1. "Significance of low hematocrit levels in asymptomatic young adults:
results of 15 years followup" by Froom P, Benbassat J, et. al.
One thousand Israeli airmen aged 18-30 yr. at entry were used as subjects.
Hematocrit levels were examined annually. We arbitrarily defined anemia
as a hematocrit of 40% or less on two or more tests, and compared the
prevalence of diagnosed disorders in subjects with and without anemia. A
finding of anemia doubled the likelihood of chronic disease."
2. "Subtle brain abnormalities in children with sickle cell disease:
relationship to blood hematocrit." by Steen RG, Xiong x, et. al.
"We compared 50 patients with 50 healthy age-similar controls, using
magnetic resonance imaging. Brain T1 was significantly lower in patients
in every gray matter structure but in none of the white matter structures.
Sickle Cell Disease was associated with a 23 fold increase in the risk
of mild mental deficiency. Full-scale IQ of Sickle Cell Disease patients
was a function of hematocrit, and when hematocrit was used to stratify
patients, those with a hematocrit of less than 27% had significantly lower
psychometric test scores, and significantly lower gray matter T! than
those with a hematocrit of 27 or more. Both cognitive deficits and
subtle T1 abnormalities were associated with a low hematocrit."
Erithropoyetin is a hormone produced by the kidney which stimulates the
bone marrow to produce more red blood cells. It has been available since
1985 in recombinant form, ie, it is now made in laboratories through genetic
engineering, and so we can inject it and put up our hematocrit and hemoglobin.
In my opinion, it will prevent senility, or senile dementia.
I watched my father become senile when this hormone was already available,
and I wish I had known then what I think I know now, to prevent him from
becoming senile. But I hope I will be able to prevent senility in myself,
and I hope that doctors and others will learn and study more about this
hormone and prevent it in their patients, and in themselves, too.
However, the use of EPO is not without danger. Too much of it can raise
hematocrit too high. This could result in an especially high concentration
of RBCs (red blood cells). The danger sets in when this hematocrit level
gets too high. At this point, blood could literally 'clog up' an artery
leading to a vascular disaster in the form of a heart attack, stroke, cardiac
failure, or a condition called pulmonary edema, which is a form of water
logging of the lungs because of left ventricular failure. You can most
definitely get too much of a good thing.
Furthermore, some people might have an allergic reaction to EPO. Their
body might create antibodies which could oppose the action of EPO, which
could result in very serious complications. (I have not heard of this
occurring, but I am speculating that it might occur.
So... EPO has to be monitored frequently with blood tests, and should
only be taken under medical supervision.
EPO is forbidden for athletes according to the rules of the International
Olympic Committee, and other sports bodies, but I think it will be shown to
be a great hormone for those senior citizens who need it after their
hematocrit drops (perhaps as early as age 50, but definitely worth monitoring
after age 70.)
EPO is relatively "expensive," but cost has come down considerably in the
past year. At present cost, a treatment costs between $500 and $1000 for the first three months. To raise red blood cells about 5%, for example from 39% (anemia) to about an average level (44%) costs about $650. Red blood cells remain viable for 4 months, or more, so after the level has been reached, a
maintenance dose of EPO is much less than to get to 44%.
EPO costs $650 for 12 vials of 4000 iu. This is enough to raise hematocrit
about 4% or 5% for 4 months, after which half as much is needed as a
maintenance dose.
For comments about this page, please write to:
etoussier@safe-mail.net
Ellis Toussier
-->
The following posts are copied and pasted from the Rejuvenation discussion list
which I moderate. I post them here (slightly edited by me, for ease of
reading and continuity) in the hope that they will be read by more patients
and doctors. I hope it will get their attention to other possible medical
uses of EPO. The first 2 posts are an introduction to the health problem that
was presented, and the interesting and important discussion that followed.
1
From: Bob/Dave
Date: Wed Aug 22, 2001 8:03 pm
Subject: Good days and Bad days
To: Rejuvenation@yahoogroups.com
Hi ,Ellis, I'm Bob/Dave..
I am a 66 year old male I have emphysema .. bronchitis... crohns, I am on
udos choice.. panthothic acid.. magnesium citrate.. golden seal root, vit C,
beta carotene 25000 units, Saw palmetto, B 12 injections 2xmo., rutin 7.5 mg,
androgel testosterone daily... also low carb., no sugar, no salt, and low
fats diet.
I just had my first Hgh injection. My AAMD started me off on 1 unit every
other day my IGF-1: 121 low average. He said everything else was low average...
He said after 1 mo. and blood test he will adjust protocol according to
results of the blood test... I walk 2 miles a day 30 minutes.. 15 minutes 3
miles on stationary bike.. I still work 50 hrs a wk some heavy lifting (self
employed fresh fish market in NJ)
Question... if you would be so kind about how long should it take to start
feeling some results?
[I expect in one week you will know you feel better... in about two weeks you
will SEE results showing up in the mirror... in about one month you will be
crowing to everybody that will listen (and very few will listen) that you are
feeling better than you have in years... and that will continue month after
month. - Ellis]
Right now I have good days and some not very good days. It seems like old age
is setting in, and I don't like the feeling.
[I wonder what you mean by you have good days and some not very good days. In
any case... please tell me your "hemoglobin" and "hematocrit" level, which is
probably on a past blood test. If these are also "low average" then the
problem is here, and I will tell you what to do next... if they are high,
then the problem isn't here. - Ellis]
Any ideas or advice would be greatly appreciated...
Thank you, Bob/Dave
Reading your posts so easily understandable moved me off the aminos. Thanks
also to Gordon and Whooo, and a few others challenging the others on the
merits of aminos vs. injectable hgh. It seems you guys gave the better
arguments with more human feeling and research data.. after all you guys
are on the real hgh and the others argue their home made hgh was more
effective and safer.. I hope it does work well for them.. Unfortunately I
don't have the time to wait ...
[We are all here to help each other. The real problem in this world is knowing
WHO TO BELIEVE, and I am glad you have chosen to believe Gordon and Whooo and
me, and others on Rejuvenation... I have chosen to believe Dr. Cranton and
Dr. Hughes and Dr. Dean and a lot of other good doctors. There is SO MUCH
STATIC from others, but through the fog I can see very clearly that this is
the right path, and I hope you will see it and keep on following us. Read
my whole program here. I invite you to do as much of it or adapt it to
yourself as you can:
Rejuvenation, My Personal Program
Thanks for writing, keep on sending your input, and just keep on going. This
will change your life for the better. - Ellis]
2
From: dave236@webtv.net
Date: Fri Aug 24, 2001 2:06 pm
Subject: Re:* * * Hemoglobin 13.5 Hematocrit 40.4
Many many thinks for your gracious reply...
MY hemoglobin 13.5 hematocrit 40.4...sorry to get off subject...
I complained about having good days and not so good days and
you asked for the above...thank you dave/bob PS what do you
think of my protocol... I'm all ears on any advice...
[Hello Dave. You asked for it, so I will give you my advice...
Your hematocrit is extremely low, and your hemoglobin is
extremely low. It is not "low average" it is "low sick".
This means you have a lot less red blood cells than average,
and red blood cells carry hemoglobin, which carries OXYGEN.
To give you an idea how low, you are in the bottom 5% of the
population, ie, of 100 people, 4 persons have less hemoglobin
than you do, you are number 5, and 95 have more hemoglobin
than you do. Those 4 who have less than you are defined as
"anemic". You are being told your level is "low-normal" but
you are in fact "low-sick" and you have to cure this illness
because it is extremely serious. I am in the top 5% or 10%
of the population, with more than 16, and you have 13.5 That
means that I have 20% or 25% more oxygen reaching my brain
than you do. I assure you that if I was locked up in a car
and they sucked out 20% of the oxygen in the car, and if I
were to spend 10 years like that, it would affect my brain.
So the low hematocrit or hemoglobin is affecting your brain.
While you still know what is happening, you have to reverse
the damage. I am not sure how much damage has already happened,
if any, but it surely will happen if you don't do something
about this right away. Also, I think much of the damage can be
reversed, if it has occurred.
