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Thick Blood - Causes, Symptoms and Treatment
contents
- definition
- Oxygen deficiency as the main cause
- Tumor diseases and oxygen level of the blood
- Other causes
- symptoms
- diagnosis
- therapy
definition
Our blood is the main supply fluid of our body and consists of a 90%, aqueous solution, which mainly contains the following substances:
- red blood cells (erythrocytes),
- white blood cells (leukocytes),
- blood plasma,
- Protein (proteins),
- salts.
Thick blood is a normal concentration of red blood cells (red blood cells, shown in the picture), which can cause serious health problems. (Image: fotomek / fotolia.com) In addition, however, there are other substances in the blood that are contained only on a molecular scale, but that reproduce the manifold functions that the blood has in the body. Roughly subdivide these tasks as follows:
- Mass transfer: The main task of the blood is to transport important substances to their place of use in the body, including nutrients, oxygen and even hormones. For the transport of oxygen in this case the erythrocytes are responsible, which bind the oxygen molecules from the lungs and release them again only at their destination in the organism. At the same time, the blood is also involved in the removal of metabolic waste products, including carbon dioxide and urea.
- Immune defenses: The leukocytes in the blood are an essential part of the immune system and are triggered by foreign bodies (such as bacteria or viruses) in their attacks on the health of their immune system. This is done in several steps, which includes not only the foreign body analysis but also the production of antibodies. In addition, the coagulation function of the blood is an important part of the body defense in case of injuries, because the blood clotting wounds are closed and thus prevented germs from entering the wound opening.
- Heat regulation: Due to the continuous flow of blood through the body, it also becomes a heat conductor. Thanks to the blood circulation, body temperature can also be regulated. It regulates both the body's own and externally acting on the organism heat surplus.
Erythrocytosis can now have dangerous effects on all mentioned functions. The cause of the disease is increased blood formation, which significantly increases the number of erythrocytes in the blood. An increased number of erythrocytes becomes clear in the so-called hematocrit value (percentage of blood cells in the blood in percent). This is usually between 37 and 45 percent in women and 42 to 50 percent in men. In the case of erythrocytosis, the value is therefore significantly increased and visibly more than 50 percent.
Due to the altered consistency of the blood, this is actually thicker and can only do its functions conditionally or not at all. Especially circulatory disorders and associated concomitants are typical of the blood thickening and can range from visible signs of oxygen deficiency (cyanosis) to organ failure due to lack of oxygen supply. Particularly dangerous in this regard are disorders of the heart and brain function.
Oxygen deficiency as the main cause
The causes of erythrocytosis are versatile and may be physiological or pathological in nature. Physiologically, the developmental mechanisms of the red blood cells play a major role. Their occurrence in the blood is usually regulated by the hormone erythropoietin (EPO for short), which is formed in the kidney. Since erythrocytes are responsible for the transport of oxygen in the blood, the control of the hormone on the oxygen content of the blood takes place. If there is not enough oxygen in the blood over a long period of time, the hormone reacts by stimulating the formation of erythrocytes in the bone marrow.
The proportion of red blood cells is usually regulated by the hormone erythropoietin (abbreviated to EPO, shown schematically here), which is formed in the kidney. (Image: molekuul.be/fotolia.com) In case of persistent lack of oxygen in the blood (hypoxemia), the body first tries to compensate the oxygen level by increasing the production of erythrocytes. Thus, erythropoietin increases, thereby increasing the production rate of red blood cells, resulting in physiologically induced erythrocytosis. Responsible for such body processes can be various influencing factors. It is conceivable, for example, a longer stay in low-oxygen environment. This is especially true for stays at high altitude of over 4000 meters.
Even permanent smoking can cause erythrocytosis. The reason for this is the fact that the carbon monoxide contained in cigarette smoke blocks the oxygen binding sites of the erythrocytes and can bind them as a result of less oxygen. The oxygen level of the blood is reduced in the long term by this disorder. In addition, in the area of the causes of illness, cardiac diseases such as cardiac insufficiency or valvular heart failure and lung diseases such as bronchial asthma, COPD or pulmonary emphysema are often responsible for hypoxemia.
Speaking of EPO: In Switzerland, researchers have recently achieved a breakthrough in the cause of the development of autosomal dominant inherited erythrocytosis. Subjects were members of a family in which about 50 percent of all male and female relatives suffered from over four generations of thick blood. The cause was a gene defect that caused a mutation of the EPO gene.
Tumor diseases and oxygen level of the blood
Another factor that can overshoot RBC production is cancer in the blood-forming system. To name here, for example, osteomyelofibrosis. Behind this is a malignant disease of the bone marrow, which leads to constant remodeling of bone marrow in connective tissue (fibrosis) through cell degeneration.
Also, Cushing's disease, a pituitary gland disease, can not be ruled out as the cause of erythrocytosis. The disease has an increased stimulation of the adrenal cortex and thus an increase in cortisol release. Cortisone in turn stimulates the production of red blood cells in the bone marrow. The same applies to various forms of kidney tumors, which cause similar disturbances in the erythrocyte formation. Last but not least, blood cancer is of course a disruptive factor that can significantly affect the formation and functionality of red blood cells.
