What causes increased hemoglobin and decreased platelet?

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1. As your platelet count decreased over four months duration, chronic infection, and drug history have to be ruled out first.
2. If they are not causative then a detailed investigation plan should be decided according to the examinations as follows:

1. 1. ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein).
   2. Blood culture.
   3. Alcohol history.
   4. Peripheral smear examination.
   5. Renal profiles such as uremia might lead to decreased platelet count.

Your hematocrit should be checked. If it is high and RBC (red blood cell) mass is elevated with persistently elevated hemoglobin over 18, then the JAK2 mutation has to be tested to rule out the myeloproliferative disorder. According to the cause, further specific treatment will be given. Hence, first, consult your physician for examination and get your liver and spleen examined by the doctor. Then, get a proper workup planned according to the need.

Take care.