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My research on EPO


links1979
(@links1979)
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Hey guys, as I am preparing to do an epo cycle I thought I'd condense everything I've read from the forums and received from helpful pms (thanks RG). If I have missed anything, please let me know and I'll edit it. The only thing I dont have is how long a cycle should be and what kind of pct is needed.

Thanks
Links

GUIDELINES FOR EPO USAGE

Dosage:

Loading Phase-

1. Always pre load iron for 2-3 weeks prior to E cycle if you are below 75 ferritin

2. IRON: 12 Ferrochels a day in 3-4 divided doses with Vit C

3. EPO: 3-4000 iu's every other day for three weeks or 50iu per kg

4. Aspirin dose is a baby aspirin...about 80-100mg per day. UNCOATED aspirin.

Maintenance

1500 iu's every 3-4 days to hold.

6 Ferrochels a day in 3-4 divided doses with Vitamin C

Safety Precautions:

1. Piss test: Make sure you are pissing 5-6 times a day and that the urine is almost clear. This signals that you are adequately hydrated. Drink a lot before bed and a lot when you wake up at 4am

2. Monitor crit 3x a week during loading and 2x a week during maintenance.

3. Take baby aspirin at the dosage above

4. Heart rate monitor can be used and set to alarm if your heart rate drops below 35 while sleeping.

5. Do not squat down for long or sit with legs crossed due to possible clot formation.

Dangers

1. Epo Associated PRCA which is an autoimmune response to the injected epo and endogenous epo. Most of the cases that have been seen have been from EPREX injected sq.

SOLUTION: IV dose

2. Fatality due to dehydration during exercise

SOLUTION: Drink like a fish during exercise

3. Heart rate drops too low during sleep and cannot pump thickened blood causing a heart attack

SOLUTION: Drink lots before bed and when you wake up and wear a heart rate monitor to go off at 35bpm.


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sportfun2
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SOLUTION: Drink lots before bed and when you wake up and wear a heart rate monitor to go off at 35bpm. [/B][/QUOTE]

what would one do if their normal HRs during sleep dip into the high 20's? Still safe to use E?


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madtrack
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All makes of E can cause PRC when SQ method is used for mainly dialysis patients;PRC has been reported in 1/10,000 cases per patient /year after months to years of treatment with eprex.Eprex puts E like eposino.cloepo and clon-biotech in the shade;it is the best and is used by most pros in Europe;Zyrop and Hemax come a close secondThe highest mortality rate for any E is darpotein alfa aka nesp.I would worry about ur BP rather than HR ;it is the first sign of probs and must be checked 2-3 P/W.HR is not an indicator of BP. M/track


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KingMassimo
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Posted by: madtrack
Eprex puts E like eposino.cloepo and clon-biotech in the shade;it is the best and is used by most pros in Europe;Zyrop and Hemax come a close second


What makes you say this track?

links, you should include B12 supplementation (sublingual or IM/SQ). A B-complex (B-50) tablet a day would also be wise. A cycle can range from 4 weeks to long term. No PCT required, although continued Fe intake would be recommended depending on where your ferritin is at. Always measure crit in the early AM after drinking some water (volume kept consistent). Expect variations in crit based on other factors, mainly training volume/intensity during the days beforehand. All blood draws must be veinous, using a 25 or lower gauge needle. Last edited by KingMassimo on 06-28-2008 at 09:42 PM


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cycle-ist
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A couple things to add:

1. There is a large amount of variability in response.....so these guidleines are very general. Someone may gain 3 points, some may gain 10 pts with your 3 week protocol.
2. Never "drink like a fish".....you will end up less hydrated due to a quick rise in central blood volume. Rather drink steadily over a few hours. In other words a liter at a time is TOO MUCH!
3. Monotoring Hct alone is not enough for efficacy. You need to find out what RBC volume is. Otherwise, you may mistakenly load after a variance in hydration state and unknowingly push yourself towards 60 when you are dehydrated. Hct should use venous blood for consistentcy as KingM mentioned.
4. Also, using urine color as hydration status is inconsistent. Especially for those who ingest any substances (i.e caffeine) which increase urine volume. Just drink ~30-40 ml/kg per day of water in addtion to the amount of fluid lost during exercise and you will be hydrated.
5. As for PCT for E use, I siuspect use of nandrolone (preferred) or Testosterone above 100 mg/ week may help.

MS, CSCS, CPT


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Realgains
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You should drink A LOT during hard training because almost nobody gets the required water intake even without epo. I ride with guys hard and most of them only take 1-2 water bottles for a 3 hour ride in the heat and that is NOT ENOUGH! If on epo a cyclist riding in the heat should drink at least 1.5 full sized water bottles per hour. If it is both hot AND humid and you are hammering you need two bottles per hour...and you better damn well stop and get more fluid when you run out.

