Elevated Hemoglobin

An increased hemoglobin concentration above the normal reference range for age and sex (women: 12.3-15.3 g/dL; men: 13.6-17.7 g/dL), reflecting increased red blood cell mass (absolute erythrocytosis) or hemoconcentration due to reduced plasma volume (relative erythrocytosis).

Causes

• Reduced plasma volume (relative erythrocytosis)

  • Dehydration

  • Fluid loss

  • Diuretic therapy

• Increased red blood cell production (absolute erythrocytosis)

  • Polycythemia vera

  • Secondary erythrocytosis due to hypoxemia

    • Tobacco smoking

    • Chronic obstructive pulmonary disease

    • Emphysema

    • Obstructive sleep apnea

    • High altitude exposure

    • Chronic heart conditions causing hypoxia

  • Increased erythropoietin production

    • Exogenous erythropoietin therapy

    • Renal or other erythropoietin-producing disorders

• Hormonal/medication-related causes

  • Testosterone therapy

  • Anabolic androgen use