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Hematology/18 year old male, high red blood cell count and bilirubin?



I am an 18 year old male and just a few months ago (early March) I had my first blood test issued by my doctor. He just wanted to check my thyroid function and if I had signs of anemia (from some symptoms I was having) and since I was a new patient to him he wanted a complete blood panel done. After the blood test I went to see him and he told me everything was normal but my red blood cell count and bilirubin was high and at the "level of a smokers". He said it was no real concern though and to go back in 6 months to check again, and that it just might have been an inaccuracy in the results. I was still very worried but then I forgot about it until now where I started reading things about polycythemia rubra Vera and all the cancer related things to this condition. I am of healthy weight (130 lbs), in otherwise perfectly healthy condition, and my white blood cells and platelets and everything else was completely normal (thyroid functions and everything). I also don't live at high aItitude. I am confused because my doctor didn't really elaborate on potential causes or consequences of this, and he gave me mixed messages because at first he said it was only "slightly" high but then he said "it's like the level of a smoker's" (I don't know if he said it as a joke because he was smiling) but I got really worried. I also get occasional chest pain on the left side that is mostly random but sometimes triggered by physical activity, so I assume that it may be caused by thicker blood. I would really appreciate a Hematologists' input on this. Do you see any signs of alarm in my situation or is my doctor taking care of this appropriately? Should I see a hematologist or just check again in a few months (or earlier) with him?

Thanks a lot!

Warm welcome to you!
I could have ignored the chance of polycythemia vera if i had just considered RBC count and bilirubin. These could be seen in a person exposed to heat. But chest pain is often associated with polycythemia vera. So despite of all other normal readings, I would recommend a reticulocyte count, Liver function tests and peripheral blood smear. Did he examine your abdomen? This could be associated with hyperactivity of liver or spleen. He should have examined your abdomen for hepato-spleenomegaly. Its better to visit the hematologist.

Thanking you!


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Dr.Shrinidhi Kulkarni


I can answer all questions related to hematology. RBC, WBC, Platelet and blood forming organs etc and related questions. hematology also includes blood proteins, hemoglobin and disorders related to clotting abnormalities. So questions about all aspects of hematology are welcome!


Working as a Doctor in Primary Health care Centre.

KIMS Banglore

MBBS, Internship in Internal Medicine

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