Normally your body adjusts the production of blood cells in the bone marrow, so that the number of blood cells that are made equals the number that are destroyed. If you have polycythemia, the mechanism becomes faulty and your marrow produces far more blood cells than usual.There are two main types of the disorder.

The first, polycythemia vera, is an over­production of red blood cells, granulocytes and platelets.

The second type of polycythemia is called secondary polycythemia. It occurs as a result of an underlying cause such as a severe lung disease, certain kinds of congenital heart disease cigarette and cigarrtte a king, and living at high altitudes. These conditions can prevent the red blood cells from obtaining enough oxygen to pass on to the body’s tissues, and the bone marrow responds by producing many more red blood cells.

There is a third and less important type of the disorder, which is called stress polycythemia or pseudopolycythemia. In this condition, the number of red blood cells in a blood sample is high, but the cause is a decrease in the amount of plasma in the blood. This is usually due to smoking, but it can be caused by taking diuretic drugs or by becoming dehydrated.

Currently, secondary polycythemia and stress polycythemia are not treated directly. Rather, the problems that cause them are dealt with. Polycythemia vera is the most serious form of the disease, however, and it can be treated directly.

What are the Symptoms?

The typical symptoms of polycythemia vera include recurrent headaches, dizziness, a feeling of fullness in the head, and a ruddy complexion. Sometimes there is severe itching, and hot baths make the itching worse. A physician who examines you may find that you have an enlarged spleen.

What are the Risks?

Although polycythemia vera cannot be cured, it is almost always readily controlled by treatment. Many people who have the disease live for many years. Possible complications from the disease include heart attack deep-vein thrombosis stroke peripheral arterial thrombosis, bleeding, and gout .

What Should be Done?

If you have the symptoms of polycythemia, you should see a physician. The physician will arrange for a blood test, which should show whether or not you have some form of the disease. If polycythemia is diagnosed, further tests are necessary to discover which type of the disorder you have. The tests may include additional blood tests, an intravenous pyelogram, or X-rays of the kidneys, and a measurement of blood volume. In this last test, for example, a small amount of radioactive albumin and a small quantity of your own red blood cells labelled with radioactive chromium are injected into a vein in one of your arms, and a blood sample is taken from your other arm about 30 minutes later. Then the volume of red blood cells and plasma in your bloodstream can be determined.

What is the Treatment?

If you have polycythemia vera, you may be able to receive treatment as an out-patient. The first goal of treatment is to lower the number of red cells in your blood to reduce the risk of thrombosis, or blockage from a clot. To do this, about a pint of blood is regularly taken from a vein in your arm. In some cases, this treatment is only needed once to clear up the condition.

Drugs are usually used to control the over­production of blood cells. Depending on what drug your physician prescribes, you may take it in tablet form for several weeks or it may be injected into a vein. Drug treatment may control the disease for up to several years. Treatment is repeated when the blood counts begin to increase again.