This is the reason why you have days where you feel very
tired, dizzy, or you forget many things, or you feel numb, and
buzzing on your hands and feet. (I am guessing, because you
didn't say it, but I know that this is happening.)
There are several solutions to your problem... good,
better, and best. Right away, start with the good one...
go and get piracetam or hydergine or vinpocetin, or all
three. These will dilate the blood vessels, and this will
increase the oxygen to your brain, and also to other vital
organs of your body. This is analogous to making the
freeways wider so traffic moves faster.
The second thing which you can do, even better than
dilating blood vessels, is hyperbaric oxygen (HBO) therapy.
This will force oxygen into your blood plasma. It is
similar to a CocaCola that they force carbon dioxide to
mix into the water with pressure. This has great
therapeutic effects on your brain and your nervous
system. For more information about this, see
Ocean HBO
See the videos, which you can link to from the left hand
column, and the SPECT scans here:
SPECT Scan of a
dizzy senior citizen.
HBO therapy is analogous to forcing more cars to go through
the freeways. This is a very good solution, but the
benefits don't last very long, and you have to continue
to take HBO frequently, and it is quite expensive.
You wrote that you are just starting on 1 i.u. of
growth hormone per day. This is very good. It might
also help to increase your hematocrit and hemoglobin...
I am not sure of this, but it might. But it will also
help you in other ways, so keep on going. I hope you
will let us know your IGF-1 blood test results when you
re-test in 30 days.
But the absolute best thing you need, urgently, is EPO,
ErithroPOyetin. Erithropoyetin is a hormone produced
by the kidneys which stimulates the bone marrow to produce
more red blood cells. EPO will increase the number of red
blood cells in your blood, and it will also increase
the hemoglobin, and therefore it will increase the
oxygen being carried everywhere in your body.
This is analogous to putting more cars in the freeway
so they can deliver their cargo. This is absolutely the
best treatment you need, and you need it urgently.
Unfortunately, EPO is very expensive. It is much less
expensive in Mexico than in the U.S. so if you decide
to take it, write to me and I will help you to buy it
in Mexico (I am in Mexico). I can deliver it to you
anywhere in Mexico, or I can send it to you legally, with
a prescription, to the U.S. I am not saying this to sell
to you, I am saying it in the hope that I can help you to
get better at less cost. I cannot tell you what dose you
need without more information, so I cannot tell you how
much it will cost for the dose you need, but a quick guess
is that it will cost about $500 to $1000 in the United
States, per month to start, and then less in the future,
and about 40% less in Mexico.
I advise that you should get your hemoglobin up at least to
15%, which is about 10% more than your present level, and if
you raise it to 16%, that would be even better.
I could write much more about EPO, and I will. It is exactly
what you need. I don't doubt your doctor may be excellent
and hasn't told you that you need it, so tell him I told you
to tell him, and tell him why I said you need it, and try to
get it. If he will not prescribe it, I will help you to get a
prescription with other doctors subscribed to Rejuvenation.
I really hope this helps you, because you need it. Three
stars for this post, for Bob/Dave for telling us his hematocrit
and hemoglobin levels, which is going to be very interesting to
others. - Ellis]
3
From: jgarciamd@aol.com
Date: Mon Aug 27, 2001 12:21 am
Subject: Re: * * * Doctor comment, please: Hemoglobin 13.5 Hematocrit 40.4
EPO can help build up your H/H after any surgery. Yes, with
significant portions of your bowel removed, that shortens the time
nutrients can be absorbed. Older people with less stomach acid will
have trouble absorbing Vitamin B-12 for example. HGH will help build the
patient up in general terms, but testosterone is more effective in terms
of the hematocrit than HGH.
EPO is made in the bone marrow and stimulates the formation of
new red blood cells, but good nutrition is also needed to make sure the
blood cells are healthy. Unfortunately iron will be the most difficult
to absorb. I would try ferrous gluconate first, then the EPO.
EPO works whether the blood count is low or normal, that is
why cycling athletes and runners use it to dope their blood before
competitions, to increase their ability to carry oxygen. In the old
days, the only way to do that was to train at high altitudes.
There have been recent studies showing good results in
stabilizing Crohn's with HGH, with or without surgery.
Julio L. Garcia, MD FACS
plastic surgery and antiaging medicine
3017 W. Charleston, suite 80
Las Vegas,NV,89102
888-FACES89
The above is for informational purposes only and does not constitute
a second medical opinion. There has been no establishment of a doctor-patient
relationship. If one would like to become an active patient please feel free
to contact me.
4
From: Dr. Allyn Brizell BrizX@doctor.com
Date: Tue Aug 28, 2001
Subject:* * * Doctor comment, please: Hemoglobin 13.5 Hematocrit 40.4
A hematocrit of 40 means that 40% of the volume of blood is composed of red
blood cells which is about normal. Most reference ranges for Hct are
between 35-47.
[I refer to "The Reykjavik Study: Distribution of Haematological Serum
and Urine Values in a General Population of Middle-Aged Men": "2955 males aged
34-61 years were invited for examination during a six month period...(snip)
The response was 75% (2203) (snip)... The approximate 5% and 95% centiles were
as follows:
Hematocrit: 41% - 49% (age group 35 to 49), 40% - 49% (age group 50 - 59);
Hemoglobin:13.4% - 16.9% (age group 35 to 49), 13.4%-16.8% (age group 50-59)"
By this study, which is the one I used to answer, Bob/Dave's 40.4 is in the
bottom 5% percentile. That is anemia, or "pre-anemia". I have put up the
tables for you to see them here:
http://www.rajeun.net/hb.html
- Ellis]
What is more important then just looking at a normal range hematocrit is the
MCV, TIBC and Ferritin level.
[What do "MCV" and "TIBC" stand for? - Ellis]
Recombinant Erithropoyetin (r-HU-EPO) EPO is an injectable protein hormone that
acts on bone marrow to stimulate red blood cell production. The recommended
criteria for initiating the prescribed erithropoyetin therapy for adult
patients is a hematocrit level below 35% or hemoglobin level below 10.
[I understand that I am recommending that he should use EPO long before "the
recommended criteria for initiating the prescribed EPO therapy for adult
patients," which is horrendously low. I am hoping to avoid the damage to his
brain that he will surely suffer for lack of oxygen if he waits until he
reaches this extreme. - Ellis]
When an athlete injects EPO (or anyone with a normal h/h), their hematocrit can
rise as much as 40%. This results in an especially high concentration of RBCs
(red blood cells). The danger sets in when this hematocrit level gets too high.
At this point, blood could literally 'clog up' an artery leading to a vascular
disaster in the form of a heart attack stroke, cardiac failure, or a condition
called pulmonary edema; this is a form of water logging of the lungs because of
left ventricular failure. You can most definitely get to much of a good thing.
[This is analogous to getting acromegalia with growth hormone. Of course I was
not suggesting he should overdose. Hematocrit rises slowly enough with EPO, and
can be easily monitored so that he would not overdose. I am recommending he has
to use the right amount of a good thing. You can also get too little of a good
thing. - Ellis]
The use of EPO in generally is for chronically ill patients for the most part.
[He is chronically ill. He is not defined as chronically ill, but his condition
is going to get worse and worse, unless it is stopped and reversed right now...
- Ellis]
When evaluating anemia the first thing that needs to be done is find the
underlying cause. In most cases that is loss through the GI tract and this can
be checked by a simple stool test for blood. Which if positive a colonscopy
should be done unless cause is obvious. Treatment options depends on cause of
anemia eg.b12 or folic acid def.,viral induced, drug induced, RBC destruction
Iron deficiency anemia: 1) adequate nutrition 2) ferrous gluconate in
combination with ascorbate acid (which aids in absorption of iron) but be aware
that overloading the body with too much iron dramatically increases risks of
cancer, heart disease, and neurological degeneration. So do not routinely takes
supplements with iron. Also, the use of testosterone replacement can greatly
increase RBC volume this can be used to the advantage of an anemic individual
or cause "polycythemia" too much blood and necessitate the need for a
therapeutic phlebotomy (donating blood) every few months.
