Boost Your Energy with EPO

Erythropoietin or EPO is one of the naturally-occurring hormones in the human body that has been used for medical purposes. Recombinant human EPO drugs are still currently in use as treatment for anemia resulting from chronic kidney diseases or chemotherapy treatments. Unfortunately, EPO is also one of the negatively publicized drugs, due to reported abuse by high-profile athletes.  

Erythropoietin is a glycoprotein produced by the kidney, a signaling protein (cytokine) that plays an important part in intra-cellular communications. Stimuli like bleeding or increase in altitude (where oxygen is scarce) trigger the release of EPO in the human body. The main function of EPO is to bind with receptors in the bone marrow to stimulate red blood cells (erythrocytes) production. It is for this reason that it is considered useful in treating anemia.

Although EPO had been studied in the 1970s and in use since the 1980s, the use of exogenous (produced outside the body) EPO as a performance enhancing drug is relatively recent. Classified as an Erythropoietin Stimulating Agent (ESA) when used to enhance performance, exogenous EPO is detectable in the bloodstream as it differs slightly from the endogenous (produced by the body) protein.

The main benefit that recombinant EPO gives users is the increase in red blood cells (RBC) which function as the oxygen-carrying containers in the blood. As a result of the increased oxygen level, aerobic efficiency and energy level is increased. In other words, more RBCs delivering oxygen to muscle tissues is directly associated with a significant boost in speed, strength and endurance of athletes [1].

There are also studies which found that EPO enhances protein synthesis, which means that EPO is an anabolic drug. Animal studies on EPO had shown substantial gains in weight and hastened repair of injuries, and this was attributed to the presence of myoblast (muscle stem cell) in the muscles. This is significant as muscle fibers are formed when myoblasts fuse together – and the presence of myoblasts during EPO treatment strongly points to the correlation between the drug and muscle building activity in the body. Aside from adding mass, EPO aids respiration, whole body metabolism, energy efficiency [2] and even improves cognitive learning functions [3].  

Reckless use of EPO, however, is not advised. Hematocrit - the proportion of blood volume occupied by RBCs – defines the concentration and viscosity of the blood where the normal values are around 46% for men and 38% for women. Use of EPO artificially increases the hematocrit, which means that the blood is more concentrated and thicker than normal. Artificial increases can normally be absorbed by the body, but only up to a certain level (for athletes, 55% is believed to be ideal). If the increase exceeds the level that the body can absorb, the blood would turn into a sludge that can clog arteries, and may result to elevated blood pressure, stroke and heart attacks. This is especially dangerous for athletes who exercise for prolonged periods, as dehydration also reduces the water content of the blood and thus may shoot-up the hematocrit which is already elevated to start with.

The drug, though banned by international sports organizations, can be used by recreational enthusiast to boost speed, strength and endurance, especially when competing in contests with no doping tests. A starting dosage is typically 20 i.u. per kilogram bodyweight, three times/week, and a once-a-week maintenance dose of 20 i.u. /kg BW can be taken 2-4 weeks after the start of the regimen. Recombinant EPO (rhEPO) is sold as an injectable, usually in freeze dried powder that is reconstituted with sterile water prior to injection. Two of the current brands of EPO are Epogen and Procrit.

References:

1. Sports Med. 2003;33(3):187-212
2. Semin Oncol. 2002 Jun;29(3 Suppl 8):69-74
3. Clin Breast Cancer. 2002 Dec;3 Suppl 3:S116-20