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Overview of High Red Blood Cell Count: Meaning, symptoms, causes, and treatment

TeamAckoDec 20, 2023

Red Blood Cells (RBCs), also known as erythrocytes, comprise 45% of total blood volume and are essential components of the human body. The red bone marrow produces these blood cells. RBCs contain a protein called haemoglobin, which takes oxygen from our lungs to all of our body organs and returns carbon dioxide to our lungs to be expelled. A High Red Blood Cell Count (HRBCC), also known as Polycythemia (PTM), is a blood disorder that causes the blood to thicken and increases the risk of additional health problems such as blood clots. This article will teach you more about the causes, symptoms, and available treatments for PTM.

High Red Blood Cell Count



What is a High Red Blood Cell Count (Polycythemia)?

A High Red Blood Cell Count or Polycythemia indicates that the bloodstream contains more red blood cells than the normal range. Your blood contains vital elements like red blood cells, platelets, and white blood cells. Red Blood Cells help in the transport of oxygen throughout your body. However, a HRBCC could indicate an underlying health issue.

The average RBC count in men, women, and children varies, and the normal average ranges are as follows.

  • 4.1–5.5 million/mcL in children

  • 4.7–6.1 million/mcL in men

  • 4.2–5.4 million/mcL in women

Besides RBCs, individuals with PTM may have elevated haemoglobin or hematocrit. PTM is classified into two broad categories.

  • Primary PTM: It is caused by the bone marrow producing too many red blood cells as a result of a mutation or a biological component in the body.

  • Secondary PTM: It is caused by conditions such as smoking, high altitude, or genetic heart defects that restrict the amount of oxygen reaching cells in the body. Some patients with secondary PTM may have red blood cells that contain an abnormal form of haemoglobin that may not efficiently release oxygen.

Potential causes of High Red Blood Cell Count

The following medical disorders may cause an increase in red blood cells.

  • Heart failure that results in low blood oxygen levels

  • Genetic heart disease

  • Kidney tumours

  • Lung disease includes emphysema, COPD, and pulmonary fibrosis (scarring of lung tissue)

  • Hypoxia (low blood oxygen levels)

  • Carbon monoxide toxicity (typically associated with smoking)

  • Sleep apnea

A HRBCC can be caused by a variety of lifestyle factors, including the following.

  • Cigarette smoking

  • Using anabolic steroids 

Risk factors

Certain people may be more vulnerable to Primary PTM than others. Most occurrences of primary PTM develop as individuals age, typically around the age of 60. It is generally seen more in men than in women.


PTM usually does not exhibit any symptoms. In some cases, PTM itself is a sign of an underlying condition. However, the following are some of its most common signs. 

  • Tiredness and fatigue

  • Blurry vision

  • Sleeping difficulties

  • Headaches

  • Breathlessness

  • Itchy skin

  • Tingling sensation and numbness

  • Pain in the joints

  • Nosebleeds

How is Polycythemia (High Red Blood Cell Count) diagnosed?

If you have symptoms of Polycythemia, your doctor may recommend the following tests to help identify the underlying cause.

  • Blood tests: A complete blood count will detect any rise in Red Blood Cells in the bloodstream as well as any abnormalities in the platelets and white blood cells. Your doctor may suggest additional blood tests if PTM appears to be a possibility.

  • Biopsy of bone marrow: A bone marrow biopsy is performed by obtaining a small sample of bone marrow using a needle and examining it under a microscope.

  • Genetic tests: Although hereditary causes of PTM are rare, your healthcare practitioner may want to examine your bone marrow for genetic abnormalities, if any. He may also suggest looking for Janus kinase 2 (JAK2) mutations in blood cells.

Treatment options for High Blood Cell Count

Treatment for PTM will be determined by the underlying cause of the illness.

In the case of Secondary Polycythemia, treating the underlying cause (such as obstructive sleep apnea) may help alleviate an elevated Red Blood Cell Count.

When it comes to Primary Polycythemia, the condition is managed by lowering both the red blood cell count and the risk of complications, such as blood clots. Also, there are treatment options available if the platelet count is abnormally high. Primary PTM treatments may include the following.

1. Phlebotomy

To manage the illness, doctors may attempt to reduce the red blood cell count using phlebotomy, which includes the manual removal of blood through one of the veins. Depending on the situation, doctors may advise extracting a specified amount of blood at regular intervals to bring the red blood cell count back to normal.

2. Medications

Phlebotomy isn't always adequate to keep red blood cell growth under control. Myelosuppressive medicines may then be prescribed by doctors to help manage blood cell counts. Hydroxyurea (Hydrea) is one such drug that inhibits the bone marrow and prevents red blood cell production.

Doctors may sometimes recommend additional medications to help reduce the symptoms. Aspirin and antihistamines are examples of such medications. Low-dose aspirin reduces the risk of clotting in many patients with primary PTM and may improve unpleasant symptoms such as headaches. Antihistamine medications may be prescribed to help relieve itching.

Prevention of High Blood Cell Count

While Polycythemia induced by an underlying condition cannot be prevented, a healthy lifestyle can lower the probability of developing Primary Polycythemia. This may include the following.

  • Quit smoking

  • Exercise on a regular basis

  • Drink a lot of water

  • Consumption of iron should be avoided

  • Increase your intake of vitamin B12

  • Avoid coffee, soda, and other diuretics

  • Avoid anabolic steroids and other performance-enhancing substances

  • If you have sleep apnea, use proper medical devices such as a CPAP

  • If you have heart failure, make sure you strictly adhere to your healthcare provider's treatment plan

Frequently Asked Questions (FAQs)

Here are some FAQs related to High Red Blood Cell Count


How is HRBCC treated?

In the case of Secondary Polycythemia, treating the basic reason for it may help alleviate an elevated Red Blood Cell Count. However, when it comes to Primary Polycythemia, the treatment options may include the following. 

  • Phlebotomy, which includes the removal of blood through one of the veins manually.

  • Myelosuppressive drugs such as Hydroxyurea (Hydrea), which inhibits the bone marrow and prevents Red Blood Cell production, aspirin to treat unpleasant headaches, and antihistamines to help alleviate itching.

What happens if your RBC count is too high?

When your RBC count is high, it causes the blood to thicken and increases the risk of additional health problems such as blood clots.

What are the main causes of High Red Blood Cell Count?

Genetic heart disease and Hypoxia (low blood oxygen levels) are some potential causes of High Red Blood Cell Count.


Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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