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EPO (erythropoietin)

Erythropoietin is a glycoprotein that is produced by the kidneys and is commonly referred to as EPO. EPO is responsible for red blood cell production; the red blood cells are responsible for carrying oxygen to and through the blood. While the human body naturally produces EPO, thanks to recombinant DNA technology we now have exogenous EPO known as Epoetin Alfa. Medicinally, this form of EPO is most commonly used to treat anemia. At one time, Anadrol 50 or Oxymetholone was a primary combatant of anemia, but Epoetin Alfa has proven much safer. The first batches of exogenous EPO hit the U.S. market in 1984 thanks to Amegen, a biotechnology firm.


The onset of exogenous EPO was in many ways a breakthrough in the medical community. Before hand, the only ways to increase red blood cell count was primarily anabolic steroid use or blood transfusion. Due to anabolic steroid testing in sports, blood transfusions were the primary means of supplementing with exogenous EPO at one time. By storing your own blood, you could administer the blood, normally on a timed schedule, in order to increase your own red blood cell count. By doing this, as red blood cells carry oxygen to the blood this will increase muscular and cardiovascular endurance, increase energy levels and it will even enhance protein synthesis. This is the process that is often referred to as blood doping, which gained cyclist Floyd Landis an enormous amount of unwanted attention in 2010. However, thanks to exogenous EPO compounds like Epoetin Alfa, EPO levels can be increased without the need of a blood transfusion and without the need for anabolic steroids.

Landis is not the only athlete to ever increase his EPO levels. By blood transfusion or exogenous therapy, blood doping has been well noted in a host of sports such as boxing, long distance running, cycling and triathlon athletes, and in any sport where endurance is a primary factor. Through the 1990s, increasing Erythropoietin was a regular practice in many sports; it was even a part of horseracing. However, for the performance athlete, blood doping would hit a set back in 2000 when a detection method was first discovered. A simple urine test will detect exogenous EPO despite it being almost identical to naturally produced Erythropoietin.

While it can be tremendously beneficial to the performance athlete and a remarkable exogenous hormone for specific therapeutic purposes, EPO is not without possible side effects. The side effects of EPO can actually be far worse than the use of anabolic steroids as the risk of death does exist. Management in a medical setting will rarely lead to this outcome, but high levels of EPO can be problematic. High levels can potentially increase hemoglobin beyond a reasonable measure, which in turn can result in a heart attack or stroke. Some forms of exogenous EPO also contain albumin, which is essentially a human blood product although purified. There is always the possibility of transferring a viral disease from the donor to the user; however, such an outcome is extremely rare thanks to stringent screening.

When used properly and with close monitoring, death is highly unlikely, but EPO still carries a host of other possible side effects. At the onset of use some may experience dizziness, flu-like symptoms, headaches, muscle pain or fatigue. Such effects should clear as the body becomes accustomed in most cases. Other possible side effects of exogenous EPO supplementation include nausea, vomiting, diarrhea, high blood pressure, rash and in some cases, hyperkalemia. Hyperkalemia is a condition that refers to an excess of potassium in the blood. This can result in weakness and heart palpitations. Some individuals may also find the injected area to become irritated.

Exogenous EPO therapy can be administered intravenously (IV) or subcutaneously (sub-Q). IV administration will result in peaked blood levels within approximately fifteen minutes, where as sub-Q can take upwards of 24 hours, sometimes less. Sub-Q peaked levels will vary from one person to the next and can be hard to predict. However, the elimination half-life sub-Q will stretch to the 24 hour mark, where the IV method will fall in the 6-12 hour range.

As for the total dosing, this can be a bit tricky. Epoetin Alfa is normally dosed at a range of 50-100 units per kilogram of body weight in a therapeutic setting. Such a dose will normally be given three times per week and adjusted based on hematocrit level readings accordingly. For the performance athlete, dosing will normally start very low; it will not take much to see a massive result. Many find that starting with 10 units per kilogram of bodyweight to be a solid starting point; sometimes less, sometimes as little as 5 units per kilogram of bodyweight. Regardless of the specific dose, three injections per week for two weeks will suffice. This will produce results and will keep your RBC count increased for as much as three months, possibly longer.

EPO is not something you will find on the black market with any regularity. However, what is found will carry with it an enormous risk when it comes to counterfeits. Of all performance enhancing drugs, while its overall market is low, a large portion of that market is plagued by counterfeits. This can make obtaining quality EPO quite difficult. Further, this is not a cheap performance enhancing drug by any means. If you do not do some hard digging when looking for a supplier, you may very well find youve spent an enormous amount of money for nothing in return.

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