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HomeAnswersFamily Physicianpolycythemia veraWill dehydration and smoking cause changes in CBC report?

I have dizziness, loss of appetite, dehydration and changes in CBC report. Please help.

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At January 6, 2021
Reviewed AtJune 30, 2023

Patient's Query

Hello doctor,

I am a 27-year-old male. I have had dizziness, weakness and shaking, sometimes chest pain, and shortness of breath. I have stiff upper back pain, and most of my body clicks and pops when I move. I have also had a loss of appetite, like no appetite at all and weight loss. I had bad upper right stomach pain for years, and I stopped drinking when all this started. And the pain in the upper right stomach has lessened greatly but still happens sometimes. I had bloodwork was done that was pretty normal, at least the CBC aspect of it. I then had bloodwork done at a rheumatologist, and a bunch of stuff came back flagged, including my CBC. Now I am just worried that I am dying or something. My symptoms seem to be better sometimes and worse during other times. I drank around 5 to 10 beers a night for around five years, and I have smoked a pack of cigarettes a day for eleven years. Does any of this bloodwork seem deadly?

I do have anxiety, and it seems like depression for the last month. I also had a chest X-ray done, but I have not followed up with the doctor for that yet. If something on that were bad or life-threatening, I would have got a phone call by now? I did not even get my doctor's bloodwork either I got it from the blood laboratory directly by calling them. So I would assume if the doctor thought it was bad, he would have called me? The rheumatologist's bloodwork looks like rheumatoid arthritis, but I do not know. I was dehydrated at both doctor visits and smoked cigarettes before I went each time.


Welcome to icliniq.com.

In the attached report (attachment removed to protect patient identity), cholesterol level is high. For that, take a low-fat diet and do some morning exercise.

In one of the attached reports, hemoglobin and PCV (packed cell volume) is high with increased RBC (red blood cells). So it can be polycythemia. But causes for polycythemia here seems most likely to be due to dehydration. So I advise you to drink lots of water and repeat CBC after a few days. Do not worry.

For depression and anxiety, you can try yoga, meditation, and exercise.

Revert to me with a repeat CBC (complete blood count).

Patient's Query

Thank you doctor,

I know that my sedimentation rate and neutrophils and a bunch of arthritis stuff came back bad. But the main worry is about possible polycythemia vera. Could that be likely with those numbers? In the previous bloodwork, the RBC and hemoglobin, and hematocrit were normal. I do smoke around a pack a day. Could that cause the elevations?


Welcome back to icliniq.com.

Yes, you are thinking in the right way. Smoking and dehydration can cause secondary polycythemia. It does not seem to be primary polycythemia.

Smoking and dehydration can cause polycythemia, which is known as secondary polycythemia, which is noncancerous. Hb, PCV, and RBC count can vary in secondary polycythemia. So drink more water and stop smoking if possible.

I hope this helps.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Goswami Parth Rajendragiri
Dr. Goswami Parth Rajendragiri


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