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Diagnosis | Leukemia and Lymphoma Society
While a person may have certain signs and symptoms of polycythemia vera (PV), laboratory tests are needed to confirm the diagnosis. Generally, a doctor will consider other conditions first.
Sometimes a condition called “secondary polycythemia” is causing the increase in red blood cells but, unlike PV, it does not begin in the bone marrow and is not a cancer. High red blood cell counts caused by secondary polycythemia are a reaction to another problem such as:
- High altitude
- Disease that leads to low oxygenation of the blood
- Kidney or liver tumor that secretes the hormone erythropoietin
- Inherited disease
Secondary polycythemia is managed primarily by treating the underlying condition causing the disorder. A patient with secondary polycythemia should have a return to normal red blood cell counts once the primary problem is successfully treated.
Medical History and Physical Examination
Evaluation of an individual with suspected PV should start with a detailed medical history and a physical examination by a hematologist-oncologist
The medical history should include information about the patient’s:
- Cardiovascular risk factors
- Past illnesses
- A history of the formation or presence of a blood clot inside a blood vessel (thrombosis) or loss of blood from damaged blood vessels (hemorrhagic events)
- History of blood relatives—some illnesses run in families
- Current symptoms
After the medical history, the doctor will conduct a physical examination. During the physical examination, the doctor may:
- Listen to the patient’s heart and lungs
- Examine the patient’s body for signs of disease
- Check different organs of the body
Complete Blood Count
This test measures the number of red blood cells, white blood cells and platelets in a sample of blood. It also measures the amount of the iron-rich protein that carries oxygen in red blood cells and the percent of whole blood made up of red blood cells (the hematocrit). People with PV have high red blood cell counts. They also often have:
- Increased white blood cells and platelets
- Increased hemoglobin levels
- Increased hematocrit levels
Red Cell Mast Test
This procedure is used to measure the volume (amount) of red blood cells in relation to the volume of plasma (fluid) in whole blood. In patients with PV, there may be an absolute increase in red blood cell mass. This test is infrequently performed in the United States due to high cost, difficulty obtaining the appropriate test materials, and the advent of new blood tests such as mutational testing.
Peripheral Blood Smear
A procedure in which a blood sample is viewed under a microscope. A pathologist examines the sample to see if there are any unusual changes in the size, shape and appearance of various blood cells. The test also checks for the presence of immature (blast) cells in the blood.
Comprehensive Metabolic Panel
These tests measure the levels of substances released into the blood by organs and tissues. These include electrolyes, fats, proteins, glucose (sugar) and enzymes. Blood chemistry tests provide important information about how well a person’s kidneys, liver and other organs are working. For patients suspected of having PV, it is important to test the serum erythropoietin level. Erythropoietin is a hormone naturally produced by the kidneys to stimulate the production of new red blood cells. Individuals with PV usually have very low levels of erythropoietin.
Bone Marrow Tests
Your doctor may examine your bone marrow even though the test isn’t needed to diagnose PV.
Bone marrow testing involves two steps usually performed at the same time in a doctor’s office or a hospital:
- A bone marrow aspiration to remove a liquid marrow sample
- A bone marrow biopsy to remove a small amount of bone filled with marrow
In PV, the bone marrow shows above-normal numbers of blood cells and an abnormal number of the platelet-forming cells called “megakaryocytes” in the bone marrow. The pathologist also examines the chromosomes of the bone marrow cells to rule out other blood diseases.
Molecular genetic tests are very sensitive tests that look for specific gene mutations. If PV is suspected, molecular testing for the JAK2 mutation should be performed. The JAK2 V617F mutation is found in more than 90 percent of PV patients.
The U.S. Food and Drug Administration (FDA) has approved a test called ipsogen JAK2 RGQ PCR Kit to detect mutations affecting the Janus Tyrosine Kinase 2 (JAK2) gene. This test is intended to help doctors evaluate patients for suspected PV.
For more information about bone marrow tests and other lab tests, please see the free LLS publication Understanding Lab and Imaging Tests.
Criteria for Diagnosing Polycythemia Vera
In 2016, the World Health Organization published new criteria for diagnosing PV. The diagnosis of PV requires the presence of
- Major Criteria 1, 2, and 3 (listed below) or
- Major Criteria 1 and 2 and the minor criterion(listed below)
Major Criteria 1. Very high red blood cell count, usually identified by either A, B, or C below:
- A. Hemoglobin level
- Elevated levels of hemoglobin
- Hemoglobin levels greater than 16. 5 g/dL in men
- Hemoglobin levels greater than 16.0 g/dL in women
- Elevated levels of hemoglobin
- B. Hematocrit level
- Elevated levels of hematocrit
- Hematocrit greater than 49 percent in men
- Hematocrit greater than 48 percent in women
- Elevated levels of hematocrit
- C. Red cell mass
Major Criteria 2. Bone marrow biopsy (A or B below) showing:
- A. An abnormal excess of blood cells in the bone marrow (called “hyercellularity”) with an elevation of red blood cells, white blood cells and platelets (called “panmyelosis”)
- B. Proliferation of mature megakaryocytes that vary in size and shape
Major Criteria 3. Presence of the JAK2V617F or JAK2 exon 12 gene mutation
Minor Criterion: Very low levels of erythropoietin
Hematocrit, hemoglobin and red blood cells are associated with vascular function and vascular structure in men
In the present study, we demonstrated for the first time that Hct, Hb and RBCs were associated with vascular function and vascular structure in men. Adjusted odds ratio of being in the low tertile of NID was significantly higher in the < 42.9% and ≥ 49.0% Hct groups. Adjusted odds ratio of being in the low tertile of NID was significantly higher in the < 13 g/dL Hb group, 14.0–14.9 g/dL Hb group and ≥ 17.0 g/dL Hb group. Adjusted odds ratio of being in the low tertile of NID was significantly higher in the < 4.19 × 106/μL and ≥ 5.40 × 106/μL RBCs groups. In addition, adjusted odds ratio of being in the low tertile of brachial IMT was significantly lower in the < 39.9% Hct groups than in the 46.0–48.9% Hct group. Adjusted odds ratio of being in the low tertile of brachial IMT was significantly lower in the < 14.9 g/dL Hb groups than in the 16.0–16.9 g/dL Hb group. Hct of 42.0–49.4%, Hb of 14.7–16.8 g/dL and RBCs of 4.82–5.24 × 106/μL may be the optimal target levels for maintenance of vascular function and vascular structure.
In the present study, Hct of 42.0–49.4% was best from the aspect of vascular smooth muscle function. Several studies have shown that high Hct levels were associated with an increased risk of cardiovascular disease1,2,3. On the other hand, the relationship between low Hct levels and cardiovascular disease is controversial. Gagnon et al. showed that there were J- or U-shaped relations between Hct and morbidity and mortality from cardiovascular events1. After risk factor adjustment, there was a significantly increased risk of cardiovascular disease in the high Hct group but not in the low Hct group in men. Gotoh et al. showed that low Hct levels were associated with hemorrhagic stroke3. The effects of Hct, Hb and RBCs on vascular function and vascular structure are unclear. In the present study, we demonstrated that both low and high levels of Hct, Hb and RBCs were associated with vascular smooth muscle dysfunction. Vosseler et al. showed that blood viscosity, which was calculated using account Hct and plasma proteins, was negatively correlated with FMD in patients without coronary artery disease, while there was no significant relationship between blood viscosity and FMD in patients with atheroclerosis15. The discrepancy in the result of our study and the results of previous studies regarding the relationship between vascular function and hematocrit is due to the different numbers of subjects and different characteristics of subjects. The number of subjects was larger in the present study than in the previous studies. Our study participants were enrolled from a general population including patients with cardiovascular disease. Interestingly, Giannattasio et al. showed that acute decreases in Hct from 39.9 ± 0.8% to 37.1 ± 0.4% and Hb from 13.3 ± 0.3 to 12.2 ± 0.4 g/dL, after removal of 500 mL of blood and infusion of 500 mL of saline, impaired vascular function in patients with hemochromatosis16. In subjects with Hct of < 48.9%, Hct was positively correlated with FMD and NID and Hct was an independent predictor of NID. These findings suggest that subjects with high or low levels of Hct, Hb and RBCs have a high risk of vascular dysfunction and prognostic atherosclerosis.
