Blood Disorders Polycythemia Vera & Myelofibrosis An Overview of Secondary Polycythemia An Overproduction of Red Blood Cells Caused by Health Disorders By Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. Learn about our editorial process Deborah Leader, RN Medically reviewed by Medically reviewed by Douglas A. Nelson, MD on July 26, 2020 linkedin Douglas A. Nelson, MD, is double board-certified in medical oncology and hematology. He was a physician in the US Air Force and now practices at MD Anderson Cancer Center, where he is an associate professor. Learn about our Medical Review Board Douglas A. Nelson, MD on July 26, 2020 Print KTS Design / Science Photo Library / Getty Images Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatment Coping Secondary polycythemia, similar to primary polycythemia vera, is a disorder that causes an overproduction of red blood cells. When too many red blood cells are produced, the blood becomes thick, hindering its passage through the smaller blood vessels. The difference between the two has to do with what the disorder is associated with. Secondary polycythemia is associated with an underlying disease process, but primary polycythemia is not. Secondary Polycythemia Symptoms Symptoms of secondary polycythemia, which are the same as those for primary polycythemia, may include: WeaknessHeadacheFatigueLightheadednessShortness of breathVisual disturbancesItching (pruritus)Pain in the chest or leg musclesRuddy complexionConfusionRinging in the ears (tinnitus)Burning sensations of the hands or feet Causes Primary polycythemia is caused by an abnormality of the cells in the bone marrow that form red blood cells. Secondary polycythemia is caused by a disorder originating outside of the bone marrow that causes overstimulation of the normal bone marrow, leading to an overproduction of red blood cells. The job of a red blood cell is to deliver oxygen to the body tissues. Smoking, for example, interferes with this process, so it is a common cause of secondary polycythemia. Others include: Brain, liver, or uterine tumorsChronic carbon monoxide exposureChronic heart diseaseChronic lung disease including chronic obstructive pulmonary disease (COPD)DiureticsHypoventilationHigh altitudeKidney cystsObesityPerformance-enhancing drugs or blood doping in sportsSleep apnea Diagnosis Measuring oxygen levels in the blood with a blood test known as arterial blood gas (ABG) can help doctors formulate a diagnose of secondary polycythemia. Other blood tests include measurement of erythropoietin and red blood cell mass levels. Additional diagnostic tests include an electrocardiogram (ECG) to measure heart function and imaging tests, such as a chest X-ray, computed tomography (CT), or ultrasound, to detect the enlargement of the heart, liver, or spleen. Your doctor may also use a genetic test that looks for a mutation in a gene called JAK2 that affects the bone marrow and blood cells. This test is positive in most cases of primary polycythemia and, as a result, is used to differentiate between primary polycythemia and secondary polycythemia. Treatment Treatment for secondary polycythemia should control or eliminate the underlying condition. Symptom relief may include medications such as antihistamines to relieve itching, or aspirin to soothe pain and burning associated with the disorder. Because it takes the time to treat the underlying condition, doctors sometimes use phlebotomy (blood-letting) to reduce the number of red blood cells in plasma. As much as a pint (475 milliliters) may be taken in one sitting as long as the individual can tolerate it. Understanding Therapeutic Phlebotomy Coping If you're already coping with one condition that can cause secondary polycythemia, such as COPD or a tumor, learning that you have a second diagnosis to cope with is understandably frustrating. You want to feel better, not worse. Remember that secondary polycythemia is caused by an underlying condition, most of which are well known and have multiple treatment options available. Once the underlying cause is corrected, symptoms of secondary polycythemia usually go away. Your health care provider will guide you along the best path for resolving both. Polycythemia Vera Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. McMullin MFF, Mead AJ, Sahra A, et al. A guideline for the management of specific situations in polycythaemia vera and secondary erythrocytosis: a British Society for Haematology guideline. Br J Haematol. 2019 Jan;184(2):161-75. doi:10.1111/bjh.15647 Assi TB, Baz E. Current applications of therapeutic phlebotomy. Blood Transfus. 2014 Jan;12(Suppl 1):s75-83. doi:10.2450/2013.0299-12