EPO article

EPO in Bodybuilding and Sport

Erythropoietin, also known as Epo, is a protein that is made by that kidney that stimulates the formation of red blood cells. Red blood cells carry oxygen in the blood and more red blood cells means better endurance performance.

Erythropoietin alpha is sold as Epogen and Procrit and a synthetic form called darbepoetin is sold as Aranesp. All of these products are produced in an injectable form. Aranesp is dosed weekly or every two weeks while Epogen is dosed three times per week.

Mircera is an artificial form of erythropoietin (EPO) stimulators similar to Amgen’s Epogen and Aranesp. But Mircera is thought to be superior to Epogen and Aranesp due to the use of pegylation technology that provides a sustained release of erythropoiesis stimulating proteins (ESPs). PEGylated erythropoietin (PEG-EPO) results when a molecule of polyethylene glycol is attached.

Mircera (PEG-EPO) belongs to a category of drugs called Continuous Erythropoeitin Receptor Activators or CERA because it continuously interacts with the EPO receptor producing longer lasting effects. Only 1-2 monthly injections of Mircera have similar results to three times weekly injections of Epogen. Mircera (methoxy polyethylene glycol-epoetin beta) is manufactured by pharmaceutical giant Hoffman-LaRoche that has been called “Super EPO.”


Hematide is the third generation EPO, first there was the usual EPO, then there was the ARANESP and meanwhile there is also the CERA. And now Hematide is already available on the black market.

The fact that it is available on the black market is because the drug companies send their new products to laboratories and hospitals anywhere in the world to have them tested. In some countries, a few boxes of those products would sometimes disappear to end up men like Fuentes and Ferrari.

The same happened with CERA, this product was not officially on the market in 2003, but it has been available for cyclist since the beginning of 2000 in. Some cyclists suddenly performed very well, but also recorded strange blood values. Despite the strange blood levels they tested negative for EPO , for the insiders, there was only one explanation: CERA.

People always wonder why there are always improved forms of EPO that hit the market. They find that the doping hunters already have enough on their minds. They forget that EPO is a very important drug for kidney and cancer patients. EPO stimulates the production of red blood cells in people whose body itself cannot do that. A few patients, however, built up a resistance to EPO, and it is also convenient for the patients when they no longer have to inject so often. Epo had to be injected three times a week, Aranesp once a week, Cera and Hematide once every three or four weeks.

Hematide is also much harder to detect than CERA. Hematide is a whole new molecule which is very different from EPA, but has the same effect. Doping hunters will need to develop a whole new test.

Another name to be monitored is EPO-mimetica, that is EPO in the form of pills, no more hassle with injections.

Dosing depends on the level of hemoglobin or hematocrit that is to be achieved. If hematocrit is elevated too much, the user runs the risk of heart attack or stroke due to increased blood thickness. Some athletes use IV fluids at the same time to dilute the blood as well as to evade blood testing. Erythropoietin testing is still in its infancy and is unreliable however, if the hemoglobin or hematocrit level is too high, then it will be interpreted as doping.

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.

EPO for Energyemia

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.

Is EPO Anabolic?

If people start asking questions on a Bodybuilding discussion forum, about Clenbuterol, DNP, Insulin or EPO most members discourage them and warn them for the severe consequences if it might go wrong. Reading the diverse posts and threads about EPO, you can find many strong pro’s and con’s. It’s always wise to be cautious because these compounds are dangerous when used without any knowledge.

Some cyclists died in the 80's. Was this entirely from EPO use? Who is to say. What we do know is that in the current cycling and endurance sports world, EPO use is rampant at the top levels. How often do you hear of someone ramping their hematocrit up too high at this day and age?

EPO is an amazing drug that has astounding benefits for someone training heavily. It increases your red blood cell count (hematocrit). The dosages of the drug affect everyone different. One guy can see a 1% increase in hematocrit (HCT) from 10,000 iu, whereas the next guy might need 30,000 iu. You also must be sure to get your serum ferritin levels above 100 before use. This can be accomplished with supplemental iron orally or by injection. Injection is much more effective, as you might imagine. You also need to be taking folic acid, vitamin C and B12 in order to allow your body to take in the iron as efficiently as possible. After beginning EPO injections you need to have blood work done to monitor your HCT levels. HCT levels about 55% are considered to be high, and this is where the drug really can be dangerous. That said, it takes a good amount of EPO to get your HCT above 55%, and it would be truly difficult to accidentally accomplish this.

