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Originally Posted by Marlene
That sounds counter-intuitive to me. So please elaborate.
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As you suppose, the intuitive explanation would be it's the difference between nitrogen washout (when the renal tissue is flooded with O2 after extended breathing) followed by the sudden
drop in renal tissue O2 (when you go back to breathing just air) that make the kidneys believe they are experiencing hypoxia.
However, that's just hand-waving. If you want to follow the detailed biochemical theory of what's going on, you'll need to get a copy of Balestra's full original article. It's counter-intuitive to biologists too, which is why it's dubbed "the normobaric oxygen paradox". Part of the reason this effect was overlooked for so long was that past experiments showed that EPO output dips when you start breathing oxygen. Balestra (due to seeing EPO increased in breath-hold divers using O2) was the first to actually monitor EPO output long enough
after O2 breathing to see that after it briefly dips for a few hours, it starts going up and up.
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Unfortunately, for most with SAA, there's no shortage of EPO. Most have unusually high EPO levels.
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Yeah, it's really mostly just relevant for Procrit users finding themselves unable to get/afford Procrit or other ESAs, especially since they were black-labeled.