What Should You Do If Hemoglobin Is High? Your Guide to Action

According to the Cleveland Clinic, a high hemoglobin count can make blood thicker, increasing the risk of serious complications like blood clots, heart attack, and stroke. Addressing the root cause is critical, so knowing what should you do if hemoglobin is high is the first step toward effective management and better health outcomes.

Quick Summary

Management for elevated hemoglobin depends on the underlying cause, which may include dehydration, smoking, or conditions like polycythemia vera. Strategies involve doctor-supervised treatment such as phlebotomy, combined with lifestyle changes like increasing hydration and dietary adjustments.

Key Points

• Seek Medical Diagnosis: Always consult a doctor after a high hemoglobin reading to determine the root cause, as it can range from dehydration to a serious medical condition.

• Stay Hydrated: If dehydration is the cause, increasing your water intake is a simple and effective step to dilute the blood and normalize hemoglobin levels.

• Quit Smoking: Tobacco use is a major cause of high hemoglobin; quitting can significantly lower your levels and improve overall health.

• Modify Your Diet: Limit or reduce intake of iron-rich foods like red meat and spinach, and avoid multivitamins containing iron unless otherwise advised by your doctor.

• Follow Medical Treatment: For conditions like polycythemia vera, a doctor may prescribe phlebotomy (blood removal) or specific medications to manage red blood cell production.

• Consider Blood Donation: For eligible individuals, donating blood can be a straightforward way to reduce excess red blood cells and iron stores.

Understanding High Hemoglobin

Hemoglobin is an iron-rich protein in red blood cells responsible for transporting oxygen from the lungs to the rest of the body. Normal levels differ based on age, sex, and other factors, but generally, readings above 16.6 g/dL for men and 15 g/dL for women are considered high. Elevated hemoglobin, also known as polycythemia, can lead to your blood becoming thicker, hindering its proper flow and increasing the risk of complications. While minor fluctuations are normal, consistently high levels warrant medical attention to identify and treat the underlying cause.

Common Causes of Elevated Hemoglobin

Identifying the cause is the crucial first step in creating an effective management plan. High hemoglobin levels can result from various factors, from simple lifestyle issues to more complex medical conditions.

Lifestyle and Environmental Causes

• Smoking: Smoking tobacco forces the body to produce more red blood cells and hemoglobin to compensate for lower oxygen levels caused by carbon monoxide exposure.
• Living at High Altitude: The lower oxygen pressure at high altitudes stimulates the body to produce more red blood cells to maintain oxygenation.
• Dehydration: When you don't drink enough fluids, the blood plasma volume decreases, making the hemoglobin appear more concentrated. Rehydrating often corrects this temporary increase.
• Performance-Enhancing Drugs: The use of certain substances like anabolic steroids or erythropoietin (EPO) can artificially boost red blood cell production.

Underlying Medical Conditions

• Polycythemia Vera (PV): This is a rare blood cancer where the bone marrow produces too many red blood cells, as well as white blood cells and platelets. It is a serious condition that requires ongoing medical management.
• Lung and Heart Conditions: Chronic issues such as Chronic Obstructive Pulmonary Disease (COPD), emphysema, or congenital heart disease can cause chronically low blood oxygen levels, triggering the body to produce more hemoglobin.
• Kidney or Liver Cancer: In rare cases, certain cancers can produce hormones that stimulate red blood cell production.
• Obstructive Sleep Apnea: Repeated interruptions in breathing during sleep lead to low oxygen levels, which can cause the body to create more hemoglobin.

Symptoms Associated with High Hemoglobin

While some people with high hemoglobin may not experience any symptoms, others may have a range of indicators, particularly if the levels are significantly elevated. It is important to note these symptoms are not unique to high hemoglobin and can overlap with many other conditions.

• Headaches and dizziness
• Fatigue and weakness
• Blurred or double vision
• Itchy skin, particularly after a hot bath or shower
• Numbness or tingling in the hands, feet, or legs
• Easy bruising or bleeding
• Swollen and painful joints
• Unexplained weight loss

What to Do: Immediate Steps and Medical Consultation

If you have a recent blood test showing high hemoglobin, the most important first step is to consult a healthcare provider. They can perform further tests, such as a complete blood count (CBC) or tests for specific conditions like polycythemia vera, to determine the underlying cause. Self-managing a potentially serious condition without a diagnosis can be dangerous and is not recommended. Based on the diagnosis, a doctor will recommend the appropriate course of action.

Managing High Hemoglobin: Lifestyle and Medical Approaches

Lifestyle Modifications

For cases where the high hemoglobin is caused by lifestyle factors or as a supplementary measure for medical conditions, certain changes can be effective.