[His testosterone levels are also "low-average," meaning low. I would think he
should also try testosterone replacement therapy, in conjunction with EPO. -
Ellis]
As for the treament of Crohn's disease with rHGH a landmark study was published
in the N Engl J Med. 2000 Jun 1;342(22):1664-6
A preliminary study of growth hormone therapy for Crohn's disease. 37 adults
with moderate-to-severe active Crohn's disease to four months of
self-administered injections of growth hormone (loading dose, 5 mg per day
subcutaneously for one week, followed by a maintenance dose of 1.5 mg per day)
or placebo and eat at least 2 g of protein per kilogram of body weight per day.
Patients continued to be treated by their usual physicians and to receive other
medications for Crohn's disease.
CONCLUSIONS: Our preliminary study suggests that growth hormone may be a
beneficial treatment for patients with Crohn's disease. I use rHGH in
combination with large dose Glutamine and have found improvement in patients
with Inflammatory bowel disease. Healing of intestinal mucosa should reduce
amounts of microscopic RBC (Red Blood Cell) loss, thus improve any iron
deficiency anemia.
Allyn A. Brizel M.D.
Center for Clinical Age managemnent
[Thank you Dr. Brizel for your post, which generally takes a much more
conservative view than I did about EPO, and which is important for Bob/Dave to
evaluate.
I am not a doctor, and I don't like to go against what doctors say, especially
not doctors who I know are good doctors...
Except in this case we don't agree that his hematocrit levels of 40.4% are
"about normal" because we are obviously using different criteria, ie, different
reference ranges for hematocrit. We will probably agree after you see the
details of the Reykjavik Study, a summary of which I quoted above, and I have
put the hemoglobin and hematocrit tables from this study, and another very
extensive study of hemoglobin on senior citizens age 70 to 88, on a page of
their own, for everybody to study. These tables document the fact that
hemoglobin drops drastically after age 60. This has been known for many years,
but it has been accepted as "normal", and it has also been accepted as normal
that senior citizens become senile... and we don't know why. Now, maybe, we
will know one reason why.
I have already sent you (and other doctors on Rejuvenation) the full Reykjavik
study and other studies and my report about this by snail-mail, and I have put
up a page with the tables of hematocrit and hemoglobin found in that study, and
another large study of the hematocrit and hemoglobin of healthy men and women
age 70 to 88.
The point I want to make is that EPO is NOT BEING PRESCRIBED by doctors for
something that I think IT SHOULD BE PRESCRIBED FOR, the lack of which will
result in grave brain damage, as is now considered "normal" in senior citizens.
Bob/Dave's case is exactly one of those cases where it should be recommended,
according to me. Bob/Dave's case (low and falling hematocrit and hemoglobin) is
very common after age 60, and becomes more common after that age, as does loss
of memory and cognitive functions.
As you will see on the tables, the AVERAGE hemoglobin after age 70 drops down
to about THE BOTTOM 5% or 10% from age 15 to 60. So in order to see what will
happen to senior citizens because their hematocrit and hemoglobin drop, we only
have to study the bottom tail end from age 15 to 60 to see what happens to
them... and that includes less cognitive functions and twice as much cronic
diseases... Anemia is also associated with low intelligence, or mental
retardation. I think this shows the reason, or one of the reasons, why senior
citizens (me, in a very few years) will lose their cognitive functions!
After age 60 hematocrit and hemoglobin drop, but not enough to notice, from day
to day, or even from year to year. From age 60 to 70 it drops only about 1/4 of
1 percent (.0025) per year... but from age 70 on it accelerates to
approximately 1/2 percent (.0050) per year. I am sure that beyond age 88 it
drops even faster. This is still not enough to notice from day to day, or year
to year, but it is enough to notice from decade to decade!
This is further complicated because the volume of blood also decreases with
age. It is even further complicated because with advancing age the incidence of
diabetes or pre-diabetes also increases greatly, and with it the average level
of glucose in the blood increases greatly also. Glucose normally adheres to
about 5.5% of hemoglobin in non-diabetic adults, but this increases about 50%
or more in pre-diabetic or diabetic adults, to 7%, or 9%, or even higher. (This
is revealed through a blood test for "Hb-A1c" where "A1c" is a sub-type of
hemoglobin that has glucose attached to it.) Hemoglobin that has been attached
to glucose loses much of its ability to deposit oxygen. It is not hemoglobin
anymore, it is ex-hemoglobin, for our discussion.
So now we have: less blood volume, less hemoglobin in that blood volume, and
less hemoglobin that can deposit oxygen. This creates a condition of hypoxia
(very low or oxygen starvation) in the brain of senior citizens, which might
also be complicated by arthritis and hardening of the arteries, which itself
might have been caused or complicated by a lack of sufficient oxygen in the
blood.
I point out that Dr. Ronald Klatz did NOT mention EPO as one of the anti-aging
hormones, or even as one of the hormones that falls with age, in either of his
two books "Grow Young With HGH" or "10 Days to a Younger You". I would be
surprised if the use of EPO to prevent brain aging has ever been discussed at
any anti-aging conference.
A search for "EPO" on www.google.com today showed zero posts related to
the use of EPO to prevent brain damage on senior citizens, or the use of
EPO to increase hemoglobin on anemic patients, or the use of EPO to
increase intelligence, and rec.drugs.smart discussion group focuses on smart
drugs, ie, ways to increase cognitive functions now and to prevent brain aging.
I could find NO studies on Medline showing the use of EPO on senior citizens
to prevent the loss of cognitive functions, to show one way or the other if I
am right, or if I am wrong.
So, I know that what I am saying is perhaps new, and going against the
"common wisdom," but I'm sure I'm right:
The cause of senility is due to lack of oxygen to the brain, and
the solution to the drop in oxygen to the brain is EPO, erithropoyetin,
a hormone that will increase the amount of red blood cells, and thus hemoglobin,
and thus oxygen to the brain!
I hope this discussion will cause some waves to suggest that the use of
EPO HAS TO BE studied on senior citizens to prevent loss of memory, or
senility. This is the ultimate smart drug, and for me, the ultimate and
most important anti-aging hormone, although I won't need it for a while (but I
am taking it already... to learn to use it... my hematocrit is UP from 48% to
50.0% and my hemoglobin is now at 16.8%.)
Three (new) stars for this post, by Dr. Brizel whose comments are very valuable.
This is an extremely important discussion which I think will affect ALL of us
someday, if we live past the age of 60. I hope we all will live to age 100
at least, in a healthy body and with our brains still functioning.
See the hemoglobin and hematocrit tables from the Reykjavik Study and another
study of hemoglobin on senior citizens, and a discussion, here :
(links on this page may not work yet.)
http://www.rajeun.net/hb.html
- Ellis]
5
On September 2, 2001 Dr. Allyn Bryzel wrote:
*** Ellis, very nice rebuttal to my last post.... though your suggestion
for the use of EPO for a HCT of 40 would make most Hematologist heads
spin 360 degrees.
Allyn A. Brizel
Center for Clinical Age Management
Boca Raton, Florida
[Hello Dr. Brizel. I know that. I am saying ALL hematologists aren't
using EPO for all the things it should be used for, and that has got to
change! So they need a bit of head spinning. I think perhaps they
haven't thought of what ELSE this amazing hormone can do for us.
I learned about erithropoyetin from an athlete, and I immediately thought
to myself, what can this do for anti-aging to reverse any of the signs of
aging? I know that VO2Max drops with age, and it is one of the most
difficult signs of aging to reverse. Aerobic exercises help a little...
probably because they create a temporary condition of hypoxia in the
blood, which then signals a healthy kidney to release some EPO... I have
a page which explains a little more about VO2Max, but without a mention of
EPO, which I just learned about in May of this year... :
VO2Max Calculator
and discussion
I suspected blood levels of red blood cells and hemoglobin would
go down with age, but it was very difficult to find tables to show this.
