Normal Erythropoietin (EPO) Levels

Normal endogenous erythropoietin levels in healthy adults range between 10 IU/L and 30 IU/L (or 10-30 mU/mL). 1

Reference Ranges by Population

Normal serum EPO levels in healthy females average 11.3 ± 3.4 mU/mL 2
Normal serum EPO levels in healthy males average 8.0 ± 3.2 mU/mL 2
The overall normal range in healthy individuals is approximately 1-27 mU/mL 3
In a different study, the mean EPO serum concentration for healthy control subjects was 9.4 ± 3.7 mU/mL (range 2-17.9) 4

EPO levels demonstrate a circadian rhythm, with lower levels typically observed in the morning compared to the afternoon 5
EPO levels are inversely related to hemoglobin concentration in non-renal anemias 2
In healthy individuals, EPO is primarily produced by interstitial cells in the peritubular capillary bed of the kidney and perivenous hepatocytes in the liver 3

Non-renal anemias typically show appropriately elevated EPO levels inversely proportional to the degree of anemia 2
Patients with aplastic anemia may have significantly elevated levels (mean 7069.9 ± 9406 mIU/mL in one study) 5
Patients with hyperglobulinemia demonstrate significantly higher EPO levels than healthy individuals 2

Patients with polycythemia vera typically have particularly low serum EPO levels 2
Hemodialysis patients exhibit EPO levels that are inadequately low relative to their degree of anemia 2
Untreated essential thrombocythemia patients show significantly lower EPO levels (mean 6.6 ± 7.6 mU/mL) compared to healthy controls 4

EPO levels >500 mU/mL indicate erythropoietin resistance, making exogenous EPO therapy less likely to be effective 1
EPO levels ≤500 mU/mL in anemic patients may predict a better response to erythropoiesis-stimulating agents (ESAs) 1
In multiple myeloma patients, the correlation between hemoglobin and EPO levels is stronger in those without renal dysfunction than in those with renal impairment 5

EPO levels can fluctuate significantly after gastrointestinal hemorrhages and in patients with iron deficiency anemia receiving iron supplementation 2
Measurement of EPO levels in patients with impaired kidney function and normochromic, normocytic anemia is rarely helpful for clinical decision-making or guiding EPO therapy 1
EPO levels should be interpreted in the context of hemoglobin levels, as the relationship between these parameters varies by underlying condition 2, 5
Failure to consider renal function when interpreting EPO levels may lead to incorrect conclusions about erythropoietic activity 5