• Increase Hydration: Drinking more water helps to dilute the blood, which can be effective if dehydration is the cause.
• Quit Smoking: Stopping tobacco use is one of the most effective ways to reverse hemoglobin increases linked to chronic oxygen deprivation.
• Adjust Diet: Limit intake of iron-rich foods, including red meat, liver, spinach, and iron-fortified cereals. Consider a Mediterranean-style diet high in vegetables and healthy fats, which can also help with cardiovascular health.
• Avoid Iron Supplements: Do not take iron-containing multivitamins or supplements unless instructed by a doctor, as excess iron can stimulate red blood cell production.
• Moderate Exercise: Regular, moderate-intensity exercise can improve circulation and overall heart and lung health.
• Consider Blood Donation: For eligible individuals, donating blood is a common and effective way to reduce excess red blood cells and iron stores.

Medical Treatments

For more serious or persistent causes, a doctor will prescribe specific treatments.

• Phlebotomy: This is a common procedure for high hemoglobin, especially in conditions like polycythemia vera. A unit of blood is removed from a vein, similar to blood donation, to reduce the number of red blood cells. Multiple sessions may be required.
• Medications: Depending on the cause, medications may be used. Low-dose aspirin can be prescribed to prevent blood clots by making platelets less sticky. For polycythemia vera, specific drugs like hydroxyurea, ruxolitinib (Jakafi), or interferon alfa may be used to control red blood cell production.
• Addressing Underlying Conditions: If high hemoglobin is a symptom of another illness, such as a heart or lung disease, treating that primary condition will often help normalize hemoglobin levels.

Management Strategy Comparison

Feature	Lifestyle Adjustments	Medical Interventions
Effectiveness	Highly effective for dehydration, smoking, and altitude-related increases. Supplements, but does not cure, serious conditions.	Necessary and highly effective for polycythemia vera and other chronic conditions. Directly reduces red blood cell count.
Application	Patient-driven through daily habits like hydration, diet, and exercise.	Administered and monitored by a healthcare professional.
Primary Goal	Preventative and supportive care, correcting environmental or behavioral causes.	Directly treats the underlying disease and manages hematocrit levels.
Risk of Complications	Minimal risk when done under a doctor's guidance.	Potential side effects depending on medication; close medical supervision is required.
Speed of Action	Gradual, takes weeks to months to see significant changes.	Can be more rapid for severe cases, especially with phlebotomy.

Conclusion

Discovering you have high hemoglobin should always prompt a conversation with a healthcare professional to determine the exact cause. While lifestyle changes like quitting smoking, staying hydrated, and dietary adjustments can be highly effective for environmental or behavior-related causes, medical treatment is essential for managing serious underlying conditions such as polycythemia vera. A holistic approach, combining professional medical guidance with positive lifestyle modifications, offers the most effective path toward normalizing hemoglobin levels and preventing potential complications like dangerous blood clots. For more in-depth medical information on blood disorders, including high hemoglobin, consider exploring resources from authoritative health organizations like the Cleveland Clinic on High Hemoglobin.

Frequently Asked Questions

Is high hemoglobin always serious?

Not always. It can be a temporary effect of dehydration or living at a high altitude. However, it can also indicate a serious underlying condition like polycythemia vera or lung disease, which is why a medical evaluation is essential.

What is phlebotomy, and how does it work?

Phlebotomy is a medical procedure where blood is removed from a vein to reduce the number of red blood cells. It is similar to donating blood and is a common treatment for high hemoglobin, especially in cases of polycythemia vera.

What foods should I avoid if my hemoglobin is high?

You should limit iron-rich foods, including red meat, liver, and iron-fortified cereals. High-sugar, saturated fat, and processed foods should also be limited for overall health.

Can exercise help manage high hemoglobin?

Yes, moderate exercise can help improve circulation and overall health. However, avoiding extreme endurance sports that can trigger increased red blood cell production might be advised.

How long does it take to lower hemoglobin levels?

For temporary issues like dehydration or high altitude, levels can normalize relatively quickly with correction. For chronic conditions, it can take weeks to months to see a reduction, depending on the treatment plan.

What is polycythemia vera?

Polycythemia vera is a rare blood cancer where the bone marrow produces too many red blood cells. This causes the blood to thicken, increasing the risk of blood clots. It requires long-term medical management.

Are there symptoms of high hemoglobin that require immediate attention?

Yes. While many symptoms are mild, persistent headaches, dizziness, or vision problems should prompt a doctor's visit. Signs of complications like blood clots, such as chest pain or a purple rash, require immediate medical care.