When a person’s blood is ‘excess’ and requires to be extracted

Dear Healthy Nation,

Is there a condition where someone has too much blood in the body that needs to be removed? Does it have any negative side effects? My neighbour died suddenly last week, and this was said to be the cause. Is that possible?

Dear reader,

There is a rare condition called polycythemia or erythrocytosis, where there is a high concentration of red blood cells in the blood, making the blood thicker than it should be, and it flows sluggishly through the blood vessels.

Polycythemia can cause dizziness, fainting, headache, blurred vision, high blood pressure, bleeding problems, or itchy skin. The sluggish blood flow can also lead to development of a blood clot, which can be deadly if the clot blocks blood flow to vital organs, like the lungs.

Polycythemia may be as a result of a genetic disorder known as Polycythimia Vera that leads to excessive production of red blood cells. It may also develop as a result of having excessive erythropoietin, the hormone that promotes production of red blood cells. This may occur due to some kidney diseases, chronic obstructive pulmonary disease and other illnesses.

Another possible cause of polycythemia is where the number of red blood cells is normal but the plasma (the liquid part of blood) is reduced, for instance due to dehydration, or as a consequence of taking some blood pressure medications, or due to obesity, smoking, or excessive alcohol consumption.

This can be corrected if the underlying cause is addressed. Polycythimia may develop as a normal physiological adaptation to the environment, for instance in persons who live in high-altitude areas that have a low oxygen concentration.

Athletes may take advantage of this effect by training at high altitude, though it may not be effective. Use of anabolic steroids and blood doping may also cause polycythemia.

Polycythemia is diagnosed through blood tests. Additional tests depend on the suspected underlying cause of polycythemia. An example is an abdominal ultrasound scan to check the kidneys. Polycythemia can be managed by venesection, which is removal of blood, usually about half a litre of blood, which is done as per the doctor’s instructions.

There are also medications to slow down the production of red blood cells, and medication to prevent blood clots. Any treatable underlying causes should also be attended to. The genetic disorder cannot be cured. Lifestyle changes like maintaining healthy weight, limiting alcohol consumption and cessation of smoking would also be beneficial.

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