High Red Blood Cell Count
A high red blood cell count is known as polycythemia or erythrocytosis. It happens when the body makes too many red blood cells. This makes the blood thicker and harder to flow.
Red blood cells carry oxygen, but too many can be a problem. It’s important to know why this happens and how to treat it.
There are many reasons for polycythemia. It can be caused by problems in the bone marrow or by other health issues. It can also be due to lifestyle choices like smoking or living at high altitudes.
Understanding the causes and symptoms is key. This helps doctors diagnose and treat the condition properly.
What is a High Red Blood Cell Count?
A high red blood cell count happens when there are more red blood cells than usual in the body. This leads to higher hematocrit levels and hemoglobin concentration. As a result, the blood can carry more oxygen.
Normal Red Blood Cell Count Range
The normal range for red blood cells is different for men and women. Generally, it falls within these ranges:
| Gender | Normal RBC Count (cells/mcL) | Normal Hematocrit Range | Normal Hemoglobin Range (g/dL) |
|---|---|---|---|
| Men | 4.7 to 6.1 million | 40.7% to 50.3% | 13.8 to 17.2 |
| Women | 4.2 to 5.4 million | 36.1% to 44.3% | 12.1 to 15.1 |
If red blood cell counts, hematocrit levels, or hemoglobin concentrations go above these ranges, it might mean you have a high red blood cell count.
Defining Polycythemia and Erythrocytosis
Polycythemia and erythrocytosis both mean having too many red blood cells. But there’s a small difference:
- Polycythemia means more red blood cells, white blood cells, and platelets.
- Erythrocytosis just means more red blood cells.
Both conditions make the blood carry more oxygen. But, the blood can get too thick, causing health problems if not treated.
Symptoms of High Red Blood Cell Count
People with too many red blood cells may feel different. They might have polycythemia symptoms that make daily life hard. It’s important to know these signs to get help fast.
Common Signs and Symptoms
Some common symptoms of too many red blood cells include:
| Symptom | Description |
|---|---|
| Headache | Persistent or recurring headaches due to increased blood viscosity |
| Dizziness | Lightheadedness or vertigo, specially when standing up or changing positions |
| Fatigue | Unusual tiredness or weakness, despite adequate rest and sleep |
| Shortness of breath | Difficulty breathing, specially during physical activity or exertion |
| Blurred vision | Unclear or hazy vision, which may be intermittent or constant |
Other polycythemia symptoms might include itching, skin that looks reddish or purplish, and feeling full or uncomfortable in the belly. This is because the spleen might be bigger.
When to Seek Medical Attention
If you often feel headache, dizziness, fatigue, shortness of breath, or blurred vision, see a doctor. Catching a high red blood cell count early can stop serious problems and make you feel better.
If your symptoms get worse or really bother you, get medical help. Your doctor might do blood tests, like a complete blood count (CBC), to check your red blood cell levels. They’ll then make a treatment plan just for you.
Causes of Polycythemia
Polycythemia is a condition where there are too many red blood cells. It can come from two main types: primary polycythemia and secondary polycythemia.
Primary polycythemia, or polycythemia vera, is a rare bone marrow disorder. It makes the bone marrow make too many red blood cells. It also increases white blood cells and platelets. The exact cause is not known, but genetic mutations are thought to be involved.
Secondary polycythemia happens because of other health issues. These issues make the body produce more erythropoietin (EPO). EPO is a hormone that helps make red blood cells. Some common causes include:
| Cause | Mechanism |
|---|---|
| Chronic lung diseases | Low oxygen levels in the blood due to impaired lung function trigger increased EPO production |
| Kidney disorders | Tumors or cysts in the kidneys can lead to excessive EPO production |
| Sleep apnea | Repeated episodes of low oxygen during sleep stimulate EPO production |
| Testosterone replacement therapy | Testosterone stimulates red blood cell production and may cause polycythemia in some individuals |
Finding out why someone has polycythemia is key to treating it. Primary polycythemia needs special care. But, secondary polycythemia often gets better when the underlying issue is treated.
Primary Polycythemia Vera: A Bone Marrow Disorder
Primary polycythemia vera is a rare blood disorder. It starts in the bone marrow and causes too many red blood cells. This happens because of a JAK2 gene mutation, which messes up blood cell production.
