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This is an old thread but here goes my answer nonetheless, I hope you get to see it.

VO2 max capacity is an adaptation that all athletes develop through cardio training, so much so that there are drugs that make this adaptation in red blood cells abnormally abundant, like Epoetin Alfa/erythropoietin. If a drug can do it, making it permanent could be possible too.

As far as we know, the drug that Lance took makes you have high blood pressure, introduces iron deficiencies and (in people with previous heart conditions) may cause cardiac insufficiency, so it's not pure benefits.

In short, your argument of 'all mutations have benefits and drawbacks' is right, but if the benefits are that high, there's no question of who'll do it but what counter-indications are you willing to put up with for the massive benefits it brings in sports (and life!) performance. Lance said he felt like a god when he was on it, he slept like 3 hours a night, rode for 12 hours a day, and won the Tour de France with it, with no sequelae, neither (according to him, so take it with a grain of salt).

Before anyone says 'just take steroids, man', I'm all in favor for a separate league of juicers in all sorts of sports, be it team sports, combat sports and solo endeavors. To me it'd be super interesting to see what humans are really capable of.



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