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Serum Erythropoietin Test – Indications, Procedures, Results

Last updated: February 8, 2026 Medically reviewed by: RxHarun Orthopedic Specialist Doctor Reading time: 5 min read

The erythropoietin test measures the amount of a hormone called erythropoietin (EPO) in blood.

The erythropoietin test measures the amount of a hormone called erythropoietin (EPO) in blood. The hormone tells stem cells in the bone marrow to make more red blood cells. EPO is made by cells in the kidney. These cells release more EPO when the blood oxygen level is low. The hormone tells stem cells in the bone marrow to make more red blood cells. EPO is made by cells in the kidney. These cells release more EPO when the blood oxygen level is low.

How the Test is Performed

A blood sample is needed.

How to Prepare for the Test

No special preparation is necessary.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

This test may be used to help determine the cause of anemia, polycythemia (high red blood cell count) or other bone marrow disorders.

A change in red blood cells will affect the release of EPO. For example, persons with anemia have too few red blood cells, so more EPO is produced.

Normal Results

The normal range is 2.6 to 18.5 milliunits per milliliter (mU/mL).

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test result.

What Abnormal Results Mean

Increased EPO levels may be due to secondary polycythemia. This is an overproduction of red blood cells that occurs in response to an event such as a low blood oxygen level. The condition may occur at high altitudes or, rarely, because of a tumor that releases EPO.

Lower-than-normal EPO levels may be seen in chronic kidney failure, anemia of chronic disease, or polycythemia vera.

Risks

Risks associated with having blood drawn are slight, but may include:

  • Excessive bleeding
  • Fainting or feeling lightheaded
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

FAQ

What is serum erythropoietin level?

  • The normal range for EPO levels can vary from 4 to 26 milliunits per liter (mU/mL). Higher-than-normal levels may mean you have anemia. In severe cases of anemia, EPO levels in the blood may be a thousand times higher than normal. Unusually low levels may be because of polycythemia vera.

Why is an erythropoietin test performed?

  • Erythropoietin testing is used to help determine if low EPO may be causing and/or worsening the anemia. If you have chronic kidney disease, an EPO test may be ordered to evaluate the kidneys’ continued ability to produce enough erythropoietin.

What does it mean if erythropoietin is high?

  • Having higher levels of erythropoietin in the blood may be a sign that the body is not getting enough oxygen, however. This may be due to a low red blood cell count from anemia or another condition. On the other hand, low levels of erythropoietin in the blood in someone with anemia may be a sign of other issues.

Does EPO increase hemoglobin?

  • EPO helps make red blood cells. Having more red blood cells raises your hemoglobin levels.

Is EPO high in iron deficiency anemia?

  • The serum EPO is involved in the process of erythrocyte hematopoiesis and can indicate the level of anemia, its sensitivity for anemia is higher than that of ferritin, and has important clinical value for evaluating the status of diseases, observing therapeutic efficacy, and judging prognosis of IDA.

What is an erythropoietin test mean?

  • The erythropoietin test measures the amount of a hormone called erythropoietin (EPO) in blood. The hormone tells stem cells in the bone marrow to make more red blood cells. EPO is made by cells in the kidney. These cells release more EPO when blood oxygen level is low.

What is EPO used to treat?

  • EPO is used to treat anemia, a shortage of red blood cells. Since red blood cells carry oxygen to the tissues and organs, anemia causes symptoms such as weakness, fatigue, and shortness of breath.

What causes elevated erythropoietin levels?

  • Excess erythropoietin results from chronic exposure to low oxygen levels or from rare tumors that produce high levels of erythropoietin. It causes a condition known as polycythemia which means high red blood cell count.

Is high hemoglobin always polycythemia?

  • Hemoglobin levels greater than 16.5 g/dL (grams per deciliter) in women and greater than 18.5 g/dL in men suggest polycythemia. In terms of hematocrit, a value greater than 48 in women and 52 in men is indicative of polycythemia.

What organ makes red blood cells?

  • The bone marrow
  • Blood cells are made in the bone marrow. The bone marrow is the soft, spongy material in the center of the bones. It produces about 95% of the body’s blood cells. Most of the adult body’s bone marrow is in the pelvic bones, breast bones, and the bones of the spine.

What drugs increase RBC count?

  • Medication to stimulate RBC production: A hormone called erythropoietin is produced in the kidneys and liver and stimulates the bone marrow to produce RBCs. Erythropoietin can be used as a treatment for some forms of anemia.