Some possible mechanisms underlying the association of low Hct with vascular smooth muscle function are postulated. It is possible that oxygen delivery dynamics at the levels of hemoglobin and hematocrit are associated with vascular function. Thorling et al. showed that Hct positively correlated with tissue tension of oxygen even within normal ranges of Hct levels, suggesting that a decrease in Hct leads to a decrease in oxygen supply to tissues17. Takemoto et al. showed that hypoxia decreased endothelial NO synthase (eNOS) expression via the activation of Rho-associated kinase18. Chronic hypoxia affects endothelial dysfunction via increases in inflammation and oxidative stress19,20. Several studies showed that Hct significantly correlated with viscosity21,22. Hct is one of the most important factors affecting blood viscosity. In addition, blood viscosity regulates shear stress, which is an inducer of NO production from the endothelium. Martini et al. showed that animals with increased Hct had increased plasma nitrate/nitrite concentrations compared with those in control animals and in eNOS knockout mice through an increase in blood viscosity22. These findings suggest that a low level of Hct is harmful for vascular function.
Some possible mechanisms underlying the association of excessively high Hct with vascular smooth muscle dysfunction are postulated. Lewis et al. showed that the patients with excessive erythrocytosis caused by chronic mountain sickness in Andean highlanders had endothelial dysfunction that was partially reversible during oxygen inhalation, suggesting that chronic hypoxia may induce endothelial dysfunction in patients with excessive erythrocytosis23. In addition, high blood viscosity caused by high levels of Hct as well as low blood viscosity caused by low levels of Hct induced low tissue tension of oxygen. According to the Hagen-Poiseuille law, blood flow depends on blood viscosity and vessel radius. Total peripheral vascular resistance is specified by blood viscosity and cardiac output. Fowler et al. showed that high viscosity caused low cardiac output24. These findings suggest that high levels of Hct may induce tissue tension of oxygen by high peripheral vascular resistance and low cardiac output. These findings also suggest that a high level of Hct may be one of the factors of vascular dysfunction.
It has been shown that RBCs directly affect endothelial function via the eNOS/NO pathway and NOS-like bioactivity and the production of reactive oxygen species25,26,27. Cortese-Krott et al. showed that RBCs contained eNOS and produced NO in healthy subjects as well as in patients with coronary artery disease and that FMD significantly correlated with the expression of eNOS and eNOS activity in RBCs in those subjects25. In addition, Zhou et al. showed new mechanisms by which endothelial function was impaired in type 2 diabetes mellitus through activation of RBC arginase 1 and increase in production of reactive oxygen species27. These findings suggest that RBC function per se plays an important role in the pathogenesis, maintenance, and development of atherosclerosis through the regulation of vascular function, leading to cardiovascular disease and cardiovascular events. Unfortunately, our study had no information on the function of RBCs, such as the eNOS/NO pathway, NOS like activity and oxidative stress. Assessment of RBC function would enable more specific conclusions concerning the role of RBCs other than the number of RBCs in vascular function to be drawn.
Simply, NID is assessed by brachial artery response to sublingual administration of nitroglycerine. However, we believe that vascular response to exogenous NO reflects vascular smooth muscle function since NO finally acts on vascular smooth muscle cells. Indeed, NID has been widely used as an indicator of vascular smooth muscle function. Several investigators have shown that vascular response to nitric acid including nitroglycerine reflects vascular smooth muscle function in the brachial artery and coronary artery of humans and in the isolated aorta artery of experimental animals28,29,30. It has been shown that NID is impaired in patients with multiple cardiovascular risk factors and that it serves as an independent predictor of cardiovascular events12,31. We believe that reduction in vascular smooth muscle response assessed by NID can also be defined vascular smooth muscle dysfunction.
Recently, some trials have shown that patients with type 2 diabetes mellitus who received an inhibitor of sodium-glucose cotransporter 2 in addition to conventional therapy had significantly lower rates of cardiovascular morbidity and mortality than did patients with type 2 diabetes mellitus who received a placebo in addition to conventional therapy32,33,34. The EMPA-REG OUTCOME trial showed that changes in Hct (increase by 5.0 ± 5.3% from baseline of 41.3 ± 5.7%) and Hb (increase by 0.8 ± 1.3 g/dL from baseline of 13.5 ± 1.5 g/dL) within normal ranges might be important mediators of the empagliflozin-induced reduction in incidence of cardiovascular events including cardiovascular mortality35. In the present study, Hct was positively correlated with FMD and NID in subjects with Hct < 48.9%, which was an independent variable of NID in multivariate analysis. In addition, Hct level of 42.0–49.4%, Hb level of 14.7–16.8 g/dL and RBC level of 4.82–5.24 × 106/μL may be the optimal target levels for maintenance of vascular function. An increase in the level of Hct up to 49.4% may reduce the incidence of cardiovascular events.
In the present study, adjusted odds ratio of being in the low tertile of brachial IMT was significantly lower in the < 37.0% Hct group and 37.0–39.9% Hct group than in the 46.0–48.9% Hct group and was significantly lower in the < 13.9 g/dL Hb groups and 14.0–14.9 g/dL Hb group than in the 16.0–16.9 g/dL Hb group. Adjusted odds ratio of being in the low tertile of baPWV was significantly lower in the level < 3.80 × 106/μL RBCs group and 4.60–4.99 × 106/μL RBCs group than in the 5.00–5.39 × 106/μL RBCs group. Lee et al. showed that carotid IMT positively correlated with blood viscosity and Hct. In their study, blood viscosity was an independent variable of carotid IMT in multivariate analysis, while Hct was not an independent variable of carotid IMT5. Kawamoto et al. showed that Hb levels were not associated with baPWV in men36. Unfortunately, the relationships of Hct, Hb and RBCs with vascular structure are also controversial. The roles of Hct, Hb and RBCs in vascular structure need to be confirmed in future in large clinical trials.
In the present study, the groups with high levels of Hct, Hb and RBCs had vascular smooth muscle dysfunction but not abnormal vascular structure. It is well known that alteration of vascular function occurs before changes in vascular structure. Unfortunately, we had no information on the duration of high levels of Hct, Hb and RBCs. Cohort studies have shown that a high Hct level per se was associated with an increased risk of cardiovascular disease1,2,3. NID may be a more sensitive marker than brachial IMT or baPWV of cardiovascular disease in subjects with high levels of Hct and Hb.
Our study has a number of limitations. First, this study is a cross-sectional design. Therefore, we cannot define causal relationships of Hct, Hb and RBCs with vascular dysfunction and abnormal vascular structure. Further studies are needed to confirm the effects of changes in levels of Hct, Hb and RBCs on vascular function and structure in long-term follow-up periods using a prospective study design. Second, we evaluated the relationships of Hct, Hb and RBCs with vascular function and structure only in men. It is well known that menstrual bleeding affects the levels of Hct, Hb and RBCs. We had no information on menstrual cycle when measuring vascular function and structure. Therefore, we excluded women as study subjects. Further studies are needed to confirm the relationships of levels of Hct, Hb and RBCs with vascular function and structure in women including premenopausal women as well as men after adjustment of the menstrual cycle. Third, we defined vascular dysfunction assessed by FMD and that assessed by NID as low tertiles of FMD and NID. The use of criteria for vascular dysfunction is a better way to calculate the odds ratio. However, diagnostic criteria for endothelial dysfunction assessed by FMD and vascular smooth muscle dysfunction assessed by NID have not been established. Therefore, we used low tertiles of FMD and NID as vascular dysfunction for calculation of the odds ratio.
Abnormal Blood Cell Counts Treatment
Blood is composed of red blood cells (RBC), white blood cells (WBC) and blood platelets. These cells and cell fragments are suspended in blood plasma. Abnormal amounts of these components can lead to several symptoms and health problems. These abnormalities can also be caused by an underlying disease. Abnormal blood counts are common and are often very treatable. In rare cases, an abnormal blood count can indicate an immune disorder or a cancer.