After I found the tables (which I had to buy, because they don't appear
on the abstracts) I couldn't find any studies at all that were related
to the use of Erithropoyetin on senior citizens to prevent the loss of
cognitive abilities.
When I searched for anemia, I learned that it is very "normal" for senior
citizens to be anemic. I also found the relation of anemia with mental
retardation, and the relationship of EPO with better intelligence test
scores, on very sick patients. But these kidney patients are having their
blood hemoglobin levels raised to a bare minimum, about 13.5, which to me
is still anemia, or pre-anemia.
I am not sure why they choose to raise it to such a low level, but it
might be because of the relatively high cost of EPO. But if I was a
kidney patient, I would prefer to pay more and to have my brain back than
to save money and stay in a state of pre-anemia.
The strange thing about lack of oxygen that I have read many times is that
nobody complains of lack of oxygen, even while it is ocurring, even while
they are sustaining brain damage. It doesn't hurt, and it isn't noticed at
all. So it is accepted as if nothing is wrong. But something is terribly
wrong, and the only way to avoid brain damage in the long run is to be
conscious that it will happen, before it happens, and then to decide
that we will not allow it to occur in ourselves, (or a doctor in his
patients.)
So I decided to take EPO myself, to learn to use it. I can buy it at a
pharmacy in Mexico without any problem, and without any prescription. I
found brands made in Germany, Switzerland, and the United States, and
surprisingly, a brand made in Mexico. I called the National Institute of
Cardiology in Mexico, which is a very good hospital where they do a few
heart transplants every day, and I asked to speak to the blood bank. I
asked them if they know the various brands, and they said yes, they do...
Is there any difference between the Mexican brand and the others? No, they
are all exactly the same. They are all excellent. So... Viva Mexico! I
bought the Mexican brand, and I can confirm it is excellent.
I have been taking EPO in various doses to understand how it affects my
hematocrit, and now I know this. My hematocrit is now 50%, and my
hemoglobin is 16.8. So now I know what Einstein might have felt like,
and he felt pretty good. I am going to get my hematocrit up to 52% and
keep it there for a while, so I can report to you what it feels like, and
what happens.
So far, riding bicycle or running on the treadmill is a lot of fun...
but I am not an athlete, and I don't care to win any races. I am only
doing this to learn, and for good health.
So, Dr. Brizel, who cares if we make a few Hematologists and
Endocrinologists' and Gerontologist's heads turn? (Or even 10,000 Anti-Aging
doctors?) It isn't me that should be teaching them about EPO. They should be
teaching me. I hope I will make their heads turn, and then I hope they will
think about what we are saying here. I don't have the slightest doubt that
what I am saying is right, and I am sure we are going to make the world a
better place with this discussion.
And, by the way, they say that copying is the best way to flatter, and you
will notice that I copied your paragraph of the possible danger of EPO onto
my page, "Hematocrit, Hemoglobin, Senility, and EPO" So thanks to you and KB
for pointing out that I should mention the possible side effects, which now
I do. Since you say it was a nice rebuttal, I hope it means you agree with
what I am saying. It will be doctors like you that will put it into
practice. - Ellis]
6
From: KB
Date: Tue Aug 28, 2001 8:11 pm
Subject: Erythropoetin (EPO)
Ellis writes
[He already is anemic. He needs EPO as a last resort to avoid
worse anemia, or what he already has for any longer. There is
no other way. I don't think he will develop antibodies to it,
but it is not a bad idea to monitor for packed cell volume, or
whatever he wants to monitor for. The only bad side effect to
EPO, as with other good medicines, is to abuse it... but Dave/Bob
is very far away from that point, as that is to raise hematocrit
above 55%, probably to 60% or more. ("hematocrit" is the percentage
of total blood volume that is made up of red blood cells... the
normal range from age 15 to 60 is roughly 40% to 50%, average is
about 45%... Below 40% is defined as "anemia" but that is only
somebody's opinion... mine is that below 45% is not good, and
deserves attention...) Since hematocrit rises very slowly, if he
is under any kind of supervision at all, he will never get above
maybe 48%, and 50% would still be safe. Please tell us what you
know about antibodies as a reaction to EPO. - Ellis]
No offense Ellis, but there is a lot more to it than that. If you tell
people that they urgently have to take it, you also have to tell them fairly
about the risks, like antibodies, resistence, possible stroke if it works too
well and so forth. You should have researched it before recommending
it, and read the package insert. You have that good reputation of
knowing what you are talking about.
Developing antibodies can lead to worse anemia, and possibly death.
Don't say, "I don't think he will develop antibodies to it" , say "These
are the tests you need to watch out for antibody development."
You say that "The only bad side effect to EPO, as with other good
medicines, is to abuse it... " is it really that simple? What about
people who are allergic to a good medicine, like penicillin? Can you define
"abuse...."? Anyway, abuse is misuse, and not a side effect, which is
an undesirable result of proper use.
It may be that it would work very well for Dave/bob. I hope he asks
his doctor and maybe gives it a try. If it does help him thats great!
But he needs to be aware of the possible complications, including
any particular ones that relate directly to chrohns (sp?) disease.
Also we all know that doctors are not always up to date on information
or willing to try new therapies that sometimes do work. But he should
still tell his doc if he takes it in case the doc later gives him
something that reacts with or counteracts with it.
KB
[KB, he has no other good alternative. I know more or less what I am
saying because I am taking it myself, with caution, to see how my hematocrit
reacts to it. I have read pretty extensively before taking it, including
the literature put out by the pharmaceutical companies. I have surely read
the package insert, and much more, I know people who have taken it and I
know what was their reaction to their dose. It is not a dangerous hormone.
And the importance of oxygen to the brain, especially, cannot be
overemphasized.
EPO is standard treatment for thousands of patients with kidney failure,
but it is not standard treatment for millions of senior citizens who we know
are getting senile dementia. The "common wisdom" is that we don't know the
cause of senile dementia... Nobody has said it might be due to the fall in
hematocrit, which translates to a fall in oxygen to the brain, so now I am
saying it... Senile dementia MIGHT be caused in part by the drop in oxygen
to the brain. I think it is very reasonable to suppose it might be, at least
in part, due to the drop in hematocrit.
Just look at the results of hyperbaric oxygen therapy on a dizzy senior
citizen... I am guessing, but I would place money that says his hematocrit
and hemoglobin were too low:
SPECT Scan of a Dizzy Senior
Citizen
In any case, he was greatly benefitted by hyperbaric oxygen, as shown by
the SPECT scan. Or read the report (below) about the increase in cognitive
functions in kidney patients who are given EPO... in my opinion, EPO is sure
to become the ultimate "smart drug."
I quote this, from "Cerebral hemodynamic changes following treatment with
erythropoietin" by Horina JH, Fazekas F, et.al.:
"We investigated the changes in cerebral perfusion, cerebral blood flow
velocity, and neuropsychologic performance in 11 patients (mean age 37)
receiving EPO... (snip) The score of the Wechsler Adult Intelligence Scale
digit symbol test improved significantly (p less than 0.01) after EPO
treatment. None of the patients developed cerebrovascular symptoms or side
effects. (snip)"
You will hear many doctors say that hematocrit does not fall, it remains
constant... And they are right, it remains constant from age 15 to about 60...
but then it starts to fall slightly... from age 60 to 70 it falls about 1/4 of
1% per year. That is too little to notice from day to day, maybe not even
from year to year. After age 70 it falls about 1/2% per year. That is still
too little to notice from year to year, but you can notice it from decade to
decade.
Have you noticed how many senior citizens of age 90 are different than the
same senior citizen were at age 80, or at age 50? They have lost their memory. I am saying that occurs partly if not wholly because of the 10 to 15% or more drop in oxygen to the brain. 10 to 15% is the average, but many senior citizens have a greater or faster than average drop.