Does erythropoietin increase platelets?

  • Erythropoietin (EPO) is the primary growth factor for the red cell lineage but treatment with recombinant human Epo (rHuEpo) has been shown to increase platelet counts.

What are the side effects of erythropoietin?

Common side effects
  • Allergic reaction. Rarely, do some people have an allergic reaction to erythropoietin. …
  • Feeling sick or being sick. You may feel sick during treatment with erythropoietin. …
  • Diarrhea.
  • Blood clot risk.
  • Headaches.
  • High blood pressure.
  • Muscle, joint, or bone pain.
  • Flu-like symptoms.

What kind of tumors release erythropoietin?

  • Malignant and benign tumors that secrete EPO have been observed in patients with renal carcinomas, cerebellar hemangioblastomas, adrenal carcinomas, adrenal adenomas, hepatomas, and uterine leiomyomas. Blood doping is an illegal practice.

What is a dangerously low level of hemoglobin?

  • What hemoglobin levels are considered severe or dangerously low? A hemoglobin level of less than 5.0 grams per deciliter (g/dl) is dangerous and could lead to heart failure or death. A normal hemoglobin level is 13.2–16.6 grams per deciliter (g/dL) for males and 11.6–15 g/dL for females.

Frequently Asked Questions

How the Test is Performed A blood sample is needed. How to Prepare for the Test No special preparation is necessary. How the Test will Feel When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing. Why the Test is Performed This test may be used to help determine the cause of anemia, polycythemia (high red blood cell count) or other bone marrow disorders.A change in red blood cells will affect the release of EPO. For example, persons with anemia have too few red blood cells, so more EPO is produced. Normal Results The normal range is 2.6 to 18.5 milliunits per milliliter (mU/mL).The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test result. What Abnormal Results Mean Increased EPO levels may be due to secondary polycythemia. This is an overproduction of red blood cells that occurs in response to an event such as a low blood oxygen level. The condition may occur at high altitudes or, rarely, because of a tumor that releases EPO.Lower-than-normal EPO levels may be seen in chronic kidney failure, anemia of chronic disease, or polycythemia vera. Risks Risks associated with having blood drawn are slight, but may include:Excessive bleeding Fainting or feeling lightheaded Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken)FAQWhat is serum erythropoietin level?The normal range for EPO levels can vary from 4 to 26 milliunits per liter (mU/mL). Higher-than-normal levels may mean you have anemia. In severe cases of anemia, EPO levels in the blood may be a thousand times higher than normal. Unusually low levels may be because of polycythemia vera.Why is an erythropoietin test performed?

Erythropoietin testing is used to help determine if low EPO may be causing and/or worsening the anemia. If you have chronic kidney disease, an EPO test may be ordered to evaluate the kidneys' continued ability to produce enough erythropoietin. What does it mean if erythropoietin is high? Having higher levels of erythropoietin in the blood may be a sign that the body is not getting enough oxygen, however. This may be due to a low red blood cell count from…

References

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Written by Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist

Dr. Md. Harun Ar Rashid, MPH, MD, PhD, is a highly respected medical specialist celebrated for his exceptional clinical expertise and unwavering commitment to patient care. With advanced qualifications including MPH, MD, and PhD, he integrates cutting-edge research with a compassionate approach to medicine, ensuring that every patient receives personalized and effective treatment. His extensive training and hands-on experience enable him to diagnose complex conditions accurately and develop innovative treatment strategies tailored to individual needs. In addition to his clinical practice, Dr. Harun Ar Rashid is dedicated to medical education and research, writing and inventory creative thinking, innovative idea, critical care managementing make in his community to outreach, often participating in initiatives that promote health awareness and advance medical knowledge. His career is a testament to the high standards represented by his credentials, and he continues to contribute significantly to his field, driving improvements in both patient outcomes and healthcare practices. Born and educated in Bangladesh, Dr. Rashid earned his BPT from the University of Dhaka before pursuing postgraduate training internationally. He completed his MD in Internal Medicine at King’s College London, where he developed a special interest in inflammatory arthritis and metabolic bone disease. He then undertook a PhD in Orthopedic Science at the University of Oxford, conducting pioneering research on cytokine signaling pathways in rheumatoid arthritis. Following his doctoral studies, Dr. Rashid returned to clinical work with a fellowship in interventional pain management at the Rx University School of Medicine, refining his skills in image-guided joint injections and minimally invasive pain-relief techniques.