Physicians in the Benign Hematology Program specialize in evaluating patients with abnormal blood counts to identify the cause of their condition and create a personalized treatment plan.
Anemia Causes and Treatments (Low Red Blood Cell Counts)
Red blood cells contain hemoglobin, a protein that enables the blood to carry oxygen to every part of the body. Anemia develops when the body does not produce enough red blood cells or red cells are lost due to bleeding or other causes. In people with anemia, the blood is unable to supply enough oxygen to the body. This is also known as “low hemoglobin” or “low hgb.”
There are many possible causes of anemia. Symptoms of anemia can include:
- Shortness of Breath (severe cases)
- Chest Pains (severe cases)
Anemia can be a temporary problem or a chronic condition. Milder anemia can be treated with dietary changes, iron replacement (oral or IV) and vitamin supplementation.
Patients with more severe anemia may receive various medications to boost red cell production or inhibit red cell destruction. Patients with very low red blood cell counts may require blood transfusion.
Leucopenia Causes and Treatments (Low White Blood Cell Counts)
Patients with low white cell counts are more vulnerable to infections. Leucopenia can be caused by infections, certain medications and several underlying conditions, including immune disorders like rheumatic arthritis and lupus and cancers such as leukemia and lymphoma.
Treatment for leucopenia can include drugs that stimulate the body to produce white blood cells.
Thrombocytopenia (Low Platelet Counts)
Platelets are made in your bone marrow along with other kinds of blood cells. They travel through your blood vessels and stick together (clot) to stop any bleeding that may happen if a blood vessel is damaged. According to the National Heart, Lung and Blood Institute, a normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood. A platelet count of less than 150,000 platelets per microliter is lower than normal. Low blood platelets can lead to abnormal bruising and bleeding. Thrombocytopenia can be caused by several different conditions:
Immune Thrombocytopenia (ITP)
Immune thrombocytopenia (ITP) is a condition in which the body produces antibodies that attack platelets. ITP is the most common cause of low platelet counts.
Heparin-induced thrombocytopenia is a potential side effect of heparin, a blood thinner medication used to treat blood clots. An immune reaction to the drug causes blood clots to form.
Gestational thrombocytopenia is a mild condition that can arise during pregnancy. Learn more about pregnancy, menstruation and blood disorders.
Abnormal bleeding and bruising can also be caused by a bleeding disorder like Von Willebrand disease.
Treatment of thrombocytopenia depends on the specific cause. Steroids can be used to calm down immune-related reactions. Several medications can be used to raise platelet counts. Some patients are treated with blood transfusion.
Pancytopenia (Low Blood Cells)
Pancytopenia is marked by low counts of all three types of blood cells—red cells, white cells and platelets. This condition can be caused by certain medications and by infections. In some cases, it is caused by a cancer or precancerous condition. Myelofibrosis, bone marrow scarring that can result from various hematologic cancers, typically leads to low blood counts.
Pancytopenia can also be caused by aplastic anemia, a bone marrow failure disorder that affects blood cell production.
Polycythemia (High Red Blood Cell Counts)
Polycythemia vera is a low-grade cancer marked by the overproduction of red blood cells. Elevated production of red blood cells can also occur in response to low levels of oxygen within body tissues. Treatment can include medications to reduce the risk of clotting. In some cases, patients undergo regular phlebotomies (blood draws) to reduce blood cell counts.
Leucocytosis (High White Blood Cell Counts)
The most common causes of elevated white blood cell counts are infections and inflammation. Some cases of leucocytosis are the result of an immune reaction. A small number of cases are caused by a blood cancer. Treatments for high white blood cell counts typically focus on addressing the underlying disease.
Thrombocytosis (High Platelet Counts)
High blood platelet counts can be caused by several conditions, including anemia, cancer, inflammation and infection. Treatment usually focuses on the underlying condition or disease. Essential thrombocythemia (ET) is a rare disease in which the bone marrow produces too many platelets. Patients may receive medicines to lower their risk of blood clots and reduce platelet counts.
Monoclonal Gammopathy of Undetermined Significance (MGUS)
MGUS is a condition characterized by abnormal plasma cells. Although it is not a cancer, it is closely related to multiple myeloma.
Understanding Your Blood Test Lab Results
For many of us, an annual physical includes a routine blood test. While the process of getting blood drawn is relatively straightforward, it can feel like you need a medical degree to understand the results that come back to you from the lab. We are here to help! Below are two of the most common blood test panels (panel just means group of tests) that your physician may order and what “labs” or biomarkers are included in that panel.
“Metabolic” refers to all of the ways your body uses and stores energy. Normally, you have to fast for at least 8 hours before getting a metabolic panel panel, which includes:
Glucose: also referred to as blood sugar. A fasting glucose test measures how well the body is regulating blood sugar and it can help determine diabetes status. Normal range is 70 to 99 mg/dL for most adults, although values can vary with age.
Want to go more in depth into your biomarkers? Download this comprehensive guide.
Electrolytes: indicates if there is an acid-base imbalance in your body. Electrolyte levels are affected by how much is taken in through the diet, the amount of water in a person’s body, and the amount of electrolytes excreted by the kidneys.
- Sodium: Irregularities in sodium levels may indicate dehydration, excessive intake of salt or certain medications, or problems with the liver or kidneys. Normal range of blood sodium is 135 to 145 millimoles/liter (mmol/L).
- Chloride: A high salt/sodium diet and certain medications can impact your chloride levels. Irregular chloride can also be an indicator of certain diseases, like kidney disorders. Healthy range: 98 to 106 mmol/L.
- Potassium: This mineral plays an important role in regulating your heartbeat, muscle function, and nerve impulses. Low potassium is usually associated with dehydration or taking diuretics. Normal range: 3.7 to 5.2 mmol/L.
Kidney function measures
Creatine: Excessive creatine in the blood can be an indication that your kidneys are not functioning properly in removing waste from the blood. Normal creatine levels are around 0.7 to 0.3 mg/dL for men and 0.6 to 1.1 mg/dL for women.
Total Protein: Abnormal blood protein levels can be an indication of kidney or liver abnormalities. Normal blood protein levels are between 6.0 and 8.3 gm/dL.
Blood Urea Nitrogen (BUN): Urea nitrogen is found in the blood when protein is broken down. High levels of BUN may indicate kidney disease, dehydration, or urinary track obstruction. Normal levels are generally between 6 and 20 mg/dL.
Liver function measures
Total bilirubin: Bilirubin is a yellowish pigment found in bile from liver. It’s yellow coloring is what causes jaundice. While some bilirubin in the blood is normal, high levels of bilirubin can indicate liver disease.Normal levels are between 0.2 and 1.9 mg/dL.
Liver Enzymes. High blood levels of any of these enzymes could be an indication that your liver is not functioning properly:
- AST (aspartate aminotransferase) — Normal range: 10 to 34 IU/L
- ALP (alkaline phosphatase) — Normal range: 44 to 47 IU/L
- ALT (alanine aminotransferase) — Normal range: 8 to 37 IU/L
The CBC is a simple blood test from which the lab can give a quick estimate of the types of cells and parts of cells in your blood:
Red blood cells (RBCs): RBCs help carry oxygen throughout the body. A normal range of RBC is between 4.2 and 5.9 million cells per cubic millimeter, or ccm.
White blood cells (WBCs): WBCs help you fight infections, so a high WBC count could be an indication that you have an infection or some type of inflammation. A normal WBC range is between 4,300 and 10,800 cmm.
Hgb (Hemoglobin): Hemoglobin is a protein found on red blood cells that is responsible for transporting oxygen. Abnormal hemoglobin levels could be a sign of anemia or another blood disorder. Hgb, like Hct, differs from men to women and is measured in grams per deciliter or g/dl. Normal range for Hgb is 13 to 18 g/dL for men and 12 to 16 g/dL for women.
Hct (Hematocrit) test: Hematocrit is a blood test that measures the percentage of the volume of whole blood that is made up of red blood cells. Hct is oftentimes used to diagnose forms of anemia and other conditions. Hematocrit test values will vary from men to women(men generally have higher values) and also between laboratories. Generally speaking, Hct results will range between 36% and 52%.
