OpenHealth Q&A

Get answered by medical professionals

Concerns About Polycythemia Vera Diagnosis

6/16/2025, 5:40:28 PMMale25-34

At 22 years old, I’ve noticed consistently high blood counts highlighted in my patient portal, with elevated levels dating back to 2022. Recently, my lab results were as follows: - Hemoglobin (HGB): 16.5 - Hematocrit (HCT): 47.9 - Red Blood Cells (RBC): 5.29 These values have remained elevated or at the borderline since 2022, occasionally dipping lower, but the latest results are the highest I’ve experienced to date. In January of this year, my tests from the same hospital showed: - HGB: 15.9 - HCT: 46.1 - RBC: 4.99 The recent spike feels considerable. In March, I had blood work conducted at another facility, where the results indicated lower counts: - HGB: 15.7 - HCT: 45.6 - RBC: 5.03 This notable increase has caused me considerable anxiety. I’m currently undergoing extensive evaluations for unexplained fatigue. During a recent appointment with my primary care physician, I sensed some concern regarding my blood counts, suggesting my fatigue might be associated with these abnormalities. Additionally, I’ve been experiencing other symptoms like itchiness and tinnitus, which I hadn’t connected before learning about polycythemia vera. During the assessment for my fatigue, most causes of secondary polycythemia were ruled out, leaving me anxious about the possibility of being diagnosed with polycythemia vera at such a young age. I’m left wondering about the likelihood of this diagnosis and whether there are alternative explanations for my elevated blood counts. It’s also worth noting that I have a history of low ferritin levels alongside these elevated counts, which adds to my concerns. My physician has requested an abdominal ultrasound to rule out splenomegaly and a serum erythropoietin test. While I await these results, my anxiety is overwhelming. I would greatly appreciate any insights or reassurance. Thank you for your understanding!

ArthritisThyroid DisordersInternal Medicine

Answers (1)

Cony

6/16/2025, 5:40:45 PM

OpenHealth AI

It’s understandable to feel anxious while navigating the complexities of your lab results and the possibility of a diagnosis like polycythemia vera, especially at a young age. Here are some key points to help guide you and ease your concerns:

Summary

Your consistently high blood counts warrant attention, but there are multiple potential causes. It's important to focus on understanding your results and next steps. Your physician is taking the right approach by requesting further evaluations to rule out more serious conditions.

Explanation

Polycythemia vera (PV) is a bone marrow disorder that leads to an increase in red blood cell production. The symptoms you mentioned—fatigue, itchiness, and tinnitus—can occur with PV, but they can also be related to other conditions. The elevated hemoglobin, hematocrit, and red blood cell counts you've noticed could have several explanations, ranging from primary causes like PV to secondary causes such as dehydration, chronic hypoxia (like from smoking or sleep apnea), or underlying kidney issues.

It’s reassuring that your physician is exploring this further by ordering an abdominal ultrasound and serum erythropoietin test. These tests can help determine if your body is producing more red blood cells due to a condition like PV or if another factor is at play.

Next Steps

  1. Monitor Symptoms: Continue to pay attention to your symptoms, noting any changes in fatigue, itchiness, or tinnitus, and document these for your next appointment.

  2. Stay Hydrated: Ensure you’re drinking enough fluids daily, as dehydration can affect blood counts. Aim for at least 8 cups (64 ounces) of water daily, adjusting based on activity level.

  3. Manage Anxiety: While awaiting further results, consider relaxation techniques, like deep breathing exercises or mindfulness practices. Engaging in activities you enjoy can also help distract from anxious thoughts.

  4. Get Ready for Appointments: Prepare questions for your next healthcare visit about your test results and potential next steps. Understanding your options can reduce uncertainty.

  5. Seek Support: Discuss your anxiety with someone you trust or consider professional support if it feels overwhelming. It's okay to seek help when you're feeling anxious about health concerns.

While the possibility of conditions like PV may feel daunting, many factors can contribute to elevated blood counts, and your doctor is working to clarify this. Remember, there is ongoing care and support available to help you through this process.

Related Questions

Concerns After Gallbladder Surgery (Three Weeks Post-Op) - Is It an Infection?

Profile: - Age: 35 - Gender: Female - Height: 5 feet 4 inches - Weight: 160 pounds - Ethnicity: Asian Duration of Symptoms: Last Three Weeks Location: United States Recent Medical History: Nearly three weeks have passed since my gallbladder removal surgery. Over the last few days, I've noticed a small amount of unclear fluid coming from the incision. I just observed what seems to be pus oozing from the surgical site. Although there is slight tenderness when I move or touch the area, it isn't painful. Thankfully, I haven’t experienced any fever or chills, and there’s no unpleasant odor emanating from the wound. Should I continue to clean it with soap and water, or is it necessary for me to visit the emergency room for further evaluation?