Understanding Polycythemia Vera
Polycythemia vera usually hits adults over 60. About 95% of people with it have the JAK2 gene mutation. This mutation makes the bone marrow produce too many blood cells. This leads to symptoms like headaches, dizziness, and itching.
It also causes complications like blood clots and an enlarged spleen. Fatigue and bleeding problems are other issues. There’s also a higher risk of getting leukemia.
Diagnosis and Treatment Options
To diagnose polycythemia vera, doctors use blood tests and a bone marrow biopsy. Once it’s confirmed, treatments aim to manage symptoms and prevent complications. The main treatments are:
- Phlebotomy: This involves regularly taking blood to lower the number of red blood cells.
- Medication: Drugs like hydroxyurea slow down red blood cell production in the bone marrow.
- Low-dose aspirin: It helps prevent blood clots and heart problems.
While polycythemia vera is a long-term condition, early treatment can improve life quality. It also lowers the risk of serious problems.
Secondary Polycythemia: Underlying Health Conditions
Secondary polycythemia is not caused by a bone marrow disorder like primary polycythemia vera. Instead, it happens when the body makes too many red blood cells due to other health issues. These issues can include chronic lung diseases, sleep apnea, kidney problems, tumors, and even testosterone therapy.
Chronic Lung Diseases and Sleep Apnea
Chronic lung diseases like chronic obstructive pulmonary disease (COPD) and interstitial lung disease can lower blood oxygen levels. This makes the kidneys release a hormone called erythropoietin (EPO). EPO tells the bone marrow to make more red blood cells, causing secondary polycythemia.
Sleep apnea, which makes breathing stop during sleep, also leads to low blood oxygen. This can cause the bone marrow to make more red blood cells.
Kidney Disorders and Tumors
Kidney problems, like renal cysts and renal cell carcinoma, can make too much erythropoietin. This hormone makes the bone marrow produce more red blood cells, causing secondary polycythemia.
Some tumors, like those in the liver, adrenal glands, or uterus, can also make erythropoietin. This leads to an increase in red blood cell production.
Testosterone Replacement Therapy
Testosterone therapy for low testosterone in men can also lead to secondary polycythemia. Testosterone helps make red blood cells in the bone marrow. So, men on this therapy need regular blood tests to check their red blood cell count.
It’s important to know that these health issues can cause secondary polycythemia. This helps doctors diagnose and treat it properly. By finding and treating the cause, doctors can manage secondary polycythemia and avoid its complications.
Lifestyle Factors Contributing to High Red Blood Cell Count
Medical conditions like polycythemia vera and secondary polycythemia are the main causes of high red blood cell count. But, lifestyle choices can also play a role. These choices can make your body produce more red blood cells. This can raise your hematocrit level and make your blood thicker.
Smoking and Tobacco Use
Smoking and using tobacco can increase red blood cell production. Cigarette smoke contains carbon monoxide. This gas binds to hemoglobin in your red blood cells, reducing their ability to carry oxygen. To make up for this, your body makes more red blood cells to ensure enough oxygen gets to your tissues.
Smoking’s effect on red blood cell count is clear when comparing smokers to non-smokers:
| Group | Average Red Blood Cell Count (million/μL) |
|---|---|
| Non-smokers | 4.5 – 5.5 |
| Smokers | 5.0 – 6.0 |
Living at High Altitudes
Living at high altitudes can also increase red blood cell count. At higher elevations, the air is thinner and has less oxygen. Your body makes more red blood cells to carry enough oxygen to your organs and tissues.
For example, people living in the Andes Mountains, over 13,000 feet, have a hematocrit level of 54-57%. This is higher than the normal range of 36-48% at sea level.
Performance-Enhancing Drugs and Steroids
Using performance-enhancing drugs and steroids can also raise red blood cell count. Some athletes and bodybuilders misuse these substances to improve their performance or appearance. Anabolic steroids increase erythropoietin (EPO) production. EPO is a hormone that makes your body produce more red blood cells.
This artificial increase in red blood cells can be dangerous. It can lead to heart attacks, strokes, and blood clots. It’s important to avoid using these drugs and steroids without a doctor’s prescription and supervision.