Now you want to be cautious, be cautious, take all the precautions you want to, except Bob/Dave can't wait for the results of a study to see if he is allergic to a hormone, or if he has anti-bodies. He has to decide to take it or not take it. His blood tests show without a doubt that his hemoglobin is extremely low, but not yet to the point where doctors arbitrarily decided they will call it "anemia," and it won't be prescribed to him because he is still not brain dead... EPO would not be prescribed to him until his hemoglobin drops further, which it surely will... His hemoglobin now is 13.5, and I am saying that is alreadytoo low... he needs EPO urgently now. However, as Dr. Brizel pointed out, the criteria to prescribe EPO is that his hemoglobin should be another 25% lower, ie., 10.0% or less.. By that time, I guarantee he will be nearly brain dead.
Why should Bob/Dave wait until he is brain dead before he takes action to try to remain well?
Or should I ask, why do doctors wait until his hematocrit is 30% lower before they decide they should take an action that they could take now?
In other words, his case is still not serious enough yet, but it will
probably be serious enough in 4 or 5 years from now after his hematocrit drops
another 10 points, from 40% to 30%. He has to wait until he is almost brain
dead before he will get a prescription, using the medical criteria that is used
today.
EPO is not even prescribed for anemia, when it is so obvious to me that it
should be, at least for many types of anemia. It is prescribed only for
kidney failure, which causes an anemia so extreme because the kidney is not
functioning at all, and it is the one that should produce EPO...
So I guess some doctor finally figured out that synthetic EPO could
substitute for natural EPO, but they never figured out that it can be used for anemia... (I'm not saying doctors are stupid... they just can't know everything unless it is brought to their attention, and EPO has simply been out of the limelight for all these years, probably because it was first approved for kidney failure, and nobody seems to have noticed it way off to the side there somewhere, with the kidney failure patients.)
It is a fact that there are several causes for anemia, and maybe some of them are not due to a lack of EPO... it could be bleeding in the intestines, etc., but they all translate to a lower hematocrit, and EPO will reverse that. So what are doctors waiting for to prescribe it? I think what is happening
is nobody has ever started a discussion like we're having right now, and now
that we're having this discussion some doctors are going to hear about this hormone that they don't even know how to spell EPO
and maybe start prescribing it a bit more, and that is what I think is needed.
(NOTE: the correct spelling for EPO in Spanish is "eritropoyetina" in Spanish, which is a Latin language with Greek roots... so it should be "erithropoyetin" in English. I see it misspelled "erythropoietin" all the time... even on this page.)
Let me ask you, if EPO could be taken in pill form, and if it cost 1 penny
per dose, do you think doctors would be so cautious as they are, because it is
taken by injection and it costs a hundred dollars (example) per treatment?
The same objections you give are also valid for melatonin and DHEA and
androstenedione and pregnenolone, etc, but they are sold in health food stores
in the U.S. and I haven't read that there is a national health emergency
because of the antibodies to them, or even due to their misuse and overdose.
So... the house is on fire, and we can't analyze the water to see if it is
contaminated and will cause anybody allergies... We have reasonable reason to
believe it will put out the fire, so we have to use it and put out the fire.
Nobody asks chronic kidney failure patients to ponder the risks of antibodies
from EPO, or of pushing hematocrit too high, but I agree it is good
form to tell them, and then use it!
And yes, you are right, I will be sure to mention the possible side effects to
an overdose of EPO, and the possibility of antibodies, next time. Thanks for
pointing it out. - Ellis]
7
From: KB
Date: Sun Sep 9, 2001 7:28 pm
Subject: Liability in case of EPO overdose?
Ellis, are you pretty sure that if you sell this man some EPO and he
strokes or dies, that you will be invulnerable to prosecution, whether
from Mexican or US authorities? Better be sure before you start
selling it.
You mentioned before that it was worth 500 to 1000 a month, and
"Hematocrit rises slowly enough with EPO, and can be easily
monitored so that he would not overdose." Since Dr Brizel wrote;
"When an athlete injects EPO (or anyone with a normal h/h), their
hematocrit can rise as much as 40%. This results in an especially high
concentration of RBCs (red blood cells). The danger sets in when this
hematocrit level gets too high. At this point, blood could literally
'clog up' an artery leading to a vascular disaster in the form of a heart
attack stroke, cardiac failure, or a condition called pulmonary edema; this is
a form of water logging of the lungs because of left ventricular failure.
You can most definitely get to much of a good thing."
And I have also read posted here that the effects of EPO last 3-4
months, I would like to see your methods of monitering it "easily enough" so
that people who are not doctors who are using this at home will
not overdose.
It really looks to me like you, Ellis, are using scare tactics and
emotionally loaded language ("horrendously low", "it sounds like your lung
"specialist" would have been content to let you die soon. - Ellis]")
in order to encourage sales. Big sales too, this stuff is expensive. You
delayed my EPO-cautionary post for 5 days while you wrote up a long, long
rebuttal to every point, and have argued with just about every other warning.
[I didn't delay your post. In order to answer it, I had to program an entire page (this one), with HTML code for three tables. If you don't consider
hemoglobin 10% and hematocrit 30% to be "horrendously low" it is because
you don't understand what you are saying, and you are forgiven, but
nonetheless you are mistaken. If you remain at the point of "anemia" which
is 13% hemoglobin too long you become SENILE, says me... You don't believe
me? Then why do senior citizens mysteriously become senile? Why is
anemia associated with mental deficiency? - Ellis]
But this isn't GH, which is relatively slow-acting and low in serious side effects. This EPO could possibly kill someone after one injection.
[No, don't say things you don't know to be true, unless you say you "think" it could possibly kill someone after one injection. It can't. EPO doesn't increase hematocrit so fast... He has hematocrit of 40%.. Anemia is defined by the World Health Organization as hemoglobin of 13% so that means hematocrit of about 39... I said ANEMIA... He is almost anemic by DEFINITION. But he has to have hematocrit of 30% and hemoglobin of 10% before the present protocol for EPO says that they can give him EPO to raise his red blood cells... but by then he might easily be BRAIN DEAD, for years of LACK OF OXYGEN ! That is why he can't wait!
Hematocrit increases by about 1% after THREE injections of the largest dose that it is sold (4000 i.u.)... (I KNOW this is true). He would have to be way above 55% hematocrit, which is the upper end of the normal range. So I say that is slow enough so that he won't accidentally increase his hematocrit above 55%, (I didn't even recommend he should raise it to 55%.) - Ellis]
What will happen to you if you sell it to them and this happens?
[He should get a doctor to approve it and monitor it with him. He can buy it in the U.S. or his insurance company would give it to him for free.
I would only help him to buy it in Mexico, if he wants it from here because
it is a very expensive medicine and it costs much less here... fact. My
advice remains the same, he needs EPO urgently, or he will become senile.
Clinical senile dementia roughly doubles every 5 years after the age of
65. about .8 - 1.6% of persons 65 - 74; 7 - 8% of persons 75-84; and
18-32% over the age of 85. He is in his 60's and is already nearly anemic
so he may be in the first group of .8 - 1.6% to become senile. I am
advising a logical treatment for low hemoglobin: EPO. That is what it
does, it increases hemoglobin! It is exactly what he needs!
This is not a dangerous hormone, in spite of all that you think it is because it has only been used for patients on kidney dyalisis. That doesn't
make it a dangerous hormone. Read Dr. Brizel's statement over again... He
says that when an athlete takes it, it can increase hematocrit as much as 40%
... the startoff point of an athlete is not 40% hematocrit, it is closer to
50%... 50% + (40% of 50%) is 70% 70% hematocrit would kill a horse, and
I certainly don't recommend 70%... not even 60%... 45% is average, 50% is
still normal... He has 40%!!! Look at the tables:
http://www.rajeun.net/hb.html
Note: Andean natives in high-altitude regions of Peru and Bolivia have adapted to thin air with hematocrits as high as 60% [*]. (* Weihe WH, ed. Physiological Effects of High Altitude. New York: Macmillan, 1964.)
Polycythemia patients present hematocrits of 75%-85%, leading to disturbances in blood flow as blood viscosity increases with rising hematocrit.
