What is Polycythemia?

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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 08 October 2016
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Polycythemia is a disorder in which there are too many red blood cells present, causing the blood to thicken over time. This condition can be caused by a number of things, including genetic abnormalities, malignancies, and oxygen deprivation. It is usually diagnosed as a result of a blood test which reveals an abnormally high red blood cell count in primary polycythemia, or an uncharacteristically low plasma count in secondary polycythemia.

Congenital polycythemia, also called polycythemia vera or polycythemia rubra, is caused by an abnormality in the bone marrow which causes the body to overproduce red blood cells. The condition usually has a very slow onset, rarely appearing in people under 40, and it is more common in men. People can inherit the abnormality, or it can occur as a result of a spontaneous mutation. In families with a history of this condition, it can be a good idea to be tested for signs of polycythemia or the genetic abnormality which causes it.

In acquired forms of the condition, the bone marrow starts overproducing red blood cells in response to environmental cues. Some malignancies can cause overproduction of the red blood cells, for example, and the condition is also linked with people who live at high altitude or who work in oxygen deprived environments. This condition can also lead to complications: the production of too many red blood cells has also been linked with the development of some types of leukemia, for example.


While the increase in red blood cells is not inherently harmful, it can lead to medical complications. Patients with polycythemia usually experience shortness of breath, slow healing of wounds, dizziness, fatigue, and red, itchy skin, especially after showering. They can also develop strokes and other medical problems as a result of clots caused by their thickened blood. People with these symptoms should see a doctor for an examination to determine the cause and discuss treatment options.

One of the primary treatments for polycythemia is therapeutic phlebotomy, in which blood is removed on a regular basis to remove excess red blood cells. Patients may also be given drugs which are designed to inhibit the formation of red blood cells so that they will be less prone to a buildup of such cells in their blood. Other medications can be used to manage the clotting problems and symptoms such as itching associated with polycythemia. It is important to receive treatment and regular examinations, because people with untreated or unmanaged forms of this disease can die.


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Post 5

I am considering phlebotomy for my treatment of polycythemia. I do not like taking medications and am trying to limit my diet to no/low-iron foods. Any others suggestions would be appreciated. Thanks!

Post 3

@bluespirit - The therapeutic phlebotomy treatments vary based on the severity of the disorder. It could be as frequent as once or twice a week. Good luck!

Post 2

@bluespirit - I can understand why you’re nervous!! Lots of people are not huge fans of needles. Hopefully you will get used to the phlebotomy as your frequency with the treatment increases.

When I give blood I reduced my anxiety by looking away from the needle, and always letting the person with the needle know that I would appreciate them inserting the needle while we were talking so that I wasn’t paying direct attention to the needle.

Post 1

I'm nervous about the polycythemia vera treatment of therapeutic phlebotomy, because I have to go in for my first session next week. I forgot to ask my doctor how long the treatment would go on, and now I'm just really worried that I'll have to do this all the time for years! Does anybody know how often is this treatment given, or how long most people have to do it?

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