It’s recommended that before giving erythropoietin (EPO) to a patient, you have to make sure that the patient is not iron, folate or B₁₂ deficient. You have to correct these deficiencies before giving the erythropoietin, because in the presence of these deficiencies the patient doesn't respond well to EPO. Not all anemic patients respond to EPO. Those with anemia of chronic disorders and anemia of renal disease often respond to EPO injections. But the fact that the patient may respond to EPO does not mean that you have to give EPO to him or her. EPO is expensive and is not harmless. Before you consider giving EPO to someone it would be best to refer the patient to a hematologist to find out whether the anemia is correctable by other means or the patient has the type of anemia that may respond to EPO and whether raising the hemoglobin with EPO would provide any benefit, other than raising the patient’s hemoglobin. For example a wheelchair-bound woman, with severe rheumatoid arthritis and hemoglobin of 90 G/L, generally would not get any benefit if you raise her hemoglobin to 110 G/L with EPO injections.

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