The following is an interview by BikePure with Award Winning Renal Specialist Dr. John Harty about EPO. Dr. Harty is a Consultant nephrologist at Daisy Hill Hospital in Ireland. He is a renal (Kidney) specialist, Consultant of the year in 2008 and himself a cyclist. Bike Pure asked Dr. Harty to clarify the unfortunately common, illegal doping abuse of Erythropoietin (EPO).
Bike Pure: What is EPO?
Dr. Harty: EPO is a naturally occurring hormone that the body produces to control the amount of blood cells and hemoglobin present in the body.
BP: You’re a renal consultant (Kidney specialist), why do you administer EPO to patients in your care?
Dr: EPO is produced in the kidneys in response to stress factors including oxygen levels, this in turn goes to the bone marrow and ‘notifies’ the bone marrow to produce additional blood cells. I use it daily with patients suffering with kidney failure. Their kidneys no longer produces this vital hormone so we have to administer it synthetically to the patient to offset this hormone imbalance and regulate their blood to a normal, healthy level.
BP: When did you first begin to administer EPO?
Dr: It came into clinical practice around 1989, when the U.S. Food and Drug Administration approved the hormone and I first administered it to my patient’s in 1990. It was pioneered to deal with the problem of anemia or low blood count in patients with kidney failure who have a blood count of 6 or 7, where a normal, healthy adult would have a blood count of 12 or 14.
BP: Is it essentially the same product that you began using in 1990 or has it evolved and improved over time?
Dr: Over the last 20 years, scientists have improved and evolved the synthetic nature of the drug. About 10 or 11 years ago ‘Aranesp’ became available, and in the last few years CERA also came into the market. EPO, Aranesp and CERA are all the same basic structure of the EPO molecule; they just have variants added in to produce a longer lasting effect. When EPO was first introduced it was required to be injected usually three times a week. When Aranesp came out this was reduced to once a week and a single injection of CERA would maintain a patient’s hemo level for up to a month.
BP: Are all these EPO derivatives made by the same people?
Dr: There are a number of companies making these syntethic EPOs. They are all modifications of the basic naturally occurring hormone. Initially it was only one company, but now there are many variants and low cost drugs available from countries such as China and Russia.
BP: We have heard of athletes being caught because the manufactures have installed ‘indicators’ or ‘markers’ into the drugs to illuminate their use in drug tests and indicate that the hemo level was achieved artificially. Could all manufacturers do this?
Dr: As synthetic drugs like Aranesp and CERA are not identical to the natural hormone, it should alone be traceable.
{BP:‘Amgen’ provide a marker within its own synthetic EPO-CREA to enable its detection in drug tests}
BP: Are there other drugs available that renal patients utilize, which cheats in sport may be using to gain an unfair advantage?
Dr: The best way to get a response from EPO is to have a lot of Iron in your system to help the body make a lot of red cells, so we found out quite early on in kidney medicine that people would become iron deficient which would blunt the effect of EPO. So with our patients we give them iron, orally or intravenously. The higher your iron stores are, the better effect the drug will have. So I imagine the dopers would artificially take iron and B12 and any other compounds, which are crucial in the production of blood.
Read the rest on BikePure.org. Big thanks to Myles for letting us share!
I caught up with Lynda Wallenfels and Dave Harris after the 24 Hrs of Moab Championship Race. One word for two people: Crushers.
