantly, it also fills out a very strange portrait of baseball’s biggest star.

For example, his meeting with Conte. Last summer, The New York Daily News reported that Rodriguez met with Conte in 2012, while A-Rod was in the Bay Area for a series against the Oakland Athletics. Conte was, as any casual sports fan can tell you, the Pablo Escobar of performance-enhancing drugs. Before pleading guilty to federal charges in 2005, he plied top international athletes like record-breaking sprinter Marion Jones with designer drugs from his BALCO laboratory. Home run-king Barry Bonds’ inhuman assault on the record books was powered by Conte’s chemistry.

When The Daily News contacted him, Conte acknowledged a visit from Rodriguez but said that their business “was about legal performance enhancement” only.

Bosch’s testimony suggests something more nefarious. Following the Conte visit, he says that he and Rodriguez began incorporating what they called the “Conte protocol” into A-Rod’s treatments. It was a doping regimen, according to Bosch, meaning it was designed to increase oxygen through red blood cells in a manner banned in the highest levels of international sport.

Specifically, Bosch suggested that through Conte’s protocol he may have provided Rodriguez with Epogen. That’s a commercial name for EPO, the blood doping agent used most infamously by disgraced cyclist Lance Armstrong, destroying his legacy and the integrity of the sport itself.

EPO increases red blood cell counts, helping to carry more oxygen to the muscles and improve endurance. It’s a sophisticated and risky form of doping, and was for a decade on the leading edge of sports performance. It also killed as many as 18 cyclists during its heyday, thanks to an unfortunate side effect if it’s not dosed properly: Blood can turn to sludge, triggering heart attacks or strokes.

In interviews with baseball officials, both Conte and Rodriguez denied Bosch’s suggestion that their protocol included EPO, according to league sources. Conte initially ignored our numerous attempts to contact him, including leaving a note at his office. But after this story was published, he tweeted a denial:

https://twitter.com/VictorConte/status/494598875110711296

Bosch himself waffled when questioned by officials, appearing unsure whether the substance prescribed was Epogen or Neupogen. There’s a huge difference between the two. Neupogen, which is designed to create more white blood cells, would aid recovery and is not considered a doping agent. Yet Bosch repeated several times that Conte’s regimen was a doping protocol, according to the source who detailed his testimony.

In the BALCO days, Conte distributed EPO to clients in the NFL, boxing, and various endurance sports, but it was not publicly linked to his alleged treatments of Bonds. EPO is not typically considered a natural fit for baseball, where the emphasis of performance enhancing drugs (PEDs) has most famously been on bulk, not endurance. It was so under-the-radar, in fact, that MLB had never added EPO to its list of banned substances. Bosch’s testimony sent baseball officials scrambling.

There is a desperate logic to the drug use which has come to define Rodriguez’s record-setting career, one in which he signed roughly $450 million worth of playing contracts. His greatest successes as a baseball player—including at least two of his three MVP seasons—are now inextricably linked to his use of banned substances.

He’s an experiment. Sometimes, as was the case in his arrangement with Bosch, Rodriguez’s chemical edge-seeking was outright cheating. Other times—as in Bosch’s testimony regarding Conte, and other new insights—Rodriguez lived on the ever-changing line that separates highly advanced legal sports science from procedures outlawed as performance enhancement. He discovered protocols which sports doping officials considered borderline but didn’t have enough information to ban, or which were banned in other sports but had gone unnoticed by baseball’s drug police.

(Photo credits, from top: AP Photo/Miami-Dade Police Department; AP Photo/Paul Sakuma; AP Photo/Dan Cappellazzo)

Bosch’s testimony also detailed Rodriguez’s relationship with a controversial doctor named Dr. Anthony Galea. The eccentric Canadian had a vast American athlete patient list, including Rodriguez and, in 2009, golfer Tiger Woods, who was recovering from serious injury.

Galea has claimed that his treatments of Woods and Rodriguez were legal within the realm of sport, including “platelet-rich plasma” (PRP) procedure, in which a patient’s blood is spun in a centrifuge and then reintroduced to the body. Though PRP initially drew the attention of the World Anti-Doping Agency (WADA), which banned it, the watchdog has since allowed PRP, following studies that showed it had no performance-enhancing effects. (Galea was indicted for an illicit substance, however, after directing an underling to bring mislabeled drugs, including human growth hormone, into the States.)

