Frequently Asked Questions

1. QUESTION:
   Is advanced stage cirrhosis and end stage cirrhosis the same thing?
   My brother was admitted to the hospital last night because he was very swollen in the abdomen. He is only 26 years old, but he is an alcoholic. We are still waiting for the test results, but it is likely he has cirrhosis. In which stage we still do not know. However, some sites say advanced symptoms, which he has many of, while some sites talk about end stage cirrhosis which is basically fatal. I am just wondering if anyone knows if advanced and end stage mean the same thing?
   He also has mental confusion, tiredness, weakness, and no appetite.

   • ANSWER:
     When something is bothering the liver such as alcohol abuse, it can cause inflammation which can lead to fibrosis (abnormal fibrous bands in the liver). As time goes by, more and more fibrosis forms. As even more time goes by, liver cells may begin to die and scar tissue replaces healthy tissue. This is called cirrhosis.

     The doctor can do a liver biopsy to see how much fibrosis is present. Here's how the stages go using a staging system of 0-4.

     Stage 0- no fibrosis present
     1- small amount of fibrosis
     2- a little more fibrosis present
     3- even more fibrosis present (stage 3 is bridging fibrosis)
     4- cirrhosis is present

     Anyone with even a little bit of cirrhosis is considered stage 4 which is called end stage liver disease (ESLD). All that means is that cirrhosis is present. It can be just a little to very severe. So that's why people refer themselves as end stage if they have any cirrhosis at all.

     But cirrhosis itself also has a staging system which gives more detail. It goes by A, B, and C.

     Stage A- compensated cirrhosis (has no symptoms)
     Stage B- beginning of decompensation (needs medications and treatments to
     help control symptoms of the disease such as fluid retention, banding
     varices, etc.
     Stage C- decompensated cirrhosis (medications no longer work very well to
     control the disease and total failure is near

     The best thing your brother can do for his disease is to stop drinking all alcohol. If he already has cirrhosis, continued drinking will only make the disease progress to total failure faster. If the disease has not progressed very far, sometimes a person is able to live quite well with some cirrhosis as long as they quit drinking and do the right things in taking care of themselves. Once the damage is severe, only a transplant will save their life. They don't give transplants to active drinkers. They require at least 6 months of proven sobriety before they will even consider you for a transplant if alcohol abuse is the cause of the cirrhosis.

     I hope this is a wake up call for your brother and he is paying attention. He is so young to have cirrhosis. Most people don't get it this young. There could be something else going on with him besides just the alcohol problem that is causing this.

2. QUESTION:
   advanced cirrhosis's, liver no longer working?
   what is the life expectancy of someone whose liver is not working at all? Even if treating the symptoms, the liver no longer works. How long can one live like that?

   • ANSWER:
     If your liver was not working at all, it would be just a short time before you would die. My guess would be within a few days. But a person can live with very little liver function. I lived with 10% function for several years. I have heard of others living with as low as 5%. Now you couldn't live a long time with that low of function, but it is quite possible to survive awhile with just a little bit of function left.

3. QUESTION:
   prognosis for those diagnosed with cirrhosis of the liver?
   heart disease patient just dignosed with cirrhosis. how long will he live?
   His symptoms are advanced-no jaundice or bleeding of the esophagous yet. Has all other symptoms-bruising, abdominal swelling, lethargy, etc.

   • ANSWER:
     Ask his doctor, only he can tell you and at that, it's only an educated guess. When my Mom was DX with a GBM, she was give 3 weeks and lived 9 months. R.I.P. Mom!!

4. QUESTION:
   Cirrhosis of the liver symptoms.. and Need Help!!?
   I have a family member who has been diagnosed 15+ years ago with cirrhosis of the liver. He is probably the largest alcoholic known to mankind. He drinks at least 30 + beers a day, and is now experiencing constant nosebleeds, for over 3 days now.. It just bleeds and bleeds when he sits up. He has blood in his urine and his stool appears blackish greenish of color and has constant diarrhea, but does not eat very often.. at all!

   I am assuming that hes in the end stages of this disease and want to know if any of you have had these issues with a family member or friend, and what is wrong and how long that this trend will continue and what will happen.

   Thank you so much for your cooperation in advance, we appreciate any answers you may have!

   • ANSWER:
     I have worked with people who had cirrhosis. They get swelling in their abdomen (ascites) & extremities (edema). The stomach can get the size of a honeydew melon.
     Vit K gets reduced & so there is more bleeding. As the toxins build up in the body, the skin begins to itch...the person becomes jaundiced & mental changes occur...sometimes during these various stages antibiotics are given.

