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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

The treatment for polycythemia is generally dependent on the cause.

In polycythemia vera or other primary polycythemia syndromes, the treatment options are more specific. Phlebotomy (drawing blood or blood letting) is the most essential part of the treatment. The recommended hematocrit of less than 45 in men and less than 42 in women is the goal of phlebotomy.

Several medications have been considered in conjunction with phlebotomy to suppress the abnormal production of red blood cells. Most of these chemotherapeutic drugs have been linked with side effects and their use has been controversial and limited.

The medication hydroxyurea (Hydrea) has been recommended for some patients with primary polycythemia and higher risk of blood clot formation due to high blood viscosity. The factors favoring treatment with hydroxyurea are age greater than 70, platelet count greater than 1.5 million, and general cardiovascular risk factors.

Aspirin and other anti-platelet agents (dipyridamole) may also be beneficial in patients with polycythemia by reducing clotting complications, unless the patient has a history of bleeding problems.

In patients with secondary polycythemia, the goal is to treat the underlying condition. For example, in patients with lung or heart disease with hypoxia, appropriate management of these conditions along with oxygen supplementation is generally advised.