Ferritin: A ferritin test indirectly measures the amount of iron in your blood. Anemia and digestive problems are the two main causes of low iron. Normal ferritin levels for men are between 12 and 300 ng/mL; and for women, they are between 12 and 150 ng/mL.
Note: Normal lab value ranges for all tests may vary slightly among different laboratories, and by patient age and sex. The values described in this article represent those provided by Medline Plus, a service of the U.S. Libraries of Medicine and the National Institutes for Health.
Get help interpreting your blood test results
To save yourself the headache of trying to interpret your blood test results, try InsideTracker’s Do-It-Yourself (DIY) option. Just enter the results of any recent blood test(s) into our online program, and we’ll take it from there. We go further than your doctor’s office, which typically only tells you if your biomarkers are “normal.”
We can tell you if your biomarkers are in the optimal ranges, based on your age, gender, ethnicity, athletic activity, and other factors. If your blood levels are less than optimal, we’ll offer nutrition and health advice to help you improve your biomarkers, your wellness, and even your athletic performance.
Haven’t had any blood work done recently? No problem. Let InsideTracker help. And the labs listed here aren’t the only ones included in an InsideTracker plan.
Learn more about your other biomarkers by downloading this guide.
Disclaimer: The information provided by this article is for informational purposes only and should not be used to diagnosis or treat any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.
Hematocrit test – Drugs.com
Medically reviewed by Drugs.com. Last updated on July 22, 2021.
A hematocrit (he-MAT-uh-krit) test measures the proportion of red blood cells in your blood. Red blood cells carry oxygen throughout your body. Having too few or too many red blood cells can be a sign of certain diseases.
The hematocrit test, also known as a packed-cell volume (PCV) test, is a simple blood test.
Why it’s done
A hematocrit test is part of a complete blood count (CBC). Measuring the proportion of red blood cells in your blood can help your doctor make a diagnosis or monitor your response to a treatment.
A lower than normal hematocrit can indicate:
- An insufficient supply of healthy red blood cells (anemia)
- A large number of white blood cells due to long-term illness, infection or a white blood cell disorder such as leukemia or lymphoma
- Vitamin or mineral deficiencies
- Recent or long-term blood loss
A higher than normal hematocrit can indicate:
- A disorder, such as polycythemia vera, that causes your body to produce too many red blood cells
- Lung or heart disease
How you prepare
The hematocrit is a simple blood test. You won’t need to fast before the test or make other preparations.
What you can expect
The blood sample is generally drawn with a needle from a vein in your arm. You may feel some tenderness at the site, but you’ll be able to resume normal activities afterward.
Results from your hematocrit test are reported as the percentage of blood cells that are red blood cells. Normal ranges vary substantially with race, age and sex. The definition of normal red-blood cell percentage also varies from one medical practice to another.
Generally, a normal range is considered to be:
- For men, 38.3 to 48.6 percent
- For women, 35.5 to 44.9 percent
For children ages 17 and younger, the normal range varies by age and sex.
Your hematocrit test provides just one piece of information about your health. Talk to your doctor about what your hematocrit test result means in light of the symptoms you’re experiencing and the results of other diagnostic tests.
Accuracy of test results
A number of factors can affect the outcome of a hematocrit test and yield inaccurate or misleading results, including:
- Living at a high altitude
- Significant recent blood loss
- Recent blood transfusion
- Severe dehydration
Your doctor will take into account possible complicating factors when interpreting the results of your hematocrit test. Your doctor may want to repeat the hematocrit test and do other blood tests if results provide conflicting or unexpected information.
© 1998-2019 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.
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What Runners Need to Know About Their Blood Test Results
There’s a message on your voice mail from your physician, saying that you need to set up an appointment to discuss abnormal results from lab work that was performed as part of a recent physical exam. Immediately your mind starts racing. Is something seriously wrong? Could the hilly half marathon that you ran the day before the exam have affected the results?
Regular distance running can cause changes to some commonly measured blood values, both in the short term and long term. Let’s look at some of those changes, including both ones that can be cause for concern and ones that you needn’t worry about.
ANEMIA AND RED BLOOD CELLS
Anemia is a fairly common problem for runners and non-athletes alike, especially females. A diagnosis of anemia is due to a decreased number of red blood cells (RBCs) or a decreased hemoglobin level. There are a number of types of anemia, with iron deficiency anemia the most common. (Iron is a component of hemoglobin, the oxygen-carrying component in RBCs.)
Iron deficiency anemia is due to nutritional deficiencies and blood loss. Small amounts of blood are lost in the gastrointestinal tract on a daily basis; the blood loss may increase during and following a strenuous bout of exercise. Due to menstrual blood loss, women normally have lower hematocrit and hemoglobin levels than men. Anemia doesn’t always cause symptoms, but it may impair performance. This is treated by finding the cause of the anemia and supplementing iron intake.
Regular exercise causes an increase in the number of RBCs in the blood. As an adaptation to training, there’s also an increase in plasma volume in the resting state. This volume expansion causes the hematocrit (the percentage of RBCs in blood) and hemoglobin levels to be lower than in non-athletes. The expansion in plasma volume will be reflected as lower hematocrit and hemoglobin levels on a complete blood count (CBC). For most runners, hemoglobin will be approximately 0.5g/dl lower than normal, while it can be 1g/dl lower in highly trained runners. This lower level is a pseudoanemia and doesn’t require medications. The dilutional effect of training will resolve after several days off from training.
“ABNORMAL” LAB RESULTS
An acute bout of exercise can cause a number of “abnormal” laboratory results. A urine test may be positive for blood. This may be due to bleeding from the bladder or kidneys; this is usually not visible to the naked eye, but is detectable in the lab. This resolves within 24 to 72 hours after exercise. If blood is still found on subsequent testing, further evaluation is indicated.
Protein may be detected in the urine within 30 minutes of strenuous exercise. This will clear within 24 to 48 hours. (Persistent signs of this condition warrant further evaluation.)
A positive test for blood in the urine may be due to myoglobin released from muscles injured during exercise; when evaluated under a microscope, red blood cells aren’t seen. When myoglobin levels are high, the urine will be dark in color, like iced tea. Blood levels of myoglobin and the muscle enzyme creatine kinase (CK) will be elevated. Strenuous exercise in conjunction with dehydration may produce very high levels of CK in the blood and myoglobin in the blood and urine, a condition known as rhabdomyolysis. This can cause renal failure and may be fatal in severe cases. Blood levels of potassium and phosphorous may be high and calcium levels low in severe cases of rhabdomyolysis.
Blood levels of CK are elevated following exercise. Many factors will affect the level of elevation, including the length and intensity of the exercise. Levels of CK (normal < 200U/L) greater than 200,000 U/L have been reported following the Western States 100-miler. Most athletes will have levels much lower than this following exercise.
Recovery from the workout and good hydration will usually take care of this issue. CK levels will gradually return to normal over the next several days to a week. During bouts of heavy training, the level may remain mildly elevated chronically. The cholesterol-lowering group of medications known as statins may also increase the CK, even at rest. This can be greatly, and potentially dangerously, elevated by strenuous exercise.
Dehydration associated with exercise may cause elevation of BUN and creatinine, two aspects of a kidney test. The BUN may be markedly elevated in the presence of severe dehydration; the creatinine may be mildly elevated. Rehydration will normalize these values.
AST is one of the tests that evaluates liver function. This enzyme is also present in skeletal muscle; levels will be elevated following exercise. The other tests that are part of a typical liver function evaluation aren’t significantly affected by exercise.
A small amount of blood is lost from the gastrointestinal tract on a daily basis; this isn’t visible to the naked eye. Strenuous exercise may increase the amount of blood lost for a day or two afterwards; although this is usually not visible, it may be detected on stool cards that are used to screen for colon cancer.
A CBC evaluates the components that make up blood — red cells, white cells, platelets and plasma. Following an acute bout of exercise, there’s a transient increase in the white blood cells and platelets. The hematocrit will be increased from baseline when you’re dehydrated.
It’s best to wait a few days following strenuous exercise to have laboratory studies performed to lower the possibility of a result that’s altered by exercise. The alteration in lab studies as a result of exercise should resolve within a few days. The first step in evaluating abnormal results may be to repeat the studies after several days of minimal training.
