Polycythemia Vera And Thyroid Disorders Connection

Is There A Link Between Thyroid Disorders And Polycythemia Vera

The blood circulatory system has vital roles to play in the body.

This system delivers blood that is rich in oxygen to all parts of the body, including every vital organ found in the body. When the blood circulatory system is affected by any particular health condition, then complications with the human body’s overall well-being is sure to develop.

Being deprived of oxygen and a steady flow of blood is known to contribute to a great number of diseases, and can even lead to fatal complications.

Polycythemia Vera, sometimes simply referred to as PV, is a condition that can have a hazardous impact on the blood circulatory system, causing the brain, the heart, and other vital parts of the human body to become deprived of oxygen-rich blood.

The condition is extremely rare, but still noteworthy. The complications that Polycythemia Vera causes can have many side-effects in store for a patient suffering from the condition, and can also cause them to experience a significant increase in their likelihood to have a stroke or a heart attack.

Today, we want to look at how the function of the Thyroid gland, and conditions that adversely affect the Thyroid gland, may share a connection to Polycythemia Vera. We will consider the common types of Thyroid disorders, and look at how they may have a link to Polycythemia Vera.

We will also discuss the symptoms that may signal Polycythemia Vera, and consider additional symptoms that may be present should a patient suffer from a Thyroid disorder along with this blood disease.

Polycythemia Vera: Overview, Risk Factors And More

Polycythemia Vera is a type of Myeloproliferative Disorder1, and is often discussed together with Essential Thrombocythemia, due to the similarity in the effects that these conditions have in the human body and, in particular, the blood circulatory system.

Other types of Myeloproliferative Disorders that also exist include Primary Myelofibrosis and Chronic Myelogenous Leukemia.

The Epidemiology Of Polycythemia Vera

Polycythemia Vera is a relatively rare blood disease that does not affect as much of the population as diseases like arthritis and lung cancer, but it is still worth looking into the epidemiology of the condition.

There is not a significant amount of data available to provide a 100% accurate figure on the prevalence of Polycythemia Vera, but some studies have provided estimates based on the review of medical records from numerous health institutes.

One review paper2 published by the Yale University School of Medicine concluded that approximately 65,243 individuals in the United States were suffering from the condition in 2003. Newer publications about updated figures have not yet been revealed, but according to this data, it is already relatively easy to determine the rarity of the condition.

Causes And Risk Factors Of Polycythemia Vera

Possible Complications Of Polycythemia Vera

Polycythemia Vera is a disease that causes a gradual increase in red blood cell production within the patient’s body. This can cause blood to become thick – this is also where the major concerns about the condition come into play.

Complications that may be caused by Polycythemia Vera makes this an especially dangerous disease when it goes undiagnosed and untreated. The most significant complications that may occur when a patient is diagnosed with Polycythemia Vera is the fact that the disease causes an increase in the risk of hemorrhagic events, as well as thrombosis3.

Additionally, in some rare cases, the condition or the treatments utilized to provide a reduction in the effects that the disease has on the body, may lead to the development of acute leukemia, which can be deadly to the affected patient4.

Symptoms Of Polycythemia Vera

Patients need to understand that Polycythemia Vera is a slow-progressing disease – the disease may be present in a patient’s body for years without them ever noticing any significant or serious symptoms. As the disease gradually causes blood cell production to become increased, symptoms may start to develop.

It should also be noted that the symptoms may become more significant when complications are starting to develop, making it even more essential for a patient to become aware of these symptoms, even if they are mild.

The sooner a treatment plan is provided to a patient, the more successful the disease can be managed, and the lower the risk of developing complications.

Symptoms that may present themselves during the gradual development of the disease include:

  • Frequently experiencing fatigue.
  • Unexpectedly losing weight, as well as a higher risk of anorexia.
  • Signs associated with thrombosis, including bleeding and bruising easily.
  • In some patients, symptoms associated with gouty arthritis, or Gout for short, may also develop. In most cases, a single joint (with the big toe being the primary area of concern) may become swollen and extremely painful. There are cases where more than a single joint may be affected.
  • Tinnitus-related symptoms may also be present in a patient with Polycythemia Vera.

Understanding the potential clinical symptoms associated with Polycythemia Vera is also important. In a clinical presentation, a doctor may notice symptoms such as complications with the liver and the spleen, including an enlargement.

Ecchymosis and Petechiae are also two particular clinical symptoms that may be present in the patient.

The Possible Connection Between Thyroid Disorders And Polycythemia Vera

Thyroid disorders are relatively common in the general population, affecting both men and women of all ages.

There are different types of disorders and diseases that can affect the Thyroid. Since the Thyroid gland is responsible for producing hormones that are essential for overall metabolism, any disorder that causes changes in the way hormones are secreted by this gland can lead to unpleasant complications.

Hyperthyroidism and Hypothyroidism are the two most common types of conditions to affect the Thyroid gland.

  • Hyperthyroidism is diagnosed when the Thyroid gland produces too much Thyroid hormones in a patient. This results in elevated levels of thyroxine in the bloodstream5, causing metabolism to speed up at a cellular level. Several functions in the body can speed up, leading to an increase in appetite, weight loss, tremors, anxiety, sweating, a faster heartbeat, more frequent bowel movements, and agitation6.
  • Hypothyroidism is the opposite of Hyperthyroidism. While the Thyroid gland produces too much thyroxine in patients with Hyperthyroidism, a patient with Hypothyroidism rather has a deficiency in Thyroid hormones. This causes metabolism of cells in the patient’s body to slow down; thus overall functions of organs and other bodily tissues can become impaired. Hypothyroidism may cause symptoms such as fatigue and weakness, as well as weight gain, dry hair, dry skin, hair loss, muscle cramps, depression, irritability and constipation7.

