Understanding Polycythemia

madman

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Understanding Polycythemia

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1. Unexpected Lab Result

What Do These Numbers Mean?


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Hemoglobin (Hgb)

* The concentration of the oxygen-carrying protein


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Hematocrit (Hct)

* The percentage of your blood volume that is made up of red blood cells


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Red Blood Cell Count (RBC)

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The Usual Suspects

Causes of True Polycythemia


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Oxygen-Related Causes

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Hormones & Medications

* Testosterone therapy, for example, is a super well known cause. It has a direct effect on the bone marrow, stimulating it to make more red cells. It's a predictable side effect, and it's one of the first things your doctor will ask about if you're on these kind of treatments.


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Kidneys

* Your kidneys are kind of like the factory foreman for red blood cells. They produce a hormone called EPO. An EPO is the direct signal that shouts at your bone marrow to make more red cells.

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The Rare Exception

Polycythemia Vera


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Most people with high hemoglobin or hematocrit do NOT have Polycythemia Vera (PV).

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Clues Suggesting PV

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* This is such a critical takeaway. High counts from, say, sleep apnea or dehydration. They don't actually feel symptoms from the blood count itself. They feel symptoms from the underlying cause, like feeling exhausted from bad sleep because of apnea. The very specific symptoms we just talked about, those are much more unique to PV itself.

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Your Path Forward

What Happens Next?


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Evaluation Process

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high red blood counts

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Stay well hydrated (fluids/electrolytes) all day/everyday otherwise your results will be skewed!

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TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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