Episode 495: Performance Enhancing Drugs In Ultramarathon | Kilian Korth

Kilian Korth joined the show to have a discussion around ultrarunning's growing professionalization without sophisticated regulated drug testing, the limits and trade-offs of WADA/USADA-style regimes, and why "doping" as a blanket term obscures intent and severity. We unpack gray areas such as THC thresholds, TUE complexity for common medications, transparency vs backlash, influencer incentives, and the future pressure regenerative medicine and technology (e.g., super shoes) may place on sport rules. Kilian: IG: @runtoughmindset | Substack: https://substack.com/@runtoughmindset Sponsors: LMNT: https://drinkLMNT.com/HPO (free sample pack with purchase) deltaG: https://deltagketones.com Code: BITTER20 (20% Off) True Nutrition: https://truenutrition.com/hpo Code: HPO (20% Off) Episode Summary & Notes: Zach Bitter & Kilian Korth on PEDs, incentives, and doping in ultrarunning Context & framing Conversation is the third appearance by Kilian on Zach's podcast; shifts from traditional training/racing episodes toward current events in running. Sparked by recent doping-related controversies (Cam Hanes / Sage Canaday online conflict, Mike McKnight's discussion of BPC-157 use on Hanes' podcast). Both emphasize moving beyond narrow focus on specific peptides/cases to broader structural issues. Activism, incentives & tribalism Skepticism of modern activism: good causes often get distorted by perverse incentives (attention, platform growth, organizational self-preservation/mission creep). Online environments (especially short-form social media) reward polarization over curiosity or truth-seeking. Parallel drawn to low-carb diet advocacy: movement shifted from exploration of pros/cons toward dietary supremacy and identity attachment. Both hosts value changing one's mind with new evidence and prefer evolving conversations over tribal "debates" aimed at winning. Core problem in ultrarunning Rapid professionalization and financial incentives exist, but sophisticated testing (especially out-of-competition) is essentially absent. Honor-code system + high rewards creates conditions in which some athletes near the top are likely to use PEDs. Contrast with Olympic sports (e.g., swimming) where positives occur even with lower financial stakes. "Doping" is an unhelpful blanket term that equates intentional, high-impact cheating (e.g., EPO) with gray-area or accidental cases. BPC-157 and gray areas BPC-157 is an experimental peptide with very limited human data (one small study of 12 people among 36 total studies reviewed). Anecdotally has been used for tendon/muscle healing; on the WADA banned list at all times (no TUE pathway currently). Gray areas exist in WADA criteria themselves (performance enhancement potential, health risk, "spirit of the sport"). THC example: banned in-competition with a relatively high threshold; removed alcohol from the list is an example of changes over time. Distinction between letter of the rules vs. moral/cosmic fairness; between intentional advantage-seeking and medical/recovery use. Testing realities & practical challenges Full USADA/WADA-style regimes require whereabouts reporting, out-o