LAB RESULTS THAT POINT TO PERFORMANCE
What laboratory studies are routinely evaluated during a physical exam that may affect performance? Blood chemistries will include electrolytes, glucose and kidney function tests. A more comprehensive evaluation will also assess liver function, in addition to calcium and uric acid. Other than the AST (liver) and CK levels, exercise shouldn’t have a significant effect on chemistry results. Abnormal results may be due to liver disease, kidney disease, diabetes and other health issues, any of which can hurt performance and require treatment. Electrolyte abnormalities are usually due to altered hydration levels and should normalize as you rehydrate.
A CBC is often performed; as mentioned, the hematocrit and hemoglobin levels may be a little low due to plasma volume expansion. The volume expansion resolves if training is discontinued for several days. Ferritin is commonly used to assess iron stores; if this is low and the hematocrit and hemoglobin levels are low, treatment for iron deficiency anemia may be called for. Anemia may cause a decrease in cardiac output and the oxygen available to tissues, negatively affecting performance.
A low ferritin level with a normal CBC is consistent with low iron stores without anemia. This condition doesn’t affect performance, but may progress to anemia over time; improving intake in the diet and possibly supplementing with iron tablets may prevent progression. It’s important to determine why the anemia is present. In women, poor dietary intake and menstrual blood loss are the most common causes. In men, gastrointestinal loss is the most common source.
Thyroid tests may be performed as part of a physical exam. A thyroid that’s under-or overactive can cause multiple symptoms and negatively impact performance.
Although a high cholesterol level will not specifically affect performance, coronary artery disease due to elevated lipids can. Coronary artery disease may cause fatigue with exercise and worsening performance despite no change in training. Don’t ignore these symptoms!
There has been a great deal of research on vitamin D levels recently, and blood levels are being checked more routinely now. Due to use of sunscreen, poor dietary intake and other factors, low levels are fairly common. A multitude of symptoms have been attributed to low levels of vitamin D, including unexplained muscle pain and an increased risk of stress fractures. Supplementing intake will correct this deficit.
It’s important to keep in mind that there are many possible causes of laboratory test anomalies, only a few of which I covered above. Although strenuous training may be the cause of the results, other causes must be considered. Don’t ignore recommendations for further evaluation made by your health care provider; if the laboratory studies were performed shortly following strenuous exercise, mention this to your provider. Decreasing training and repeating the studies in several days may be all that is necessary.
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90,000 “Hematocrit is below normal, what does this mean in an adult?” – Yandex.Qu
In this article, we consider what to do if the hematocrit is below normal, what does this mean in an adult?
Determination of the hematocrit value is included in the extended general blood test. The criterion allows you to assess the work of the hematopoietic system. The functioning of other organs directly depends on its full functional activity, since it is erythrocytes that deliver oxygen to organs and tissues.
A decrease in the hematocrit value can proceed without manifestation of pronounced clinical symptoms. A person can attribute increased fatigue to high workload and lack of time for rest. However, a decrease in hematocrit is one of the first symptoms of anemia that requires treatment. The article also discusses the danger of a prolonged decrease in hematocrit.
What does hematocrit show?
The value reflects the volume of the liquid part of the blood, which contains the formed elements (erythrocytes, leukocytes, platelets) in the bloodstream.The hematocrit is measured as a percentage. So, if the analysis indicates that the hematocrit is 40%, this means that 100 ml of blood contains 40% of erythrocytes, platelets, etc.
Decreased blood hematocrit is observed in patients with a low number of red blood cells in the bloodstream. The indicator also takes into account the size of the blood cells. Their decrease is naturally reflected in the results of the analysis.
Measurement of hematocrit is advisable in the diagnosis of anemia and hyperproteinemia, as well as in assessing the effectiveness of the selected treatment methods.A study is done on dehydrated patients to assess the severity of their condition. It is included in the list of mandatory determinable indicators for people who are planning a blood transfusion and for pregnant women.
Main article: What is hematocrit, why is it needed and what are its norms?
Below normal hematocrit – what does it mean?
A low adult hematocrit indicates a decrease in the number of red blood cells in the blood.In this case, the doctor will prescribe additional laboratory tests and methods of instrumental diagnostics. Among the laboratory parameters, it is important to determine: the level of iron and ferritin, as well as to assess the biochemical parameters of the blood. From instrumental methods, it is preferable to conduct an ultrasound examination of the digestive organs, liver and small pelvis. Based on the results of a comprehensive examination and the patient’s anamnesis, the doctor determines the cause of the lowered hematocrit.
It should be borne in mind that if a woman took a biomaterial for analysis during menstruation, then the hematocrit below normal is a standard phenomenon.During this period, a woman loses a certain amount of blood, which means that the level of red blood cells is somewhat reduced.
It is important to follow the rules of patient preparation, as well as taking and transporting biomaterial. During venipuncture, destruction of red blood cells in the test tube (hemolysis) can occur. For example, due to strong or prolonged squeezing of the site of taking the biomaterial with a tourniquet or at improper storage temperature of the collected blood. The readings obtained cannot be considered reliable, and the patient will definitely need to take the biomaterial again.
Reasons for a decrease in hematocrit in adults
Only the attending physician after a complete diagnosis can establish the exact cause in each specific case. Consider the main causes of low hematocrit in adults.
Anemia (anemia) describes a group of similar syndromes, combined according to the total decrease in hemoglobin level and the number of red blood cells. It should be noted that the isolated term “anemia”, without clarifying explanations, does not describe a specific disease.In this case, it is only a separate symptom of a disease.
A decrease in the number of erythrocytes is mainly accompanied by changes in their qualitative composition. This leads to a deterioration in respiratory activity and the gradual development of oxygen starvation of tissues of all organs. The main symptoms of anemia are:
- pale skin;
- increased weakness and fatigue;
- desire to eat chalk, earth, raw meat;
- hair loss, brittle nails, dry skin;
- bluish or yellowish tint to the sclera;
- an earthy shade of leather and;
- Constant sleepiness;
- frequent headaches and dizziness;
90,041 decrease in memory and performance;
90,041 shortness of breath even with little physical activity;
The main causes of anemia
Many mechanisms of the development of anemia are known. Let’s consider the main ones:
- Disruptions in the synthesis of red blood cells and hemoglobin due to a lack of iron, vitamins B 9 and 12 in the human body, as well as for pathologies of the red bone marrow.
- Deficiency of red blood cells against a background of large blood loss, for example, in serious injuries or during surgery. A similar condition occurs in people with chronic bleeding (hemorrhoidal bleeding, inter-cycle blood loss in women, etc.)etc.). The main mechanism is a decrease in iron concentration, not a decrease in the number of red blood cells.
- The mechanism of enhanced destruction of blood cells. The average lifespan of red blood cells is 4 months. With the manifestation of pathologies affecting the hematopoietic system, blood cells begin to degrade at an increased rate. The decay process is also influenced by external factors, for example, the use of large quantities of vinegar.
The prognosis of the outcome of iron deficiency anemia is extremely favorable.The condition is stopped by taking iron and vitamins. The outcome of other forms of anemia depends on their severity.
Fluid in the body
The hematocrit is also lowered with an increased fluid content in the body of an adult. This condition is not associated with excessive fluid intake, but with its retention in the body. Causes: kidney pathology, viral or bacterial infection. An increase in blood plasma volumes occurs, while the number of erythrocytes does not increase.This naturally leads to a decrease in the hematocrit value.
Hyperproteinemia and nutrition
Another reason is hyperproteinemia. Pathology is characterized by an excess content of proteins in the bloodstream. It occurs due to a violation of the normal functioning of the liver. Proteins begin to “attract” excess water, while the number of red blood cells does not increase. Thus, their percentage with blood plasma decreases.
In adult patients, the hematocrit is also lowered with a sharp change in diet, prolonged fasting and blood loss.
During pregnancy, especially in the second trimester, a decrease in the value under consideration is considered normal. In women, the level of plasma volume rises, and red blood cells are not synthesized at an increased rate. Thus, the percentage of plasma-erythrocytes shifts towards a decrease in the latter. The decrease in the hematocrit value begins from the fourth week, the peak reaches 31-35 weeks.