Bosch’s Galea testimony concerned a little-known and mysterious elixir called Actovegin. MLB officials discovered a mention of it in one of the handwritten notebooks that Bosch kept on all of his patients, records that ultimately were entered into league evidence against Rodriguez.

When questioned, Bosch told the attorney he’d written the note after visiting Rodriguez’s apartment overlooking the Hudson River. Before entering the massive condo, Bosch was asked to take off his shoes; inside, he found out why: the décor and furniture—everything was all bright white.

During that meeting, Bosch claimed Rodriguez had told him to look into procuring a certain substance, as part of his protocol administered by Galea. In his notes, Bosch actually spelled out “Activagen,” which is an obscure horse bone paste with no known benefit to athletes, but even A-Rod isn’t that weird: When Bosch described the stuff to baseball officials as consisting of insulin-like growth factor 1, they realized which substance he really meant.

Actovegin is essentially an extract of calves’ blood. It’s a world away from the Steroid Era lore of knuckleheads like Mark McGwire and Jose Canseco shooting each other up with Venice Beach juice in stadium bathrooms. Said to quicken tissue recovery, it is banned from sale in the United States and Canada.

Though WADA has said it would “closely monitor” Actovegin, it is not banned in sport because, on its own, use of the substance is not considered to be doping. Usain Bolt, the world’s fastest man, has made no secret of regularly visiting a doctor in Germany famed for administering the substance. But Actovegin is also said to boost the nutrients, such as iron, that dopers crave. Experts have said it could be used in conjunction with EPO. Conte himself told the Daily News in 2009 that he believed the insulin-based recovery aspects of Actovegin made it a doping agent, calling it “a powerful performance-enhancing drug.”

Actovegin hit the center of Rodriguez’s Venn diagram: potent, but murky enough to remain legal.

Bosch said that Rodriguez told him Galea prescribed a cocktail of Actovegin, L-carnitine—a supplement often used both for weight loss and by men with low testosterone levels—and B-complex vitamins. Though he scribbled it among his notes, Bosch claims he never incorporated Actovegin into his own protocols for A-Rod.

Informed of Bosch’s testimony, Galea’s Canadian attorney Brian Greenspan refused to discuss whether or not it was accurate. “I’m not commenting on it,” said Greenspan. “He said what he said.”

In the years just before meeting up with Galea, Rodriguez was the pioneer of another sort of experiment — this one with the consent of MLB’s drug police. One of the bigger news breaks in our book is the revelation that Rodriguez was granted medical exemptions allowing him to use testosterone and the women’s infertility drug clomiphene citrate, both of which are often prescribed to boost levels in patients suffering from the dreaded “low T.”

Bosch’s testimony helps answer an obvious follow-up question: Why would Rodriguez—otherwise an apparently healthy young athlete—have such low testosterone levels?

Bosch said he started working with Rodriguez in August 2010. A medical school dropout, he first treated his star client in an unlikely spot: a public sitting room adjacent to the lobby of 15 Central Park West, where Rodriguez lived. Bosch had been ushered there by Yuri Sucart, Rodriguez’s doting cousin and nurse of all things illicit. When Rodriguez finally arrived in the early morning hours, Bosch later said, the superstar sat in the common room, where neighbors Sting or Denzel Washington might stumble onto a bizarre scene: Bosch drawing his blood. Bosch, ever the professional, insisted on testing his clients’ blood before deciding on doping protocols.

Bosch then flew back to Miami and took Rodriguez’s blood to a Little Havana laboratory. Sucart called his younger cousin “Cacique,” an indigenous term in the Caribbean for a chief of a fiefdom. Bosch would later give the samples to chemists, who added a seemingly random first name, “Cacique, Belloy”—Rodriguez’s new medical pseudonym.

Bosch testified that the sample came back as low in testosterone and when he asked Sucart about the deficiency, the cousin had a ready answer: Rodriguez had been using PEDs, provided by Sucart himself, for many years. Sucart added that Rodriguez was exhausted after games and workouts.

Bosch had dealt with long-term dopers before, he said in arbitration. Bosch testified openly that he had treated slugger Manny Ramirez in 2009, providing him his trademark “troches”—essentially gummies packed with testosterone, which he claimed could evade an MLB drug test even if chewed only hours before giving a urine sample—along with creams and injections. Like Rodriguez, Ramirez had used PEDs for years, having failed the league’s first batch of urine tests in 2003. For his patients with low-T, Bosch could administer even more testosterone than he otherwise would, all the while remaining confident that the levels would not exceed the threshold which would trigger a failed drug test. (Ramirez actually did fail a drug test in 2009, but Bosch blames that misstep on a cousin injecting him at the wrong time.)

