Erythropoietin (Procrit) is…

a hormone produced by the kidneys and liver that tells the bone marrow to  produce red blood cells. It also increases red blood cell survival rates and plays an important role in healing damaged neurons in the brain.

Erythropoietin has been used to treat anemia in cancer, kidney disease, orthostatic intolerance and other diseases.  Anemia is associated with fatigue and erythropoietin was  recent shown to improve fatigue and the quality of life in seniors with anemia.  Two brands of erythropoietin, epoetin (Procrit) and darbepoietin (Aranesp) are available.

Recent clinical trials indicating erythropoietin had little benefit in cancer patients and may increase the risk of several cancers resulted in the FDA giving the drug a ‘black box’ warning. In high doses erythropoietin also increases the risk of cardiovascular events. In general erythropoietin is given at the smallest possible dose needed to produce an effect.

Because it increases red blood cell levels – which in turn deliver oxygen to the muscles – erythropoietin has been used as a performance enhancing drug in athletics and is banned in cycling and other sports.

Erythropoietin May Be Effective in Chronic Fatigue Syndrome (ME/CFS) Because…

it increases red blood cell mass, which can be low in ME/CFS. Low red blood cell mass and low  blood volume may contribute to orthostatic intolerance (symptoms when standing), low blood flows to the brain and other organs and low energy in this disorder.

Chronic Fatigue Syndrome (ME/CFS) Studies

Hurwtiz found that 60-70% of ME/CFS patients have low blood volume but at the 2007 IACFS/ME conference Dr. Hurwitz reported that while an NIH sponsored trial of erythropoietin did increase blood volume in ME/CFS patients it did not result in significant health benefits. This is the second trial of a blood volume enhancer that succeeded in its first purpose – increasing blood volume- but failed at its second – improving patients health. This suggests low blood volume is a secondary component of CFS.

In an interview, however, Hurwitz stated that some patients had demonstrated remarkable improvements with some returning to work.  Read about one patients improvement here.  One of the investigators, Dr. Klimas, later stated that if they had used different endpoints the study would have been more effective.  Procrit appears to be another example of a drug that works very well for some people with ME/CFS.

Chronic Fatigue Syndrome Doctors Report

Dr. Shoemarker reports that low doses of erythropoietin lowers a form of complement (complement C4a) that some studies suggest is increased after exercise.

Side Effects

Used at levels that produce high red blood cell levels erythropoietin can increase the risk of cardiovascular events such as blood clots, heart attacks and stroke. Erythropoietin may increase the risk of several cancers. Hurwitz, however, noted that no negative side effects had been seen in his ongoing trial 

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