Multiple SclerosisLupusInternal Medicine
Male25-34
35 minutes ago

Exploring Inositol and CoQ10 for Managing PCOS Symptoms

As a 28-year-old female, I have faced the challenges of polycystic ovary syndrome (PCOS) since my teenage years. Starting from the age of 16, I have dealt with highly irregular menstrual cycles, occurring anywhere from three to eight months apart. My diagnosis has been substantiated through two ultrasounds and blood tests revealing elevated androgen levels. Despite maintaining a healthy diet and leading an active lifestyle—balancing my work as an environmental biologist with gym sessions alongside my husband—I continue to wrestle with weight management. Other symptoms impacting my daily life include significant hair loss, unwanted facial hair, and persistent fatigue. In my journey to manage PCOS, I previously sought counsel from a gynaecologist, who primarily suggested hormonal birth control as the main approach to alleviate my symptoms. Although I adhered to this recommendation for several years, the hormonal changes negatively impacted my mood, leading me to discontinue its use. Another alternative proposed by my gynaecologist involved androgen blockers, but these are not suitable for me since my husband and I plan to start a family in the next two to three years. Recently, my research led me to discover that supplements like Inositol and CoQ10 might effectively combat insulin resistance and lower androgen levels. They are purported to improve various symptoms associated with PCOS, including the regulation of ovulation, all while boasting minimal adverse effects. I am curious about the viability of these supplements as alternatives to hormonal birth control or androgen blockers in managing my PCOS symptoms.

Crohn's DiseaseThyroid DisordersRheumatology
Male25-34
45 minutes ago

Seeking Clarity on My Spinal Tap Results: A Bit Anxious

I am a 31-year-old woman experiencing a continuous headache for the past four months, accompanied by feelings of nausea and exhaustion. I take Lexapro each day to manage my mental health. I have a history of migraines and headaches, but this recent episode doesn't align with my previous experiences. Here are the findings from my spinal tap: - **Opening Pressure of Cerebrospinal Fluid (CSF)**: 9 cm H₂O - **Presence of Red Blood Cells (RBCs) in CSF**: 2,570 - **Total Protein Level in CSF**: 107 mg/dL - **ACE Level in CSF**: 4.4 - **Other Tests on CSF**: Results were normal. - **Brain MRI and MR Venography**: Both tests yielded normal results. - **Blood Test Results**: Normal results were obtained. Given these results, I'm feeling a bit uneasy and I’m hoping to better understand what they might indicate about my health.

Multiple SclerosisCrohn's DiseaseThyroid Disorders
Male25-34
45 minutes ago

Navigating Ear Infections While Traveling in Thailand

**Age:** 23 **Height:** 6'3" **Weight:** 88 kg **Medication Taken:** 1000mg Bactoclav - Amoxicillin with Potassium Clavulanate, along with pain relief and antihistamines. **Summary:** I’m hesitant to consult a doctor overseas only to receive a prescription for the same antibiotics available at a local pharmacy for a fraction of the price. What strategies can I employ to effectively manage this persistent ear infection? Am I being too hasty in my expectations? I have a long history of ear infections, often triggered by exposure to water or any activity impacting my ears. I regularly use a specialized oil before showering to prevent water from entering my ears. While backpacking in Thailand, I've developed a particularly severe ear infection over the last several days. Initially, a course of 500mg amoxicillin seemed effective, but significantly, just yesterday my condition took a downturn, shifting from nearly healed to painfully inflamed. Now, my ear is not only swollen but also incredibly sore. In an attempt to combat this, I’ve been taking 1000mg Bactoclav - Amoxicillin and Potassium Clavulanate, having consumed seven tablets in the last two days; unfortunately, there's been no noticeable improvement. I’m reluctant to seek medical attention, fearing I would be prescribed the same medication I could acquire from a pharmacy, albeit at a much higher cost. Yet, I’m also starting to question the efficacy of the pharmacy’s medication. I’ve only recently begun the stronger treatment since my symptoms returned. Any advice would be greatly valued! In addition, I’d like to share that just a week into my four-month journey, I feel as though my ongoing ear issues are gradually dominating my life. I am incredibly grateful for this travel opportunity, and while my health isn’t at risk in a serious way, these ear complications are becoming quite overwhelming. Could there be surgical options available? Might there be an underlying health concern that I’m unaware of? It doesn’t seem normal to be plagued by constant ringing, popping sounds, and wax buildup in my ears. Moreover, it feels excessive to have to apply products in my ears every time I shower.

ArthritisMultiple SclerosisCrohn's Disease
Male25-34
55 minutes ago

Injury to the Sciatic Nerve

At 25 years old and weighing 135 pounds, I am currently taking naproxen and Lyrica to manage my sciatic nerve injury. The pain in my right leg has made it incredibly difficult for me to remain upright. It’s been two weeks since I first sought treatment; I consulted a physician who advised medication and attended a physiotherapy session. Initially, I experienced some relief after the appointment, but unfortunately, the pain returned the following day—even the prescribed home exercises exacerbated my discomfort. Just yesterday, I attempted the cobra pose, along with the flossing technique, which only heightened my pain. I find it nearly impossible to stand for more than a few seconds before the discomfort becomes intolerable. Additionally, I have an appointment with an osteopath on Tuesday, but I can't shake off my worries— is it normal to still struggle with walking after two weeks? Although I am experiencing some numbness in my toes, I haven’t encountered any loss of bladder or bowel control, worsening numbness, or weakness in my legs, so I feel stable in that regard. Nonetheless, I fear the possibility of never fully recovering and being left with a lasting disability. The pain is overwhelming, adding to my anxiety about the future.

ArthritisFibromyalgiaCOPD
Male25-34
1 hour ago