Hematocrit measures the proportion of red blood cells in a person’s total blood volume. Elevated hematocrit, known as erythrocytosis, requires medical attention to identify its cause and manage health implications.
Understanding High Hematocrit
Numerous factors can contribute to elevated hematocrit levels, each affecting the body’s red blood cell production or fluid balance. Dehydration is a common and often temporary cause. When the body lacks fluids, plasma volume decreases, concentrating red blood cells and artificially increasing hematocrit. Addressing dehydration typically normalizes these levels.
Chronic lung diseases, such as COPD, can also lead to high hematocrit. These conditions impair oxygen absorption, resulting in lower blood oxygen. In response, kidneys produce more erythropoietin, a hormone stimulating red blood cell production. Kidney conditions, like tumors, can similarly cause erythropoietin overproduction.
Living at high altitudes, where oxygen is lower, triggers increased red blood cell production for efficient oxygen transport. Smoking is another lifestyle factor; carbon monoxide binds to hemoglobin, reducing oxygen-carrying capacity and prompting more red blood cell production. Rare blood disorders, like polycythemia vera, involve the bone marrow directly overproducing red blood cells due to a genetic mutation.
Medical Evaluation and Diagnosis
High hematocrit is typically identified through a routine complete blood count (CBC) test, which measures the percentage of red blood cells. If the initial CBC indicates elevated hematocrit, further diagnostic investigation is necessary to pinpoint the underlying cause.
A healthcare provider will often order additional blood tests, such as erythropoietin (EPO) levels, to determine if the body produces too much of this hormone. Kidney and lung function tests may also be performed. In specific cases, particularly when polycythemia vera is suspected, a bone marrow biopsy may be conducted to examine red blood cell production and identify genetic markers like the JAK2 mutation. Professional medical guidance is crucial for accurate diagnosis and treatment.
Strategies for Reducing Hematocrit Levels
Reducing elevated hematocrit levels often involves a multi-faceted approach, with strategies tailored to the underlying cause. If dehydration is the reason, increasing fluid intake is effective. Staying well-hydrated helps dilute the blood.
For cases where an underlying medical condition is responsible, treating that condition is paramount. Managing chronic lung diseases like COPD with medications or therapies can improve oxygen levels, reducing the body’s need for excess red blood cells. Addressing kidney issues or tumors that lead to excessive erythropoietin production will similarly help normalize hematocrit.
Therapeutic phlebotomy, similar to blood donation, is a common medical intervention to reduce red blood cell volume. A healthcare professional removes blood, typically a pint, to lower the red blood cell count and decrease blood viscosity. This procedure is often used for conditions like polycythemia vera or when hematocrit levels are high, with frequency depending on severity.
Lifestyle adjustments also play a role. Quitting smoking improves oxygen transport and reduces compensatory red blood cell production. Avoiding excessive alcohol and maintaining a healthy diet support overall blood health. For conditions like polycythemia vera, medications such as hydroxyurea, interferon alpha, or ruxolitinib may be prescribed to suppress red blood cell production. Low-dose aspirin is often recommended to reduce blood clot risk associated with thicker blood.
Importance of Ongoing Management
Managing high hematocrit is an ongoing process requiring consistent medical oversight. Regular blood tests are essential to track levels and ensure treatment effectiveness. Test frequency varies based on the individual’s condition and response, often ranging from weeks to months.
Adherence to recommendations is crucial for long-term management. This includes following prescribed medication regimens, maintaining lifestyle changes, and attending scheduled therapeutic phlebotomy sessions. With proper management, many individuals can control hematocrit levels, reducing the risk of complications such as blood clots, stroke, or heart attack.