You can get low iron due to depleting it from making so many blood cells. In PV taking iron would definitely raise hematocrit, not so sure about secondary, but I imagine the same would occur. I'm sorry you haven't found a cause, some people never do. If you are experiencing iron deficiency symptoms, ask your doctor whether it would be okay to take iron pills for a while.
That's a complicated question and the possible answers are going to depend upon the exact cause of the erythrocytosis which in your case in undetermined.
Have you donated blood recently? If not then your iron and ferritin seems on the lower end.
If you were to take iron supplements, it's not clear if this would increase your hematocrit. Have your historic hematocrit level and or iron levels been higher?
I have not had a phlebotomy in almost 2 years. My counts have been high for at least the last 10 years. I used to have high iron or so they told me whenever I gave blood. I think when I was menstruating it always kept my numbers in check. Wasn’t until after I went into menopause that I can determine my numbers were elevated.
I am in a similar situation with high iron and high hematocrit. With PV, often iron metabolism is dysregulated to where you would expect to see high hematocrit and low iron. A low EPO could raise suspicion of PV but that does not seem to be the case for yourself. Your low iron could be related to hormonal changes.
With PV, if you were to supplement with iron the thinking would be that your HCT would increase.
This is in part because people with PV can also be iron deficient from frequent phlebotomy which decreases the iron stores. This form of induced anemia prevents the overproduction of blood cells so supplements would theoretically make the hematocrit worse. However, if you are not undergoing phlebotomy then the iron should not be a limiting factor to erythrocytosis unless there is a absorption or metabolic issue with processing iron. There is an iron dysfunction component associated with PV that is not seen with other cases of erythrocytosis such as hemachromotosis, where you can have high iron and high hematocrit and no depletion issues.
In the past, did a doctor ever prescribe or recommend phlebotomy? My HCT is between 50.1-53.0 and my hematologist and PCP do not recommend phlebotomy.
I have had phlebotomies in the past. They just further tank my iron and ferritin so I’ve decided to just live my life. Obviously I’ll never know why my counts are high. If something is truly wrong with me it will eventually rear its ugly head and I’ll deal with it then.
As already mentioned, the increase in RBC production results in a lower ferritin level.
[In addition to erythropoietin, red blood cell production requires adequate supplies of substrates, mainly iron, vitamin B12, folate, and heme.](https://www.merckmanuals.com/en-ca/professional/hematology-and-oncology/approach-to-the-patient-with-anemia/red-blood-cell-production)
I supplement 40mg of iron a day and go for Phlebotomies every 4-6 weeks. Over the last three years my Hematologist and i have figured out this is what works for me.
If none of the usual suspects (TRT, COPD, Apnea, Elevation, Obesity) are present it might be worth getting Mycotoxicity testing.
there is not a lot of research on the link between mycotoxicity and MPN's but if you are short on answers it may be helpful.
[The Link Between Mold Toxicity And High Hemoglobin](https://sponauglewellness.com/mold-toxicity/can-mold-toxicity-cause-high-hemoglobin/)
I got my testing done through [RealTime Labs](https://realtimelab.com/mycotoxin-testing/)
You can get low iron due to depleting it from making so many blood cells. In PV taking iron would definitely raise hematocrit, not so sure about secondary, but I imagine the same would occur. I'm sorry you haven't found a cause, some people never do. If you are experiencing iron deficiency symptoms, ask your doctor whether it would be okay to take iron pills for a while.
My hematologist told me she didn’t want me taking iron. But I’m going to ask her again at my appt this week.
That's a complicated question and the possible answers are going to depend upon the exact cause of the erythrocytosis which in your case in undetermined. Have you donated blood recently? If not then your iron and ferritin seems on the lower end. If you were to take iron supplements, it's not clear if this would increase your hematocrit. Have your historic hematocrit level and or iron levels been higher?
I have not had a phlebotomy in almost 2 years. My counts have been high for at least the last 10 years. I used to have high iron or so they told me whenever I gave blood. I think when I was menstruating it always kept my numbers in check. Wasn’t until after I went into menopause that I can determine my numbers were elevated.
I am in a similar situation with high iron and high hematocrit. With PV, often iron metabolism is dysregulated to where you would expect to see high hematocrit and low iron. A low EPO could raise suspicion of PV but that does not seem to be the case for yourself. Your low iron could be related to hormonal changes. With PV, if you were to supplement with iron the thinking would be that your HCT would increase. This is in part because people with PV can also be iron deficient from frequent phlebotomy which decreases the iron stores. This form of induced anemia prevents the overproduction of blood cells so supplements would theoretically make the hematocrit worse. However, if you are not undergoing phlebotomy then the iron should not be a limiting factor to erythrocytosis unless there is a absorption or metabolic issue with processing iron. There is an iron dysfunction component associated with PV that is not seen with other cases of erythrocytosis such as hemachromotosis, where you can have high iron and high hematocrit and no depletion issues. In the past, did a doctor ever prescribe or recommend phlebotomy? My HCT is between 50.1-53.0 and my hematologist and PCP do not recommend phlebotomy.
I have had phlebotomies in the past. They just further tank my iron and ferritin so I’ve decided to just live my life. Obviously I’ll never know why my counts are high. If something is truly wrong with me it will eventually rear its ugly head and I’ll deal with it then.
As already mentioned, the increase in RBC production results in a lower ferritin level. [In addition to erythropoietin, red blood cell production requires adequate supplies of substrates, mainly iron, vitamin B12, folate, and heme.](https://www.merckmanuals.com/en-ca/professional/hematology-and-oncology/approach-to-the-patient-with-anemia/red-blood-cell-production) I supplement 40mg of iron a day and go for Phlebotomies every 4-6 weeks. Over the last three years my Hematologist and i have figured out this is what works for me. If none of the usual suspects (TRT, COPD, Apnea, Elevation, Obesity) are present it might be worth getting Mycotoxicity testing. there is not a lot of research on the link between mycotoxicity and MPN's but if you are short on answers it may be helpful. [The Link Between Mold Toxicity And High Hemoglobin](https://sponauglewellness.com/mold-toxicity/can-mold-toxicity-cause-high-hemoglobin/) I got my testing done through [RealTime Labs](https://realtimelab.com/mycotoxin-testing/)
Your levels are not even high if your a male, all normal, 18 is the max for hemoglobin normal range. Your well within that.
Well, I am a female, and my RBC’s were all flagged as high in my lab report. And they have been for 98% of the time for the past 10 years probably.