Liver & polycythemia. Liver dysfunction and erythrocytosis can be seen with serious conditions like hemochromatosis (where the body absorbs and retains too much iron), polycythemia vera (where the bone marrow makes too many cells - red, white, & platelets), and liver tumors (both benign & malignant). A henatologist should always be consulted in cases like this so that an accurate and timely diagnosis can be made.
What is something that can cause high red blood cell count along with smaller then normal red blood cells?
Thalassemia. The most connon would be thalassemia minor or trait, an inherited disorder characterized by an increased number of rbcs that are smaller than normal in size, usually with mild anemia. These are disiases where to body has trouble making enough hemoglobin and are congenital. There are some other, more rare conditions as well that can do it.
Rbc count. Unlikely.
Probably not. It takes a considerable amount of time for the red cell mass to react to hypoxia.