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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In this Article

• What is polycythemia?
• What are normal ranges of hematocrit, red cell counts, and hemoglobin?
• What causes polycythemia?
• What are the causes of primary polycythemia?
• What are the common causes of secondary polycythemia?
• Can other sources of erythropoietin (EPO) cause polycythemia?
• What is relative polycythemia?
• What is stress polycythemia?
• What are the risk factors for polycythemia?
• What are the symptoms of polycythemia?
• When should I see a doctor about polycythemia?
• How is polycythemia diagnosed?
• What is the treatment for polycythemia?
• What are the complications of polycythemia?
• Can polycythemia be prevented?
• What is the outlook (prognosis) for polycythemia?
• Polycythemia At A Glance
• Patient Comments: Polycythemia (High Red Blood Cell Count) - Cause
• Patient Comments: Polycythemia - Experience
• Patient Comments: Polycythemia - Symptoms
• Find a local Hematologist in your town
• Polycythemia (High Red Blood Cell Count) Index

• Hypoxia from long standing (chronic) lung disease and smoking are common causes of polycythemia. Therefore, smoking can be significant risk factor for polycythemia.
  
  
• Chronic carbon monoxide (CO) exposure can also be risk factor for polycythemia. Hemoglobin has a higher affinity for CO than for oxygen; therefore, as it replaces oxygen in favor of CO, polycythemia may ensue to compensate for the low oxygen carried by hemoglobin.
  
  
• Chronic carbon monoxide exposure is a risk factor for people working in underground tunnels or parking garages, cab drivers in highly polluted and congested cities, or workers in factories with exposure to engine exhaust.
  
  
• People living at high altitudes may also be at risk of developing polycythemia due to low environmental oxygen levels.
  
  
• People with genetic mutations and familial types of polycythemia and certain hemoglobin abnormalities also carry risk factors for this condition as mentioned in earlier sections.

Symptoms of polycythemia can be none to minimal in many people. There are some general and non-specific symptoms that can be seen with polycythemia. Some of these include:

• weakness,
  
  
• fatigue,
  
  
• headache,
  
  
• itching,
  
  
• bruising,
  
  
• joint pain,
  
  
• dizziness, or
  
  
• abdominal pain.

In patients with polycythemia vera, other blood disorders are also very common. Thus, bleeding problems or clotting events may be seen in these patients. Itching after showers or baths (post-bath pruritus) can also be seen in patients with polycythemia vera for unclear reasons. Joint pains also common in patients with polycythemia vera.

Symptoms of secondary polycythemia may be more closely attributed to the underlying condition, such as, chronic lung disease, than to polycythemia itself. Therefore, shortness of breath, chronic cough, sleep disturbance (sleep apnea), dizziness, poor exercise tolerance, or fatigue may be common in patients with polycythemia.

If polycythemia is related to kidney cancer, liver cancer, or other erythropoietin secreting tumors, the symptoms of these conditions, such as, weight loss, abdominal pain or fullness, or jaundice may be predominant.