by Sharon Hopkins

Erythropoietin (EPO) or Hemopoietin is a glycoprotein (sugar attached) hormone, that acts as a precursor for red blood cell in the bone marrow and stimulates the manufacture of hemoglobin, the fragment within red cells that acts as a oxygen carrier. It also boosts the survival factor for developing cells. It act as a boost for the augmentation of specific kinds of blood cells in the bone marrow. Movement to higher altitudes or bleeding stimulates the release of erythropoietin. Hypoxia, or lack of oxygen supply stimulates erythropoietin production. There are two types of erythropoietin that work in similar ways. These are epoetin and darbepoetin.

The special kidney cells that produce this hormone are sensitive to the oxygen concentration in the blood, and increase the production of EPO during low levels of oxygen. Man-made commercial erythropoietin, which performs a similar function of stimulating red blood cells production is available. Erythropoietin is a colorless fluid in a small glass bottle stored in a refrigerator.

Anemia, as a result of chemotherapy or chronic renal failure is a regular feature and erythropoietin levels are low. Anemia is a common condition which results in erythropoietin release. They act on the marrow stem cells to raise the production of red blood cells. As it increases the hematocrit, it results in increased oxygen flow to the skeletal muscles. Pharmaceutical erythropoietin is used by athletes to improve the body's oxygen transporting capacity resulting in unfair competition advantages. EPO administration on diagnosis of anemia is regular. The administration lasts till a noticeable increase in blood hemoglobin levels are seen.

The probability or risk of adverse cardiovascular complications is greater if it is used to increase hemoglobin levels greater than 13.0 g/dl. It is believed to be common as a doping agent in endurance sports (triathlon and marathon). The normal level is 0-19 mU/ml (milliunits per milliliter). Raised levels indicate the presence of secondary polycythemia. The risks of high EPO levels include fainting, excessive bleeding, multiple punctures to locate veins, hematoma and infection.

Erythropoietin is administered by a subcutaneous injection under the skin in the thigh or abdomen. It is given once a day or once in three weeks based on the condition and depending on the kind of erythropoietin used. The erythropoietin side effects include Headaches and Flu-like symptoms with joint pain, dizziness, tiredness and fatigue. A pain killer might prove helpful, under a physician’s guidance. Recombinant DNA technology is effective in producing synthetic EPO for anemic individuals.

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