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How quickly can EPO produce a significant increase in hemoglobin?

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asked May 25, 2012 in Conditions and Treatments by Informaticus (470 points)
retagged Jun 4, 2012 by LarryEitel

 See article in the journal  MedicalXpress of May 6, 2013 in  tab Surgery.

Link source: http://medicalxpress.com/news/2013-05-high-dose-erythropoietin-days-pre-op-transfused.html?

Single, high-dose erythropoietin given two days pre-op reduces need for transfused blood

Quote: 'A simple new protocol has been proposed that helps correcting anemia using a single, high dose of recombinant human erythropoietin (HRE) administered only two days prior to surgery.'
 

3 Answers

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Every case is different and will depend greatly on the entire clinical treatment being administered at the time.  Typically, if the patient is receiving a multipronged approach to manage his/her anemia or as a means of preoperative evaluation and planning, which includes addressing iron deficiencies as well as the restrictions of diagnostic phlebotomy thru the use of pediatric tubes for any diagnostic testing, and increased ventilation and oxygenation,  one can usually see an increase in hemoglobin response anywhere from 4 to 7 days of beggining the erythropoiesis.
answered Jun 10, 2012 by anonymous
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My first shot of Procrit produced a rise in less than 24 hours. I was on I.v.'s, shots of B-12, and oxygen as well. The same hospital has never readmitted me, although I have needed it, and, used less Procrit...it has taken much longer to rise this second time I have gotten anaemic since 2011. If you followed through with the complete therapy, in hospital, please contact me. I need help to prove a point to the hospital staff.
answered May 28, 2013 by 21stCentury (630 points)
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To produce a good oxygen-carrying red blood cell, the body needs iron, B12, Folic Acid, Vitamin C and the hormone, Erythropoietin, which is produced in the kidney.  So raising the hemoglobin depends on having enough of these substances in the body.  An injection of an ESA (erythropoietin stimulating agent) may work quickly if there are enough of the other substances to stimulate production of red blood cells in the bone marrow.  Sometimes, people are just iron deficient, or are unable to absorb iron through the foods they are eating.  So just getting an EPO injection may not have any effect.  As a coordinator of blood conservation, and analyzing the effect of anemia management on patients, I have seen patients respond, significantly, in as short as 5 days.
answered May 28, 2013 by jlvarisco (2,070 points)
Since July,2013, when I was given Procrit (again, with all the trimmings of B-12, folic acid, vit.c, etc.), I moved to central coast, California. I had a difficult time continuing with my Procrit therapy because no one wanted to prescribe it at the time I fell under 10 hemoglobin. I also couldn't find anyone to connect me to a liason committee to find a doctor who would work as long with the Procrit. I was essentially slowly bleeding to death with a 12 ferritin level and 6% iron saturation, with only one more, poorly absorbing iron tab per day (648 mg.). I found a hematologist on my own who worked with Procrit. After about 1 entire month, he finally gave me an i.v. with iron infusion. I then felt strong enough to go into a colonoscopy, where another excellent gastroenterologist, found the AVMs in my caecum intestine that 2 hospitals were unable to locate in 2013! Procrit was finally given to me the night before the colonoscopy, and, just as in 2012 & 13, raised my blood count in less than 18 hours. It is likely the ibuprofen ulcer in my caecum, helped expose the veins. My ferritin jumped from 12 to 178 in about 4-6 days with only a 9.9 hemoglobin. I am tired as heck but I believe it is because my body has been running on adrenaline, endorphins, and hormones since the on&off spot bleeding started up again in late 2013. I was convinced it was still the ulcer even though the symptoms seemed skewed. This time the hemorrhaging was less than in 2013, but my recovery is more real and I am very tired and do have pain. I didn't have anything much back then. It took cautery and 4 clips to repair the one bleeding AVM.

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