     High potency Vit B complex can be helpful as can milk thistle. However, I don't know how long it will prolong his life.

     Google: mayo clinic>>diseases>>cirrhosis

     I'm very sorry to hear of your situation.
     Good luck.

5. QUESTION:
   Questions about severity of cirrhosis progression?
   An alcoholic family member has the symptoms listed below. I wondered if a medical professional or someone with knowledge about cirrhosis could determine how advanced this case is.

   ascites
   gynecomastia
   asterixis
   spider angiomata
   hepatopulmonary syndrome
   extreme fatigue
   muscle weakness to the point of not being able to walk

   • ANSWER:
     I had to answer this question because Ringo is SO SO wrong in his answers.

     I had cirrhosis and a liver transplant and am doing great today. No, someone with cirrhosis does not die 3-4 days after getting ascites. That's ridiculous. It is a sign that the liver is not functioning right and can usually be controlled with medication. I had ascites and the doctors told me I could live 5-7 years before needing a transplant.

     A lot depends on what stage of cirrhosis your family member is in right now. There are 4 stages. Your family member must stop drinking now and forever. Alcohol will only cause his liver disease to progress much faster. They may or may not need a transplant. They need to go to a hepatologist that can evaluate them to see exactly how far along the disease might be.

     If they would need a transplant, all transplant centers require at least 6 months of proven sobriety before they will be considered to possibly be listed for a transplant. It a long tough road to getting well again for an alcoholic, but there are many success stories out there that have gotten their life back together and are happy and healthy today. The alcoholic not only has to stop drinking and struggle with their addiction to alcohol, but they must also deal with a diseased cirrhotic liver. It's not going to be easy.

     When an alcoholic does stop drinking and stops poisoning their liver, then the disease process with cirrhosis can be slowed down very much as long as the liver failure is not in the very end stage. If your family member has to get tapped due to all the fluid in the abdomen accumulating quite often, like every week or two, then that would probably mean that they were in the later stage of liver failure. Even then they can do a TIPS procedure to help that, but a transplant would probably be needed soon.

6. QUESTION:
   Liver cirrhosis and liver cancer?
   My husband has just been informed that he has "slight scarring" on the liver and that his liver is enlarged. I have many questions regarding this, but PLEASE, I am looking for serious-minded answers, not for people telling me that he should stop drinking or other kinds of moralizing; it is hard enough as it is. First: the doctor said "there is slight scarring but no sign of cirrhosis". I don't quite understand this because I though scarring of the liver IS cirrhosis, although it might be at a very early stage in his case. Also, is an enlarged liver the same thing as fatty liver, or could there be other reasons for it being enlarged? Unfortunately, his main health issue is not the liver but advanced heart failure (severe dilated cardiomyopathy) and also COPD. He was told some years ago that he has Hepatitis C but then it was in a dormant state. Could his Hepatitis C have caused the scarring over time even if it has been in a dormant state? Also, when the scarring has started, is it bound continue? His doctor says that his liver is "working", although I'm not sure whether she meant that it is working without any problems or working at a diminished capacity. I have done a lot of reading and it seems to me that he has many of the symptoms associated with acute liver failure: itching and small red lesions scattered over his body, a brief (one day) period of yellow skin and vomiting, periods of flu-like symptoms with fever, loss of appetite, severe sleep disturbances, clay-colored stool, brown urine, and his nails have turned very light. Also, he quit smoking, not because of his own determination but because he lost taste for cigarettes, which apparently is a sign of liver failure. He also bruise and bleed very easily, and he is easily fatigued. Many of these symptoms are of course also associated with heart disease, but it seems that they have become worse in the last couple of months. His bleeding and bruising can of course be caused by the heavy doses of coumadin he is on, but it seems that the bruising has gotten worse too. He is also getting easy confused and is becoming more and more forgetful. He is 60 years old. So, this is what I wonder: Can the heart disease and/or the COPD have caused the liver disease, or affect it negatively? And vice versa, what effect does the liver issue have on the heart disease and the COPD? His doctor wrote in the last report that there is no sign of ascites but he keeps saying that he feels very bloated and to me it seems like fluid, not fat. He often complain of discomfort in his lower right side and get winded very easily (also a sign of the heart disease, of course). How serious is this liver problem? If in fact he does have acute liver failure due to Hepatitis C, what is the outlook? I don't believe liver transplant is an option in his case due to his advanced heart failure and generally poor condition. If it is left untreated and he continues to drink (he has at least 3 beers and usually a couple of shots of hard liquor per day. I am desperately trying to make him stop or seek help, but I am not able to), what is likely to happen? If scar tissue continues to build up in his liver, how dangerous is it and what kind of life expectancy does he have? Is it a matter of decades or years/months before his liver gives in completely? How do people with this kind of disease typically die, slowly by wasting away or suddenly? If it is not acute liver failure, what else could it be? Does the complications of Hepatitis C always come from cirrhosis/scarring caused by it, or can it cause symptoms independently without leading to cirrhosis? And is scarring always a sign of cirrhosis or can there be other reasons for it? If so, how likely is it that the scarring does lead to cirrhosis (unless it is the same disease just at different stages) How great is the risk of developing liver cancer? Is this risk increased because of his generally poor health or is it determined by other factors? Please, please, any information at all would be of great help. I know that all these questions should be directed to his doctor, but my husband refuses to let me meet her, and he himself seems to live in denial and doesn't want to know anything about his disease. This is my reality, and any information you could provide would be gratefully accepted. Thankyou for reading all the way through this long question.