However, a long-term decrease in the indicator should not be ignored; additional diagnostics should be carried out in order to exclude the possible development of pathological conditions.So, a decrease in hematocrit up to 30% can cause the development of intrauterine fetal hypoxia, impaired placental circulation, delayed fetal development, etc. The indicator from 15 to 25% indicates the need for immediate hospitalization of a pregnant woman, followed by continuous monitoring.
Also, a low hematocrit in adults can be observed at:
- lead intoxication;
- acute infectious processes;
- severe intoxication.
90,041 conditions after chemotherapy;
Is low hematocrit dangerous?
The main function of red blood cells is an adequate supply of cells and tissues with molecular oxygen. When they decrease, there is an insufficient supply of oxygen to the organs. This is especially negatively reflected in the functional activity of the brain. A person has a decrease in concentration, memory and mental activity.
Adults with low hematocrit are more susceptible to infectious diseases, unable to work properly, get tired faster and lose concentration.In the future, a shortage of red blood cells can lead to the development of pathologies of the cardiovascular system, liver and kidneys.
Methods for increasing hematocrit
You should not try to increase the level of red blood cells in your blood on your own. The necessary treatment will be selected by a specialist based on the results of laboratory and instrumental studies. In the event of prolonged fasting or dehydration, it is necessary to restore a normal diet and the amount of fluid consumed per day.In this case, the patient can do without drug therapy. It is also important to establish a daily routine and plan enough time for rest and walks in the fresh air.
In case of a shortage of iron or other elements, the doctor will select the necessary drugs, their dosage and determine the duration of the course of taking them. You should not independently interrupt the course of treatment, even if the symptoms of anemia are no longer bothering you. The diet should include foods rich in iron. For example, beef liver, seafood, lentils, red meat, nuts, and pomegranate.
The use of alternative methods of treatment without prior agreement with a doctor is unacceptable. It should be emphasized that these methods cannot be a sufficient alternative to the methods of official medicine. They can only complement the treatment, provided that the selected components do not block the action of the medicinal components.
A well-grounded approach to the treatment of iron deficiency anemia
If a decrease in hemoglobin is observed in the blood test, but the erythrocyte indices are increased, we are talking about macrocytic anemia .In this case, it is additionally necessary to prescribe an analysis for the level of serum ferritin, folate and vitamin B12 in order to exclude iron deficiency anemia and B12 and folate deficiency anemia. Accordingly, if B12 and folate levels are low, the patient is diagnosed with B12 and folate deficiency anemia. In the opposite case (when B12 and folates are normal, and the patient’s hemoglobin is reduced), this indicates the presence of a concomitant chronic disease (COPD, hypothyroidism, prolonged intoxication, alcoholism, etc.).etc.). In the latter case, serum ferritin can be increased (100-800 ng / ml).
If a decrease in hemoglobin is observed in the blood test, but the erythrocyte indices are normal, this indicates normocytic anemia , the picture of which is characteristic of hemolytic reactions (hemolytic anemia), chronic kidney disease or deficiency of food factors (alimentary anemia).
Epidemiology of iron deficiency (WHO, 2009)
Iron deficiency anemias account for 70-80% of all anemias, with about 1.7 billion.a person in the world suffers from iron deficiency anemia (IDA), and people with latent iron deficiency, when the level of hemoglobin is still normal, and iron stores are reduced – 2 times more. Up to 35% of the world’s population has a latent iron deficiency (50% of them are women). 41.8% of pregnant women have IDA, 12% of women of childbearing age have IDA, 47.4% of preschool children have IDA.
Reasons for IDA
1. Blood loss. Both a single blood loss and repeated bleeding can lead to depletion of the body in iron.In girls, the main factor is abundant, long periods. It is believed that blood loss equal to 40-60 ml of blood per cycle is critical for the development of iron deficiency. Gastrointestinal bleeding due to erosion, peptic ulcer, polyps, oncopathology. Helminthic invasions due to constant blood loss. Donation.
2. Violation of iron resorption in case of partial gastrointestinal excision, malabsorption syndromes (sprue, Crohn’s disease), in the presence of factors inhibiting resorption.
3. Increased needs – in the period of increased growth (the first 2 years of life) and puberty, an increase in physical mass during regular sports, with frequent infections, pregnancy, lactation.
4. The role of nutrition.
Symptoms of iron deficiency with or without anemia in adults
1. Anemic syndrome:
– Decreased exercise tolerance and endurance
– Decreased concentration, nervousness, forgetfulness
– Depression, mental lability
– Increased susceptibility to infections
– Pale skin
2.Tissue hypoxic syndrome:
– Brittle hair and nails, koilonychia
– Dry skin
– Long non-healing “seizures”, glossitis, angular stomatitis
– Whims of taste, perverted appetite (chalk, coal)
– Swallowing disorders, esophagitis
iron deficiency in pregnant women
– Delayed intrauterine development of the fetus due to dysfunction of the placenta
– Risk of intrauterine fetal death
– Risk of premature birth
– Risk of pyelonephritis
– Reduced tolerance to birth blood loss
– Patient mortality factor 9213 with maternal mortality 9000 IDA are presented below.
LOW LEVEL OF HEMATOCRITIS, THIS IS THE REASON IS HEALTH
Hematocrit Test is a test used to measure the number of red blood cells in the blood. H. If the test results show a low hematocrit level or below the normal range, then this indicates that the number of red blood cells in the body is decreasing.
Hematocrit is often done as part of a complete blood count.Your doctor may advise you to take this test as part of your routine health check ( check ).
However, in some cases, your doctor may do this to determine if you have a specific medical condition, such as anemia.
The hematocrit is measured in percent (%). Each person has a different hematocrit level, depending on gender and age.The following are normal hematocrit values based on age and gender:
- Adult men: 40–54%. 90,042 90,041 Adult females: 38–46%.
- Children: 30 – 40%
Normal hematocrit values may also vary from laboratory to laboratory. However, the comparison of these indicators usually does not exceed 7%. If your hematocrit level in your body is below the above range, it means that your hematocrit level is low.
Watch for a low hematocrit if there are complaints or certain symptoms such as weakness, pallor, slight fatigue and often dizziness.
Causes and Management Low Hematocrit
Low hematocrit is often a sign of anemia. This condition can be caused by several reasons, including:
1. Blood Loss
Excessive blood loss due to accidents, surgery, bleeding, or heavy menstruation can lead to a decrease in hematocrit. If the cause of some of these causes is low hematocrit, then the doctor must find the source of the bleeding and stop it.
Blood loss that is severe enough to cause shock also usually requires treatment with blood transfusions.
2. Nutritional deficiencies
Anemia or low hematocrit can be caused by iron deficiency (iron deficiency anemia) or deficiency of folate and vitamin B12 (folate and vitamin B12 deficiency anemia).
To overcome this condition, your doctor will usually recommend that you take supplements and foods that contain iron, folate, and vitamin B12.
3. Damage to or damage to the bone marrow
Damage to the bone marrow due to toxins, radiation, chemotherapy, infections, or the side effects of certain medications can lower hematocrit levels.
This also applies to diseases of the bone marrow such as aplastic anemia, myelodysplasia syndrome, or cancers such as leukemia, lymphoma or cancer from other organs that have spread to the bone marrow (metastasis).
4. Kidney disease
Severe or prolonged kidney disease can lead to anemia and a decrease in hematocrit.This is caused by a decrease in the amount of hormone (erythropoietin) secreted by the erythropoietin in the kidneys.
Anemia or low hematocrit caused by chronic kidney disease can usually be treated with an injection of epoetin alfa or darbepoetin alfa.
5. Decreased hemoglobin levels
Hemoglobin or Hb is a protein in red blood cells that is responsible for carrying oxygen throughout the body. When the amount of hemoglobin is insufficient, red blood cells cannot function properly and are destroyed.This can lower the hematocrit level.
Decreased hemoglobin is often caused by anemia. But besides anemia, low hemoglobin counts can also be caused by a number of other conditions, including:
Thalassemia is a genetic disorder in which patients cannot produce enough hemoglobin.