- Ellis]
KB
PS I am sending this to a few other people simultaneously in order to
be sure that it is seen by someone. (I hope that all of you will not
mind, and will take an interest.) I expect that you, Ellis, will not
want to post it to Rejuvenation at all.
[You expect wrong. I am putting it up on a page on the internet for many others to read. I hope you sent it to Dr. Brizel and other doctors, and I hope that Dr. Brizel will comment, because he didn't write to say I am wrong. He wrote to say it was a very good rebuttal to his post.
- Ellis]
It seems to me that you have been unappreciative of my posts for
some time, for reasons which mystify me. Maybe you can explain.
It is easy to understand, however, why you would not want others
to read *this* post.... however, I write it in the good spirit of not
wanting others to get hurt or die by being mislead into abusing a
powerful substance usually only given to patients at the transfusion
level, and you spend the rest of your life in jail.
KB
[Thanks for your concern. If I ever sell it, it is completely legal
for me to buy it and completely legal for you to receive it, with a prescription. You seem to be obsessed with the fact that it is a dangerous hormone. It is only dangerous if you get your hematocrit too high. You can't get your hematocrit too high "accidentally" so that is out of the question. You monitor hematocrit with a simple, quick, and inexpensive blood test. If
a person takes it constantly, he could buy a meter to monitor it at home,
and if not, any lab will do it and have the answer in half an hour. I say
it is impossible to accidentally overdose, and that is the only possible
danger of EPO.
In any case, KB, someday you might be in the position that your hematocrit is at 40% and the only direction it will go in the future is DOWN... so at that point you can decide if it is too dangerous, or if it is more dangerous NOT to take it. If you decide to take it, let me know. - Ellis]
8
From: "rsmith"
Date: Mon Sep 10, 2001 11:57 am
Subject: Re: Liability in case of EPO overdose?
KB,
I was extremely appreciative of Ellis's research on EPO and his six month
personal experience report. I plan to discuss EPO with my M.D. and if
appropriate take the drug under his care. Note that Ellis required a
prescription to accompany my order.
I believe that Ellis acted properly in
presenting this information and offering to sell us EPO at a discount.
Richard
[Thank you, Richard. I also told you that you can perhaps raise hematocrit
with B-12 or testosterone, and that you could try vinpocetin, hydergine and
piracetam, and hyperbaric oxygen. That is bad salesmanship. If you want EPO
after all that, then I offered to help you. I'm not going to break any
sales records like that. - Ellis]
9
On Sept. 2, 2001 Dr. Ron Rothenberg wrote:
PS Ellis, you are performing an invaluable service to Medicine and to
the world community who wish to avoid the programmed destruction of aging.
Thanks for all your time and effort.
Ron Rothenberg MD
www.eHealthSpan.com
I copy and paste the following which was posted on Rejuvenation.
From: Richard Smith
Date: Wed Mar 20, 2002
Subject: * * * Feeling Better with EPO Results
Ellis, After a single 4000 Unit EPO SC injection my hematocrit jumped
from 39.7 to 41.3%, RBC 4.20 to 4.40, and hemoglobin 13.6 to 14.1. .
Note I had also taken 15 hyperbaric oxygen treatments during this test
interval, so I can't attribute all of this gain to EPO. However, my
brain fog symptom substantially cleared two days after the EPO injection.
I should know more clearly if EPO is truly this effective next Monday
when I check my hematocrit again. Thank you for encouraging me to take
EPO.
Regards, Richard
[Hyperbaric oxygen wouldn't raise your hematocrit
or RBC or hemoglobin... so I think it was the EPO. Excellent!
Wow! I'm impressed. I am more impressed by the physical result than by
the blood test result, since the blood test can be plus or minus 3% and
can even be affected a few percentage points up or down by how much water
you drank. But the physical result you mention is a very good sign, and
shows you really did have an upward increase. I too am really glad you
are taking EPO. Maybe your case will serve as an example for others
feeling mental fog when they are anemic, and for doctors to that now you
are feeling so much better. Keep on going and let us know how you are
feeling. Every bit more helps. - Ellis]
==================
Copied from Life Extension Magazine,
[I copy and paste the text of the editorial by William Falloon,
from the March 2002 issue of Life Extension Magazine. As you
might know, I have been saying that senior citizens become senile
while erithropoyetin (EPO) could reverse it in the long run, but
doctors don't prescribe EPO enough, because the guideline to
prescribe EPO is that hemoglobin should be... BELOW 10%... Anemia
is defined as hemoglobin BELOW 12%... and normal hemoglobin is 15%...
I have argued that the delay in taking EPO results in permanent
brain damage and senility.
Now William Falloon writes an editorial in which he blames the lack
of care for anemia in all patients for "tens of thousands" of deaths.
According to the reference cited in his article, 24% to 40% of hospitalized
patients over age 65 are anemic. What Mr. Falloon is saying now makes
what I have been saying since a year ago come into focus. If patients in
a hospital are being denied EPO, senior citizens outside of a hospital
are definitely being denied EPO. Anemia is a treatable condition with
EPO, and I continue to insist that anemia is at least one cause, and
probably the most important, of senile dementia. I hope that now that
Life Extension Magazine is also saying that doctors should prescribe
EPO more often, perhaps KB and others might change their minds that
I will go to jail for putting up this page about EPO. - Ellis]
============
By William Falloon, LEF Magazine, Mar. 2002
============
http://www.lef.org/magazine/mag2002/mar2002_awsi_01.html
I regret having to write this editorial. The reason being that it forces me to
discuss elementary medicine instead of cutting-edge science. The problem is
that conventional medicine has regressed to a point where I am compelled to
alert members about a life-threatening situation that is supposed to be taken
care of by doctors.[1] The result of this physician neglect is that tens of
thousands of people are needlessly dying because an easy-to-treat disorder is
being ignored because doctors accept anemia as a normal state in elderly
patients and are failing to treat it.
Most people think that modern medicine properly diagnoses and treats anemia.
The startling fact is that 24% to 40% of hospitalized patients over age 65 are
anemic.[2] Compared to non-anemic people, these blood deficient individuals
have high mortality rates from diseases such as heart failure, stroke and
cancer.
When the oxygen carrying capacity of the blood is impaired (i.e. anemia),
people with reduced blood flow to any organ (such as those with coronary artery
disease) are at a much greater risk for infirmity and death. Cancer cells
thrive in a low oxygen environment and even borderline anemia predicts higher
mortality.
Anemia can be detected by a standard CBC blood test, yet busy doctors are often accepting anemia as being a normal state in aged people and are failing to treat it. Since drugs used to treat severe anemia (such as Procrit) are very
expensive, many insurance companies are not paying for these drugs unless blood
oxygen carrying capacity is far below the standard reference range. This means
that those most in need of these anti-anemia drugs (such as cancer and
congestive heart failure patients) are being denied access. Anemia greatly
increases all-cause mortality risk. Health insurance companies are thus saving
big dollars by denying Procrit to their sickest policyholders.
The neglect of doctors in ignoring tests that reveal anemia, coupled with
insurance company refusal to pay for anti-anemia drugs, amounts to widespread
euthanasia being inflicted upon the elderly. In this editorial, you will learn
about natural and pharmaceutical approaches to reversing anemia.
Anemia predicts who will die from acute heart attack
In a recent New England Journal of Medicine study,[2] doctors looked at heart
attack victims presenting at the hospital. Anemia was a strong predictor of who
was most likely to die.
One of the tests used in this study was the hematocrit. The hematocrit measures
the percentage of whole blood that is made up of red blood cells. Normal
hematocrit ranges are between 36% to 50%. Below 36% indicates anemia. What
follows are the shocking findings revealed in the New England Journal of
Medicine study:
Heart Attack Patients Hematocrit Percentage / Odds Of These Patients Dying Within 30 days
5.0 to 24.0% / 78%
24.1 to 27.0% /52%
27.1 to 30.0% / 40%
30.1 to 33.0% / 31%
Over 33.1% / (No increased risk)
The statistics presented above show that anemia sharply increases the risk that
a heart attack victim will die within 30 days. The doctors also found a high
prevalence of anemia among these elderly heart attack patients.
