Dr. Puri , Can You Please Advise How High Should

Posted on Wed, 22 Jan 2020

Question: Dr. Puri ,

Can you please advise how high should the hemoglobin and ferratin be in order to conclude
Polycythemia vera or secondary ? I did some blood work and the results are high . Please see results . Your opinion will be highly appreciated .
Can the blood medicine cause hig numbers due to dehydration . I am taking co-diovan 320/25 .Please see results and comments . How do I know if I am dehydrated ???

Answered by Dr. Shailja Puri (9 minutes later)

Brief Answer:
Co-diovan unlikely to cause dehydration.

Detailed Answer:
Hello and welcome again,
Haemoglobin higher than 18 gm% is indicative of polycythemia.
However, some other criteria also need to be fulfilled for diagnosis of polycythemia.
The anti-hypertensive drug co-diovan is unlikely to cause dehydration.
BUN levels should be monitored at least once to assess its levels.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Shailja Puri (45 minutes later)

Thank you for your reply . I did other tests and they are ok . Please see attached . BUN is ok . You think it might be Polycythemia vera ? It can't be other reason that elevated the hemoglobin ??? Please review the tests attached . Thanks

Answered by Dr. Shailja Puri (38 minutes later)

Brief Answer:
High altitude is also a cause of high hemoglobin

Detailed Answer:
Hello and welcome again,
High altitude is also one of reasons for high haemoglobin.
In case this cause is not applicable in your case, then you need to undergo molecular tests to rule out primary polycythemia vera.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Kampana

Answered by Dr. Shailja Puri (43 minutes later)

Brief Answer:
Smoking is one of the cause of elevated haemoglobin.

Detailed Answer:
Hello and welcome again,
Smoking is one if the cause of high haemoglobin.
Quiting smoking can reduce high haemoglobin levels.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Shailja Puri (15 minutes later)

Thank you very much for your quick reply . As I mentioned before , I am a long time smoker & obese (200 kg) and long time controlled hypertension . Can't these be the reason for the elevated hemoglobin ? My internal medical doctor asked to simply donate blood . Other GP doctor suggested an appointment with hematology dept which made me scared !!!! . I asked about the JAK2 lab test . It costs too much & it takes 4 months for the results to come (here , where I live , they have to send sample to Germany , it is not done here locally ) . Is there any relation between high FERRITIN and high HEMOGLOBIN ? . I don't live in high altitude . My white cell level is OK . From reviewing your answers to others , you seem expert in the field of lab tests . I really appreciate your opinion and advise . Doctors here are giving me many ways to follow . I am concussed . Worried & stressed .

polycythemia vera.is very rare , as I googled the net . And it seems like cancer , dangerous . Please advise what to do . What food to avoid at this stage ? . I am sorry for repeating myself and bothering you with my questions . Thank you so much .