Scientists & doctors please chime in - Is EPO a prescription given to malaria patients as a 2:05 marathoner claims?

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  • rojo
    cofounder
    5 years ago 04/07/2016 4:31pm CDT
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    So this week there has been a fascinating case going on in Korea as told by Japan Running News Brett Larner:

    http://japanrunningnews.blogspot.com/2016/04/special-session-to-decide-tomorrow.html

    A special hearing of the South Korean Olympic Committee was held to see if 2:05 marathoner Wilson Loyanae Erupe of Kenya, who was banned for EPO use, should be put on the fast-track for citizenship so he could represent Korea in theOlympics.

    Erupe desperately wanted to run for Korea and even has adopted a second name of Joo Han Oh, meaning "I will run for Korea."

    The Koreans were tempted to give him fast-track citizenship but were concerned by the EPO bust. Erupe explained to them that he was given EPO by doctors when he got malaria and provided proof backing up that claim as shown here:

    B Larner wrote:

    Erupe claimed that, "The positive result was due to medicine I took for malaria, but Athletics Kenya did not accept this and suspended me for two years."

    Following the postponement of the recommendation, the Korean Amateur Athletic Federation (KAAF) applied to the KSC for the special recommendation session after gathering further documentation. The documentation includes records indicating Erupe's admission to a local hospital in Kenya and certification of verification of these records by the Korean General Hospital. A KAAF spokesperson commented, "In consultation with domestic malaria experts we have confirmed that prescriptions for the drug in question were unavoidable at the time."

    So doctors and scientists, is this true? Might someone be given EPO for malaria?

    I'd love to know the answer to this question. If not, how do you explain the proof he provided?

    In the end, he didn't get the citizenship as an article in the Korean press today said the following:

    http://english.chosun.com/site/data/html_dir/2016/04/07/2016040701678.html

    The article says:

    "Erupe explained that he took the drug to treat malaria and submitted doctor's notes and medical history, but the committee did not accept them and rejected Erupe's plea, saying he should have notified it in advance if he was to take the drug for medical reasons."
  • Sounds feasible.
    5 years ago 04/07/2016 4:38pm CDT
    re: rojo
    Forum Index

    Sounds feasible, it also helps prevent tooth decay if you put it in your toothpaste.
  • mr
    registered
    5 years ago 04/07/2016 4:44pm CDT
    re: rojo
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    FWIW - med student, aka not quite a doctor

    I just finished an infectious disease rotation and we actually had two kids come in with malaria within a week of each other. Long story short, neither of them got EPO as there was no reason they needed it. In theory, a high parasite load could cause a severe anemia to develop. This is more common in children than it is in adults. At least one of the medications used to treat severe malaria (artesunate) can also cause anemia. Treatment for severe anemia is more likely to be blood transfusions rather than EPO. I suppose EPO could be used, but I don't believe that would be anywhere in the realm of standard treatment.
  • Googlemaster General
    5 years ago 04/07/2016 4:46pm CDT
    re: rojo
    Forum Index

    If you Google "EPO malaria", a bunch of articles come up. I couldn't be bothered reading them, but judging from the titles it looks like there is at least some use of EPO for treating malaria. Make of that what you will.
  • not a doctor, but...
    5 years ago 04/07/2016 4:47pm CDT
    re: rojo
    Forum Index

    Definitely seems plausible. Malaria destroys erythrocytes, so erythropoietin would be a logical drug to administer in order to bring about enough new production to offset the destruction of existing RBCs.
  • Metric Miler
    registered
    5 years ago 04/07/2016 5:01pm CDT
    re: rojo
    Forum Index

    There are 4 types of malaria that affect humans. Two of those, Plasmodium vivax and plasmodium falciparum cause extreme anemia. This is partly because the malaria virus resides inside the red blood cells, which it destroys. The affected red blood cells also tend to pool and agglomerate as their often abnormal shape can prevent them from passing through capillaries etc. Also, the virus affects the production of red blood cells in the bone marrow.
    It would seem that providing a patient with artificial EPO could help the combat severe and potentially deadly anemia by stimulating red blood cell production.

