Echinacea and Erythropoietin?
This is the second post in my series of articles on dietary supplements that may improve athletic performance. Though Echinacea is commonly used in the hopes of preventing the common cold, this article discusses its role as an ergogenic aid for endurance athletes.
Performance improvement in endurance sports is enabled because of the extra oxygen carrying capacity provided by the increase in red cell mass. In the past, athletes accomplished this by blood transfusion. The practice of blood doping has been outlawed not only because it confers an unfair advantage, but also because of the dangers involved.
What is Erythropoietin / EPO?
Erythropoietin (EPO), a glycoprotein hormone which is produced by the liver and kidneys, has put a whole new spin on blood doping. It plays a role in the regulation of red blood cell production. When exogenous EPO is used, it is a performance enhancing drug which can now be detected.
How Dangerous is Erythropoietin Used by Athletes?
To the many athletes who have tried EPO as a performance enhancing drug, the results have often been deadly. Numerous athletes including many cyclists have died from heart attacks which have been speculated to be related to EPO use. In short, EPO use as a performance enhancing drug is extremely dangerous as its use thickens user’s blood which increases their risk of developing a heart attack or stroke. In the past, the only way to test for EPO use was to detect elevated hematocrit levels, i.e. above 50%.
Normal hematocrit ranges are:
- Adult males: 42-50%
- Adult women: 36-44%
Fortunately, newer tests are now available that can distinguish between the recombinant human EPO and the natural form.
Does Echinacea Increase Erythropoietin Levels?
The results of a recent study, published in the International Journal of Sports Nutrition and Exercise Metabolism, suggest that Echinacea may actually elevate levels of EPO. In fact, statistically significant increases of EPO were found at days 7, 14, and 21 reflecting 44%, 63%, and 36% increases, respectively (Whitehead et al, 2007).
However, despite these statistically significant increases in EPO levels, Echinacea use did not significantly alter hemoglobin or hematocrit levels. The dose of Echinacea that was used in this particular study was 8000 mg/day which was divided in four separate doses. Given that the Echinacea users did not experience an increase in hemoglobin or hematocrit, it is unlikely that Echinacea will be used as a blood doping alternative in these Olympics.
Echinacea / EPO – Conclusion:
Echinacea is commonly used by people in the hopes of preventing the common cold. Given that much of the latest research finds the data for Echincea’s efficacy at preventing the common cold to be inconclusive (Woelkart et al, 2008), further studies are necessary to support this use.
References:
- Whitehead MT, Martin TD, Scheett TP, Webster MJ. The effect of 4 wk of oral echinacea supplementation on serum erythropoietin and indices of erythropoietic status. Int J Sport Nutr Exerc Metab. 2007 Aug;17(4):378-90.
- Woelkart K, Linde K, Bauer R. Echinacea for preventing and treating the common cold. Planta Med. 2008 May;74(6):633-7. Epub 2008 Jan 10.


How is it possible for the erythropoeitin levels to have such a dramatic increase without an increase in hematocrit levels? The only reason I could see would be if there was no training stimulus therefore no reason for the body to make more red blood cells. I am also wondering why the epo levels go from a 63% increase on day 14 to a 36% increase on day 21 unless it is an increase upon the previous week in which case the total increase from day 1 to day 21 would be a massive 319% increase.
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