Q. Kindly help me get rid of my knee pain, swollen feet, bloating, and fatigue.

Answered by
Dr. Zubayeralam
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Nov 11, 2021

Hello doctor,

I am a 35-year-old female. I have knee pain, swollen feet, bloating, and fatigue.

Kindly help.



Welcome to

I can understand your concern. According to your statement, you have been suffering from fatigue, knee pain, bloating, and swollen feet.

According to your investigation reports (attachments removed to protect the patient’s identity), your hemoglobin level, platelet count, and MCHC (mean corpuscular hemoglobin concentration) count are above the normal range, and some other parameters are below the normal range.

Your high hemoglobin counts, along with raised platelet counts, are suggestive of polycythemia. But, to confirm the diagnosis of polycythemia, you should undergo some other investigations like erythropoietin level, bone marrow aspiration or biopsy, and specific gene testing like JAK2 (Janus kinase 2).

Polycythemia may cause fatigue, knee pain, bloating, swollen feet, and itching. Other underlying health conditions that may cause such symptoms are thyroid hormone dysfunction, vitamin D deficiency, fibromyalgia, lupus, arthritis, and gout.

So, I suggest you do thyroid function tests, test for vitamin D3 and serum calcium level, CRP (C-reactive protein), ANA (antineutrophil antibody), serum uric acid, renal function test to find out the exact underlying causes for your present sufferings and then treat them accordingly.

Take care.

Thank you doctor,

I just want to give you an update. I have attached the new reports that may give you a more clear picture.



Welcome back to

Thank you for joining again. Sorry to say, I have not found any update report here. Please contact the team and they will help to upload your new reports here. No new attachment is available here. Take care. In case of any other query ask me.

Thank you doctor,

Thanks for your reply. Can you please check the attached?



Welcome back to

Thank you for joining again. According to your investment reports, your erythropoietin levels are less than 1 mIU/ml (N. 4.3-29) and your JAK2 mutation are positive. Diagnostic criteria of polycythemia are a hemoglobin level of greater than 16.5 gm/dl in women and the presence of JAK2 mutation. In addition, there may be the presence of a low erythropoietin level. Sorry to say, my earlier diagnosis has been confirmed and you may suffer from polycythemia.

The good news is that most cases of polycythemia are mild and usually do not cause any further complications. In the case of well-controlled polycythemia, you will be able to lead a normal life like others without polycythemia. Treatment options for polycythemia are venesection, medications like Hydroxycarbamide or Interferon, and blood thinners like Aspirin. So, do not be worried at all. Treatment are available for polycythemia. Early diagnosis will help you to prevent any further complications. Take care. Let me know if I can assist you further.

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