Jardiance and lower HCT/Hgb

[Jsb45]

I am trying to sort an unusual but positive change in my PV. I am Jak2 + and was diagnosed 4 years ago. I am on Hydroxy 500 mg once a day for 5 days and 2 tabs Sat and Sun. My HCT wanted to stay around 46-47% so I asked the doc to increase my phlebotomy and lower the Hgb Level to 13.5. Data I had collected over the years showed that with a Hgb of 15 my HCT ran about 46-47%. He agreed to the change in phlebotomy to every two weeks and a level of 13.5.

Since this change I have only had 2 blood draws in the last 5 months; one draw at 16.2 and the next one at 13.7. Previously, I was needing a draw each time I went in and was typically at 16 -16.5 Hgb. Lately, I have been around 13.3 each time.

I have been at a loss to understand this positive dramatic downward shift. I like it, yesterday I went in for my phlebotomy and was at 13.3!! After considerable noodling on this and the lifestyle changes, the only thing I can figure out is that in January my GP started me on Jardiance for type 2 diabetes. Now several months later my Hgb levels are where they need to be and only once were they above 13.5 and I had a draw at 13.7. This is a huge change for me as before I was running about 16 all the time.

Has anyone else noticed a change using the Jardiance? I know these levels go in cycles, at least for me, but this is a lot lower than I would normally cycle over an entire year!

I am excited for my labs next week to confirm what I am seeing at the phlebo's!

[Aneliv9]

Is it possible that this is something that has to do with progression? I have read that Hg can become normal when mpn progresses. What your doctor said?

[Jsb45 in reply to Aneliv9]

I asked the Dr yesterday and he said that the numbers could drop off it progressed to MF. All my other numbers were good and not going up. So for the time being I'm happy they are staying low!

[Aneliv9 in reply to Jsb45]

I don't understand.. didn't you say that your HGb was dropping off? And your doctor told you that if blood counts dropping has to do with progression? Or must other blood counts drop in order to consider progression?

[Jsb45]

Yes, it could indicate progression if the Hgb levels continue to drop. It could indicate bone marrow burnout. Luckily this is not the cause as my levels this week were 14.4 back up! All my other blood levels are where they should be for having PV. I'm looking for some rationale for the step-change in levels besides the unpredictability of PV. I have had my levels go from 18.3 to 14.8 over a weekend! But not drop to sub 15.0 and stay there for several months. If I was doing something right I wanted to know.Thanks for asking!