Author: Alex Thompson

Blood Doping and EPO: An Anti-Doping FAQ

If you feel that you are underperforming as an athlete, don’t let supplements be your first choice of treatment either. Healthcare providers measure EPO in your blood in milliunits per milliliter (mU/mL). Even if your EPO levels are within a normal range, you may still require treatment. The EPO detection method is widely accepted by the scientific community and has gone through an extensive scientific validation process. Accredited anti-doping laboratories worldwide have also successfully used it for years. In September 2005, the WADA Laboratory Committee reaffirmed its support of the method when applied appropriately.

1. Accredited anti-doping laboratories worldwide have also successfully used it for years.
2. The answer, in short, is that EPO didn’t do anything to muscle fibers and blood vessels.
3. If you follow sports, you’ve undoubtedly heard about athletes who have been caught using performance-enhancing drugs (PEDs).
4. Healthcare providers measure EPO in your blood in milliunits per milliliter (mU/mL).
5. Athletes who test positive for EPO face possible suspension, loss of competition titles, and even a lifetime ban from sports if the PED abuse is especially egregious.
6. Elaine Hinzey is a registered dietitian, writer, and fact-checker with nearly two decades of experience in educating clients and other healthcare professionals.

It is reported to increase the reticulocyte count within 10 days of initiation, followed by increases in the RBC count, hemoglobin, and hematocrit, usually within 2 to 6 weeks 7. Depending on the dose administered, the rate of hemoglobin increase may vary. In patients receiving hemodialysis, a greater biologic response is not observed at doses exceeding 300 Units/kg 3 times weekly 7. Erythropoietin (EPO) is a hormone produced by the kidney that promotes the formation of red blood cells by the bone marrow. EPO is part of a class of substances called Erythropoiesis-Stimulating Agents (ESAs).

Erythropoietin (EPO) is a glycoprotein hormone, naturally produced by the peritubular cells of the kidney, that stimulates red blood cell production. Renal cortex peritubular cells produce most EPO in the human body. Erythropoietin stimulating agents (ESAs) are recombinant versions of EPO produced pharmacologically. Examples of ESAs are epoetin, darbepoetin, and methoxy polyethylene glycol-epoetin beta. ESAs are generally indicated in conditions where there is impaired red blood cell production.

Training (with or without EPO) increased fiber size, capillary density, and several other parameters; EPO didn’t make it better or worse. Normal levels of erythropoietin range from 4 up to 24 mU/ml (milliunits per milliliter). The patient is usually asked to fast for 8-10 hours (overnight) and sometimes to lie quietly and relax for 20 or 30 minutes before the test.

Sports Medicine and Performance

So for anyone who says “Oh, EPO doesn’t really do anything, you still have to do the training…” Well, it’s true that you still have to train, but this graph makes it pretty clear that EPO has powerful effects on its own. Along those lines, VO2max jumped 27% in the training-EPO group, but it also jumped 15% in the sedentary-EPO group. There’s a new study from Danish researchers at Aarhus University, published in Experimental Physiology, that explores how the endurance drug of choice, EPO, works. A test for EPO was first presented at the 2000 Olympic Games in Sydney, Australia that was based on a complementary analysis using blood and urine matrix. With this test, a blood screening took place first, followed by a urine test to confirm possible use of EPO.

Erythropoietin can be used to correct anemia by stimulating red blood cell production in the bone marrow in these conditions. The medication is known as epoetin alfa (Epogen, Procrit) or as darbepoietin alfa (Arnesp). It can be given as an injection intravenously (into a vein) or subcutaneously (under the skin). Erythropoietin is a hormone that your kidneys naturally make to stimulate the production of red blood cells. A healthcare provider can measure your erythropoietin levels with a blood test. Blood doping is the practice of misusing certain techniques and substances to increase the number of circulating red blood cells (and hemoglobin mass) in the body.

What is blood doping?

