Q. Do increased levels of RBC and vitamin B12 indicate early onset polycythemia vera?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 04, 2017

Hi doctor,

My RBC levels have been slightly elevated for the past six months. It was 5.17 a year back, and a couple of months back it was 5.39. I noticed that from the last two years, the RBC count has been borderline high. Last week my vitamin B12 was tested due to a nerve issue in my face, which came back elevated. My MCH and MCV are always low or borderline low. My WBC, hemoglobin, and hematocrit levels, are all in the normal range. I am concerned that the RBC and vitamin B12 levels might indicate early onset polycythemia vera. I have not taken any supplements of vitamin B12 nor am I taking any supplements with vitamin B12 in it. Also, I got a full thyroidectomy due to stage 1 papillary carcinoma, a year back. Do you think I might be concerned for nothing? Thank you for your time.



Welcome to icliniq.com.

I appreciate your knowledge and awareness towards your health, and I have seen your reports (attachment removed to protect patient identity).

  • Your vitamin B12 level is certainly high, enough that warrants further investigation. Following are the common causes for high vitamin B12 level.
  1. Excess intake of vitamin B12 supplement.
  2. Any liver disorder.
  3. A myeloproliferative disease like polycythemia or CML (chronic myeloid leukemia).
  4. Any cancer and kidney disease.
  • Now as your RBC (red blood cells) are elevated, first of all, polycythemia vera comes in mind, but normal hemoglobin and hematocrit levels are against the diagnosis of it. Regular screening should be done up to one year at least, if hematocrit and hemoglobin are increasing, then JAK 2 mutation study can be done for its confirmation.
  • In myeloproliferative disorder, WBC (white blood cells) count is usually high which is normal. If in screening, the WBC count is increased, then it can be confirmed by BCR-ABL t(9;22) study by molecular testing.
  • Evaluate liver functions by serum SGPT (serum glutamic pyruvic transaminase), SGOT (serum glutamic oxaloacetic transaminase), serum albumin and ultrasound. Kidney function test also should be evaluated with serum creatinine and serum urea like investigations.
  • Avoid alcohol. Consult a nearby physician for examination and regular screening. If no cause is found in subsequent follow-up, and vitamin B12 level comes to normal, then it might be elevated because of papillary carcinoma history.

For further queries consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

Was this answer helpful?


Related Questions:
Which medicine is recommended for diabetes instead of Sitaglu Met?

If your diabetic level is not controlled at this stage, it can lead to kidney problem and vision problem in two to three years ...   Read full

How to get someone to stop taking alcohol forever?

.. the alcohol, firstly you need to take him to nearby deaddiction center. You need to talk to him regarding the harmful consequences like liver damage which has now begun. You need to take him into confidence and take him to deaddiction center. Ther...   Read full

My heart beats fast and eyes become red if I drink alcohol. Is there a treatment?

.. ingested is metabolized in the liver and converted to acetaldehyde. This takes place in the liver. The variations in the effect of alcohol in different people take place because of the difference in the genetics of enzymes called alcohol dehydroge...   Read full

Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

What diet can be given to prevent dialysis and control creatinine level in a diabetic?

Query: Hello doctor, I am a male, 68 years old, diabetic, with chronic kidney disease, and creatinine level 5.96. What diet should be given to prevent dialysis and control creatinine level?  Read Full »

Do I need to worry about my LFT report?

Query: Hi doctor, I am a 29 year old male. My weight is 75 kg and height is 5'11". Two years ago, I was a heavy drinker. But, nowadays I only drink beer once a week for about 6 to 7 pints. My SGOT AND SGPT levels were much higher two years ago. I think they were around 150 to 175. I just got my LFT done b...  Read Full »

Are high sugar and raised liver enzymes side effects of Protonix?

Query: Hi doctor, I have been taking Protonix for almost three weeks for acid reflux. I had some blood laboratory work done and it showed my AST 812 and ALT 1,115. Could this be a rare side effect of Protonix? My glucose also went up to 192 and lipase is 72. I do not drink, smoke or use drugs...  Read Full »

Also Read

Sinusitis - Causes, Symptoms and Treatment
Sinusitis is the infection of the air cavities within the nasal passages. Normally, the healthy sinuses are filled with ...  Read more»
Asthma and Its Rising Incidence
This article explains about asthma and its causes. It also focuses on the benefits of starting early treatment to lead a...  Read more»
Parkinson's Disease: Historical Aspects and Current Treatment Approaches
This article discusses the historical aspects of Parkinsonism and, the evidence based approaches currently available for...  Read more»

Ask your health query to a doctor online?

Ask a Hematologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website are not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.