Erythropoietin (EPO) Risks & Side Effects: It’s Bad For Your Brain!

In the heat of competition, many athletes have resorted to using erythropoietin (EPO) as a performance enhancing” drug, but new research shows that doing so may increase their risk of developing vascular problems in the brain.

In a new study, Swiss researchers led by Dr. Peter Rasmussen of the University of Zurich’s Center for Integrative Human Physiology found that both short- and long-term use of EPO raised blood pressure by constricting arteries, which reduces the flow of blood to the brain.

The study findings are published online by Federation of the American Societies for Experimental Biology (FASEB) Journal, and were reported by the United Press International (UPI) on Dec. 15.

“EPO is used by doctors to increase red blood cells in sick people who can’t make enough of them. When EPO is used by healthy bikers and runners to boost their performance, it’s called cheating,” said Dr. Gerald Weissmann, editor-in-chief of The FASEB Journal in an editorial accompanying the study results.

“Now we know that folks who use EPO covertly are cheating not only the time-clock, but themselves,” Dr. Weissmann said. “Not only is EPO likely unsafe in healthy athletes, but there are many other ways to build up stamina without drugs.”

Dr. Rasmussen and his colleagues evaluated the effects of acute high doses of EPO for three days, as well as chronic low doses of EPO for 13 weeks in two groups of healthy men.

The researchers also examined the responsiveness of brain vessels during rest and during bike-riding exercise, with and without hypoxia—or low oxygen concentration. Blood vessels were analyzed using ultrasound measurements that calculated how much oxygen reached the brain.

The study found that prolonged EPO administration increased hematocrit—the concentration of red blood cells in blood—while acute administration did not. Both groups were also found to have increases in blood vessel constriction and higher blood pressure.

The findings also contradict earlier evidence suggesting that EPO may be a viable early treatment for stroke victims.

“The new findings of suggest a need to scrutinize present indications for EPO, to better delineate positive versus adverse health effects of EPO for each patient,” said Dr. Rasmussen.

“Future research should aim at developing an EPO-based agent for treatment that does not have a negative effect on the blood vessels of the brain,” he said.

EPO misuse is dangerous
Performance enhancing drugs are used to dull pain, build muscle quickly, reduce weight, lower stress, and even hide other drugs that may be in the system.

Different drugs are used for each of these purposes, and some athletes take a daily ‘cocktail’ that consists of a variety of steroids and growth supplements.

Erythropoietin, a naturally occurring protein hormone that is secreted by the kidneys during low-oxygen conditions, stimulates the bone marrow stem cells to make red blood cells—thus increasing the delivery of oxygen to the kidney.

EPO has been much misused as a performance-enhancing drug by endurance athletes like long-distance runners, speed skaters, and cross-country, Nordic skiers and even some Tour de France cyclists.

Endurance athletes use EPO to increase their oxygen supply by as much as seven to 10 percent. But the main side effect is that increased red cell density caused by EPO thickens the blood, and thickened blood—which is more like honey than water—does not flow through the blood vessels well. To pump the thickened blood, the heart must work harder, and this increases the chances of heart attack and stroke.

When misused by athletes, health experts warn that EPO is especially dangerous because
dehydration can further increase the blood’s viscosity—increasing the risk for heart attacks and strokes.

EPO has been banned by the Tour de France, the Olympics, and sports organizations worldwide, but it is very difficult to detect.

Long in demand
“If I could give you a pill that would make you an Olympic champion—and also kill you in a year—would you take it?”

Dr. Gabe Mirkin, a physician and sports medicine expert, was said to have asked competitive runners that question before a Washington D.C. road race in 1967.

Of about 100 athletes who returned Mirkin’s questionnaire, more than half said that they would take the pill, according to a HowStuffWorks article on performance enhancement drugs.

The prevalence of performance-enhancing drugs in sports has increased in the 43 years since Mirkin handed out his survey.

Cheating by using enhancement substances for sporting events reportedly dates back to ancient Greece, where writings refer to ‘performance potions’ and ‘performance elixirs’ given to athletes in preparation for the Olympics.

In the latter half of the 20th century, testing technology became sufficiently advanced to begin screening athletes regularly and enforcing bans on the use of steroids and other enhancements.

But while performance-enhancing drugs are banned by organizers of the Olympics and other athletic organizations worldwide, the number of designer steroids being produced each year increases at an overwhelming rate, making it hard for athletic organizations to track.

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