Diagnostic Tests for Polycythemia
To diagnose polycythemia, doctors use several tests. These tests check red blood cell levels and look for causes. They help doctors plan the best treatment.
Complete Blood Count (CBC) and Hematocrit Levels
The first test is a complete blood count (CBC). It checks red, white blood cells, and platelets. It also looks at the hematocrit level, which shows red blood cell percentage. High hematocrit levels mean polycythemia.
The normal hematocrit range changes with age and sex:
| Age Group | Male Hematocrit Range | Female Hematocrit Range |
|---|---|---|
| Newborns | 45% – 60% | 45% – 60% |
| Adults | 41% – 50% | 36% – 48% |
Erythropoietin (EPO) Level Tests
Erythropoietin (EPO) is a hormone that helps make red blood cells. Blood tests measure EPO levels. This helps figure out if polycythemia is primary or secondary.
In primary polycythemia vera, EPO levels are low. This is because the bone marrow makes too many red blood cells without EPO. In secondary polycythemia, EPO levels might be high because of another condition.
Bone Marrow Biopsy
A bone marrow biopsy is key for diagnosing primary polycythemia vera. It takes a small bone marrow sample, usually from the hip. Then, it’s checked under a microscope.
In polycythemia vera, the bone marrow has more red blood cell precursors. It might also show genetic mutations like JAK2 V617F. This mutation is found in about 95% of polycythemia vera patients.
Treatment Options for High Red Blood Cell Count
There are several ways to treat high red blood cell count, depending on the cause and how severe it is. The main goal is to lower the risk of problems like blood clots, heart issues, and stroke. Treatment might include medical procedures, medicines, and fixing any underlying health problems.
Phlebotomy: Removing Excess Red Blood Cells
Phlebotomy is a common treatment for polycythemia vera. It involves taking a certain amount of blood out to lower the number of red blood cells. This is done regularly to keep the red blood cell count healthy. Phlebotomy helps manage symptoms and lowers the risk of complications from polycythemia vera.
Medications to Reduce Red Blood Cell Production
Medicines can slow down red blood cell production in the bone marrow. Hydroxyurea is often used to help manage polycythemia vera by reducing red blood cell production. Ruxolitinib may be given to those who don’t do well with hydroxyurea or have bad side effects.
Treating Underlying Conditions
For secondary polycythemia caused by other health issues, treating the main problem is key. This might mean taking medicines, making lifestyle changes, or using other therapies specific to the condition. By fixing the underlying issue, the red blood cell count can often return to normal. This helps ease symptoms and lowers the risk of complications.
FAQ
Q: What is a high red blood cell count?
A: A high red blood cell count, or polycythemia, means you have more red blood cells than usual. This can make your blood carry less oxygen. It’s a condition that affects how well your blood transports oxygen.
Q: What are the symptoms of high red blood cell count?
A: Signs of high red blood cell count include headaches and dizziness. You might also feel tired, have trouble breathing, or see things less clearly. Some people get a reddish skin tone or feel itchy and have joint pain.
Q: What causes polycythemia?
A: Polycythemia can come from several sources. It might be due to a rare bone marrow disorder or chronic lung diseases. Sleep apnea, kidney issues, and tumors can also cause it. Lifestyle choices like smoking or living at high altitudes can play a role too.
Q: How is high red blood cell count diagnosed?
A: To diagnose polycythemia, doctors do a complete blood count (CBC). They check your hematocrit levels. They might also test your erythropoietin (EPO) levels and do a bone marrow biopsy to confirm polycythemia vera.
Q: What are the treatment options for polycythemia?
A: Treatments for high red blood cell count include phlebotomy. This removes extra red blood cells. Doctors might also prescribe medications like hydroxyurea or ruxolitinib to slow down red blood cell production. Treating the cause of secondary polycythemia is also key.
Q: Can dehydration cause a high red blood cell count?
A: Yes, dehydration can temporarily raise your red blood cell count. When you’re dehydrated, your blood’s plasma volume goes down. This makes your red blood cells more concentrated. Drinking water can help fix this.
Q: How does smoking affect red blood cell count?
A: Smoking can increase your red blood cell count. The carbon monoxide in smoke binds to hemoglobin, reducing its oxygen-carrying ability. To compensate, your body makes more red blood cells.