EPO is mixed and injected sub-q exactly the same way as rhGH, with the exception of the injection location. You are trying to get these EPO proteins to your kidneys where the red blood cells will be created. SO, you have to pinch you love handle area, and do your sub-q injection on your side. Injecting near the belly button will drastically reduce the effectiveness of the drug.

It is also odd to me that if you attempt to search out the information I have just laid out above on the internet that you will be hard pressed to find anything at all. I think more people could benefit from the effects of an elevated hematocrit.

Getting oxygen to your muscles and brain is only a good thing. Imagine your hardest training days when bulking, and being able to push out 2 or 3 more reps than you used to be able to before failure? Imagine waking up and feeling more fresh and recovered from intense training than you ever have with hGH and AAS?

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 and even improves cognitive learning functions.

Side-effects of EPO use

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.

Evidence of synergistic/additive effects of sildenafil and erythropoietin in enhancing survival and migration of hypoxic endothelial cells. Gamella et all 2012

“Endothelial cell dysfunction is a common event to several pathologies including pulmonary hypertension, which is often associated with hypoxia.

We investigated the protective effects of sildenafil, a phosphodiesterase type 5 inhibitor, given in combination with erythropoietin (Epo), as it has been demonstrated that both drugs have antiapoptotic effects on several cell types.

We therefore conclude that both drugs exert protective effects on endothelial cells on hypoxia and that sildenafil enhances the migratory and angiogenic properties, especially in hypoxic conditions. Furthermore, we present evidence of possible additive or synergistic effects of both drugs”.

Victor Conte, the steroid guru convicted in the high-profile BALCO case, routinely recommended Viagra as part of drug cocktails in combination with the blood-booster EPO.

Hardcore Bodybuilders Underground Use of EPO Boosting.

Bodybuilders and other strength athletes using testosterone replacement drugs have long known the benefits of boosting EPO and red blood cells, as this is a secondary effect of this category of drugs.

Prior to the development of rhEPO, the popular anabolic steroid Anadrol was used to increase red blood cells. Anadrol has a reputation in bodybuilding for producing the best pumps and extreme vascularity. In addition to increasing muscle size and strength, noticeable improvements in workout endurance are reported to occur. To maximize these steroid induced EPO benefits, actual rhEPO use is suspected to be on the rise among bodybuilders and strength athletes.

Dual Action EPO and Nitric Oxide Stimulation

One of the hottest topics capturing the attention of athletes centers on using the drug rhEPO (recombinant erythropoietin). EPO (erythropoietin) is a hormone that is naturally produced in the body and primarily functions to stimulate the production of new red blood cells.

Increasing the amount of red blood cells increases the oxygen carrying capacity of the blood to deliver more oxygen to exercising muscles. The extra oxygen significantly increases the muscles' energy production and can therefore help to improve athletic performance output ability; higher intensity and longer duration. These benefits have led to the widespread use of synthetic rhEPO drug doping.

While EPO does increase the blood hematocrit, or red-blood-cell proportion, it presents potential problems. In some cases, EPO works too well, increasing the blood viscosity to the point of near sludging. This, in turn, decreases both blood circulation and oxygen delivery, thereby defeating the whole purpose of taking EPO for athletic purposes. And that’s exactly why athletes use nitric oxide boosters or even better an ED (erectile dysfunction) drug like Cialis, Viagra, Levitra or Avanafil which work due to their action on the nitric oxide pathway. Nitric oxide is a vasodilator, meaning that it dilates [opens up] the blood vessels and lowers blood pressure.

Due to the increase in oxygen carrying capacity and other vasoactive effects of interest, EPO has also gained interest among athletes outside of the endurance crowd; strength athletes, including bodybuilders, who are looking to increase exercise intensity, training session volume and quality of their workouts and those who are equally interested in achieving the "perpetual pump".

Nitric oxide stimulates the blood vessel dilating effects, to create a wider circulatory system conduit for the EPO stimulated red blood cell enriched volumized bloodstream to deliver more oxygen and nutrients to the muscles and other tissues, with a new level of performance expected from these synergistic effects.

But there are even more interesting aspects to the EPO blood boosting story, including combating the fatigue causing drop in pH levels, a synergistic Nitric Oxide connection and enhanced nutrient delivery to stimulate muscle growth.

From a straightforward athletic performance bio-energetic perspective, oxygen is required for the body to make energy (aerobically) to produce muscle contractions, in addition to anaerobic produced energy.