EPO - Erythropoietin

General

Erythropoietin (EPO) is a natural glycoprotein hormone, which regulates production of red blood cells. Erythropoietin is more effective in stimulating and maintaining erythropoiesis than steroids. Therefore it is usually prescribed to treat anemia.

Since EPO increases the amount of red blood cells, it automatically increases the amount of oxygen delivered from lungs to different tissues, including muscles. In this way it increases endurance, which is important for athletes of different kind of sports.

Today allavailable erythropoietinis made by recombinant technology.It is calledrecombinant human erythropoietin (rHuEPO)

EPO in the SPORT

Due to its ability to increase endurance EPO became a new kind of doping among athletes. According to different studies, athletes using EPO had an 9% increase in VO2 max, 7% increase in power output, and a 5% decrease in max heart rate.

Before Erythropoietin hit the market, athletes practiced “blood doping”.It means removing and storing of certain volume of your blood and transfusing it before the contests. This procedure boosts the amount of erythrocytes, which leads to high endurance.

However, blood is not an easy substance to store and administer, which makes this procedure risky, messy and inconvenient. EPO can solve most of the “blood doping” problems, except for increased volume of erythrocytes. Some people regard this drug as dangerous, but it is not that dangerous if you use it properly. Nevertheless, if you exceed the dose itmay increase blood viscosity. This leads to thrombosis of blood vessels, which can be fatal.

Erythropoietin Dosage and Usage

The weekly doses of Erythropoietin vary from 50 to 300 IU per kilogram of body weight. It means thatmaximal dosage of a 176 lb (80 kg) athlete is 4000 U per injection. You should make injection few days/weeks before competition. Some athletes report about peak results after 2 weeks of usage (hematocrit level increases 3-4%). Remember that you should not use erythropoietin for more than 6 weeks!

The optimal scheme of EPO usage is the following:

• Loading phase (week 1-3)4500-12000 IU (6000 IU in average)
• Supportive phase(weeks 4-6) 3000-4000 IU

You should split the weekly dosage into3 equal injections.

There is also alternative scheme, such as 20-30 IU per kg for every shot (three shots a week). According to conservative scheme you should take 4500 IU / week (3 injections by 1500 IU) with 3000 IU / week for supportive phase (3 injections by 1000 IU).

Remember that higher doses faster induce erythropoiesis, which leads to higher results. However, they also increase theheath risks, besides they become more detectable by doping tests. Therefore, we do not recommend you to play with high doses.

In order to reduce the risk of thrombosis you should takeone tablet of aspirin 2 times a day. Take it after meal or along with milk to prevent stomach damage (milk can neutralize the aspirin acids).

How to inject EPO

EPO comes in the form of lyophilized powder which you have to dilute with sterile water before injection. Make injections with insulin syringe. There are 2 ways of EPO administration – subcutaneous and intravenous. They have different effects. During intravenous injection the peak level of the drug reaches its maximum very quickly and its half-life is rather short - 4-5 hours.

Meanwhile during subcutaneous injection it takes about 12-18 hours to reach the peak level and its half-life is about 24 hours. Make subcutaneous injectionin the outer upper arms, front of thighs, or abdomen (but not too close to umbilicus). The injection may burn due to cold temperature, however you can make it painless if you let it get room temperature between your hands.

Stacking EPO

You should be very careful if you stack Erythropoietin (EPO) with anabolic steroids.Some steroids like Anadrol may induce erythropoetesis and cause the critical mass of erythrocytes.

Some endurance athletes use EPO along with Winstrol, however we don’t have reliable information as to synergistic effect and side-effects of this combination.

If you use high doses you should take anticoagulant (such as Lovenox) in order to reduce deep vein thrombosis (DVT). For regular dosages aspirin is enough.

During rhEPO intake you should take oral supplementation of iron. However, Iron overdose can lead to symptoms similar to genetic hemochromatosis. Folic acid and Vitamins are also advisable.

Here is the weekly dosage of EPO stack

• 100 IU/kg of EPO
• 25mg of iron
• 25mg of folic acid
• 2500mcg of Vitamin B12

Duration of a cycle 10-20 days, 2-3 shots per week.

Doping control and EPO

Few years ago it was difficult to detect recombinant EPO, as it is almost identical to natural one. Therefore in the past an athlete could be banned according hematocrit level only (more than 50%). Unfortunately today there are precise urine and blood tests that can discern normal and synthetic EPO.

Therefore, an athlete shouldstop using EPO before the contest. So that theactive substance is eliminated from the body, but the effect stillremains.

it`s better to use smaller doses regularly than do a single big injection. This reduces the possibility of detection.After all smaller regular doses are more natural for your body than one big shot. Detection time may vary from 12 to 48 hours, however it greatly depends on the doses you use.

Side effects of EPO

Just like with other potent drugs, you should be verycareful with EPO. Remember that overdose may be fatal. The major risk of EPO usage is increased blood viscosity, which leads to thrombosis of blood vessels.However today we know how to reduce the risks.

EPO is more dangerous for those who exercise for a long time. During prolonged trainings you sweat a lot, and thus lose a lot of water, which increases blood viscosity. Therefore you should drink enough liquid, also take aspirin (or anticoagulants in case of high doses).

Do not use it for longer than 6 weeks! Do EPO cycles only 1-2 times a year before the most important competitions.

Among other side effects, one should mention headache, high blood pressure, flu-like symptoms, irritation in the spot of injection.