POLYCYTHEMIA: ALL BLOOD CELLS ARE ELEVATED, INCLUDING PLATELETS

[thebear]

Found this online....

POLYCYTHEMIA: ALL BLOOD CELLS ARE ELEVATED, INCLUDING PLATELETS

Also known as: polycythemia vera, polycythemia rubra vera, erythremia, vaquez disease, osler-vaquez disease. It is a stem cell disorder characterized as a panhyperplastic, malignant, and neoplastic marrow disorder. Its most prominent feature is an elevated absolute red blood cell mass because of uncontrolled red blood cell production.

ERYTHROCYTOSIS: ONLY HEMOGLOBIN AND HEMATOCRIT ARE ELEVATED

The condition that men injecting testosterone often develop is termed erythrocytosis, and is simply an increase in the red blood cells due to the stimulation of hematopoietic growth factors from testosterone therapy. In addition, serum testosterone levels are related to erythrocytosis, rather than erythropoietin (EPO) levels in hypogonadal men.

Testosterone was shown to dose-dependently increase the hemoglobin and hematocrit rate (i.e. depending on the dose), but does not show an increase in EPO. Testosterone stimulates erythropoiesis through the production of hematopoietic growth factors and is suggested to act directly on bone marrow, specifi cally on the polychromatophylic erythroblast. This is a similar phenomenon that occurs when athletes use Epogen or Procrit to raise their blood count to enhance their Endurance.

This is also the same process that causes people who live at high altitude to have an increase in red blood cell counts. This*is because it is a physiologic yet harmless increase in RBCs alone, not in any other cells or clotting factors. Treatment is not necessary for anyone with erythrocytosis that lives at high altitude, as it does not cause any problem whatsoever and is quite benefi cial. Over 400 million people worldwide live at high altitudes and have higher blood counts, and yet no treatment is necessary, nor is there ever*any harm. In fact, athletes train at high altitudes to raise their blood cell counts and increase their exercise endurance at*sea level. Why do you think the Olympic Training Center is in Colorado?! It gives them an advantage. Colorado has the 8th lowest mortality rate, the 3rd lowest cardiovascular rate in the US and the longest life expectancy at 87 in the high ski country, all despite having the highest average altitude and hematocrit rates. People with chronic lung problems such as COPD also have high blood counts and we never treat them as the response is physiologic. In other words, the response is normal, expected, and not harmful in order for their blood to carry more oxygen.

Many physicians confuse erythrocytosis with a blood disorder called polycythemia rubra vera. This is a harmful blood condition that causes an increase in clotting, which can lead to strokes and heart attacks. The diff erence is that erythrocytosis only causes increased red blood cells and no harm. Polycythemia causes an increase in platelets, which causes increased clotting. More importantly, polycythemia is associated with a defect in the blood vessel wall, which stimulates the clotting cascade of thrombosis, in addition to increasing platelet count. These two factors cause an increased risk of blood clots and strokes, thereby requiring treatment by phlebotomy or blood donation to lower blood*counts and prevent the complications of polycythemia. Hydroxyurea is also a possible form of therapy. Additionally, a JAK-2 V617F Gene mutation test can simply be performed*to make the polycythemia diagnosis.

Polycythemia is classically defi ned as an increase in red blood cells, white blood cells, platelets, splenomegaly, and clotting disorders. In addition, the literature clearly demonstrates that TOT causes erythrocytosis only, and not polycythemia vera.

Testosterone administration has never been associated with any risk of clotting or stroke in any of the studies over the last 40 years. Therefore, the erythrocytosis itself requires no*treatment. Nearly all men using injectable testosterone have the same erythrocytosis that people have who live at high altitudes, and they should receive the same treatment as*they do, which is nothing! For any physician uncomfortable with this data, refer your patient to a hematologist who will hopefully understand this very well.

[jackofspades]

I had to argue, and argue, and argue to get my internist to remove polycethemia from my record.
Then I had to school him a little bit about the differences between polycethemia and erythrocyctosis.
Thanks for posting this.

[Quantumleap]

Erythrocytosis Following Testosterone Therapy