Mild thalassemia usually does not require specific treatment. However, thalassemia, which is classified as severe, must be treated with a blood transfusion every few weeks.
In addition, treatment can also be carried out with therapy to eliminate excess iron in the blood during bone marrow transplantation.
Hemolytic anemia occurs when the number of destroyed red blood cells in the body exceeds the number of red blood cells produced by the body.
Treatment for this condition varies and is adjusted depending on the cause, ranging from blood transfusions, corticosteroid medications, treatments to strengthen or weaken the immune system, to surgical removal of the spleen.
Sickle cell anemia
Red blood cells are usually round and move easily in blood vessels. However, in patients with sickle cell disease, the red blood cells in the body are crescent-shaped and hard and easily thicken.
Irregular shape of red blood cells makes red blood cells easily destroyed and stuck in small blood vessels. As a result, the flow of blood and oxygen to the body becomes difficult.
So far, no cure has been found for sickle cell anemia.Treatment is only done to relieve pain and prevent complications. Regarding the treatment of sickle cell disease, including penicillin antibiotics, pain relievers, hydroxyurea drugs, and bone marrow transplants.
In addition to the various conditions noted above, low hematocrit can also be caused by a number of other factors, such as blood transfusions, autoimmune diseases, or high altitude life.
To help diagnose conditions with low hematocrit, your doctor will do a physical exam along with other tests such as blood tests, bone marrow aspirations, and x-rays such as x-rays and computed tomography.
If the hematocrit level drops slightly without symptoms, the condition should not be a cause for concern. However, if you have symptoms or a history of certain medical conditions and your blood test results show that you have a low hematocrit, then this condition should be consulted with your doctor immediately.
90,000 Low blood hematocrit: what it means, causes and treatment of low hematocrit
What level does the hematocrit show in pregnant women?
As already mentioned, this indicator is lowered in pregnant women.Such a decrease is due to a sharp increase in the amount of plasma (up to 33 percent), and this is considered normal for such a situation and does not require additional treatment. Because already at the end of pregnancy, the HCT indicator will recover and return to normal. But it is necessary to monitor its indicator in pregnant women especially carefully, since it can manifest itself in the form of iron deficiency anemia, which is associated with overhydration.
Particularly low HCT levels during pregnancy can be observed in the following cases:
- Severe toxicosis,
- Pregnancy at a very young age,
- Multiple fetuses,
- Re-pregnancy after a very short period of time,
- Iron deficiency in food,
- If the woman was diagnosed with anemia before pregnancy.
Anemia adversely affects a woman, causing bleeding, premature birth and postpartum depression, but even more harmful to the fetus, since its development can occur with pathologies:
- Defective (slow) physical development,
- Congenital anemia,
- Pathologies of the nervous system and brain.
It should be noted that if a low vitamin B12 level is also noted in the mother’s body, then the child may be born with pathologies of the central nervous system.
Norms of the indicator in adults and children
In the KLA protocol, hematocrit can be indicated by Latin letters (Ht, HCT). The value depends on the volume of the bloodstream, the intensity of the production of corpuscles by the bone marrow. The hemoglobin level does not change it.
In men, the saturation of blood with corpuscular elements is always higher than in women.This is due to a stable hormonal background, greater muscle mass. In women, the indicator is lower due to regular blood loss during menstruation. During pregnancy, the value decreases, which is explained by an increase in the total blood volume in the body due to plasma (liquid component), fluid retention due to the activity of hormones.
Table – Physiological values of hematocrit
|Adolescents under 15||35‒45||34‒44|
|Adults under 45||42‒50||38‒47|
|45 to 65||39‒50||35‒47|
The hematocrit of a child is often lower than that of an adult.This is a variant of the norm. The indicator is about 20% higher than the generally accepted norms in newborns, which is associated with adaptive reactions to life in a new environment. Upon reaching the first year of life, the value gradually decreases and can be 10% lower than in adults. This is due to the active growth of the body. In adolescents, the values are close to those of adults.
Table – Children’s hematocrit norms
|Up to 2 weeks||41‒65|
|Up to month||33‒55|
|Up to 2 months||28‒42|
|Up to 4 months||32‒44|
|Up to six months||31‒41|
|Up to 9 months||32‒40|
|Up to year||32‒42|
|Up to 3 years||33‒41|
|Up to 6 years||32‒40|
Hematocrit in pregnant women
The indicator rapidly decreases already in the first months of pregnancy, although the amount of plasma in the body increases by 10–16% only by 12 weeks.Later, as the child grows and develops, the volume of blood in the mother’s body also increases. By the end of pregnancy, it can be 30-50% higher than before conception. Hematopoiesis does not always keep up with this process and the number of blood cells remains the same, which is why the hematocrit decreases.
In the 2nd trimester, the jump is most noticeable. The percentage of calves also falls in later periods. The doctor must monitor the hematocrit index, since anemia is common among pregnant women.The danger of the condition lies in the fact that the baby’s body may not receive enough oxygen in the right amount. The tissues of the mother’s body can also suffer from hypoxia, which is fraught with exacerbation of chronic diseases, the development of cardiovascular problems.
A dangerous phenomenon is a decrease in the hematocrit number to 31% or less. In this case, the woman needs not only regular observation, but also the intake of vitamin preparations, iron-based medicines.
Table – Norms of hematocrit for pregnant women
Who is at risk
The decrease in the hematocrit value does not depend on age or gender, but there are categories of people who are most susceptible to this:
90,040 90,041 children whose diet is unbalanced;
90,041 children developing rapidly;
90,041 women during pregnancy;
90,041 women in the first six weeks after giving birth;
90,041 patients with chronic diseases;
90,041 patients with cardiovascular diseases;
90,041 alcoholics and smokers;
If a decrease in hematocrit is detected in an infant, it is supposed to conduct a comprehensive examination to clarify the full picture and the alleged diagnosis. The driving factors for lowering the hematocrit are: slow formation of red blood cells, a high rate of their decay, increased accumulation of protein in the blood, or excessively thinned blood.
In an older child, a decrease in hematocrit is observed in most cases due to anemia. What does it mean? First of all, the wrong diet.Due to the lack of blood saturation with iron. A healthy child’s menu should include foods rich in iron: meat, eggs, liver, nuts, apples.
During pregnancy, a drop in the volume fraction of blood is provoked by overhydration. This is a failure of the ratio of water to salt, during which the tissues and organs are oversaturated with water, due to which the blood cells lack oxygen and nutrients.
The postpartum periods last 6-8 weeks. If there were no complications and diseases during the entire period of bearing a child and the birth itself, then during this time all indicators will return to normal.
Chronic diseases act as a catalyst for decreased hematocrit, especially in old age. During the development of the disease, immunity decreases so much that it is unable to produce red blood cells in the bone marrow, significantly reducing their number in the blood.
In smokers and people who abuse alcohol, difficulty breathing is listed as the root cause of the imbalance in blood cells. During shortness of breath, the lack of oxygen to enter the lungs, the body replaces oxygen from the blood cells.
A person who has had cases of cancer in the family should carefully monitor their health. The percentage of hereditary diseases is too high to be neglected.
Complete blood count – transcript online
With the help of the online analysis decryption service, you can check your indicators in a general blood test. We take into account both the gender of the patient and his age, as the results for these cases can be very different. All parameter maps were compiled using medical literature.To start working with the service, specify the gender and age of the person and select the parameters you are interested in.
Do not self-medicate. At the first sign of illness, see your doctor.
Often, such a deviation from the norm indicates the course of anemia. In addition, starting sources can be: severe internal bleeding, overly strict diets and prolonged bed rest.
The clinical picture may include several specific manifestations, for example, decreased performance, increased heart rate and painful pallor of the skin.
It is possible to identify the error only when conducting a general and biochemical blood test. Deciphering the results is dealt with by the hematologist, who transmits all the information to the attending physician of a particular patient.
Treatment is carried out using conservative therapeutic techniques, which are based on adherence to a specially formulated diet and lifestyle changes. However, the problem will not be completely eliminated without addressing the root cause.
What does a decrease in hematocrit indicate?
