Polycythemia or erythremia is a condition in which there is an abnormally large number of red blood cells in the body, this condition is the opposite of anemia, which result from too few red blood cells in the body. Polycythemia rubra vera also called also called primary polycythemia, is a disorder in which the bone marrow abnormally produces excess red blood cells, white blood cells, and platelets. The total volume of blood is increased, and the spleen becomes enlarged. Polycythemia vera occurs in all age groups which include children, and its incidence increases with age, patient with polycythemia vera are prone to the development of blood clots (thrombosis).

Causes:

• Polycythemia occurs as a normal response to high altitudes, because when the oxygen content of the air is low, the bone marrow increases its production of oxygen-carrying red blood cells.
• Polycythemia may also occur when the oxygen-carrying pigment, hemoglobin has an abnormality that results in a poor delivery of oxygen to the tissues. In this case polycythemia is just a symptom of other disorders rather than a disorder in its own.

Symptoms: Symptoms may vary on each individual patient.

• Some patient may not experience any symptoms
• General itching
• Very ruddy complexion
• Headaches or feelings of fullness of head
• Dizziness, Disturbed vision
• Bloodshot eyes
• Tiredness, Breathlessness
• Enlarged spleen
• Enlarged liver

Diagnosis will show the following result:

• Elevated hemoglobin (protein in the blood that carries oxygen) level, reflecting the increased number of red blood cells, white blood may also be increased.
• Enlarged liver or spleen and gouty nodules.
• Total blood volume may sometimes increase to as much as twice its normal volume. The circulation time for blood throughout the body can increase up to twice the normal value. Capillaries can become plugged by the very thick blood, and the flow of blood through the vessels tends to be extremely sluggish.

Treatments: There is no real cure for Polycythemia rubra vera, so treatment just focuses on treating its symptoms. Treatment includes;

• Removing the excess blood from the patient or by administering drugs that retard the activity of the bone-marrow cells. But eventually the bone marrow wears out, and then anemia or leukemia may develop.

• Bloodletting the removal of blood from the body reduces the blood volume and brings down the hematocrit levels; in patients with polycythemia vera, this reduces the risk of blood clots. This treatment is often combined with other therapies.
• Low dose aspirin is often prescribed. Studies have shown that aspirin reduces the risk for various thrombotic complications.
• Taking 2 tablespoon of apple cider vinegar with half glass of water 3 times a day (30 mins before each meal) can help prevent headache symptom.