Q. Is it possible to have low erythropoietin count and high RBC count together?
Answered by Dr. Girish C Kamat and medically reviewed by iCliniq medical review team.
Hello doctor,
I am 27 years old male, 6 feet, and 180 lbs. I started a new job and the life insurance company wanted me to take a blood test. The results are attached. My blood test shows a low erythropoietin of 4.4 U/L (normal range 4.3 to 29) and high red blood cell count of 5.6x10^12/L (normal range 3.7-6). The insurance company now wants me to see a hematologist for polycythemia. What are the odds that my result is actually related to that? I was also just diagnosed with moderate sleep apnea.
Related Questions:
• Is it possible to get high RBC in blood test due to fasting?
• What is your suggestion for polycythemia?
• Why do I have increased white cells, proteins, leucocytes and epithelial cells in my urine?
Dr. Girish C Kamat
MBBS., MD., DNB., MNAMS., PGDFM
Hematology, Internal Medicine
Hello,
Welcome to icliniq.com.
- Your hemogram and erythropoietin levels are normal. I would not evaluate you any further. They should not have asked for a hematology consultation, but if it is mandatory, get it done.
All the best and do well in your new job.
For further queries consult a hematologist online --> https://icliniq.com./ask-a-doctor-online/hematologist
Hello doctor,
Thank you for getting back to me. The levels are within normal as you say, but what worries me is that they are on opposite ends of their limits. EPO low, and RBC high. Usually, high EPO produces red blood cells, but in my case, EPO is on the lower limit and my red blood cell count is close to the higher limit. Can you please elaborate on what can cause my red blood cells level to be so high if the EPO, that is controlling their production, is so low? I am just wondering as if my red blood cell drops, then my EPO could drop below the limit as well. Could it be related to my sleep apnea?
Dr. Girish C Kamat
MBBS., MD., DNB., MNAMS., PGDFM
Hematology, Internal Medicine
Hello,
Welcome back to icliniq.com.
- There are only two conditions where there is polycythemia with low erythropoietin level. They are:
- Polycythemia vera. This is a mild cancerous condition, diagnosis of which can be confirmed by testing for JAK2 gene mutation and bone marrow examination. In this condition, the platelet count and WBC counts are also generally high, and the spleen size is increased.
- Congenital or familial polycythemia is a rare condition where there is a mutation in the erythropoietin receptor.
- If your hemoglobin level were more than 16.5 g/dl, I would have asked you to do JAK2 mutation testing (V617F and exon 12). But, it is normal. Erythropoietin levels also, if it is outside the normal range, we need to worry about it.
- Polycythemia can be due to sleep apnea, but in that case, erythropoietin level is high.
- Please take it out of your head that your RBC count is high and EPO level is low. They are in the normal range.
- You can do a hemogram six months later to ensure that the hemoglobin is in the normal range. If it is polycythemia, Hb level will increase by that time.
I hope you are convinced with the answer.
For more information consult a hematologist online --> https://icliniq.com./ask-a-doctor-online/hematologist
Related Questions & Answers
Query: Hello doctor,My Hb is 15.8 but HCT is 49.2 and total RBC count is 5.63. What is the reason? I fear about polycythemia. Is it possible to reduce HCT? Read Full »
Medical Oncologist
Answer: Hello, Welcome to icliniq.com. If you are a smoker, then stop smoking. At this stage, secondary polycythemia is more common than primary and smoking is the most common reason for secondary. For further queries consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hemat... Read Full »
Query: Hi doctor, I am a 40 year old male. My hemoglobin was 18.3 g/dL, but it has come down to 17.7 g/dL since the last two months. My RBC count varies between 6.1 to 6.27 now, and PCV is 51.9 %. I am taking mini Aspirin as suggested by my doctor. Do I have any reason to worry? Read Full »
Family Physician, General Practitioner, Hematologist, Pathologist
Answer: Hi, Welcome to icliniq.com. Your hemoglobin level, RBC (red blood cells), and PCV (packed cell volume) are high. The lymph node, liver, and spleen need to be clinically examined. Do you have a history of dizziness, weakness, and stroke? High level of RBC and hemoglobin can cause blood clots and ca... Read Full »
Most Viewed
I have acne on my cheeks, chin, jawline, and neck for the past four years. Please help.
Hello doctor, I have been dealing with acne on my cheeks, chin, jawline, and neck for the past four years. I have recen ...Read more »
What can be done for horseness of voice which is lasting for more than a month?
Hello doctor, I have problem in one cord and it is for about a month now. I was given Defcort and antibiotic for a week ...Read more »
Yasmin Birth Control Pills - Quick Facts | Composition | Works | Usage | Side Effects
Yasmin birth control pill is a combination birth control pill. It is made of two female hormones and is used to prevent ...Read more »