Hyperthyroidism And Polycythemia Vera

Hyperthyroidism, as previously explained, is a condition where an elevated level of Thyroid hormones is produced by the Thyroid gland in the patient’s body. In turn, many processes in the body can start to work faster. The complications that may be caused by the speedup in bodily functions can be detrimental to the overall health, as well as day-to-day capabilities, of the affected patient.

Some evidence has suggested that Hyperthyroidism may be a risk factor for Polycythemia Vera, as explained by a contributed on TiredThyroid.com8.

The patient had been diagnosed with Polycythemia Vera – later on, it was discovered that the patient was suffering from Erythrocytosis and not Polycythemia Vera, as previously diagnosed. This condition causes similar symptoms and complications as Polycythemia Vera, explaining the initial misdiagnosis.

The cause of the condition was later on tracked to the synthetic Thyroid hormones the patient was taking. An inappropriate dosage of Thyroid hormones for the treatment of Hypothyroidism can cause levels of thyroxine in the bloodstream to become too high; thus leading to similar effects as Hyperthyroidism in the body.

When pharmaceutical treatments for Hypothyroidism is causing too much thyroxine to be present in the patient’s body, and, in turn, causing symptoms associated with Erythrocytosis or Polycythemia Vera, then an appropriate treatment approach would be to lower the dose of synthetic Thyroid hormones.

It might take some time to find the most appropriate reduction in the dosage of the Thyroid hormones before the complications can be adequately alleviated.

Hypothyroidism And Polycythemia Vera

A possible connection may also exist between Hypothyroidism and Polycythemia Vera, but there is still an insignificant amount of scientific evidence to provide accurate data on this link. A publication on eHealthMe9 explains that data from the FDA provided more insight into this possible connection. All patients observed to suffer from both Polycythemia Vera and Hypothyroidism were male and older than 60.

It was also found that the patients who suffered from both of these conditions, had certain co-existing medical concerns that were common amongst the monitored patients. These co-existing medical conditions include high blood pressure, chronic myeloid leukemia, hyperuricemia, and embolism venous.

The most common clinical symptoms that were observed amongst these patients included a positive test result for anti-thyroid antibodies, a reduced level of Thyroid Stimulating Hormone was observed in the blood of the patients, and high blood sugar levels were also observed. A

reduction in Thyroxine levels in the blood, as well as triiodothyronine was also observed amongst the patients. This data provided clear evidence that patients were, in deed, suffering from a deficiency in Thyroid hormones; thus they have met the criteria for a diagnosis of Hypothyroidism. The addition of high red blood cell counts, as well as other tests, provided further evidence that Polycythemia Vera was also present amongst the patients.

The data provided by the FDA only took into account an insignificant number of patients, but still provides a reason for additional research to be implemented.

More accurate data can assist with better understanding how these conditions may be connected, and allow for more effective treatment approaches to be implemented to help avoid possible complications that might occur when a patient suffers from both conditions simultaneously.

Conclusion

Polycythemia Vera is a relatively uncommon blood disease that causes the body to increase the production of red blood cells. This can lead to blood becoming thicker; thus causing a number of complications, including a higher risk of a stroke or heart attack.

Some scientific studies have suggested that a connection may exist between Polycythemia Vera and Thyroid disorders, with hyperthyroidism being a primary concern in the medical industry at the moment. Some evidence also suggests that hypothyroidism and Polycythemia Vera might also share a link, but additional research is needed to provide more insight into the topic.

In this post, we provided a comprehensive overview of Polycythemia Vera, including the possible complications that may develop when a patient develops this condition, and particular symptoms that patients should look out for.

Additionally, we also discussed how a possible connection might exist between Polycythemia Vera and the two most common Thyroid disorders, Hyperthyroidism and Hypothyroidism.

References

1 Haleem J. Rasool. Myeloproliferative Disease. 26 February 2016. https://emedicine.medscape.com/article/204714-overview#a1

2 Multiple Authors. Prevalence of polycythemia vera and essential thrombocythemia. U.S. National Library of medicine. May 2008. https://www.ncbi.nlm.nih.gov/pubmed/18181200

3 T.C. Pearson, M. Messinezy. Investigation of patients with polycythaemia. Postgraduate Medical Journal. September 1996. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2398572/

4 Polycythemia vera. BMJ Publishing Group. June 2016. http://bestpractice.bmj.com/topics/en-us/178

5 Hyperthyroidism. PubMed Health. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024711/

6 Melissa Conrad Stoppler, Ruchi Mathur. Hyperthyroidism. MedicineNet.com. https://www.medicinenet.com/hyperthyroidism/article.htm#what_is_hyperthyroidism

7 James Norman. Hypothyroidism: Overview, Causes, and Symptoms. Endocrine Web. https://www.endocrineweb.com/conditions/thyroid/hypothyroidism-too-little-thyroid-hormone

8 Das, K. C., et al. Erythropoiesis and erythropoietin in hypo-and hyperthyroidism” The Journal of Clinical Endocrinology & Metabolism 40.2 (1975): 211-220.

9 Polycythemia vera and Hypothyroidism – from FDA reports. eHealthMe. https://www.ehealthme.com/cs/polycythemia-vera/hypothyroidism/

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