Treating Chronic Fatigue Syndrome (ME/CFS): Erythropoietin
and Low Blood Volume
Erythropoietin is a hormone that controls red blood cell
production. Produced by the liver
and the kidney erythropoietin activates the red blood cell precursors in the
bone marrow to begin producing 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 and other diseases.
Erythorpoietin recently improved fatigue
and quality of life in seniors with anemia. The first erythropoietin agent,
Epogen , was FDA approved in 1989. Two brands of erythropoietin, epoetin (Procrit)
and darbepoietin (Aranesp)
Recent clinical trials indicating erythropoietin had little
benefit in cancer patients and may increase the risk of several cancers resulted
in the FDA giving it 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. It use is banned in cycling and other sports.
Erythropoietin May Work in Chronic Fatigue Syndrome
(ME/CFS) Because – it increases red blood cell mass and thus may help increase
blood volume in a prominent subset of patients. Low blood volume may contribute
to orthostatic intolerance (symptoms when standing), low blood flows to the
brain and other organs and low energy in ME/CFS.
Chronic Fatigue Syndrome (ME/CFS) Studies- At the 2007 IACFS/ME conference Dr. Hurwitz reported that an NIH sponsored trial of erythropoietin did
increase blood volume in ME/CFS patients but 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.
At the same conference, however, Dr. Shoemaker reported
that higher doses of the drug reduced levels of the complement protein C4a,
normalized lactate levels in the hippocampus and improved patients health and
cognitive functioning. Neither his study (which had no control group, etc.) nor
Dr. Hurwitz’s s have been published.
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.
___________________________
Mayo Clinic Erthyropoietin drugs: what to know about anemia
fighting medications.
http://www.mayoclinic.com/health/erythropoietin/DA00137
Cort
Johnson, The Phoenix Rising Guide to the
8th IACFS Conference, Jan 2007
Part IV: The
Clinical Trials
Anemia drugs increase death risk.
http://foodconsumer.org/7777/8888/Non-f_ood_Things_27/030912112007_Anemia_drugs_increase_death_risk_printer.shtml