Polycythemia - Experience

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What is polycythemia?

Polycythemia is a condition that results in an increased level of circulating red blood cells in the bloodstream. People with polycythemia have an increase in hematocrit, hemoglobin, or red blood cell count above the normal limits.

Polycythemia is normally reported in terms of increased hematocrit or hemoglobin.

  • Hematocrit (HCT): Polycythemia is considered when the hematocrit is greater than 48% in women and 52% in men.
  • Hemoglobin (HGB): Polycythemia is considered when a hemoglobin level of greater than 16.5g/dL in women or hemoglobin level greater than18.5 g/dL in men.

Polycythemia can be divided into two categories; primary and secondary.

  • Primary polycythemia: In primary polycythemia the increase in red blood cells is due to inherent problems in the process of red blood cell production.
  • Secondary polycythemia: Secondary polycythemia generally occurs as a response to other factors or underlying conditions that promote red blood cell production.

Red cell production (erythropoiesis) takes place in the bone marrow through a complex sequence of tightly regulated steps. The main regulator of the red cell production is the hormone erythropoietin (EPO). This hormone is largely secreted by the kidneys, although, about 10% may be produced and secreted by the liver.

Erythropoietin secretion is up-regulated in response to low oxygen levels (hypoxia) in the blood. More oxygen can be carried to tissues when erythropoietin stimulates red blood cell production in the bone marrow to compensate for the hypoxia.

Neonatal (newborn) polycythemia can be seen in 1% to 5% of newborns. The most common causes may be related to transfusion of blood, transfer of placental blood to the infant after delivery, or chronic inadequate oxygenation of the fetus (intrauterine hypoxia) due to placental insufficiency.

Return to Polycythemia (High Red Blood Cell Count)

See what others are saying

Comment from: Darren, 45-54 Male (Patient) Published: January 13

The pains I experience myself are pains in my joints and legs, fatigue, dizziness, pains in my feet, difficulty breathing, and low blood pressure. During my phlebotomies I have crashed as my blood pressure drop to critical levels. Even before the blood withdraws start my blood pressure is already low. I believe that this polycythemia has caused me to have a mild stroke and very mild heart attack. This disorder I don't wish on anyone at all because it limits what you can physically do every day.

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Comment from: Connie, 65-74 Female (Patient) Published: July 28

I am on my 20th year with polycythemia, but my whole system has switched. I used to have phlebotomies, and now I am just on the hydroxyurea pill 1500 mg 4 times a week and 2000 mg 3 times a week. It is bringing down all my other counts, but I have to take it because of the high platelet count. There is nothing more they can do for me other than a blood transfusion. My hemoglobin has to go down to 70, before I will get that. It is at 81 now. I am tired all the time. I do sleep a lot, as oxygen is not being carried through my body like it should be. I am a 73 years old female. If there was only some other medication to just bring down the platelets. Anyhow, I struggle on. I have no pain, and it could be worse. Now, my bone marrow has quit producing red blood cells. That is no good; sort of opposite of polycythemia.

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