Could I Have Polycythemia Vera?
Greetings everyone, I'm currently contemplating whether I might have polycythemia vera and could use some guidance on the matter. As of late 2023, I’m a 36-year-old male, standing 5’9” tall and weighing 175 pounds. I am of Caucasian descent and have been diagnosed with Hashimoto’s thyroiditis, although it remains asymptomatic. My regular throat examinations and TSH levels have consistently fallen within normal ranges. Recently, my hemoglobin (HGB) and hematocrit (HCT) levels have been slightly elevated: **- November 2023:** - HGB: 1.72 - HCT: 52 - White Blood Cell Count (WBC): 9.4 - Platelets: 299 - Neutrophils: 4.03 Despite this, no healthcare providers prompted further investigation, leading me to brush it off. I haven't experienced any symptoms and maintain an ordinary lifestyle; my blood pressure averages around 130/80. In early 2025, during my annual health assessment required by my workplace in Italy, a new cardiologist observed that my blood test results indicated fluctuating HGB and HCT levels: **- February 2025:** - HGB: 1.77 - HCT: 53 - WBC: 6.42 - Platelets: 288 - Neutrophils: 3.01 **- June 2025:** - HGB: 1.7 - HCT: 49 - WBC: 6.61 - Platelets: 252 - Neutrophils: 2.75 **- November 2025:** - HGB: 1.84 - HCT: 52 - WBC: 6.9 - Platelets: 280 - Neutrophils: 2.77 **- December 2025:** - HGB: 1.75 - HCT: 53 - WBC: 7.47 - Platelets: 275 - Neutrophils: 3.5 Consequently, she referred me to a hematologist for a thorough evaluation. At the end of December 2025, I had my appointment with the hematologist, who recommended retesting my blood in January 2026 to see if increased hydration would make a difference: **- January 2026:** - HGB: 1.79 - HCT: 54 - WBC: 6.5 - Platelets: 290 - Neutrophils: 3.92 - Erythropoietin (EPO): 4.6 u/mg - C-reactive protein (CRP): Negative Since the effects of hydration weren't apparent, she suggested the following actions: 1. Conduct another blood test in March 2026 to further evaluate hydration impact. 2. Perform a JAK2 genetic test to rule out the possibility of polycythemia vera. 3. Undergo a polysomnography to investigate whether my nocturnal snoring could be contributing to elevated HGB and HCT levels. The prospect of polycythemia vera is concerning to me, and I would appreciate any knowledgeable insights from this community. Thank you!
Answers (1)
2/6/2026, 8:20:47 AM
OpenHealth AI
It's understandable to feel concerned about the possibility of polycythemia vera (PV), especially after noting elevated hemoglobin (HGB) and hematocrit (HCT) levels over time. Let's focus on what you can do as you move forward with your health evaluation.
Main Points:
- Your elevated HGB and HCT levels warrant investigation, and your hematologist is taking the right steps.
- Polycythemia vera is a condition characterized by increased red blood cell production, and additional tests are necessary to confirm or rule out this diagnosis.
- Maintaining close communication with your healthcare providers and following their guidance is critical.
Explanation:
Polycythemia vera is a blood disorder that leads to increased red blood cells, which can cause blood to thicken. Symptoms may include headaches, dizziness, and blood clots, but you mentioned not having any symptoms. Other factors, like hydration status or possible sleep apnea (hinted at by your nocturnal snoring), can also affect blood counts. The tests your hematologist has recommended—especially the JAK2 mutation test—are important for diagnosis, as around 95% of people with PV have this mutation.
Next Steps:
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Follow Medical Recommendations:
- Blood Tests: Attend scheduled labs, including the repeat test in March and the JAK2 genetic test, as these will help clarify your situation.
- Polysomnography: This sleep study is crucial as it can identify if sleep-disordered breathing is influencing your blood counts.
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Hydration:
- Continue to stay well-hydrated, as dehydration can lead to elevated blood cell counts. Aim for at least 8 glasses of water a day, adjusting based on your activity level and environment.
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Monitor Symptoms:
- Keep track of any new symptoms such as headaches, dizziness, or changes in energy levels. Make a note of this to discuss during your next appointment.
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Lifestyle Considerations:
- Maintain a balanced diet and engage in regular exercise, as these can support overall health and may help in managing your blood levels.
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Educate Yourself:
- Learn more about polycythemia vera and its management from reliable sources to help better understand what you might be dealing with.
Reassurance:
It's commendable that you're proactive about your health. Though the prospect of a serious condition like polycythemia vera is understandably daunting, you're taking the appropriate steps with your healthcare team. Monitoring and further testing will provide clearer insights into your condition. Don’t hesitate to ask your hematologist any questions you may have, as open communication is key to understanding and managing your health.
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