Patient's Query
Hi doctor,
My laboratory results from last week show increased hematocrit (50.7%) and high end of normal hemoglobin (16.7%) and RBC (5.72). While the hemoglobin and the RBC are technically within the normal range, historically, I never had high values like this. Usually, my RBC (red blood cells) is between 5.2 and 5.5, and my hematocrit is up to 48%.
Currently, I have no symptoms or complaints of any kind. As you can see, platelets and WBC (white blood cells) are normal. Alkaline phosphatase (64 u/L) and hs-CRP (high-sensitivity C-reactive protein) 1 my/L is also normal.
My questions are:
1. Do you think these values warrant further investigation to exclude Polycythemia Vera or a secondary cause of Polycythemia?
2. In recent months, I have been supplementing heavily with B12 (2500 mcg daily) and zinc (30 mg daily). Do you think these supplements could have caused the increase?
Please guide.
Hello,
Welcome to icliniq.com.
Following is my opinion on your question.
Hemoglobin level above 16.5 and hematocrit more than 49 should be investigated further, especially for secondary polycythemia. You can investigate with an ECG (electrocardiogram) and a chest x-ray to check for the cardiac cause and the respiratory cause.
If all is normal, then dehydration, smoking, excess non-vegetarian food, etc., might be the reason.
Drink lots of water and repeat the CBC (complete blood count) after a few weeks. You can investigate further with serum EPO (erythropoietin) blood tests as well. B12 supplements usually do not cause polycythemia.
I hope this information will help you.
Let me know if I can assist you further.
Discuss all these with your doctor.
Regards.
Patient's Query
Hi doctor,
Thank you for your reply.
Can you give me an example of the most likely cardiac causes without symptoms? I have mild bronchiectasis (sequelae of previous infection) with mild obstruction on PFT (Pulmonary function testing), but normal gas exchange and oxygen always sat above 96. I do have a parapelvic cyst in the left kidney measuring up to 2 cm. Could that cause increased EPO? Should I have to check my EPO levels?
Thanks.
Hello,
Welcome back to icliniq.com.
Following is my further opinion for your asked question.
Long-standing bronchiectasis can be the cause of secondary polycythemia. You should continue management of bronchiectasis as per your doctors' advice. However, it is good that your oxygen saturation is good. Hypertension-induced left ventricular hypertrophy, and heart failure changes cause patients to be asymptomatic only in the early stage. You can check your blood pressure and investigate with Echocardiography which rules out the cardiac cause.
Parapelvic cyst does not secrete EPO. However, if a cyst is located in the kidney, it might cause secondary polycythemia by EPO secretion.
Investigate with serum EPO and discuss all these with your treating doctor.
I hope this will help you.
Regards.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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