Blood transfusion reduces mortality
The doctors who published the New England Journal of Medicine study then
evaluated the effects of a blood transfusion to reverse the anemic state in
this large group of heart attack victims.
A blood transfusion was associated with a significant reduction in mortality in
heart attack patients with low hematocrit (below 33%). In patients with very
low hematocrit (below 24%), transfusion was associated with a 64% reduction in
mortality. In patients with hematocrit between 24.1 and 27.0, transfusion
reduced mortality by 31%. Mortality was reduced by transfusion by 25% in those
with a hematocrit between 27.1 and 30.
These numbers show that the greater the severity of anemia, the more likely a
heart attack patient will benefit from a blood transfusion. Mortality actually
increased when transfusions were administered to non-anemic patients, possibly
a result of transfusion-related complications.
Despite numerous published studies showing the lethal effects of anemia in
heart attack patients, only 4.7% of the elderly patients in this study received
a blood transfusion. The doctors concluded that "more aggressive use of
transfusion in the management of lower hematocrit levels in elderly patients
with acute coronary disease may be warranted."
Anemia and cancer
Anemia is common in cancer patients. Conventional cancer therapies
(chemotherapy, radiation, testosterone blockade, etc.) often induce anemia.
Elevated levels of cytokines seen in cancer patients (such as tumor necrosis
factor-alpha) also suppress red blood cell formation.
When we talk to oncologists on behalf of Foundation members, we inquire about the patient's hematological condition. Since cancer cells thrive in a low
oxygen environment (hypoxia), we want to make sure the cancer patient's red
blood cell count, hematocrit and hemoglobin are in the upper one-third range of
normal.
The importance of avoiding anemia is well established in the scientific
literature. A recent study was conducted to systematically review and obtain an
estimate of the effect of anemia on survival in cancer patients.[3] This study
found that the increased risk of mortality in cancer patients who were anemic
was an astounding 65%!
Despite this data, most oncologists fail to adequately treat for anemia. One
reason for this is that insurance companies refuse to reimburse for expensive
anti-anemia drugs unless the patient is severely anemic (often 25% below the
lowest number on the standard reference range).
Since anemia predisposes cancer patients to greatly increased mortality, it is in the economic interest of the insurance companies to deny reimbursement for anti-anemic drugs like Procrit [EPO - Ellis]. In fairness, it is important to note that the cost of Procrit is so prohibitively expensive, that if everyone in need were allowed to have these kinds of drugs, many health insurance companies could go bankrupt. So part of this problem gets back to the
outrageously high cost of prescription drugs that only exists because of
today's FDA-protected monopoly.[4]
It should be noted that the sickest cancer patients are often the most anemic, which makes our case even stronger that anti-anemic drug therapy should be used more often. We do not usually recommend blood transfusions for cancer patients because of potential immune- suppressing effects. Cancer patients need to maintain healthy immune function.
Anemia predicts mortality
Anemia is a strong predictor of early death in the elderly. In a recent study, anemic individuals aged 70 to 79 were 28% more likely to die over a five year time period.[5] Anemic people aged 80 to 89 were 34% more likely to die, while those aged 90 to 99 were 48% more likely to die over a five year period.
Cerebrovascular disease (stroke) was the most common disease associated with
anemia. If you are over age 65, it is a life or death matter to correct an
anemia state.
Don't let doctors bleed you to death
Two centuries ago, doctors treated sick people by draining their blood
(bloodletting). Based on what we now know, those who could afford the
bloodletting procedure died much sooner than those who avoided doctors.
Medicine has not changed much over the past 200 years. Here we are in the year 2002 and most doctors still do not take anemia seriously. It is shocking to have a member send us their blood results, complain of the symptoms of anemia, and then hear that their doctor said not to worry about their low hematocrit, red blood count, etc.
Conventional doctors often tell their elderly patients that anemia is "normal." While it is true that anemia is epidemic in the elderly, this is not an excuse to leave it untreated.
I strongly urge all Foundation members to have an annual CBC/ Chemistry blood test that can detect anemia and a host of other correctable life-threatening abnormalities. Those who have health insurance can sometimes have this test done for free at their own doctor's office. Members can order this test directly by calling 1-800-208-3444. The cost at this time is only $26.00.
If the blood test reveals that you are anemic, follow the recommendation in the side bar entitled "How To Correct Anemia."
Americans are routinely dying from a deficiency of oxygenated blood, yet
doctors are failing to recommend supplements, prescribe transfusions and
anti-anemia drugs to elderly people most in need.
To avoid becoming a victim of this appalling neglect by the medical
establishment, have your blood tested annually and if necessary, aggressively
pursue the anti-anemia strategies that have been outlined in this article.
========
It is often the aging process itself, however, that causes people to become
anemic. Aged men are usually deficient in testosterone and testosterone
deficiency can induce anemia.[6] Aged women and men usually secrete low levels
of melatonin, and melatonin deficiency has been linked with anemia.[7]
Low levels of folic acid, vitamin B12 and other nutrients can induce
anemia.[8] Excess levels of the pro- inflammatory cytokines can also induce an
anemic state by attacking the blood cell forming proteins (erythropoietin).[9]
Supplements that suppress these dangerous cytokines include the DHA fraction of
fish oil, vitamin K, DHEA and nettle leaf extract.[10] The prescription drug
pentoxifylline is also effective in suppressing the pro-inflammatory cytokines
that can reduce red blood production in the body.[11]
If supplements such as melatonin, folic acid, B12 and DHA fish oil fail to
correct anemia, then testosterone replacement and pentoxifylline drug therapies
should be considered.
If anemia continues to persist, see if your doctor will prescribe the drug
Procrit. [note: EPO - Ellis] The high cost of Procrit will keep most people
from being able to afford it unless their health insurance will pay for it. If
you are prescribed Procrit, it is especially important that most people take
supplemental iron, as Procrit will cause iron to be utilized to help form new
red blood cells. Some people fail on Procrit because their doctor forgets to
prescribe an iron supplement.
It is important to note that when treating life-threatening anemia, the only
effective therapy is immediate blood transfusion, as it can take six weeks for
Procrit or Epogen to reverse the anemic state.
======================
Three short articles, two by the same investigator, Dr.
Donald Silverberg, dated June 1, 2000 and the second one year later, May 31,
2001.
======================
Anemia & Heart Failure
June 1, 2000 - Anemia is common in CHF patients and treating their anemia
improves heart function and reduces hospitalizations. To test for anemia in
CHF patients, Dr. Donald Silverberg and colleagues reviewed the records of
142 such patients and found that 56% were anemic (defined as hemoglobin less
than 12 g%). The percentage of anemic patients increased with CHF severity,
from 9% in class one CHFers to 79% in class 4 CHFers.
Of the CHFers, 26 were still anemic and had severe CHF even after 6
months of maximum CHF therapy. Treatment of these patients with
erythropoietin and IV iron raised their average hemoglobin level and EF,
even though doses of CHF meds were unchanged except for diuretics. This
treatment also reduced hospitalizations by 92%, lowered heart class,
decreased doses of oral and intravenous Lasix, and slowed progression of
kidney failure.
"Treatment of anemia with erythropoietin and intravenous iron may be a
useful addition to the attack on CHF," write the researchers. "It would seem
from our findings, however, that these useful tools are grossly under used.
Clearly, the role of anemia in worsening of CHF requires further controlled
trials."
Source: J Am Coll Cardiol 2000;35:1737-1744
=======================
Treating Anemia Helpful
May 31, 2001 - Heart failure patients who are also anemic that get treatment
with erythropoietin and IV iron see improved heart function, according to
Israeli researchers. Dr. Donald Silverberg studied 32 patients with class 3
to class 4 CHF. The patients had hemoglobin levels between 10 and 11.5 g %.
They were randomly assigned to injected erythropoietin and IV iron or to no
anemia treatment.
