Did we ever get an answer to the person who had PV and Anemia?

[Limitpusher]

I have a new Hemoc Doc and my HCT is 45, my old doc wanted me under 45. Since I was HCT 45 this week I called to ask about a TP. He thought now then said go ahead. The issue is, I am on 500 mg Hydreaa 2xs per day.I think I am anemic. I know I need to be low on iron but my scores wereFeritin 3.8Iron 24Total Iron Binding 473Transferrin Saturation 5%Transferrin 338 (only normal)I am confused because for the first time since 2017 I have a normal WBC 7.0 and RBC 5.33The other counts were abnormal as usualMCH26.9 pg (Low)MCHC31.8 g/dL (Low)MPV6.3 fL (Low)NE%80.8 % (High)MO%3.6 %NE#5.66 x10 (High)So, should I or should I not get a therapeutic phlebotomy.I have been having itching skin, headaches, joint aches, fatigue and dizziness, all of which usually mean the need for a TP, however If I am already anemic and RBC is normal what should I do?

[hunter5582]

Iron deficiency and anemia are not the same thing.

Anemia is caused by lack of Hemoglobin.

Iron Deficiency is caused by lack of Iron.

Iron Deficiency with Anemia is caused by both a lack of Iron AND a lack of Hemoglobin.

ironology.life/blogs/news/y....

The purpose of therapeutic phlebotomy is to induce iron deficiency without inducing anemia. It is a balancing act to get this right. Using TP to control erythrocytosis can help control the symptoms but can have its own issues. It is also worth noting that iron deficiency without anemia can also have its own adverse effects.

Some of the issues you are experiencing may be directly related to hyperviscosity of the blood associated with the higher HCT. However, some issues may be related to other factors. Itching skin is likely related to a histamine response due to increased mast cell activity. Joint aches are likely related to the increased production of inflammatory cytokines related to the JAK2 mutation.

PV is a complex disease with multiple factors to address and manage. Suggest you go back to your MPN care team and ask for a better explanation of your current status. Regardless of whether you move forward with a TP at this point, you need to feel comfortable with your decision and understand why you are taking the next step.

All the best moving forward.

[Limitpusher in reply to hunter5582]

Thank you, I was never told why my joints hurt so badly or why my skin itched just that it was normal with PV.

[JOY2THEWORLD49]

Hi

Just so you know you can be anaemic on lower than normal B12 and Folic Acid.

I have no idea of your many abbreviations!

No one should use abbreviations on this forum please.

cheers JOY. 73. (NZ)