Erythrocytes are to some extent responsible for the state of the whole organism, since they provide oxygen to each of its cells, and these elliptical bodies are also required to take carbon dioxide from the cells.
But if the supply of cells is disrupted (with a decrease in the number of red blood cells and their inability to cope with the task at hand), hypoxia develops, which in turn will lead to a violation of the acid-base balance and dysfunction of each individual organ.
Reduced blood level causes:
- Rapid fatigue and general malaise,
- Rapid heart rate and tachypnea,
- Headaches and hair loss,
- Marbling of the skin.
These indicators are lowered very often if a woman is pregnant, but in order to confirm the diagnosis of anemia, you need to go for an additional examination and pass the appropriate analysis.
90,000 Symptoms, prevention and treatment of anemia in the elderly
Causes of anemia in old age
According to statistics, more than 30% of elderly people experience symptoms of low hemoglobin. Among the main reasons for the development of this pathology, it is worth noting:
- Anemia (anemia) due to various chronic diseases.Often, infectious, autoimmune and oncological diseases are accompanied by a low level and concentration of hemoglobin in the blood. This type of anemia is usually treated at the same time as the main diagnosis.
- Iron deficiency. Not having enough iron to support the normal functioning of blood and tissues, including muscles and the brain, is the most common cause of anemia. Most often observed with malnutrition and large blood loss.
- Folic acid deficiency.Caused by insufficient consumption of foods fortified with folic acid. Its deficiency is compensated by taking certain drugs.
- Lack of vitamin B12. Vitamin B12 deficiency symptoms include anemia, numbness in the limbs, coordination and memory problems. You can replenish the vitamin supply from animal products: beef, lamb, egg yolk, cod, mackerel, nuts, beef liver, seafood (mussels, shrimps).
Low blood hemoglobin is often the cause of prolonged wound healing.In addition, low iron levels may indicate the development of neoplasms.
Symptoms of anemia in old age
Anemia is a dangerous condition in which the number of red blood cells in the blood decreases, as well as the transport of oxygen, which is necessary to ensure the vital activity of cells and tissues, is disrupted. With anemia, any pathology is treated much longer – this is due to a decrease in physical activity and a deterioration in the work of the cardiovascular system.However, some people do not consider anemia to be a serious medical condition and ignore its symptoms, thereby increasing the risk of serious complications from other medical conditions.
Symptoms of anemia are blurred, for this reason they are often confused with other diseases characteristic of elderly people. Most often, anemia is manifested by symptoms such as:
- Dizziness, loss of balance.
- Frequent headache and mood swings.
- Muscle weakness.
- Increased irritability.
- Poorly healing wounds (“sticking” in the lip area).
- Change in taste.
- “Flies” or “veil” before the eyes.
- Pallor and dryness of the skin.
- Brittle nails.
- Chronic fatigue.
In addition, people with anemia are often worried about the stomach, intestines, and diseases of the cardiovascular system. They often complain of heart palpitations and tinnitus.
If at an early stage of the development of pathology these symptoms do not cause concern, then over time they become permanent and cause discomfort. To avoid serious consequences, it is important to consult a doctor in a timely manner. The specialist will prescribe a number of diagnostic measures and complex therapy.
The main method for diagnosing anemia is a complete blood count, which reveals a decrease in the level of hemoglobin in the blood in women less than 120 g / l and in men – less than 130 g / l.In old age, this limit is slightly lower and the norm of the hemoglobin level is 110 g / l.
If the indicator is reduced to 70-90 g / l, then this indicates anemia of moderate severity. In severe pathology, hemoglobin values are lower than 70 g / l. In this case, urgent hospitalization and treatment in a hospital environment is required.
Additional diagnostic methods include:
- Biochemical blood test.
- Determination of the level of ferritin and serum iron.
- Total iron binding capacity of serum.
- Determination of the number of erythrocytes, the level and concentration of hemoglobin.
- Transferrin receptor study.
In addition, the doctor collects anamnesis and conducts a visual examination of the patient. If a change in the size of the spleen (on palpation) and the color of the skin is noticed, an additional examination is prescribed.
Peculiarities of anemia treatment
Before prescribing treatment, the specialist takes into account the data of laboratory studies, as well as the presence of chronic diseases and the age of the elderly person.At an early stage of pathology, when the hemoglobin parameters are not critical, its deficiency is corrected by a special diet.
When it comes to moderate anemia, drugs are prescribed that promote the formation of erythrocytes and hemoglobin in blood cells. Most often, such iron preparations as “Ferrum”, “Aktiferrin” and “Maltofer” are prescribed.
In severe anemia (critical hemoglobin values below 70 g / l), erythrocyte transfusion is prescribed. To avoid the occurrence of adverse reactions, this procedure is carried out under the supervision of a physician.
All medications are taken strictly according to the scheme prescribed by the attending physician. In case of side effects (pain in the stomach, nausea, constipation, diarrhea, dizziness), the treatment is adjusted or other drugs are prescribed (intravenous or intramuscular injections).
Treatment of anemia is quite long – from 3 to 6 months and, in addition to taking medicinal iron-containing preparations, includes a special diet, taking dietary supplements and vitamin-mineral complexes.
Diet for anemia
A special diet is one of the most effective ways to increase the level of hemoglobin in the blood. In addition, it is also an excellent prevention of the development of anemia. At the initial stage of anemia, it is recommended to eat foods with a high protein content, since it is protein that contributes to the good synthesis of hemoglobin.
You should also include in your daily diet foods high in iron (beef liver and kidneys, pomegranate, apricots, green apples).
List of foods recommended by nutritionists for anemia:
- Vegetables, berries, fruits (citrus fruits, tomatoes, bell peppers, mountain ash, sea buckthorn).
- Animal proteins (chicken yolk, meat (veal, beef), seafood, seaweed).
- Nuts (pine nuts, hazelnuts, peanuts, cashews).
- Sunflower seeds, sesame seeds, wheat bran,
- Chocolate (bitter).
- Buckwheat groats, lentils (grain), soybeans (grain), peas, barley (grain), oat bran, beans (grain).
- Porcini mushrooms (dried).
People with anemia need to exclude foods high in “fast carbohydrates” from their diet:
- Wheat flour baked goods.
- Milk chocolate.
- Watermelon, grapes.
- Sugar, honey.
- Semolina, potatoes, pasta (except for pasta made from durum wheat).
Nutritionists recommend that people on a diet eat at about the same time and avoid hunger.
For anemia, freshly squeezed juices from pomegranate (diluted), carrots and beets are useful. Their daily use will enrich the diet and increase the level of hemoglobin in the blood. In addition, a large amount of important trace elements for the body is contained in the infusion of fresh and dry rose hips.
Important! When consuming dairy products, you should be aware of their incompatibility with medicines containing iron. Also, for the period of treatment of anemia, you should stop drinking strong black tea, since it interferes with the absorption of iron.
Often, proven folk remedies are used to treat anemia. Most effective:
- Infusion of rowan fruits. Steam two tablespoons (tablespoons) of mountain ash with 200 ml of boiling water, insist for half an hour, strain, drink 70 ml three times a day before meals. The course is two weeks.
- Infusion of nettle leaves. 1 tbsp. l. raw materials pour 300 ml of boiling water, take 100 ml 3 times a day before meals. The course is two weeks.
- Vitamin Blend.Mix dried fruits (dried apricots, prunes, raisins) in proportions 1: 1, steam 200 ml of boiled water overnight, strain, mince. Consume 1 tbsp. l. three times a day before meals. The course is 7-10 days.
Compliance with dietary nutrition in combination with drug therapy allows you to achieve high results and normalize the level of hemoglobin in the blood, the main thing is to follow the prescriptions of the attending physician.
Prevention of anemia
To reduce the risk of developing anemia, the following recommendations of specialists should be followed:
- Eat right, including foods high in iron and animal protein in your daily diet.
- Consume at least 0.5 kg of fruits and vegetables every day.
- Once a year, every six months, drink vitamin-mineral complexes and preparations with B12 and folic acid.
- To exclude helminthic invasion.
- Avoid direct contact with toxic and chemical substances.
- Take daily walks.