Counseling Sheet

Agatha Thrash, MD
Preventive Medicine

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Almost everyone is aware that a low hemoglobin is associated with fatigue, but it is the rare person who understands that rich, heavy blood can also cause fatigue. Pushing around the heavy blood is a strain on the heart and arteries, uses up energy, and results in fatigue.

There are several forms of this disease in which the production of red blood cells in the bone marrow is greatly increased. The condition adds to the viscosity or thickness of the blood, and in its severest forms affects blood flow to the brain and other parts of the body. Symptoms may include dizziness, headaches, feeling of fullness in the head, sometimes sluggishness. There may be spells of amnesia. There may be constant ringing in the the ears. The skin sometimes has a bluish cast because of the prominence of small veins filled with excess blood. There is an increased tendency to form blood clots, and, of course, to have heart attacks and strokes.

The most severe form is called polycythemia rubra vera. Very high levels of hemoglobin, over 17 grams, may represent polycythemia rubra vera and should be investigated, as it is quite serious.

A second form, not as severe as the first, is a reaction to such factors as living at high altitudes, pulmonary or cardiac disease and, most commonly, from stress. Polycythemia is so commonly related to stress that it is often referred to as "stress polycythemia." It probably occurs from excessive diuresis due to stress, alcohol, caffeine products, smoking, and inadequate exercise.

Everything that will reduce stress will eventually bring the hemoglobin down. One should take plenty of exercise, eat more fruits and vegetables prepared simply or eaten raw, and eat less of all rich or concentrated foods. The ideal levels of hemoglobin where people function best, for women living at sea level to about 1500 feet elevation, are probably around 10.5-12.5, and for men from 12-14, not up to 15 grams for women and 18 grams for men as carried on most laboratory report slips. In our opinion this is much too high for an ideal level. Above or below the ideal may result in fatigue, weakness, inability to concentrate, headaches, dizziness, and blood vessel diseases. As the hemoglobin goes up, there is greater and greater likelihood of these symptoms, and more serious complications such as an increase in the risks of heart attacks and strokes.

Treatment

1. Reduce stress in every way possible. The stress hormones may increase diuresis, which can lead to relative dehydration. The fluid content of the blood is decreased, with the red blood cells staying constant, giving an increase of red cells per unit volume.
2. Get adequate exercise for your age and physical condition. For otherwise healthy adults, to build up to one hour of walking or other vigorous out-of-doors exercise daily can be most helpful.
3. Do not overeat, especially of concentrated foods such as animal products, nuts, seeds, fats, and concentrated sugars. Overeating causes stress on the chemistry of the body, and can produce stress polycythemia.
4. Use a diet high in fruits and vegetables, and low in all other substances, so that three servings of fruits are taken to one of grains, legumes, nuts, or any other food. Three servings of vegetables would be taken to one of any other food.
5. Drink adequate quantities of water to keep the blood as thin as possible.
6. Smoking, alcohol, and use of caffeine beverages and drugs are potent causes of chronic dehydration. They must be strictly avoided.
7. Practice daily devotions, trusting in God to keep your affairs and to keep your body in good functioning order. Learn to handle the unavoidable stresses through prayer and trust in God.
8. Diets rich in soybean products can help to reduce iron content of individuals having polycythemia or high serum iron or ferritin levels.
9. Donation of blood frequently may be very helpful in both kinds of polycythemia; although in true polycythemia it will be done under supervision of a physician.

See also Blood Viscosity.

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