What should I do if my hematocrit is high?
Aug 20, 2025
Source: Cainiu Health
Dr. Liu Feng
Introduction
In general, elevated hematocrit levels may result from dehydration after strenuous exercise, long-term residence at high altitudes, mild dehydration, chronic obstructive pulmonary disease (COPD), or polycythemia vera. It is recommended to seek timely medical attention, identify the underlying cause, and then improve the condition under a doctor's guidance through general treatment, medication, or other appropriate methods. Additionally, maintaining a regular作息 (作息 translates to作息 habits or routine) and avoiding熬夜 (熬夜 translates to staying up late) are advised in daily life.
Generally, elevated hematocrit levels may be caused by factors such as dehydration after strenuous exercise, long-term residence in high-altitude areas, mild dehydration, chronic obstructive pulmonary disease (COPD), or polycythemia vera. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general treatments, medications, and other methods. A detailed analysis is as follows:
1. Dehydration after strenuous exercise: Excessive sweating during intense physical activity leads to significant fluid loss, causing blood concentration and elevated hematocrit. This may be accompanied by thirst and fatigue. Immediately stop exercising, drink warm water or lightly salted water to replenish fluids—500–800 mL in divided amounts over 1–2 hours—and maintain a daily water intake of 1500–2000 mL afterward. Avoid engaging in strenuous exercise again until full recovery.
2. Long-term residence in high-altitude areas: Due to the thin air at high altitudes, the body compensatorily increases red blood cell production to enhance oxygen-carrying capacity, resulting in elevated hematocrit. This usually does not cause significant discomfort. Regular follow-up at lower altitudes is recommended, along with avoiding excessive fatigue in daily life. Low-intensity exercises such as walking or practicing tai chi may be beneficial.
3. Mild dehydration: Fluid loss due to insufficient water intake, vomiting, or diarrhea can cause blood concentration and elevated hematocrit, often accompanied by reduced urine output and dry lips. Increase fluid intake, preferably with warm water, and avoid sugary drinks. Oral rehydration salts may be used by those experiencing vomiting or diarrhea.
4. Chronic obstructive pulmonary disease (COPD): Impaired lung ventilation and chronic hypoxia stimulate increased red blood cell production, leading to elevated hematocrit. Symptoms may include coughing, sputum production, and shortness of breath. Patients should follow medical advice to use medications such as salbutamol inhaler, budesonide-formoterol powder inhaler, and tiotropium bromide powder inhaler to improve ventilation.
5. Polycythemia vera: Abnormal bone marrow hematopoiesis causes excessive red blood cell proliferation, resulting in significantly elevated hematocrit. Symptoms may include dizziness, numbness in hands and feet, and an enlarged spleen. Patients should follow medical advice to use medications such as hydroxyurea tablets, aspirin enteric-coated tablets, and homoharringtonine injection to suppress red blood cell production and prevent thrombosis.
In daily life, maintain a regular routine and avoid staying up late. Eat a light diet, reduce intake of high-salt and high-fat foods, and consume more fresh vegetables and fruits. Regularly monitor complete blood counts, track changes in hematocrit levels, and adjust treatment and care plans according to medical advice to maintain healthy blood function.
