What is Epoetin (erythropoietin)?

Erythropoietin (also known as EPO) can be defined as hormone that is produced by the kidney. It functions to promote red blood cells formation in the bone marrow. The kidney cells that are responsible for the production of erythropoietin are quite sensitive to low levels of oxygen in the blood which travels via the kidney.

The particular kidney cells make and consequently release erythropoietin in instances of low oxygen levels. Low levels of oxygen are likely to indicate that the quantity of red blood cells or even hemoglobin molecules have diminished. Chemically, erythropoietin can be described as a protein that has an attached sugar i.e. a glycoprotein. In fact, it is one among many similar glycoproteins which serve as effective stimulants for the growth of certain kinds of blood cells found in the bone marrow. Currently all EPO in the market is in form of Recombinant human erythropoietin (rHuEPO). The 5 agents that stimulate erythropoiesis and are available include darbepoetin-alpha, epoetin-delta, epoetin-omega, epoetin-beta and epoetin-alpha.

What is Epoetin
Is It Safe To Buy Epoetin?
EPO is a drug that is both safe and effective to use especially when it is administered in the correct manner. It is approved by the Food and Drug Administration because their policy is that all drugs should be safe and effective. This means that it is therefore perfectly safe to buy Epoetin and use it.


Sources Of Erythropoietin
The sources of erythropoietin can be mainly categorized into 2 i.e. natural sources and synthetic sources. They are explained in detail below:

1.Natural Erythropoietin
Most of the natural erythropoietin is produced by the renal cortex in the kidney. However, some natural erythropoietin is produced in the liver (especially fetus), the uterus and brain. The natural production of erythropoietin is stimulated by very low levels of oxygen inside the interstitial cells found in the peritubular capillaries of the kidneys. The kidneys initiate close to 90% of the natural production of erythropoietin.

2.Synthetic Erythropoietin

Synthetic erythropoietin can be described as a drug which is manufactured to treat disease and should therefore not be used by any endurance athlete. The primary use of administrating exogenous sources of EPO i.e. not produced within the body of EPO in human beings include the treatment of people who are suffering from anemia. This is especially for people who have anemia that is related to chemotherapy for cancer and kidney failure.
How EPO Works

How EPO Works
EPO essentially works by stimulating the production of red blood cells. This has the effect of improving the delivery of oxygen to the working muscles from the lungs. This is what allows athletes to have an improved performance and endurance. If you were wondering does epo boost work, now you know it does and it has a scientific background that is easy to follow.

EPO interacts with EPO receptors on the surface of red blood cells in a rather direct manner. This triggers the activation of numerous signal transduction pathways that in turn results in both the proliferation as well as the terminal differentiation of the erythroid precursor cells. This action functions to provide protection to the red blood cells precursor apoptosis. The length of time for which EPO concentrations are maintained is what mainly controls the magnitude of increase in the con centration of red blood cells as a response to the administration of the EPO.

Why It is Important?
EPO is important for the regulation of red blood cell production. It helps patients who are suffering from chronic renal failure or anemia. Erythropoietin is effective in the stimulation and maintenance of erythropoiesis in a good number of patients who receive its treatment.
Both recombinant EPO and endogenous EPO promote the body to produce increased number of red blood cells. This means that there is an increase in the transmission of oxygen from the lungs to each and every system of the human body, inclusive of muscles. The result is always an enhanced stamina with regard to sport and cures symptoms associated with anemia.
The importance of EPO in human health cannot be over emphasized.
Health Benefits
There are several health benefits that are associated with erythropoietin, the notables ones are as listed below:

i. Anti-inflammatory – EPO is very effective with regard to increasing the production of certain cytokines i.e. IL-10, IL-4 and IL-2 by T cells that are activated. This means that it directly decreases the responses of regulation of pro-inflammatory T cells.

ii. Anemia – EPO has clinical uses for anemia associated with patients with HIV infection, cancer chemotherapeutic agents and end-stage kidney disease. The use of erythropoietin is beneficial to patients who have low hemoglobin.

iii. Muscular Performance – EPO improves the long-duration muscular performance of athletes. It achieves this by increasing the number of red blood cells that carry oxygen to the body tissues. In addition, reliable clinical experience and experimental evidence indicates that erythropoietin positively affects cardiac and skeletal muscle.

iv. Protects The Brain – Erythropoietin is indeed a promising neuroprotective agent. This is because it has bimodal effect on oxidative stress, glial reactivity and on cell death.

v. Prevent Eye Damage – Treatment using EPO serves to fully protect the retina following trauma. The effective forms of EPO are treatment with non-erythropoietic and intraocular delivery of EPO.

vi. Bone Regeneration – EPO has indicated a significant effect in the formation of bones as well as in the formation of new blood vessels (angiogenesis). Furthermore, it has the capacity to facilitate the repair of bone defects.

vii. Wound Healing – EPO can promote wound healing when administered in low doses. This is especially for ulcer wounds in diabetics.
Is EPO Obtainable As Prescribed Medicine?
EPO can be obtained through a prescription but this is only allowed for people who have been diagnosed with cancer or are anemic. This means that EPO is strictly a prescription drug and is the only way of how to get epo legally. Athletes who want to enhance their performance/endurance should therefore not buy the drug as it provides them with an unfair advantage over others.
Medical Uses
Erythropoietin is utilized in several clinical settings, the main ones are as listed below:
• It is commonly used for the treatment of people who have been diagnosed with anemia that is specifically associate with kidney dysfunction. This is because when the kidneys fail to function properly, the situation results in decreased quantities of erythropoietin that translates to anemia or the low production of red blood cells.

