What causes high hematocrit levels, and what should I do?
Aug 21, 2025
Source: Cainiu Health
Dr. Liu Feng
Introduction
In general, elevated hematocrit levels may be caused by factors such as dehydration, long-term residence at high altitudes, polycythemia vera, chronic obstructive pulmonary disease (COPD), or congenital heart disease. It is recommended to seek timely medical consultation to identify the underlying cause, followed by improvement under a physician's guidance through measures such as hydration, environmental adjustments, and medication. In daily life, maintaining a regular sleep schedule and avoiding late nights and excessive fatigue is also important.
Generally, elevated hematocrit levels may be caused by dehydration, long-term residence at high altitudes, polycythemia vera, chronic obstructive pulmonary disease (COPD), or congenital heart disease. It is recommended to seek timely medical attention to identify the underlying cause, followed by improvement under a doctor's guidance through hydration, environmental adjustments, medication, and other measures. The detailed analysis is as follows:
1. Dehydration: Excessive sweating or insufficient water intake leads to fluid loss in the body, causing blood concentration and a relative increase in red blood cell concentration, resulting in elevated hematocrit. Symptoms may include dry mouth and reduced urine output. Increase water intake immediately, drinking 100–200 mL of warm water each time, with a daily total of 1500–2000 mL. Avoid strenuous exercise to reduce sweating, and recheck the indicators after 1–2 days for normalization.
2. Long-term residence at high altitudes: The low oxygen levels at high altitudes prompt the body to produce more red blood cells to carry oxygen, leading to elevated hematocrit, accompanied by fatigue and shortness of breath. If long-term stay is required due to work, regular oxygen therapy can help alleviate hypoxia.
3. Polycythemia Vera: Abnormal bone marrow hematopoietic function causes excessive red blood cell proliferation, resulting in elevated hematocrit, accompanied by facial flushing, dizziness, numbness in hands and feet. Patients should follow medical advice to use medications such as hydroxyurea tablets, aspirin enteric-coated tablets, or interferon alpha-2b injection to suppress red blood cell production and prevent thrombosis.
4. Chronic Obstructive Pulmonary Disease (COPD): Long-term pulmonary inflammation leads to impaired ventilation, causing hypoxia that stimulates red blood cell production, resulting in elevated hematocrit, accompanied by cough, sputum production, and breathing difficulties. Patients should follow medical advice to use medications such as salbutamol aerosol, budesonide-formoterol powder inhaler, or tiotropium bromide powder inhaler to improve ventilation.
5. Congenital Heart Disease: Structural heart abnormalities cause circulatory dysfunction, leading to insufficient pulmonary blood supply and hypoxia, which stimulates red blood cell production, resulting in elevated hematocrit, accompanied by palpitations, chest tightness, and shortness of breath during physical activity. Patients with mild symptoms should follow medical advice to use medications such as digoxin tablets, spironolactone tablets, or hydrochlorothiazide tablets to improve heart function.
Daily routines should include maintaining regular sleep patterns, avoiding late nights and excessive fatigue, and reducing oxygen consumption. Diet should be light and low in salt, with increased intake of fresh vegetables and fruits, avoiding high-fat and high-sugar foods. Smoking should be quit and alcohol consumption limited to reduce stress on cardiopulmonary function. Comprehensive care helps maintain the health of the circulatory system and cardiopulmonary function.