Rodriguez found a way to turn his low-T into an advantage. To get a “therapeutic use exemption,” all he had to do was prove to a doctor appointed by both the league and the union that he had a medical need for a testosterone boost. That doctor, a North Carolina physician named Dr. Bryan Smith, agreed with the low-T reading, and for the full 2007 season, A-Rod could use testosterone. Rodriguez won his third MVP that year—slamming 54 home runs, knocking in 156 runs and stealing 24 bases—and the Yankees rewarded him with a ten-year, $275 million playing contract. The next year, he was granted another similar exemption: for Clomid, a fertility drug that can also boost T in men.

“Is it important for me to take my blood tomorrow or do you have it for V?” Rodriguez texted Bosch on May 30, 2012, the same month as A-Rod’s Bay Area meeting with Conte, according to a trove of messages entered into league evidence against the superstar.

“V” was half-hearted code identifying Victor Conte. By then, both Rodriguez and Bosch knew that the authorities were closing in on them. Sometime in 2012, according to Bosch’s testimony, Rodriguez had called him warning that a New York newspaper—Bosch didn’t identify which—was close to running a story exposing their relationship. Within an hour, Rodriguez had called back and said his attorneys managed to spike the story.

Now Rodriguez wanted to bring in outside consultation. Rodriguez told Bosch as much during a meeting at his townhouse on Bank Street in Manhattan—the one with the leased hyperbaric chamber. (Bosch suggested, with dubious scientific basis, that doping worked best in 100 percent oxygen.) Rodriguez told Bosch that he wanted him to speak with Conte on the phone and hear out the rival self-proclaimed sports chemist’s ideas.

It was a meeting of the doping scientists, likely rife with professional jealousy, and an eager patient at the ready. We now know what Bosch says came next: a doping protocol possibly unprecedented in baseball, further lies and, ultimately, another lesson learned by MLB.

This past March, in the fallout from the Biogenesis scandal, the league and the union agreed to a raft of reforms to the game’s drug policy. Those fixes have been far from complete. Despite Bosch’s claims that he doped Rodriguez intravenously, for example, IVs have not been banned outright in baseball (though they are currently banned by WADA).

But significantly, the Commissioner’s Office did work with the MLB Players Association to forge an agreement to ban EPO as a direct result of Bosch’s testimony. The drug was officially outlawed this summer, though it’s not clear when—or if—the league will start testing for the drug. Until that testing begins, it will be impossible to know whether Rodriguez might have been alone among ballplayers in experimenting with the doping agent, or if its use is widespread.

There have been other changes, too: for the first time, every player will face a Carbon Isotope Mass Spectrometry test, a pricey procedure that can find synthetic molecules in blood. The test, which has been used in select cases in the past, helped bust several Biogenesis clients who had taken testosterone but had evaded MLB’s more basic test. Random urine tests will be twice as common going forward, blood tests for human growth hormone have been upped, and fines were stiffened for those violating the policy.

Yet how stiff is a matter of opinion.

For all the post-Biogenesis turbulence, A-Rod only lost $22 million from his record $275 million Yankees deal, just seven million more than he profited flipping a Miami Beach mansion last year. Biogenesis cheats Ryan Braun (who signed a $105 million contract extension the same season in which he tested positive for PEDs), Jhonny Peralta ($53 million deal after returning from a 50-game suspension), and Bartolo Colon ($20 million, two-year deal, which he also inked after returning from suspension, at the age of 40) are just a few examples of players who reaped financial rewards for PED use.

The nature of doping is that even with EPO now added to the banned list, the A-Rods of the game will always find something else. The financial incentives to cheat — for those willing to take the risks — are simply too strong. It’s like any other business with stakes so high: bankers will work around regulation, politicians will open up loopholes, drug smugglers will move their product through submarines and deeper tunnels.

The athlete experiments will continue. There is no shortage of willing subjects.

This story builds on the authors’ reporting for the book Blood Sport: Alex Rodriguez, Biogenesis, and the Quest to End Baseball’s Steroid Era (Dutton, Penguin Random House).


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