I’ve been bordeline anemic since some surgery earlier this year. If my red blood cell count doesn’t start coming up soon using normal means (diet & supplements) my doctor has talked about putting me on EPO.
The Question: If I’m on prescription EPO for a real medical problem and my count doesn’t exceed the 50 limit in the rules, am I still legal?
I believe that the UCI is the only organization that utilizes the 50% hematocrit limit. Are you going to be racing in UCI events?
Here’s a pretty cool article on this stuff: http://www.sportsci.org/news/news9703/AISblood.html
prescribing EPO for a (presumably mild) anemia without investigating the cause is malpractice.
so don’t worry - if your doc gives you epo you can buy your own triathlon with all the money you will win in the lawsuit.
No. You would need an approved T.U.E.: http://www.wada-ama.org/en/dynamic.ch2?pageCategory_id=98
Dan
sebBo,
I’ve been tested for a number of suspected causes but nothing definitive shows up. I’ve been on/off anmeic at least since high school and my mother was anemic all her life. The doctor thinks it just might be genitic.
EPO is a serious drug for patients with serious problems (kidney failure, cancer, chemotherapy, premature babies) and serious side effects - and not a way to improve your speed. so if you don’t have severe symptoms that justify the use of EPO i as a doctor would never even think about prescribing it.
my hemoglobin btw has been consistantly below 15 mg/dl (which could be called borderline anemic) and i don’t see a reason to do anything about it.
Thanks, sebBo. That’s where mine is hovering, in the 13.5 -14.5 range.
in your own best interest - don’t push your doctor toward that epo thing! didn’t want to sound like an a&*^%$# before.
quite some athletes asked me about this problem - hb/crit in the lower normal or even just high abnormal (always dependeng on the lab), no iron or vit b12 deficiency, no chronic illness, no hemolysis, noting, nada, null, niente.
seems to me like endurance sport itself has to be understood as some sort of chronic illness …
normal range of serum hemoglobin is between 11.5 and 15.5…
why would you get EPO when your values are normal?
Normal ranges vary from institution to institution, most ranges are more like 13-16 for men. but Francois’ point still stands.
Seems weird your doc would be considering EPO in your case.
Francois,
I have most of the symtoms of anemia: tired all the time, depressed, etc, and, worst of all, I’m having trouble on the bike. I can burn myself out without feeling any lactate burn. My heart rate is up 5-10 bpm for any given effort compared to what I was doing just a few months ago. It just “seems” like I’m not getting enough oxygen to the muscles. And until I started on a better diet (more red meat) and supplements my red blood cell count was actually drifing down over a period of about two months. My count is back up a bit now and I am doing better on the bike but I just don’t have the energy to train back up the (rather pathetic) level I was at.
The range that is given as “normal” varies, depending on the source. For instance, the lab I get my blood work done at, and my doctor, call 13.5 anemic. This can also vary with individuals. Some folks may not be anemic at 12 or 13 and others may be anemic at 15.
Francois;
I sent you a PM yesterday, let me know if I can help
.
Azby,
sorry for stating the obvious, but there a LOT of health problems that have the symptoms you’ve listed…like depression (as you state being depressed), chronic fatigue syndrom, allergies etc…
13.5 for Hb would likely not qualify for EPO treatment…not to mention that to test anemia you could also check iron levels (I think there are 3 different dosages you can do, and some of them are pretty sensitive so need to be done very precisely).
Before using a very ‘serious’ drug, I would definitely suggest more test…not to mention that you would be treating the effect not the cause unless indeed your anemia is genetic…for instance ‘anemie falciforme’ (don’t know the english term) where the gene responsible for the production of Hb has an error on the 17th base and replaces glutamine by valine on the 6th position of Hb. The lab dudes here will say if this is easily tested.
Roche for instance is developing drugs to ‘correct’ the cause instead of the effects…not sure how they are doing that however…
it doesn’t really matter how his iron levels (or vit b12) are - with an hb of 13.something and no symptoms like tachycardia, syncope or dizziness/nausea there is definitely no indication for epo!
if a patient on epo develops side effects like stroke, hypertensive crisis and/or heart attack the prescribing doctor better has a very good justification for using epo - a hemoglobin of 13.5 is not one!!
I agree…However, I have seen one case of someone with a normal Hb, iron levels really low at times and Hb dropping suddently soon after. So just to be on the safe side…I think testing iron just to be on the safe side is better than going straight for EPO…
I am still puzzled by a doctor who prescribes EPO for Hb at 13.5…
but then on this same forum someone was given prednisone for a mild case of poison ivy…it looks like some doctors try to kill flies with a hammer.
you would be amazed how often corticosteroids (at least topicals) are used just to please the patient.
dermatology’s rule no 1 (actually it’s the only rule ;-): if it’s black excise it, if it’s red put cortisone on it …
epo on the other side is a pharmacological machine gun to boost the bone marrow of cancer and aids patients who are in the range of clearly below 10, sometimes as low as 6-8.
in the other thread, it wasn’t a topical use of prednisone…that’s quite scary I think.
I had a bike crash in 97, fell over the handlebars and punctured a kidney…I still went on training…wouldn’t heal of course and my HCT dropped to 29%, forgot the values of Hb, but I didn’t get epo for that.
just rest…and I got married too 
sebBo, Francois,
Thanks for all the help; you’ve been more informative than my own doctor. The EPO talk was just in passing at a time when my red cell count was still going down in spite of diet changes. It just crossed my mind the other day and I thought I would post the question. I’m going for another blood test in 3-4 weeks and I’ll be sure to ask for the “full-meal-deal” that you guys have discussed.
Interesting that you mentioned disiness and tachycardia. On most of my rides back in Feb into early April (this is when my red cell count was dropping) I would occasionally feel slightly off balance and find my self drifting off to one side or the other. I also had my heart rate spike a few times (as high as 219, my ‘max HR’ is about 188-190. I’m 52).