Advantages and Disadvantages Erythropoietin for Endurance Athletes

EPO (Erythropoietin), its advantages and disadvantages for endurance athletes.

For the purposes of this essay an understanding of what EPO (Erythropoietin) is will be established. An understanding of how EPO works in the body will also be established. EPO’s use in medicinal practice is wide and varied and will be referred to also. Given an understanding of its mechanism and its effect on the body, its usefulness to endurance athletes will be established. Studies on its effectiveness will then be analyzed and referred to with reference to the health risks attached to this use. This will culminate in a brief overview of the history of EPO usage or “Blood Doping” in professional sports.

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EPO acts in the body as a glycoprotein hormone that regulates red blood cell (RBC) production. Its function is as a protein signaling molecule for RBC precursors in the bone marrow. EPO is produced naturally in the body by interstitial fibroblasts in the kidneys and by perisinusoidal cells present in the liver. Production of EPO in adults is most common in the kidneys. Notwithstanding, EPO is also involved in the healing process after the infliction of wounds and is part of the cerebral response to neuronal trauma.

In terms of modern medicine, EPO is harvested from cell cultures and is used to treat anemia (a decrease in the bodies RBC count). EPO is also used in the treatment of Myelodysplasia, which is a type of cancer that inhibits the bone marrows ability to produce healthy RBCs. Most EPO prescribed to patients contain major health warnings about increased risk of heart attack, stroke and even the reoccurrence of certain tumors.

Put simply, athletes who harness the power of EPO can go harder for longer. EPO allows bone marrow to create RBCs and thus extra hemoglobin. Consequently EPO is most generally utilized among endurance athletes as a means to increasing their RBC count which in turn results in better oxygen transportation along these lines and a vast improvement in aerobic respiration. The quicker the rate of high-impact respiration, the higher the level at which the competitor can work without using the anaerobic frameworks which deliver lactic acid and increase weakness. Traditionally, “blood doping” involved training at high altitude for a period of between 4 and 6 weeks. The blood that was rich in oxygen was then harvested from the body exactly as one would donate blood. The oxygen rich blood was then transfused back into the body at sea level prior to or during competition. Despite its natural occurrence in the body it can be synthesized into a serum that people can inject through the skin. Therefore its usefulness for endurance athletes is quite apparent.

A vast number of studies concerning the effectiveness of EPO injection for Endurance athletes. The primary study to be analyzed as part of this essay is “Hemoglobin Mass and Running Time Trial Performance after Recombinant Human Erythropoietin Administration in Trained Men” by Yiannis Pitsiladis et al. The study was undertaken by infusing long distance runners with EPO every other day for a month. Their times were enhanced 3% to 6% on average after 4 weeks of use.

The Pitsiladis study was part funded by the World Anti-Doping agency. They stated the reason for funding the study was the find ways of increasing the detectability of EPO use among professional endurance athletes, rather than to highlight the drug’s effectiveness. Be that as it may, the current report made no notice of any such testing or test outcomes. The study did note that EPO infusions, which expand the body’s RBC mass (consequently prompting more prominent oxygen conveyance and speedier running exhibitions on persistent occasions), additionally diminish the body’s aggregate blood plasma volume.

A further study by Prof. Max Gassmann from the University of Zurich stated that EPO usage had massive psychological benefits to an athlete. He found that there were serious gains to be made in terms of motivation after treating genetically modified mice that produced human EPO solely in their brains. He surmised that EPOs possible mental health benefits were limitless given proper dosage and that it could be used to potentially alleviate the devastating symptoms suffered by Schizophrenics.

I contrast to this, a peer reviewed study of the effectiveness of EPO doping for cyclists suggested that there was no tangible evidence to support the claim that EPO enhances performance in top athletes. The study was titled “Erythropoietin doping in cycling: Lack of evidence for efficacy and a negative risk benefit” by J A A C Heuberger et al. The summary of their findings suggested there was no increase in performance for top cyclists and that performance was based on more than V02 max results and that higher power output for longer doesn’t correlate with athletic performance, particularly in cycling. The main finding of the report was that the health risks associated with EPO supplementation were simply not worth the increase in V02 max or power output.

Athlete’s use of artificial EPO became a very popular method of performance enhancement, specifically for cyclists in the 1980s and has been linked with many champion athletes being stripped of titles and banned from the sport. The most famous case of admitted EPO use was by seven times Tour De France Champion, Lance Armstrong. Advances in retroactive testing of blood, hair and urine samples may lead to other high profile athletes suffering the same fate in the years to come. However athletes prior to the EPO era were more inclined to use anabolic steroids and amphetamines as a means of performance enhancement.

To summarize, EPO usage leads to an increase in RBC mass and its ability to transfer oxygen molecules around the body. It allows for an increase in Vo2 max and power output. However its effectiveness on the performance of top athletes is up for debate as an increased ability to go harder for longer does not necessarily lead to increased athletic performance. Despite this EPOs prevalence endurance sports would suggest that many athletes across different codes consider it a performance enhancing substance, despite the obvious health risks.

References

• Amby Burfoot. (2013).Study: EPO Effective, Long-Lasting.Available: http://www.runnersworld.com/race-training/study-epo-effective-long-lasting. Last accessed 22nd Nov 2014.
• J A A C Heuberger et al. . (2013). “Erythropoietin doping in cycling: Lack of evidence for efficacy and a negative risk benefit”.British Journal of Clinical Pharmacology. 75 (6), 1406-21.
• Andy Layhe. (2011).Types of Drugs and Methods Used in Cycling. Available: http://bikepure.org/resources/list-of-banned-substances/types-of-drugs-and-methods-used-in-cycling/. Last accessed 22nd Nov 1014.
• Carsten Lundby and Niels Vidiendal Olsen. (2011). Effects of recombinant human erythropoietin in normal humans.The Journal of Physiology. 589 (1), p1265-1271.
• Yannis P. Pitsiladis et al.. (2013).Haemoglobin Mass and Running Time Trial Performance after Recombinant Human Erythropoietin Administration in Trained Men.Available: http://www.plosone.org/article/info:doi/10.1371/journal.pone.0056151. Last accessed 18th Nov 2014.
• Elizabeth Quinn. (2014).EPO and Blood Doping in Sports.Available: http://sportsmedicine.about.com/od/performanceenhancingdrugs/a/EPO.htm. Last accessed 19th Nov 2014.
• Johannes Vogel, Max Gassmann. (2007). Erythropoietic and non-erythropoietic functions of erythropoietin (Epo) in mouse models.The Journal of Physiology. 584 (1), 709.