Seems erythrocytosis .. too many red blood cells .. and polycythemia .. are .. the same ..
The marker used to assess polycythemia {too many red blood cells] is set by .. cost.
The higher the marker {red blood cells] to eliminate 'false positives' ..
So .. do YOU have the iron levels of a pre-menopausal woman?
You know that .. anemic .. one .. ?
THAT is the level research has shown to be the healthiest.
---------------------------------------------------------
Thus, although individuals at high risk for ASCVD are not Fe-overloaded, they seem to benefit,
metabolically and hemodynamically, from lowering of body Fe to levels commonly seen in
premenopausal females.
PMID: 12079862
--------------------------------------------------------
Chest 1990 Nov;98(5):1073-7
Exercise performance of polycythemic chronic obstructive pulmonary disease patients. Effect of
phlebotomies.
Chetty KG, Light RW, Stansbury DW, Milne N
Department of Medicine, VA Medical Center, Long Beach, CA 90822.
The purpose of this study was to determine the effects of phlebotomy on the exercise tolerance
and right and left ventricular ejection fraction of polycythemic patients with chronic
obstructive pulmonary disease. Ten patients with COPD (mean FEV1 = 1.32 +/- 0.55 L) and
polycythemia (mean Hct = 62 +/- 3 percent) were studied before and after their hematocrits had
been reduced to approximately 50 percent. Post-phlebotomy the maximal oxygen consumption
increased from 1.09 +/- .34 L/min to 1.26 +/- 0.43 L/min (p less than 0.05) and the maximum
workload increased from 56.5 +/- 32.6 watts to 74.5 +/- 23.4 watts (p less than 0.05). The
increase in the exercise tolerance appeared to be primarily due to an increased cardiac output at
Emax. There was no relationship between the increases in the upright exercise capacity and
changes in the supine ejection fractions of the right or left ventricular either at rest or
during exercise.
PMID: 2225946, UI: 91030710
_________________________________________________________________
Int J Cardiol 1994 Apr;44(2):175-7
Effects of phlebotomy on a patient with secondary polycythemia and angina pectoris.
Piccirillo G, Fimognari FL, Valdivia JL, Marigliano V
Cattedra di Geriatria e Gerontologia Universita, La Sapienza, Rome, Italy.
A 67-year-old man with polycythemia, secondary to chronic obstructive pulmonary disease, had
angina attacks at rest treated successfully by supplementing conventional therapy with frequent
phlebotomies. Although phlebotomy reduces arterial oxygen content, it also decreases blood
viscosity, improves peripheral oxygen consumption and thus yields the clinical benefit.
PMID: 8045664, UI: 94321077
_________________________________________________________________
Respiration 1979;38(6):305-13
Phlebotomy improves pulmonary gas exchange in chronic mountain polycythemia.
Cruz JC, Diaz C, Marticorena E, Hilario V
There is not unanimous agreement in the literature regarding the effects of bleeding on pulmonary
gas exchange in polycythemic patients. Spirometry, alveolar arterial O2 and CO2 tension
differences, PaO2 breathing 100% oxygen and carbon monoxide-diffusing capacity were measured
before and after 1 week of chronic phlebotomy in 4 chronic mountain polycythemic patients.
Studies were carried out at 3,700 m above sea level (PB = 491 mm Hg). Before phlebotomy, 2
patients showed abnormal spirometry and gas exchange. Only 1 patient had high PaCO2 and all of
them showed low values of PaO2 breathing oxygen. Phlebotomy improved both spirometry and gas
exchange. Improvement in arterial oxygen saturation and PaO2 could not be attributed to changes
in alveolar ventilation, but rather to better distribution of VA/Qc ratios since physiological
dead space decreased. Our results are similar to those reported in polycythemia vera patients. A
significant correlation between the changes in PaO2 with phlebotomy and the control PaO2 have
been found from 45 polycythemic patients with chronic obstructive pulmonary disease collected
from the literature. It is concluded that excessive polycythemia worsened hypoxemia and that
phlebotomy improved gas exchange.
PMID: 538338, UI: 80146854
_________________________________________________________________
Am J Med 1983 Mar;74(3):415-20
Improved exercise tolerance of the polycythemic lung patient following phlebotomy.
Chetty KG, Brown SE, Light RW
The present study evaluated the effects of therapeutic phlebotomy on the exercise tolerance and
the maximal carbon dioxide output of polycythemic patients with chronic obstructive pulmonary
disease. Fifteen maximal exercise studies were performed before and after phlebotomy in patients
with moderate to severe chronic obstructive pulmonary disease (mean forced expiratory volume in
one second [FEV1]= 970 ml). After phlebotomy there were no significant differences in pulmonary
function, blood gases, oxygen consumption, or carbon dioxide production at rest. However, after
phlebotomy there was a significant increase in the exercise tolerance of the patients. The mean
workload, the duration of exercise, the maximal oxygen consumption, the maximal carbon dioxide
production, and the ventilation at maximal exercise all increased significantly. The improved
exercise tolerance after phlebotomy appeared due to an increased cardiac output generated mainly
through an increased stroke volume. We hypothesize that the increased stroke volume was due to a
higher ejection fraction of the right ventricle secondary to a lower pulmonary artery pressure.
This study provides further evidence that patients with chronic obstructive pulmonary disease
who have polycythemia benefit by therapeutic interventions that maintain their hematocrits below
55 percent.
PMID: 6402930, UI: 83149913
_________________________________________________________________
Surgery 1980 Nov;88(5):686-92
Increased oxygen uptake following phlebotomy and simultaneous fluid replacement in
polycythemic patients.
Shah DM, Powers SR Jr, Bernard HR, Scovill WA, Newell JC, Stratton HH
To study the isolated effects of decreased hemoglobin concentration without volume loss, eight
patients with the diagnosis of polycythemia were studied following acute phlebotomy and
simultaneous volume replacement. These patients had been treated previously by repeated
phlebotomy, without volume replacement, to a hemoglobin level of 14.8 +/- 0.5 gm%. Following
hemodilution by additional phlebotomy and volume replacement, which further lowered the mean
hemoglobin level to
11.4 +/- 0.4 gm%, cardiac index increased significantly from 2.8 +/- .3 to 3.5 +/- 0. 3
liter/min/m(2) (P<0.05), oxygen delivery did not change, but total body oxygen consumption
increased significantly from 140 +/- 16 to 180 +/- 15 ml/min/m(2) (P<0.05). Mixed venous PO2,
systemic and pulmonary vascular resistance decreased significantly (P<0.05). Vascular
pressure, heart rate, intrapulmonary shunt, arterial pH and bicarbonate, limb blood flow, limb
oxygen delivery and limb oxygen consumption did not change. Thus, with phlebotomy and fluid
replacement, a reduction of hemoglobin concentration to a subnormal level increased oxygen
consumption without lowering oxygen delivery.
PMID: 7434209, UI: 81056744
_________________________________________________________________
Who loves ya. Tom
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