    If an athlete has anemia, he is certainly in no position to be training or competing! Regarding alerting the anti-doping authorities, rules are the rules really. I'm pretty sure athletes are allowed to be prescribed life saving drugs (lol) but they have to alert WADA or whoever.
  • Not a virus
    5 years ago 04/07/2016 5:05pm CDT
    re: Metric Miler
    Forum Index
    Metric Miler wrote:

    There are 4 types of malaria that affect humans. Two of those, Plasmodium vivax and plasmodium falciparum cause extreme anemia. This is partly because the malaria virus resides inside the red blood cells, which it destroys. The affected red blood cells also tend to pool and agglomerate as their often abnormal shape can prevent them from passing through capillaries etc. Also, the virus affects the production of red blood cells in the bone marrow.
    It would seem that providing a patient with artificial EPO could help the combat severe and potentially deadly anemia by stimulating red blood cell production.

    If an athlete has anemia, he is certainly in no position to be training or competing! Regarding alerting the anti-doping authorities, rules are the rules really. I'm pretty sure athletes are allowed to be prescribed life saving drugs (lol) but they have to alert WADA or whoever.

    Malaria is not a virus...
  • 3rd world probs
    5 years ago 04/07/2016 5:05pm CDT
    re: Metric Miler
    Forum Index

    In simple, yes. As outlined above, destruction of erythrocytes secondary to disease as well as medications to tx the disease both cause anemia. There is currently a movement for utilization of epo for tx of anemia in 3rd world countries secondary to malaria because of the sketchy blood available for transfusion.
  • Eyes on you...
    5 years ago 04/07/2016 5:06pm CDT
    re: Sounds feasible.
    Forum Index

    I see what you did there! Very clever... verrry clever!

    Sounds feasible. wrote:

    Sounds feasible, it also helps prevent tooth decay if you put it in your toothpaste.
  • Clerk
    registered
    5 years ago 04/07/2016 5:08pm CDT
    re: Sounds feasible.
    Forum Index
    Sounds feasible. wrote:

    Sounds feasible, it also helps prevent tooth decay if you put it in your toothpaste.

    Not unlike that nandrolone spiked toothpaste:

    http://www.cyclingsupports.com/wp-content/uploads/2016/02/38-8-e1456299595689.jpg
  • 50 Shades Of Gray Area
    5 years ago 04/07/2016 5:13pm CDT
    re: 3rd world probs
    Forum Index
    3rd world probs wrote:

    In simple, yes. As outlined above, destruction of erythrocytes secondary to disease as well as medications to tx the disease both cause anemia. There is currently a movement for utilization of epo for tx of anemia in 3rd world countries secondary to malaria because of the sketchy blood available for transfusion.

    Cue scenarios of relatively wealthy athletes black market buying EPO meant for malaria victims. Very unpleasant on several levels.
  • Metric Miler
    registered
    5 years ago 04/07/2016 5:13pm CDT
    re: Not a virus
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    Excuse me, parasite of course.
  • Marksch
    5 years ago 04/07/2016 5:14pm CDT
    re: Eyes on you...
    Forum Index

    I'm an MD, and I have worked in Eldoret, Kenya. I very vividly recall a terribly ill young woman with severe falciparum malaria. She had a pulse of 180, lying still. Her hemoglobin was 1.8!!! Lowest I have ever seen. EPO was NOT part of her treatment, though others have pointed out that in cases such as this, it could be used.
  • rjm33
    5 years ago 04/07/2016 5:52pm CDT
    re: Clerk
    Forum Index

    Warning!...Warning!...Warning!...

    Dennis Kimetto ... the world record holder at 2:02:57 in the marathon has a history of MALARIA!!!....

    http://sports.yahoo.com/news/kenyas-dennis-kimetto-wins-chicago-145430963--spt.html;_ylt=AwrXgCMm4wZXnhYAkCKTmYlQ;_ylu=X3oDMTByZDNzZTI1BGNvbG8DZ3ExBHBvcwMyBHZ0aWQDBHNlYwNzYw--


    I also remember several other top tier Kenyans with a history of malaria...