The proof in the pudding re: not enough fluid intake, comes from a 3-5(or more) pound loss in body weight after hard training. This weight is mostly water weight with some gylcogen weight loss. Be damn sure that the fluid you ingest during training has sodium and potassium(especially sodium). Sports drinks have sodium and potassium but often not enough sodium for long hard events in the heat. There can be serious problems for drinking a LOT of plain water with no sodium.....see below

Before bed drink a large mug of water and again if you get up to pee at night.

Drink well after training if you feel any thirst at all...weigh yourself. You might loose 2 pounds of weight from glycogen loss(and a small amount of fat) if you had a long hard session but the rest is water loss. Remember glycogen holds onto water so less glycogen means less water. For every gram of glycogen you hold 3 grams of water with it.

Some guys will loose 5 or more pounds in a bike ride/race, and that's nuts!

No PCT required. Monitor ferritin.

Simply monitor your crit every other day while loading. If you stay hydrated you will not see big shits in hematocirt(percentage of red cells in total blood volume). If your crit drops a bit the day after a hard event or hard training then know that this can happen and don't be firing in another 5000 units if your crit was 55% before the event.

The reason crit will drop in a very hard training athlete, like with a cyclist the day after a very long hard ride or race, is because the body senses a slight dehydrated state in the training or competition and supercompensates for this by producing more plasma after the event. If one stays very well hydrated during training and racing then this does not happen much at all. There is some stress response from training or competition and that can also increase plasma levels but not by much. Training hard does not destroy red cells unless you are a runner(hemolysis through foot pounding/kidney shaking).

Measure crit at the same time each day and the best time is in the am. When you are getting high...like 54%....then you should see what your crit is when you rise from bed and before drinking because you want to know how high your crit was early in the am while sleeping as this is when you would be the most dehydrated and also when your heart rate is at it's lowest.......then drink some water and re-test 45 minutes later. When you get used to poking yourself in various veins it will not be an issue to check crit even daily.

Any water that is ingested that takes you above full hydration will simply be pissed out. You CAN take too much plain water and this can cause Dilutional hyponatremia. This is not easy to do by the way. Dilutional hyponatremia occurs when you drink A LOT of fluid with no salt in the mix. Your sodium balance gets very low and beyond what your kidneys can compensate for(re sodium), and that can cause a lot of problems and can even cause seizures. However, this takes a lot of fluid intake above what you need to stay fully hydrated and very few athletes do this.

You may need more iron than 6 ferrochels while holding...monitor
ferritin.

Note that it takes about 4 days to make new red cells once epo stimulates....so be patient after a shot.

Bikerider233 made a good post on IM iron.....read that one over. Madtrack has put up posts and replies re: IM iron.

If you are checking your crit with a centrifuge like a Zipocrit, and you ALL should be doing that by yourself, then you already know how to get into veins. So with that in mind there in no reason for you to dose sub Q>>>YES the chances of developing antibodies to epo(including your own) and getting PRCA are very low BUT it can happen. I for one will not take that chance and thus I dose IV. There has not been one case of PRCA from IV dosing. In my home country all dialysis patients now dose IV.

RG


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cycle-ist
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Posted by: Realgains
You should drink A LOT during hard training because almost nobody gets the required water intake even without epo.

RG

Yes, you should drink A LOT on the bike, BUT IT SHOULD BE STEADY AND FREQUENT. You do not want to drink a large amount all at once (i.e guzzling a liter of water in a couple minutes). This is usually not a problem, unless you are at a rest stop. Drinking large volumes of water at once WILL have an immediate dehydrating effect. My advising professor is one of the leading experts on hydration and performance and works with the USOC. You will likely see products like Gatorade make recommendations like this in a year or two (on their labels) based upon our findings.

MS, CSCS, CPT


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cycle-ist
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Posted by: Realgains
Before bed drink a large mug of water and again if you get up to pee at night.

RG [/B]


What is a large mug? How fast should this be drank? You will pee is you guzzle a large amount at once. Let me define this better. Drink 1 liter of water in the preceeding two hours before bedtime.

MS, CSCS, CPT


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links1979
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Anyone else want to weight in on any of this before I edit to include the changes from subsequent post? Thanks guys!!


