Hello. Thanks for asking on Healthcaremagic. Polycythemia is persistent increased rbcs and hence increased hemoglobin levels in the blood. It could be primary ie Vera or secondary to certain causes. Polycythemia Vera has low erythropoietin levels and on cytogenetics Jak2 mutation is found. In secondary Polycythemia underlying causes may be those causing chronic hypoxia which increase erythyopoietin production like sleep apnea, obesity hypo ventilation syndrome, copd, testosterone replacement therapy, smoking etc. Epo secreting tumors like hepatocellular CA, renal cell CA, adrenal adenoma could also cause it. High rbc count causes blood flow to be sluggish in brain and other essential organs causing symptoms like impaired alertness, dizziness, headaches, thrombosis, stroke, myocardial infarction, DVT. It is essential to find out the underlying cause and treat it to relieve secondary Polycythemia. Hope the doctor has checked erythyopoietin levels before labeling it as secondary. Otherwise regular blood removal is advised to keep hb from rising too much. Kindly look for a cause and treat it. Thanks.