Erythropoietin
and Eva Rudolf-Müller, doctorValeria Dahm is a freelance writer in the medical department. She studied medicine at the Technical University of Munich. It is particularly important to her to give the curious reader an insight into the exciting subject area of medicine and at the same time to maintain the content.
More about the expertsEva Rudolf-Müller is a freelance writer in the medical team. She studied human medicine and newspaper sciences and has repeatedly worked in both areas - as a doctor in the clinic, as a reviewer, and as a medical journalist for various specialist journals. She is currently working in online journalism, where a wide range of medicine is offered to everyone.
More about the experts All content is checked by medical journalists.Erythropoietin (erythropoietin, epoetin) is an important hormone in the body. It is mainly produced in the kidneys and stimulates the formation and maturation of red blood cells (erythrocytes) in the bone marrow. In sport, erythropoietin is often used as an illegal doping agent to improve performance. Find out what erythropoietin can tell you about your health here.
What is erythropoietin?
Erythropoietin is a hormone that consists of a protein and several sugar groups (glycoprotein). It is also called erythropoietin or epoetin. The term erythropoietin comes from ancient Greek and is made up of the words "erythros" (red) and "poiein" (to form).
If the number of red blood cells (erythrocytes) or the oxygen level in the blood drops, the kidneys in particular produce erythropoietin. The liver, brain, uterus, testes and spleen are also able to produce the hormone.
Erythropoietin reaches the erythropoietin receptors (EPOR) via the blood. These are located in the bone marrow. As the hormone binds to these docking sites, the formation of erythrocytes is stimulated via several intermediate stages from so-called "erythropoietin responsive cells" (ERC). If the body needs more erythrocytes, for example in the case of anemia (anemia), production can be increased eight to ten times by increasing the release of erythropoietin.
Erythrocytes carry oxygen in the blood and only survive for about 120 days. Because of this, the bone marrow has to keep getting supplies. If the erythropoietin is insufficient, it can also be given as a drug (EPO) for certain diseases. These diseases include various forms of anemia such as renal anemia or anemia caused by a tumor or its therapy.
Doping with EPO
Above all in endurance sports, where the aim is to get as much oxygen as possible to the cells as quickly as possible, EPO is misused: It can increase the endurance performance of an athlete by more than ten percent and is therefore often injected as an illegal doping agent. However, EPO increases the risk of suffering a heart attack or stroke.
An artificial supply of EPO during doping can often only be proven with difficulty, since the athletes only inject small doses that are broken down by the body very quickly. EPO is often no longer detectable after six to eight hours.
When is the value of erythropoietin determined?
When looking for the cause of anemia (anemia), erythropoietin provides important clues. The value is also measured if there is an excess of red blood cells (polyglobules), as some tumors produce erythropoietin on their own. When treating such tumors, the success of the therapy can be assessed by regularly measuring the erythropoietin level.
Normal erythropoietin value
The level of erythropoietin in the blood can be determined in both serum and plasma. The hormone level is subject to daily fluctuations: it shows a minimum in the morning and a maximum around midnight. The unit of measurement U / l stands for the enzyme unit (U) per liter.
|
U / l | |
|
adult |
5 - 25 |
When is erythropoietin decreased?
In severe kidney diseases such as chronic kidney failure, the kidneys are no longer able to produce sufficient amounts of erythropoietin. Renal anemia develops with reduced erythropoietin levels.
Tumors or fighting them with chemotherapeutic agents or radiation therapy can also lead to a deficiency. Classic symptoms are shortness of breath, headaches and a general reduction in performance due to the anemia.
A greatly increased number of erythrocytes inhibits the production of the hormone. Diseases of the bone marrow lead to such an excess of blood cells as, for example, polycythemia vera.
When is erythropoietin increased?
On the one hand, a lack of oxygen leads to an increased concentration of erythropoietin in the blood, as the body wants to compensate for the deficiency by increasing the production of red blood cells. This is the case, for example, when staying in high mountains. Heart and lung diseases or carbon monoxide poisoning also lead to increased erythropoietin formation.
On the other hand, anemia is one of the most common reasons for elevated erythropoietin. If there is an iron deficiency, not enough red blood cells can be produced in the bone marrow (iron deficiency anemia). In response, the kidneys try to increase the production of red blood cells by increasing the release of erythropoietin.
Cancer cells very rarely produce erythropoietin. This is particularly possible with kidney and liver cancer as well as ovarian cancer (ovarian cancer). In the second and third trimesters of pregnancy, the increase in erythropoietin levels is quite natural.
What to do if the erythropoietin is low or high?
If the value is lowered due to renal anemia, a tumor, chemotherapy or radiation therapy, artificially produced erythropoietin can alleviate the symptoms and even extend the patient's survival time.
An increase in the erythropoietin level should always be clarified in order to rule out serious illnesses or to be able to identify and treat them as early as possible.
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