Since hemoglobin within the red blood cells carry oxygen to the muscles, this lets the body transport more oxygen to working muscles and can increase their aerobic capacity and endurance, as well as improve recovery. Blood doping involves using pharmaceuticals, such as EPO and other biosimilars, to stimulate the production of more red blood cells, or the infusion of additional red blood cell volume. Blood doping involves the misuse of certain techniques and/or substances like EPO to increase one’s red blood cell mass, which allows the body to transport more oxygen to muscles and therefore increase stamina and performance. EPO has been shown to increase performance parameters such as maximal oxygen consumption (VO2max) and time to exhaustion, which is why it’s commonly abused in endurance sports. The most common use is in people with anemia (low blood count) related to kidney dysfunction. When the kidneys are not properly functioning, they produce less than normal amounts of erythropoietin, which can lead to low red blood cell production, or anemia.

Subsequent stage, the colony-forming unit-erythroid (CFU-E), expresses maximal erythropoietin receptor density and is completely dependent on erythropoietin for further differentiation. Precursors of red cells, the proerythroblasts and basophilic erythroblasts also express erythropoietin receptor and are therefore affected by it. Erythropoietin (EPO) is a naturally occurring protein hormone produced by cells in the kidneys. These cells are sensitive to the oxygen concentration in the blood, and release increased EPO when the oxygen concentration is low. The erythropoietin gene has been found on human chromosome 7 (in band 7q21).

Psychiatry and Mental Health

Erythropoietin is produced by interstitial fibroblasts in the kidney in close association with the peritubular capillary and proximal convoluted tubule. Liver production predominates in the fetal and perinatal period; renal production predominates in adulthood. The use of performance-enhancing drugs spans the categories of legitimate use and substance abuse. Atypical ABP profiles are used to facilitate target testing and guide further ESA analyses. Not only is there no guarantee that EPO can improve sports performance, but there are serious health risks to be aware of as well. Abuse of EPO made world headlines when Floyd Landis, the 2006 Tour de France winner, was stripped of his title after testing positive for doping.

In a clinical setting, EPO is primarily used for kidney failure, chemotherapy, and other medical conditions involving red blood cell loss and anemia. The increased red blood cells resulting from EPO therapy can “thicken” the blood, increase vascular constriction, and cause hypertension (high blood pressure). Thicker and more viscous blood puts an increased strain on the heart, thereby increasing the risk of blood clots, heart attacks, and stroke.

How can I increase my erythropoietin levels naturally?

This may be due to chronic smoking or living in a high-altitude environment where air oxygen levels are lower. Elevated EPO from a high-altitude environment is normal and appropriately high. The answer, in short, is that EPO didn’t do anything to muscle fibers and blood vessels.

Instead, talk to your coach about safer options, such as nutrition, alternate forms of training, or the implementation of sports psychology techniques. If you need to increase your red blood cell count for medical reasons, consult with your doctor to develop a treatment plan that makes sense for you. For example, erythropoietin has been misused as a performance-enhancing drug in athletes such as cyclists (in the Tour de France), long-distance runners, speed skaters, and Nordic (cross-country) skiers. Erythropoietin has been banned by the Tour de France, the Olympics, and other sports organizations.

EPO is commonly marketed under the brand names Procrit® and Epogen® in the US, Eprex and NeoRecormon in Europe and elsewhere. Epogen® and Procrit® contain 2.5 mg human serum albumin, which prevents the drug from sticking to the vial, and acts as a carrier molecule to help the EPO remain in the bloodstream until it reaches its destination at the bone marrow. ESAs are generally indicated in conditions where there is impaired red blood cell production. Epoetin alfa serves to restore erythropoietin deficiency in pathological and other clinical conditions where normal production of erythropoietin is impaired or compromised. Epoetin alfa was shown to be effective in increasing hematocrit in zidovudine-treated HIV-infected patients and anemic cancer patients undergoing chemotherapy Label.