The last time the supplement EPO (erythropoietin) made headlines was in 2013.
That’s when cyclist Lance Armstrong admitted he cheated by using the performance-enhancing hormone to win all seven of his Tour de France titles.
Now, EPO is in the news again. Researchers say early findings show that it may have the potential to become a treatment for COVID-19.
What’s more, since it is completely natural, it has fewer side effects than many of the drugs now being tested against coronavirus.
EPO increases production of red blood cells, which bring oxygen to our muscles and brain. With more oxygen, we become faster, stronger, and have more endurance.
But there’s another reason Armstrong may have used it.
Since EPO is naturally produced in our bodies, it’s difficult to detect in doping tests. The tests have a hard time telling which EPO in an athletes’ body was produced naturally and which was the result of doping.
Armstrong was stripped of his Tour de France titles not because his EPO use was discovered in blood tests, but because of eyewitness testimony from fellow cyclists who saw him take it.
When the coronavirus pandemic began, doctors theorized that EPO might help COVID-19 patients for the same reason it made Armstrong pedal faster—by increasing oxygen.
Coronavirus often damages lungs. The result is a low-oxygen condition called hypoxia. In severe COVID-19 cases, hypoxia leads to organ damage and, eventually, death.
A ‘Miraculous’ COVID Recovery
Early in the pandemic, doctors wondered if EPO could help coronavirus patients avoid deadly hypoxia by increasing their supply of red blood cells, thereby boosting oxygen levels.
Iranian doctors are believed to be the first to use EPO as a coronavirus treatment. The case was documented in the August 2020 issue of the journal Respiratory Physiology & Neurobiology.
According to the journal, an 80-year-old man was admitted to a hospital in late March with severe COVID-19 symptoms. The patient had severe anemia, a fever of 102, extremely low oxygen levels, and was on the verge of organ failure.
In desperation, the doctors administered EPO along with other therapies. Seven days after the start of the treatment, the patient astonished his doctors by walking out of the hospital having recovered. The physicians called it “miraculous.”
Since then, other evidence has emerged that EPO could have the potential to not only treat COVID-19, but possibly protect against it.
For example, when the pandemic began, doctors believed that kidney dialysis patients would be a high-risk group. They are typically weaker and sicker than the general population because of their impaired kidney function.
But Dr. Hannelore Ehrenreich said that as the pandemic progressed, something unexpected happened.
Kidney patients actually tend to get mild cases COVID-19 than the general population.
“We have observed that dialysis patients withstand COVID-19 remarkably well,” said Dr. Ehrenreich, a coronavirus researcher at the Max Planck Institute of Experimental Medicine in Gottingen, Germany.
Why is this?
Kidney dialysis patients are typically given EPO, which reduces their need for transfusions. Dr. Ehrenreich believes EPO may help them from developing full blown pneumonia if they have COVID-19.
Why Severe COVID-19 Is Rare Among People Who Live at High Elevations
Another indication of EPO’s possible effectiveness comes from South America. Researchers there have found that severe COVID-19 is rare in people who live at elevations above 8,200 feet.
People who live in the mountains at high altitudes have natural levels of EPO that are two to four times greater than people who live closer to sea level. Dr. Ehrenreich believes this may be why mountain dwellers do not get seriously ill from coronavirus.
A recent collaborative review by researchers in Canada, Switzerland, Bolivia, and Australia looked at EPO’s potential effectiveness against COVID-19 as an adjuvant therapy. It concluded that the hormone could have “a major therapeutic impact” in coronavirus severe patients.
So why isn’t EPO being used as a potential standard coronavirus adjunctive treatment?
Dr. Ehrenreich believes the answer is as simple as it is disturbing There’s no profit in it.
Pharmaceutical companies won’t spend the millions of dollars it would take to test EPO in a clinical trial because it is an old treatment not under patent protection.
So if the trial was successful, the sponsoring company would not have exclusive rights to sell EPO. Its competitors could jump in and sell it without having to bear the costs of testing.
“Unfortunately, pharmaceutical companies have only limited interest in financing further studies on approved active ingredients such as EPO for which patent protection has expired,” said Dr. Ehrenreich.
Since drug companies have so far refused to step up, Dr. Ehrenreich and her colleagues are now conducting their own clinical trial on EPO. It is being funded by the nonprofit Max Planck Society. It will test the hormone in 60 coronavirus patients. We’ll bring you the results when the trial is complete.
In the meantime, there are two options—one better than the other—for coronavirus patients who believe they may be helped by EPO…
EPO supplements are available without a prescription through online sites. However, we urge you not to take EPO without your doctor’s supervision.
Even though it is a natural hormone, supplementing with EPO can cause high blood pressure, fever, dizziness, and other side effects. It can also raise the risk of having a heart attack in people with existing heart disease. 
Here’s the better choice: Since EPO is already approved by the FDA for other conditions, doctors might be able to prescribe it to COVID patients as an “off-label” use. We suggest checking with them.
If you think that you or someone you know might benefit from EPO, show the attending physician this article and refer the doctor to the recent scientific paper on EPO’s use as a potential coronavirus adjunctive treatment HERE.
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