A1C and PV

[Barbiebreath]

Does anyone know if PV affects A1C accuracy?

[EPguy]

I looked into it some. According to :

marshfieldlabs.org/sites/lt...

"Patients with polycythemia or post-splenectomy may exhibit increased HbA1c levels due to longer erythrocyte lifespan. " and:

ncbi.nlm.nih.gov/pmc/articl...

"the mean age of RBCs in the circulation" is a factor in A1c.

So PV causes older RBCs hence higher A1c.

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This idea that PV makes RBCs older, not just more, is new to me. RBCs normally last ~120days. Must be the excess creation of them overwhelms the normal destruction process of old ones.

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Which leaves the question whether properly controlled PV normalizes RBC age.

So it might be uncontrolled PV gives high A1c while controlled PV reads accurate RBC. But no clear answer there from what I can find.

[Hopetohelp in reply to EPguy]

very interesting

[LIGEBA]

I'm so happy you asked this question because just this morning (once again) I set out to try to understand why my blood sugar is in the 140s and 150s first thing in the morning. Up until about fall of last year it would fluctuate between 95 - 108 and my A1C would go between 5.8 and 6.1. My last A1Cs were 6.4 in January in 6.1 in March of this year.

Here's the search I plugged into Google: "does iron deficiency cause raised blood sugar" and it came back with a big yes! I am currently on 2 low dose aspirin and Therapeutic Phlebotomies every few weeks.

Then I also came across this from goodrx.com:

"Yes, you can have a high A1C level and not have diabetes. This is because an A1C test measures the amount of glucose that's attached to hemoglobin. So anything that affects hemoglobin can alter the results. Certain medications, such as steroids, can also raise blood glucose levels in people who don't have diabetes."

So, in the end, I still have no idea if the high blood sugars are concerning or not. So far none of my dr.s have raised concern and I have not asked about it, but will this week. I will share what I find out.

I should add that with the TPs my PV is considered controlled (Hct = 42.2 before last TP so I presume lower now, HGB 11.2, RBC 5.9 (high but no concern). MCV, MCH, MCHC all low and RDW high and Platelets at 612.

[Hopetohelp in reply to LIGEBA]

yes thanks to Barbiebreath for asking question too and thanks Ligeba for your answer. Mine is borderline and I have a test at end of week.

[EPguy in reply to LIGEBA]

Interesting details. If disregulated iron and A1c are related then TP (Phleb) might also lead to high A1C since TP can affect iron. If Hb is controlled by cytoreduction keeping iron balanced, would A1C read lower?

Three relevant possibilities from the info here, separate or together:

-RBC age

-RBC quantity

-Iron levels

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I'll also try to ask my MPN Dr this week. My blood sugar readings have been ok thru all but my HCT was never way high.

[Hopetohelp]

thanks for asking this question. I have asked this in my mind too

[falconered53]

I was told by an endocrinologist that the A1C test is not valid for me with PV. Makes sense since there are more red blood cells circulating