• It is used in the treatment of anemia that is associated with the medication AZT that is used in the treatment of AIDS.

• It is used in the treatment of anemia caused by cancer.

• Erythropoietin is caused for the treatment of anemia that is a result of dysfunctional bone marrow.

• It is used in the treatment of patients who have been diagnosed with renal failure.

• Erythropoietin is used to treat patients before they go for surgical operations.

• It is used in the prevention of anemia in patients who are undergoing the renowned platinum-based chemotherapy.

• It is used to treat anemia of prematurity.

Facts You Must Know Before Using Erythropoietin

The following are a few facts that all patients must know before they start using the drug erythropoietin:

i. Patients who have a history of allergic reaction to erythropoietin or even to the drug albumin should consult with their doctor first before using it.

ii. Patients who have been diagnosed with cancer like leukemias that emanate from the bone marrow should not use erythropoietin.

iii. Patients who are using erythropoietin should take oral iron tablets while using it so as to increase the effectiveness of the drug.

iv. It is important for patients to regularly monitor their blood pressure while using erythropoietin. In addition, patients who have been diagnosed with blood pressure which is not under control are advised not to use erythropoietin.

v. Blood counts should be monitored before erythropoietin is received as well as regularly when using the drug erythropoietin. The exercise helps doctors to determine if a patient is a candidate for the treatment as well as if the dose being prescribed to the patient requires to be decreased or increased.
How To Use EPO
The following are some guidelines of how to use epo:
1) Erythropoietin should be administered subcutaneously between the muscle and the skin and this should be done routinely. This helps in maximizing the effects of the drug.

2) All patients who are receiving recombinant human erythropoietin (rHuEpo) should use iron supplementation. This is attributed to the fact that people who are undergoing rHuEpo treatment tend to develop a functional iron deficiency.
3) The weekly dosage of EPO varies from 50UI to 300UI per one kilogram of body weight. The dosage depends on target goals desired, base levels and personal characteristics of the user.

4) EPO for injection is sold in recombinant form (rhEPO). Patients should make EPO injections using thin needle with insulin syringes. It has a short half-life of approximately 4-5 hours.

Levels Of Erythropoietin
An erythropoietin test is required in order to determine the levels of EPO in blood. The level is measured in international units per liter (commonly abbreviated as IU/L). The test that determines the levels of erythropoietin only requires a blood sample.

1.What Are The Normal EPO Levels?
Normal EPO levels can vary from 3.7 IU/L to 36 IU/L.

2. What Are The Abnormal EPO Levels?
Abnormal EPO levels are anything above the normal range stated above. Levels that are higher than normal may indicate that a patient has anemia. In fact, EPO levels may become thousand times higher compared to the normal in severe cases of anemia. However, EPO levels that are unusually low may be as a result of polycythemia vera. It is disorder of the bone marrow that makes the body to produce excess red blood cells. In addition, EPO levels that are low indicate that a patient has kidney disease.
Be Alert If You Are Taking Epoetin
There are a few things that patients should avoid after taking EPO, these include the following:

i. Driving of vehicles.
ii. Operating heavy machinery.

Side Effects Of EPO
There are a few side effects that are associated with the use of EPO, these include the following:

Burning or pain at the injection site. This effect can be reduced by ensuring that erythropoietin is at room temperature prior to administering the injection.

• Patients experience some swelling

• Patients suffer from diarrhea

• People who use EPO may feel weak.

• Users may suffer from shortness of breath.

• It can cause fatigue in patients.

• Patients experience fevers.

• It can cause patients to vomit.

• The use of EPO can result in nausea.

• Seizures is also a side effect but only for patients diagnosed with kidney failure.

• Synthetic EPO is tied to side effects like blood clotting and hypertension.

Erythropoietin Warnings During Pregnancy And Breastfeeding
Patients who are pregnant or are even trying to get pregnant are strictly advised to consult their doctor before they receive erythropoietin. This is because the drug may have adverse effects on the development of the baby in the womb or may affect the mother’s milk. This is a common warning on almost all packaging of the EPO drug.

Natural Diet And Ways To Increase Epoetin

Natural diet to increase EPO

It is very important for individuals to have knowledge of how various supplements and foods affect their natural Epoetin. The following are natural diet and ways by which to increase Epoetin:

i. Protein adequacy is a major factor in the production of erythropoietin. This means that the quality and adequacy of dietary protein has a significant impact on EPO production. The adequate intake of protein here refers to 1.4-1.7 grams/kilogram of body weight every single day for endurance athletes.

ii. Dietary iron is yet another nutritional element that affects the production of EPO. People should consume the daily value of iron if they would like to increase their oxygen carrying capacity. Food sources for iron are egg yolks, liver and meat. In addition, most cereals, bread and flour are fortified with iron.

iii. Calories are also required to increase Epoetin. Calorie efficiency is key to the optimal release of EPO.

iv. Glucose and hormone affect the production of Epoetin. The production of EPO has hormonal-dependant roots that are complexly associated with glucose metabolism as well as calorie adequacy.

v. Iron absorption is another factor that affects the production of Epoetin. Dietary interventions greatly promote the absorption rate of nonheme iron during the production of Epoetin. This is why it is important to consume foods that enhance the absorption of nonheme iron like red meat and foods rich in vitamin C.

vi. Fitness provides a good physiological environment for the natural increase of Epoetin.
Conclusion
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