Find cause. Polycythemia refers to having too many red blood cells. This can be caused by conditions that decrease the oxygen in the blood (like smoking), congenital heart defects, etc. Sometimes it can be a disorder of red blood cell production. Treatment includes correcting the cause and/or removing excess blood (phlebotomy) and medication like hydroxyurea.
Physiologic or PV? Polycythemia (increase in red blood cells) is often secondary -- that is a physiologic response to low oxygen. That can occur if you live in a high mountain in nepal, or have sleep apnea or smoke. If there are no secondary reasons for polycythemia, then it may be primary (clonal). The tests: jak2v617f and epo can discriminate. Tx: phlebotomy is only needed if primary polycythemia vera (pv).