In treated patients, hemoglobin levels increased to at least 12.5 g %.
During an average follow-up of 8 months, heart class improved 42%. Among
untreated patients, heart class worsened by 11%. Blood level of creatinine
did not change in patients being treated for anemia but increased by 29% in
untreated patients - this indicates worsening kidney function in untreated
patients.
The number of days spent in the hospital during the trial - compared to
the period before entering the study - was 79% less in treated patients and
58% higher in untreated patients.
"The correction of anemia is not a substitute for effective CHF therapy,
but seems to be an important, if not vital, addition to the therapy," the
researchers conclude.
Source: J Am Coll Cardiol 2001;37:1775-1780
======================
CHF and Brain Function
March 8, 2000 - Blood flow through the brain is significantly reduced in
patients with chronic heart failure. The worse the heart class and EF, the
worse the reduction in blood flow. This may explain the cognitive defects
(problems with memory, problem solving, etc.) seen in CHF patients.
Dr. Dimitrios Georgiadis and colleagues used ultrasound to measure
arteries in the brain and their reactivity to carbon dioxide in CHF
patients. For comparison, the investigators studied 50 CHF patients, 20
age-matched controls, and 20 young controls, average age 29. The authors
report that "brain artery reactivity was significantly reduced in all
patients compared to controls, and especially in class 4 as compared to
class 2 and class 3 CHF patients." They also saw "a significant relationship
between the decline in heart function and the reduction in brain
reactivity."
Dr. Georgiadis' group concludes that in patients with chronic heart
failure, a decline in the brain's blood flow may result in cognitive
impairment - reduced ability to reason and remember.
In an editorial, Dr. C. Mathias said that although drugs may improve
heart output, they may have adverse effects if the brain's blood flow is not
corrected, or if blood flow is impaired by a decline in blood pressure. He
also notes that measurement of brain blood flow before and after treatments
"is likely to provide valuable information that will also be of benefit to
patients."
Lead study author Dr. Georgiadis said, "We are presently trying to find
links between neurological and psychological findings, and brain blood flow.
If these are closely related, then cerebrovascular reactivity could be
useful in selecting patients for heart transplant."
Source: Eur Heart J 2000;21:407-413
I copy and paste the following discussion which was posted on my forum, Rejuvenation, March, 2004.
Mike: Regarding the use of EPO and a high hematocrit, there
is one big caveat.
DVT, or deep vein thrombosis.
A hematocrit of ~54 or greater is associated with an increased
incidence of DVT, or clots in the deep veins of the leg, because
the blood becomes more viscous as hematocrit increases and flows
more slowly.
DVTs can cause severe pain, redness, and swelling
at the area around/below the clot(s), but may cause no symptoms,
as was the case w/the last 40 something patients I recently took
care of on a heparin drip.
Ellis: What is "a heparin drip" and what does it do to help somebody with a high hematocrit?
Mike: Heparin is an anti-thrombolyic that the body makes. A heparin
drip is a continuous IV infusion that is regulated to achieve
the optimal level of anti-coagulation based on the PTT (Partial
Thromboplastin Time) level, which is drawn every six hours
while the optimal dose is being regulated. Heparin is used to
anti-coagulate after open heart surgery, to prevent deep-vein
thrombosis, after heart attacks, etc
However, the real danger (and it does happen) is when a clot
breaks off and floats to/lodges in the lung (or heart, or brain).
It is then called a pulmonary embolus. If it's small, you may have
no symptoms at all. If it's large, your anti-aging regimen often
just came to a hasty halt, as in about 60% of the time.
I keep my hematocrit at around 52. - Mike
Ellis: That is good advice. I have never been too sure where the edge of the cliff really is, and I don't want to find
out, so I try to stay in a good area which I consider is good for
my health, and I don't do anything that I consider to be dangerous,
or maybe dangerous...
However... a hematocrit of 54% is the upper limit of that
found in a normal population at sea level, so I don't think
54% is "dangerous" because if I did, I would not even
approach 54%... - Ellis
Mike: -- 54% is the level I've heard used in the clinical
setting as absolutely safe. You're right, the vast majority
of people won't have any problems at that level or slightly
higher. There is no hard/fast figure that I know of.
But there are other factors involved. For instance, if a
person eats lots of hydrogenated fat and the intimal lining
of the arteries and veins are 'rough', that person is much
more likely to develop clots than someone else in this group
(assuming we all eat right:).
Being sedentary, wearing high heels, family history of
varicose veins, multiple pregnancies, obesity, low fiber
diet...all add to the risk.
So 54 isn't 54... it's different things to different people.
Add these risk factors to a person who already has respiratory
disease or lives at high altitude and already has a high
hematocrit, and the risk rises rapidly. A little wiggle room
is a good thing. Clots are like meteors; thousands enter the
atmosphere daily, but few hit Earth (lungs/heart/brain) before
they burn up (dissolve). Unfortunately it only takes one big
one.
Ellis: In La Paz, Bolivia, and in the Himalayas,
hematocrit in the upper 50's and even 60% are common. I have read that
these are natives and their bodies are genetically different,
but I don't think this is the case. Not everybody in La Paz
is a "native"... and even if they are "natives" they surely
also can get "deep vein thrombosis" but they don't, because
they are also healthy in other ways...
Mike: -- I wouldn't be so sure that they don't. If they eat
right, they probably don't have as high an incidence as here
in the US (land of gluttony). But many times coronary artery
disease or CVA is not attributed to a clot that originated in
the legs. Even pulmonary embolism, which kills almost
immediately, is often misdiagnosed untill autopsy, if one is
done.
Patients with emphyzema get to the 70's and of course THAT is
surely too high for comfort, and many of them die, especially
when it is complicated with diabetes, high blood pressure, etc.
Ellis: So... I think we have to look at the whole picture...
You and I both keep our hematocrit at around 52% (I have tested
mine several times, and it has always been between 52% and 54%,
for the past 2 years...) and now, with your warning, (and your
example) I will stay right where I am... I feel fine with 52 to
54% and I think the extra oxygen to all my body is good for my
health...
Mike: -- Just b/c your hct is elevated doesn't mean your body is
getting any extra oxygen. To a certain point, that's true (say
45% versus 52%). But there is a point of diminishing returns.
Once again, other factors are involved.
The body extracts oxygen from the blood at the cellular level based
on need. For instance, if you breath from a paper bag, as the O2
(oxygen) content of the inspired air decreases, your body will
extract a greater percentage of O2 from the O2-depleted air you are
inhaling (ie, O2 affinity increases).
Exercise also changes the extraction equation as well as respiratory
disease. The Oxyhemoglobin Dissociation Curve comes into play at the
cellular/cappillary AND alveolar/cappillary interfaces, and is
affected by pH (which, btw, is another consideration when eating a
high protein diet which strains the buffer systems.
Blood pH will be maintained at all costs, but not intracellular pH,
which can become chronically acidic and decrease O2 extraction -
that is, shift the oxy-hemaglobin dissociation curve). The
oxyhemoglobin dissociation curve determines how readily hemoglobin
acquires and releases oxygen molecules from/to its surrounding
tissue. Too really get a grip on your O2 use and affinity at the
cellular level, you would need to do some pulmonary function tests
(VO2 max, etc) as well as exhaled gas analysis to determine your
extraction rate.
The point being that anything above, say, 52-54% may not be worth
the added risk anyway since the body just slows down its extraction
rate at some point unless you have a pathology that severely
decreases your ability to oxygenate your cells (COPD, emphysema).
Ellis: As long as I am not diabetic, and my blood pressure is "low" or "normal" I think I'm safe. If I will ever become a diabetic, I might drop to 49% if I can't control glucose, and I might stay at
52-54% if I can keep glucose under control.
I won't increase it to upper 50's UNLESS I would want to climb EVEREST, or go to... La Paz, Bolivia!
Ellis: Thanks for writing. Please tell us more about your experience
with patients with high hematocrit.
Three stars for this very interesting post from Mike. - Ellis
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