Hello,
Welcome to icliniq.com.
I understand your concern.
The information that you have provided is too little to comment on specifically. However, read the following write-up for causes and workup of high hemoglobin, hematocrit, and RBCs.
Elevated hemoglobin is seen in smokers, people living in high altitudes, congestive cardiac failure, chronic obstructive pulmonary disease, some erythropoietin-secreting adenomas of the kidney, and very rarely a part of primary polycythemia.
I suggest you rule out the causes of secondary polycythemia. If all the causes are excluded, get tested for JAK2, Exon12, and CALR mutations. Even in primary polycythemia, also called polycythemia rubra vera, these mutations are frequently negative. In cases of secondary polycythemia, the treatment of elevated hemoglobin is to treat the cause. In primary polycythemia, if JAK2 is negative, the treatment is therapeutic, including phlebotomy or venesection. The goal is to keep hemoglobin and hematocrit within the range that is less than 50 for males and less than 48 for females, and hemoglobin is 16 g/dL for males and 15 g/dL for females.
It can be combined with hydroxyurea, whose dose could be calculated according to the patient's weight. Repeated venesections or phlebotomies can lead to micronutrient deficiencies, especially iron. The patient should be given micronutrient replacement therapy. For JAK2-positive patients, tablets Ruxolitinib (Jakavi) are given in a dose of 5 to 15 mg per day. The other option is the tablet Pegasys (Pega Interferon Alfa 2 a) in low doses (45 ug/week) in both JAK2 positive or negative cases. CALR-positive cases show superior results in this mode. It could take years to cure the disease.
Meanwhile, along with all therapeutic modalities, thrombophilia prophylaxis is given. This is not a life-threatening disease. The patient can die from this but does not die from it.
I hope you found this useful.
Thank you.