Are you feeling tired all the time because you have low blood pressure? Let's talk about Erythropoietin!

Do you sometimes feel tired and lifeless? One reason for this is a decrease in the number of red blood cells in the body. Our body has a very important hormone that helps in the production of these red blood cells. That is the hormone we are going to talk about today. Its name is Erythropoietin, or EPO for short.

What is Erythropoietin?

Simply put, Erythropoietin is a hormone that is mainly produced by our kidneys. Yes, you heard it right, when we think of kidneys, we only think of urine production, but the kidneys do a lot more in our body. One such important job is to produce this hormone (EPO). This hormone (EPO) helps maintain a healthy number of red blood cells, that is, erythrocytes, in our body.

Sometimes, doctors use a synthetic form of erythropoietin to treat anemia , especially in conditions like chronic kidney disease . Also, some athletes misuse this drug to enhance their performance. Because EPO increases the amount of oxygen that reaches their muscles. Is that illegal? Okay?

Other names for this erythropoietin include erythropoietin, hematopoietin, and hemopoietin. However, they all mean the same thing.

What service does erythropoietin (EPO) provide to our body?

Okay, now let's see what exactly EPO does. The main function of EPO is to help make red blood cells. These red blood cells are what carry oxygen to the tissues in our body. The oxygen is converted into energy, and then carbon dioxide is released from our tissues. When you breathe out, these same red blood cells help remove that carbon dioxide.

This is what usually happens: When a special type of cell in our kidneys detects that the oxygen level in our blood is low, they increase their production of (EPO). This hormone (EPO) then tells the spongy part of our bones, the bone marrow, to make more red blood cells. Think of it like giving an order to a factory.

When the cells in the kidneys sense that there is enough oxygen in the blood, they reduce the production of erythropoietin. This is a very complex, but beautifully controlled process.

However, some medical conditions can affect the amount of EPO produced by the kidneys. They can either produce too much or not produce enough. This can cause problems with either too many or too few red blood cells.

What happens if erythropoietin (EPO) levels increase?

If EPO levels increase inappropriately, that is, if the body has more EPO than it needs, the number of red blood cells can also increase unnecessarily. We call this polycythemia. It's like a traffic jam on the road, when there are too many red blood cells, blood flow can be impeded.

What are the reasons for such an increase in EPO levels?

There can be several reasons why EPO levels may be unnecessarily high.

• Prolonged exposure to low oxygen levels: This can happen to people who smoke or live in mountainous areas, which are high above sea level. This is because the air contains less oxygen as you go up. However, it is normal for someone living in a mountainous area to have higher levels of EPO, which is a way for the body to adapt.
• Anemia not caused by kidney disease: Sometimes anemia is not caused by a kidney problem. However, when the kidneys sense that the body is low on red blood cells, they produce more EPO to help make red blood cells. This is also a normal, necessary increase in EPO.
• Rare cancers: Very rarely, some types of cancer can cause the kidneys to produce too much EPO inappropriately.

What are the causes of low erythropoietin (EPO) levels?

The main and most common cause of low EPO levels is chronic kidney disease ( CKD ). When the kidneys are damaged, they cannot produce enough EPO. This causes low EPO levels. This condition, along with low EPO levels, can lead to anemia. You can see how many problems can arise if the kidneys are not working properly, right?

Also, a condition called Polycythemia Vera can cause low EPO levels. This is a type of blood cancer. In this, a genetic mutation causes our bone marrow to produce too many red blood cells. Then, the kidneys sense that there are too many red blood cells in the body, and they reduce their production of EPO.

How is low erythropoietin (EPO) levels treated?

If your EPO level is low, the first thing to do when treating it is to find the underlying cause and treat it.

The main way to directly treat anemia caused by low EPO levels is by injecting recombinant erythropoietin. These are also called erythropoietin-stimulating agents or ESAs. These are both the natural EPO hormone and a synthetic, or lab-made, form of EPO. Doctors clone, or copy, the EPO gene and give it to you as a shot to stimulate the production of more red blood cells.

These (ESAs) are mainly used to treat anemia caused by chronic kidney failure . They are also given to people with some rare types of cancer.

However, these (ESAs) vaccines can cause some side effects. Not everyone gets them, but some people may:

• High blood pressure
• Fever
• Dizziness
• Nausea
• Pain at the injection site

Before starting this type of treatment, it is very important to discuss all of this with your doctor and ask any questions you may have.

How do doctors measure erythropoietin (EPO) levels?

Your doctor can measure your EPO levels with a blood test. This blood test can help determine if changes in your blood cells, such as polycythemia, anemia, or other bone marrow conditions, are affecting EPO production.

Here's what you do when taking blood:

1. First, clean the skin around the vein on your arm with something like iodine or isopropyl alcohol.

2. Then, using a thin needle (usually 21 gauge, which is slightly smaller than a regular earring post), a small amount of blood is taken from a vein in your arm.

3. The blood sample is then sent to a lab for analysis.

Once the lab has finished testing your blood sample, your doctor will call you to discuss the test results and answer any questions you may have. Sometimes, even if your EPO levels are within the normal range, you may need other treatments. This will be determined by your doctor.

What should the normal level of erythropoietin (EPO) be?

Doctors measure EPO in milliunits per milliliter (mU/mL). A healthy person's EPO level can range from 4 to 26 mU/mL.

But remember, your (EPO) test results can vary slightly depending on a number of factors. For example:

• your age
• Your biological sex
• Your overall health status

Therefore, it is your doctor who will analyze your results accurately and tell you whether your (EPO) levels are healthy or not. Don't just look at the numbers and jump to conclusions, okay?

What are the ways to increase erythropoietin (EPO) levels naturally?

If you have chronic kidney disease (CKD), or if you have anemia with low EPO levels, some dietary and lifestyle changes may help to slightly increase your EPO levels. However, these should only be done with medical advice.

• Exercise: Research has shown that when you exercise regularly, at a moderate intensity (vigorous exercise), your body uses more oxygen. Your brain then tells your body to make more EPO. Examples of this type of exercise are cycling, jogging, and swimming.
• Dietary iron: Iron is a major component of hemoglobin. This hemoglobin helps carry oxygen to the cells of our body. Foods rich in iron include red meat, egg yolks, liver, tofu, and foods fortified with iron (e.g., some cereals, bread, and pasta).

But these things alone may not make a big difference, especially if the underlying condition is severe. So it's important to follow your doctor's advice.

Things you should remember from all of this (Take-Home Message)

Erythropoietin is a very important, essential hormone that tells our bone marrow to “make more red blood cells.” However, sometimes our bodies inappropriately make too many red blood cells, or not enough. Both of these can cause health problems.

If you are constantly feeling tired and lethargic, don't ignore it. You can see a doctor and have your blood (EPO) levels checked. The doctor can then recommend the most appropriate treatment for you. Remember, the balance of these hormones is very important for a healthy life.