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DrThomasMd
DrThomasMd, Doctor (MD)
Category: Oncology
Satisfied Customers: 63830
Experience:  Many years in internal medicine. Oncology is one or our sub-speciaties/I help Onc fix side effects
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Months ago, I had a 50.2% hematocrit reading. It surprised

Customer Question

Months ago, I had a 50.2% hematocrit reading. It surprised me so I looked at my old blood tests & it looks like it slowly went up. In 2011, I had a 47 hct and 15.6 hbg. In 2012, I had a 48 & a 15.9, in 2013, I had a 48.6 & a 16.0 , in 2015, i had a 49.0 twice with a 16.5.
I saw a hematologist who did not think it was polycythemia vera and said they do not really check until the numbers are higher, but due to my anxiety with it, ran some tests. We ruled out some 2nd'ry causes like steroids, apnea, etc. In his office 3 monts ago, I was a 52.4 hematocrit and 17.6 hemoglobin. He also ran 2 jak2 gene tests and a CLA test, which all came back negative. He also checked my EPO, normal as well. Lastly, he did a RBC mass test which came back "normal".
I just had a 3 month follow up with him & he said "90 - 95% ruled out PV" & he drew my blood in the office and my hct was 47 and hbg 15.9. Only difference this time was I drank about 8oz an hour before the test.
Submitted: 7 months ago.
Category: Oncology
Expert:  DrThomasMd replied 7 months ago.

Hello

Then I would say this is normal for you.

There is no pathologic finding here.

If you are at a high altitude, this could explain it.

I don't think it is PV, but in fact, a bone marrow biopsy is the definitive test.

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Customer: replied 7 months ago.
I am sea level altitude. Can dehydration be to blame? I normally take my blood tests for the late morning/early afternoon and don't eat or drink anything before.
I am just worried /concerned that drinking a glass of water the morning before my recent test is why it falsely reported as a normal hematocrit (47%).
Expert:  DrThomasMd replied 7 months ago.

Put it this way, if you stay hydrated, you are going to be in the normal range, apparently.

I don't think there is pathology here.

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Customer: replied 7 months ago.
I forgot to mention that my vitamin B12 level was elevated at 1,000 about a year ago. I read that a high B12 value can indicate certain pathologies, one being PV. My hematologist shrugged it off saying he didn't think it was relevant. Do you have any insight on that?
Expert:  DrThomasMd replied 7 months ago.

It almost always indicates nothing.

It can indicate liver inflammation, which is easy to check with a lab.

It usually indicates supplementation.

It often has no explanation.

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