Polycythemia rubra vera
Causes | Dietary Factors, Dehydration, Smoking, Environmental Chemicals |
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See Also | Cardiovascular Conditions, Atherosclerosis |
Books | Books on Cardiovascular Conditions |
Articles | Articles on Cardiovascular Conditions |
Polycythemia, also known as erythrocytosis, refers to an increased number of red blood cells.[1] Peak age of onset is 50 to 60 years.[2]
Contents
Naturopathic Assessment
Causal Factors
In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. Polycythemia may be a symptom of an associated condition, such as dehydration or plasma loss, or it may be due to genetic, environmental or external factors.[2]
Environmental
- Altitudes
- High altitudes.[1]
- Exposure to chemicals such as benzene or petroleum can cause polycythemia.[3]
External
- Heavy cigarette smoking leads to hypoxemia and secondary polycythemia.[1]
- Occupations
- Certain occupations such as; poultry workers, petroleum refinery workers, kitchen workers, agricultural workers, tradesmen, transport workers and metal workers.[3]
Medical Interventions
- Medical Procedures
Genetics
- Genetics factors include:
Diagnostic Testing
- Blood tests including[5], [2] CBC, hematocrit, platelet count, WBC count and differential, erythropoetin, Serum B12 and B12 binding capacity, oxygen saturation, arterial blood gases, carboxyhemoglobin levels, alkaline phosphatase,
- Urine tests including urinalysis
- Other diagnostic testing including CT of head or renal sonography.
Related Symptoms and Conditions
The underlying conditions that may cause or contribute to polycythemia include:[1], [5]
- chronic myeloproliferative disorders such as essential thrombocythemia and myelofibrosis.
- Secondary erythrocytosis or relative (spurious) erythrocytosis.
- Atherosclerosis.
- Dehydration.
- Peptic ulcer disease.
- Thrombosis.
- Gout and renal calculi secondary to hyperuricemia.
- Autoimmune disease
- Crohn's Disease, giant cell arteritis and parathyroid adenoma may show increased risk of Polycythemia.[3]
- Severe pulmonary disease can also lead to hypoxemia and secondary polycythemia.[1]
- Cyanotic heart disease with right to left shunt.[1]
Characteristics
Symptoms develop gradually and are usually vague and non-specific.[1]
- An elevated hematocrit may be the first and only sign of true polycythemia.
- Polycythemia usually appears insidiously in late middle age.
- Phenotypic shifts from polycythemia to essential thrombocytemia and progress towards myelofibrosis or leukemia are possible sequelae to this condition.[6]
Common Symptoms
Polycythemia may present with no symptoms at all or may present with the following symptoms.[1], [2]
- Bleeding such as epistaxis, menorrhagia, easy bruising or oozing from gums. Bleeding may also occur as hematemesis and melena.
- In advanced cases peripheral cyanosis or burning and redness of the hands and feet.
- Generalized weakness, sweating and fatigue.
- Neurological symptoms such as dizziness or vertigo, blurred vision, headaches, tinnitus or fullness in the head.
- Reddish or purplish skin, early feeling of fullness (satiety), itchiness (pruritis) especially after the shower
- Pruritus (Itchiness) may occur secondary to histamine release from neoplastic basophils particularly after hot bathing.
- Bone pain.
Naturopathic Treatment
The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. The treatment strategy is strongly dependent on other associated conditions. In some cases phlebotomy, the removal of the blood from the blood vessels, is required if the hematocrit level is too high.
It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.
Lifestyle
Lifestyle recommendations include:
- Dietary recommendations
Naturopathic Therapies
The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.
Naturopathic Therapies for Polycythemia rubra vera include:
- Clinical Nutritional Supplementation includes
- Vitamins such as Vitamin E
- Minerals such as Magnesium
- Other supplements such as Green Tea, bioflavonoids
- Herbs such as Alfalfa (Medicago sativa), Aloe (Aloe vera), Burdock (Arctium lappa), Cat's Claw (Uncaria tomentosa), Garlic (Allium sativum), Ginseng (Panax ginseng), Turmeric (Curcuma longa)
- Homeopathics may be beneficial in treating the underlying cause or other associated conditions.
- Acupuncture can be beneficial in improving overall circulation.
References
Reviewed by Iva Lloyd, BScH, RPE, ND [1]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 Goroll A, Mulley A, editors. (2009) Primary Care Medicine – Office evaluation and management of the adult patient. Boston: Lippincott Williams and Wilkins;163:pg637-641
- ↑ 2.0 2.1 2.2 2.3 Kumar Vinay, Abbas Abul, Fausto Nelson, Mitchell Richard, editors. (2007) Robbins Basic Pathology 8th Edition. Saunders Elselvier, Philidelphia:pg465-466
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Anderson LA, Duncombe AS, Hughes M, Mills ME, Wilson JC, McMullin MF (2011)Environmental, lifestyle, and familial/ethnic factors associated with myeloproliferative neoplasms. Am J Hematol.;87:175-182.PMID:22076943
- ↑ Wang K, Swierczek S, Hickman K, Hakonarson H, Prchal JT(2011)Convergent mechanisms of somatic mutations in polycythemia vera. Discov Med.;12(62):25-32.PMID:21794206
- ↑ 5.0 5.1 Berga S, Bowman M, Drossman D, Faling J, Frenkel E, Gabbard G et al. editors.(1992) The Merck Manual of Diagnosis and therapy 16th edition. Rathway: Merck & Co Inc.
- ↑ Vannucchi AM, Biamonte F (2011) Epigenetics and mutations in chronic myeloproliferative neoplasms. Haematologica.;96(10):1398-402. PMID:21972209