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madtrack
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Posted by: KingMassimo
What makes you say this track?
Eprex has always worked best for me,I have used most of the Chinese E,s and amgen,aranesp(works quicker than epotein alfa);prob is it is not that easy to get nowadays and is sometimes expensive(depending on avaliability)M/track
links, you should include B12 supplementation (sublingual or IM/SQ). A B-complex (B-50) tablet a day would also be wise. A cycle can range from 4 weeks to long term. No PCT required, although continued Fe intake would be recommended depending on where your ferritin is at. Always measure crit in the early AM after drinking some water (volume kept consistent). Expect variations in crit based on other factors, mainly training volume/intensity during the days beforehand. All blood draws must be veinous, using a 25 or lower gauge needle.

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Realgains
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Posted by: cycle-ist
Yes, you should drink A LOT on the bike, BUT IT SHOULD BE STEADY AND FREQUENT. You do not want to drink a large amount all at once (i.e guzzling a liter of water in a couple minutes). This is usually not a problem, unless you are at a rest stop. Drinking large volumes of water at once WILL have an immediate dehydrating effect. My advising professor is one of the leading experts on hydration and performance and works with the USOC. You will likely see products like Gatorade make recommendations like this in a year or two (on their labels) based upon our findings.

Please explain this bro.....
I would respectfully disagree with you.

It's certainly better to take small sips frequently though, so you avoid any level of dehydration. ie: It would not be wise to ride for an hour without drinking and then drink a liter.
The stomach can only pass "so much" water into the intestines at once and the colon can only transmit "so much" water into the blood at once....better to take small sips frequently so you maintain a steady hydrated state.

The idea that you get a large and fast increase in circulating blood volume by drinking large amounts of water at one time is not correct. You CAN get too much total water for the day, and thus suffer from hyponatremia, but I am not talking about people drinking tons of water all day. It takes a LOT of water to cause this.

Also, a rapid increase in circulating blood volume will not dehydrate you. If this was the case we would never rapidly push in liters of fluid IV in the Operating Room with a fluid pump. When we rapidly infuse fluid IV quite the opposite is true...dehydration is reserved and hematocrit drops as total blood volume increases.

If the fluid was somewhat hyper-tonic then in theory it can pull water from the cells and into the blood stream through osmosis. The thing is the colon is able to absorb water into the blood stream against a considerable osmotic gradient>>> The water that is put into the blood stream from drinking is not hyper-tonic....fact it is simply water and is HYPO-tonic and thus it naturally moves via osmosis into cells, which have a higher osmolarity. Again that "blood water" moves into cells and does not draw fluid out of the cells and into the blood stream.

Now IF you take a highly hypertonic fluid IV , such as mannitol,
water is retained at the kidney level within the proximal tubule and descending limb of loop of Henle (freely permeable to water).
Thus taken IV such hypertonic fluids will extract water from intracellular compartments, reducing total body water.

The more dehydrated you are the quicker water will move out of the blood and into the cells because the osmolaric difference is greater....the hypertonic cells such up water through osmosis.

On another angle>>> rapid large increases in blood water and thus circulating blood volume(ie: via IV infusion) is actually good for the epo user.....we want some water to stay in the blood stream to dilute hematocrit. When we advise on dehydration with the epo user we are more concerned about blood dehydration so to speak because it is the resulting high hematocrit that can kill you. Of course you can't be blood dehydrated without cellular dehydration first.

When pro riders finish a hard long race IV saline infusion is very common....resulting in a rapid increase in circulating blood volume, and this does not dehydrate them...it hydrates them.

I am willing to read any research your professor has published on this subject though as I always have lots to learn and I am open to anything.

As an aside....
Water will readily pass into the blood stream from the colon and sports drinks will to as long as they are not greater than about 8% sugar. If they are then they are not a sports drink and the higher sugar content will slow water absorption and can make you feel sick to your stomach.

RG Last edited by Realgains on 06-29-2008 at 11:55 PM


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cycle-ist
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No worries RG. Please remember I am not the principal investigator on this research and that I cannot discuss too many details. Based upon his hypotheses, I can suggest that fluid should be consumed at the rates I previously mentioned.

That being said, I uderstand your premises. The only thing I can say is that during the trials the subjects will not be ingesting large amounts of fluid ON a bike. My suggestions are during the rest (no exercise) and recovery (post exercise) periods. For example, drinking a liter of water in a couple minutes before retiring will increase urine production relative to drinking that same amount over and hour or two. So if you have two individuals who drink the same given amount of fluids over a given period of time, the person who drinks regular small amounts will likely be more hydrated.

As for post exercise IV fluid replaGRWOXXLent....what we need to know is the drip rate? What is the typical rate of fluid absorption from the intestines (water and hypotonic solutions) post workout?