Thrombosis caused by the blood thickening is also a high risk. The latter develop very well as part of an erythrocytosis, as the blood flow slows down due to the thickened blood and thus ensures blood congestion in the veins. Overall, further complications are to be expected due to illness.
Other causes
Influencing factors such as massive vomiting and persistent diarrhea are underestimated when it comes to thick blood. Because of the associated fluid loss of the body, namely, the relative proportions of liquid blood components are greatly reduced in the long term, which can change the material concentration of the blood to the extent that red blood cells take over. Often associated with severe nausea and constant vomiting are mainly gastrointestinal infections, poisoning and food intolerances.
Influencing factors such as massive vomiting and persistent diarrhea are often underestimated, but due to the loss of fluid they are a possible trigger for thick blood. (Image: Doris Heinrichs / fotolia.com) An increased supply of the erythrocyte-forming hormone erythropoietin from the outside can not be ruled out as the cause of the disease. This is mainly due to doping with drugs such as EPO or androgens. A relatively rare cause of disease is also the so-called fetofetale transfusion syndrome - a circulatory and nutritional disorder that occurs only in identical twins in the womb and ensures a mutual blood exchange between the children. A material imbalance in the blood of the affected twins is relatively likely in the context of this syndrome.
symptoms
The symptoms of erythrocytosis include, above all, consequences that result from insufficient oxygen transport of the blood. For example, persistent fatigue and headaches are typical consequences of lack of oxygen. The cyanosis, a blue coloration of body parts by oxygen-poor and therefore darkly discolored blood, is considered to be generally typical. Above all, the extremities and acres are affected as remote limbs especially by cyanosis.
In addition, the blood thickening promotes respiratory problems and thromboses. The latter develop very well as part of an erythrocytosis, because the blood pressure due to the thickened blood increases rapidly and thus ensures blood congestion in the veins. Overall, due to illness, the following complaints can be expected:
- a headache,
- dizziness,
- high blood pressure,
- increased risk of thrombosis,
- cyanosis,
- Metabolic disorders,
- Feeling of breathlessness,
- Disorders of organ functions.
Attention: If left untreated, erythrocytosis can lead to severe dysfunction of the heart and brain. Stroke and heart attack risk increases enormously! A pulmonary embolism may also be the result of untreated blood thickening.
diagnosis
The diagnosis is made by analyzing blood samples in the case of thick blood. In addition to the hematocrit value, the most important laboratory parameters are above all the hemoglobin values and the oxygen saturation in the blood vessels. Depending on the focus, further diagnostics are followed by sonographic procedures and cardiodiagnostic procedures (such as ECG and cardiac ultrasound). If there is a suspicion of a tumor disease, imaging techniques such as CT or MRI are also used.
Blood sample for the laboratory determination of thick blood. In addition to the hematocrit value, the most important laboratory parameters are mainly hemoglobin values and the oxygen saturation in the blood vessels. (Image: Henrik Dolle / fotolia.com) therapy
The therapeutic measures against erythrocytosis depend entirely on the underlying cause. If these are due to a genetic defect, unfortunately, there are hardly any possibilities to completely cure the disease. For most other influencing factors, however, there are now very good treatment options.
Targeted hydration
If the proportion of erythrocytes only relatively increased because too little liquid components are present in the blood, the therapy consists of the supply of physiological fluid solutions through the vein. Patients should also drink a lot during therapy in order to bring the fluid balance of their body back to normal. Necessary are such measures especially for diarrheal diseases such as gastrointestinal influenza.
oxygen therapy
If the erythrocytosis is based on a hypoxic condition, the first measure is usually a supply of high-dose oxygen from the outside. Following this, the actual underlying disease must be treated, which in the case of heart and lung diseases often proves to be very lengthy, but not completely impossible. Of course, if smoking was involved in the development of hypoxemia, the initiated therapeutic measures aimed at a permanent abstinence from cigarettes. Support can provide appropriate smoking cessation programs as a therapy support.
Medication and radiotherapy
Tumor diseases as the cause of the thick blood usually require a chemotherapeutic treatment with drugs. Especially blood cancer is not surgically treatable, but makes a combination therapy of cytostatic drugs and radiation necessary. Promising medicines here include drugs such as chlorambucil, which are now often given in leukemia together with the antibody obinutuzumab. In addition, gene therapies are increasingly showing signs of success in fighting blood cancer. In addition, erythrocytosis can be used to dilute the blood.
hemodilution
The term hemodilution therapy is the specialist term for bloodletting. In this case, 300 to 500 ml of blood are removed at regular intervals and replaced by physiological fluid solutions. The aim is to transfer the hematocrit back into the normal physiological range through bloodletting. The therapy is usually an emergency solution for illnesses that can not be treated otherwise. This applies, for example, to genetically caused defects in the EPO gene, but also to untreatable cancers.
Illnesses as a cause of thick blood: hypoxemia, blood cancer, Cushing's disease, kidney tumor, osteomyelofibrosis, bronchial asthma, COPD, pulmonary emphysema, fetofetales transfusion syndrome, gastrointestinal infection, poisoning. (Ma)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)