    ...I think this may be an investigative project for Metric Miler and Clerk!..

    .........Go readers!!!..........
  • Runner MD
    5 years ago 04/07/2016 5:58pm CDT
    re: Marksch
    Forum Index

    No - he is a doper and this is an excuse.

    In very severe malaria a patient may need a transfusion because hemoglobin is so low (
  • pop_pop!_v2.2.1
    5 years ago 04/07/2016 6:02pm CDT
    re: 3rd world probs
    Forum Index
    3rd world probs wrote:

    In simple, yes. As outlined above, destruction of erythrocytes secondary to disease as well as medications to tx the disease both cause anemia. There is currently a movement for utilization of epo for tx of anemia in 3rd world countries secondary to malaria because of the sketchy blood available for transfusion.

    Ok, all good. But.....


    We're talking about a theoretical malaria-ravaged health condition to RUNNING A MARATHON at national elite times or better, in a matter of a few days.

    That's the only possible way to test positive is to test very close to a non-micro dosage window, 2-3 days. Maybe the urine test has gotten better? Add a day or two.

    If recovery is that instantaneous, then I'm happy to have my doubts removed. Otherwise, this excuse is fantastic.
  • Metric Miler
    registered
    5 years ago 04/07/2016 6:08pm CDT
    re: pop_pop!_v2.2.1
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    pop_pop!_v2.2.1 wrote:

    3rd world probs wrote:

    In simple, yes. As outlined above, destruction of erythrocytes secondary to disease as well as medications to tx the disease both cause anemia. There is currently a movement for utilization of epo for tx of anemia in 3rd world countries secondary to malaria because of the sketchy blood available for transfusion.

    Ok, all good. But.....


    We're talking about a theoretical malaria-ravaged health condition to RUNNING A MARATHON at national elite times or better, in a matter of a few days.

    That's the only possible way to test positive is to test very close to a non-micro dosage window, 2-3 days. Maybe the urine test has gotten better? Add a day or two.

    If recovery is that instantaneous, then I'm happy to have my doubts removed. Otherwise, this excuse is fantastic.


    A quick Google search has led me to believe that it was an out of competition test. He didn't need to be racing or training to be subject to the test.
  • rjm33
    5 years ago 04/07/2016 6:28pm CDT
    re: rjm33
    Forum Index

    Oh my!

    Here is a partial list of Kenyan runners who have had bouts of malaria:

    1) Cosmos Ndeti
    2) Moses Kiptanui
    3) Paul Tergat
    4) Dennis Kimetto


    http://www.kenyarunners.com/pages/167372/index.htm


    Keep reading the whole site page down!

    ...the Italian manager Dr. Gabriele Rosa (who was manager to Moses Tanui and Paul Tergat, and many other famous Kenyan runners both male and female) and EPO use rumors by top Kenyan runners is discussed a lot on this site!.....
  • rjm33
    5 years ago 04/07/2016 6:49pm CDT
    re: rjm33
    Forum Index

    The site http://www.kenyarunners.com/pages/167372/index.htm

    ...also states that EPO was available in Europe as early as 1984...which means all of my previous research which established the earliest verified use of EPO by any endurance athletes in any sports as 1986 may be wrong!...since I was basing my information on US availability of EPO..

    ...EPO may have been available in Europe earlier than the US...I will try to check..

    This is very interesting if true...Alberto Cova won 1984 10K gold for Italy, and in 1988 Salvatore Antibo won 10k silver (gold was won by Boutayeb(sp) a Moroccan runner!)...and Gelindo Bordin of Italy won the 1988 marathon gold, and Boston 1990...

    .......this story gets better every day!....
  • Made it look easy
    5 years ago 04/07/2016 6:57pm CDT
    re: rjm33
    Forum Index

    I was out of track by 84 but remember watching the 84 Oly 10k and thinking how easy Cova looked when he kicked at the end.
 
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