Erythropoietin (EPO) Test

What is Erythropoietin?

Erythropoietin or EPO is a hormone that is produced by the kidney cells and stimulates the bone marrow to produce more red blood cells or RBCs. Erythropoietin is released during hypoxemia or when the blood oxygen level is low.

The amount of erythropoietin that is released in the blood is directly proportional to how low the blood oxygen levels are or how much erythropoietin can be produced by the kidneys. The production of erythropoietin continues until the blood oxygen levels become normal.

Does Erythropoietin have any other name?

Yes. The other names or erythropoietin are EPO and serum erythropoietin.

What is an Erythropoietin test?

An erythropoietin test helps to detect the amount of erythropoietin that is present in the blood.

Why do we need an Erythropoietin test?

Erythropoietin helps to maintain stability in the blood oxygen levels and the number of red blood cells produced in the blood. If the erythropoietin levels are abnormally low, it may suggest various medical conditions such as:

– Anemia due to decreased production of RBCs or kidney disorders.
– Bone marrow disorders.

High erythropoietin levels may indicate:

– Kidney tumors.
– Increased production of red blood cells or polycythemia.
– Recombinant human erythropoietin or rHuEPO used by endurance athletes may lead to erythropoietin abuse.

When do I need the test?

Your health care provider may order an erythropoietin test if you have the following signs or symptoms of:
 
– Shortness of breath.
– An increase in the heart rate.
– Joint pain.
– Recombinant erythropoietin or rHuEPO abuse is quite common in endurance sports. The test is often done in professional athletes and long-distance runners to detect the presence of synthetic EPO in the blood.
The test can also be done if your doctor suspects you have:

– Chronic kidney disease.
– Bone marrow disorder.
– Decreased or increased red blood cell count.
– Anemia during pregnancy.

How do I prepare for the test?

This test does not require any special preparation. However, you need to inform your health care provider if you are taking any particular medication, vitamins, supplements, herbs, or illicit drugs.

Do I need to fast before the test?

No. You do not need to fast before the test. However, if you are taking any other blood test, you may be asked not to eat or drink anything 8 to 10 hours before the test.

How is the test performed?

The erythropoietin test is a simple blood test.

– You will be asked to wear a short-sleeved dress or shirt for the convenience of the test.

– The technician will clean a small patch of skin on the upper part of your arm.

– He will tie a tourniquet or elastic band leaving a gap of 3 to 4 inches above the site of collection on the arm. This will swell up the veins and make it easier to draw the blood.

– A small needle will be inserted into the vein of the arm and blood is withdrawn.

– The blood is then collected into a syringe or a vial.

– The tourniquet is removed and a cotton swab is pressed on the puncture site.

– A band-aid is then applied to the puncture site.

The blood is then sent to the laboratory for further testing.

How do I feel during the test?

You will feel mild to moderate pain while the needle is inserted into the vein. It is like a stinging sensation and will go away in a short while.

How long will the test take to perform?

The test will take a maximum of 5 minutes to complete.

When will I get my test report?

You will get your test report within one or two days.

What is the cost of the Erythropoietin test in India?

The average cost of the erythropoietin test in India may vary between Rs 700 to Rs 5000.

Does this test have any risks?

This test has no risks. Some people may experience certain side effects such as:

– Continuous bleeding from the puncture site.
– Hematoma is a condition where blood accumulates under the skin
– Slight dizziness or lightheadedness when the blood is drawn.
 
If any of these conditions persist, you may visit your doctor and ask for a remedy.

What is the normal range of Erythropoietin?

The normal range of erythropoietin may vary slightly according to gender, age, and other factors like family history. The chart below shows the normal range of erythropoietin.

What does abnormal test results mean?

An abnormal test result means that the erythropoietin levels are either too low or too high than the normal levels. An abnormal report may indicate several medical conditions such as:

– A low erythropoietin level accompanied by anemia may indicate the person has kidney disorders.

– High erythropoietin level along with anemia may be due to bone marrow disorder or iron or vitamin deficiency.

– Secondary polycythemia where the erythropoietin levels are high along with increased production of RBCs.

– If the erythropoietin levels are low or normal along with excessive production of RBCs, then it probably indicates a condition called primary polycythemia.

What other tests can be done along with this test?

Tests that can be ordered along with the erythropoietin test include:

– A complete blood count or CBC.
– Total iron-binding capacity or TIBC test.
– Iron levels test.
– Ferritin levels test.
– Reticulocyte count test.

What are Erythropoietin-Stimulating Agents or ESAs?

Patients who are anemic or are unable to produce enough EPOs, need to have blood transfusions. At times, patients refuse or are incapable to take transfusions. In such cases, doctors may administer recombinant erythropoietin drugs to boost up the erythropoietin levels in the blood.

Recombinant erythropoietin is man-made synthetic drugs that are made by cloning the erythropoietin gene. The recombinant erythropoietin medicines are called erythropoietin-stimulating agents or ESAs and are used by giving injection shots into patients. These shots then instigate the bone marrow to produce more red blood cells that are then released in the bloodstream.

ESAs are given to patients with kidney disorders, end-stage renal disease, anemia, or cancer.

What is the role of Erythropoietin in blood doping?

ESAs have been illicitly used in endurance sports. Erythropoietin increases the production of red blood cells, reduces fatigue, and increases the endurance level in the body. RBCs increase the hemoglobin levels and are extremely important in transporting oxygen throughout the body. This is believed to improve the overall metabolism and also heals the muscles faster.

Athletes like cyclists, bodybuilders, and long-distance runners have been using ESAs for improving their performance, energy, and overall performance. This is an unfair practice of doping and has been banned in the early 1990s. In the present day, a blood screening, as well as a urine test, is conducted to evaluate the use of EPO in national and international sports events.

How is the Erythropoietin test helpful during pregnancy?

Recombinant human erythropoietin or rHuEPO along with parenteral iron is used to treat iron deficiency during pregnancy. The erythropoietin test in pregnancy will help to understand the underlying causes of EPO deficiency and their subsequent remedies.

Can the Erythropoietin test be done in children?

Yes. Serum erythropoietin tests can be done in children suffering from anemia, bone marrow disorders, polycythemia, and cancer. There are numerous cases where recombinant human erythropoietin or rHuEPO has been used to treat cancer in patients. Blood transfusions can cause serious side-effects and infusion-related infections like HIV, hepatitis B and C, and excess iron among patients. The rHuEPO is an alternative therapy and is a more comfortable approach for treating cancer-associated anemia or CAA.