I will pose your question to him this week under my own suspicion of course and see if I can get back to you

MS, CSCS, CPT


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Realgains
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Posted by: cycle-ist
No worries RG. Please remember I am not the principal investigator on this research and that I cannot discuss too many details. Based upon his hypotheses, I can suggest that fluid should be consumed at the rates I previously mentioned.

That being said, I uderstand your premises. The only thing I can say is that during the trials the subjects will not be ingesting large amounts of fluid ON a bike. My suggestions are during the rest (no exercise) and recovery (post exercise) periods. For example, drinking a liter of water in a couple minutes before retiring will increase urine production relative to drinking that same amount over and hour or two. So if you have two individuals who drink the same given amount of fluids over a given period of time, the person who drinks regular small amounts will likely be more hydrated.

As for post exercise IV fluid replaGRWOXXLent....what we need to know is the drip rate? What is the typical rate of fluid absorption from the intestines (water and hypotonic solutions) post workout?

I will pose your question to him this week under my own suspicion of course and see if I can get back to you

Coolio bro....
About post workout IV infusion.....we don't worry about the drip rate we simply shove it in as fast as possible with a pump....it's pouring in like a small stream. So it's an IV bolus of a liter in like 5 minutes. If one has no heart condition, and no competitive cyclist would , then it's no biggy to get this volume quickly and especially if somewhat dehydrated.

During fairly intense exercise antidiuretic hormone increases so you make less urine.

I don't know how fast the colon can shove water into the blood...but it isn't that fast really even if dehydrated.

Cheers

RG Last edited by Realgains on 06-30-2008 at 06:50 AM


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cycle-ist
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RG,

Here are some references to look over when you have time. I should have known.... my advising professor never gives me a straight answer to my questions. We should be able to figure out why in these studies and maybe open up both of our eyes. IMO, you bring up some good points.

Casa DJ, Maresh CM, Armstrong LE, Kavouras SA, Herrera JA, Hacker FT Jr,
Keith NR, Elliott TA. Intravenous versus oral rehydration during a
brief period: responses to subsequent exercise in the heat. Med Sci
Sports Exerc. 2000 Jan;32(1):124-33.

Casa DJ, Maresh CM, Armstrong LE, Kavouras SA, Herrera-Soto JA, Hacker
Jr FT, Scheett TP, Stoppani J. Intravenous versus oral rehydration
during a brief period: stress hormone responses to subsequent exhaustive
exercise in the heat. Int J Sport Nutr Exerc Metab. 2000
Dec;10(4):361-74.

Kenefick RW, O'Moore KM, Mahood NV, Castellani JW. Rapid IV versus oral
rehydration: responses to subsequent exercise heat stress. Med Sci
Sports Exerc. 2006 Dec;38(12):2125-31.

Maresh CM, Herrera-Soto JA, Armstrong LE, Casa DJ, Kavouras SA, Hacker
FT Jr, Elliott TA, Stoppani J, Scheett TP. Perceptual responses in the
heat after brief intravenous versus oral rehydration. Med Sci Sports
Exerc. 2001 Jun;33(6):1039-45.

Castellani JW, Maresh CM, Armstrong LE, Kenefick RW, Riebe D, Echegaray
M, Casa D, Castracane VD. Intravenous vs. oral rehydration: effects on
subsequent exercise-heat stress. J Appl Physiol. 1997
Mar;82(3):799-806.

Riebe D, Maresh CM, Armstrong LE, Kenefick RW, Castellani JW, Echegaray
ME, Clark BA, Camaione DN. Effects of oral and intravenous rehydration
on ratings of perceived exertion and thirst. Med Sci Sports Exerc. 1997
Jan;29(1):117-24.

MS, CSCS, CPT


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Going-Long
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Hey 1979 - Depending on the length of your even, and more importantly, depending on how much you will be at risk to getting dehydrated = You may waish to consider 2 things.

A) immediatly after the finish line, and again every hour, consume 1 liter of water with a glycerol supp in it to get the fuild into you and keep it into you. Of course, electrolytes would be requiered with the fluid.
B) If you have it available to you - take one or two bags of IV fliud. You will not have the dehydration danger, and your reco will be much better.

NOTE - These ideas apply to events of 8 to 10 hours.

KingM - You mentioned this"using a 25 or lower gauge needle."

Just wondering why? I have always used 29 for EPO,HGH and for pulling blod to spin test.

Cheers - G/L

To most the marathon is the ultimate test of human endurance. To us it's just the cool down!

Pain is temporary - Quitting lasts forever

Regardless of how hard you train - The time is going to go by anyway so if you are going to throw a leg over your bike you may aswell bust you ass, make as many watts / do as many intervals as you can.


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