   • ANSWER:

7. QUESTION:
   Scarring of the liver and cirrhosis?
   My husband has just been informed that he has "slight scarring" on the liver and that his liver is enlarged. I have many questions regarding this, but PLEASE, I am looking for serious-minded answers, not for people telling me that he should stop drinking or other kinds of moralizing; it is hard enough as it is. First: the doctor said "there is slight scarring but no sign of cirrhosis". I don't quite understand this because I though scarring of the liver IS cirrhosis, although it might be at a very early stage in his case. Also, is an enlarged liver the same thing as fatty liver, or could there be other reasons for it being enlarged? Unfortunately, his main health issue is not the liver but advanced heart failure (severe dilated cardiomyopathy) and also COPD. He was told some years ago that he has Hepatitis C but then it was in a dormant state. Could his Hepatitis C have caused the scarring over time even if it has been in a dormant state? Also, when the scarring has started, is it bound continue? His doctor says that his liver is "working", although I'm not sure whether she meant that it is working without any problems or working at a diminished capacity. I have done a lot of reading and it seems to me that he has many of the symptoms associated with acute liver failure: itching and small red lesions scattered over his body, a brief (one day) period of yellow skin and vomiting, periods of flu-like symptoms with fever, loss of appetite, severe sleep disturbances, clay-colored stool, brown urine, and his nails have turned very light. Also, he quit smoking, not because of his own determination but because he lost taste for cigarettes, which apparently is a sign of liver failure. He also bruise and bleed very easily, and he is easily fatigued. Many of these symptoms are of course also associated with heart disease, but it seems that they have become worse in the last couple of months. His bleeding and bruising can of course be caused by the heavy doses of coumadin he is on, but it seems that the bruising has gotten worse too. He is also getting easy confused and is becoming more and more forgetful. He is 60 years old. So, this is what I wonder: Can the heart disease and/or the COPD have caused the liver disease, or affect it negatively? And vice versa, what effect does the liver issue have on the heart disease and the COPD? His doctor wrote in the last report that there is no sign of ascites but he keeps saying that he feels very bloated and to me it seems like fluid, not fat. He often complain of discomfort in his lower right side and get winded very easily (also a sign of the heart disease, of course). How serious is this liver problem? If in fact he does have acute liver failure due to Hepatitis C, what is the outlook? I don't believe liver transplant is an option in his case due to his advanced heart failure and generally poor condition. If it is left untreated and he continues to drink (he has at least 3 beers and usually a couple of shots of hard liquor per day. I am desperately trying to make him stop or seek help, but I am not able to), what is likely to happen? If scar tissue continues to build up in his liver, how dangerous is it and what kind of life expectancy does he have? Is it a matter of decades or years/months before his liver gives in completely? How do people with this kind of disease typically die, slowly by wasting away or suddenly? If it is not acute liver failure, what else could it be? Does the complications of Hepatitis C always come from cirrhosis/scarring caused by it, or can it cause symptoms independently without leading to cirrhosis? And is scarring always a sign of cirrhosis or can there be other reasons for it? If so, how likely is it that the scarring does lead to cirrhosis (unless it is the same disease just at different stages) How great is the risk of developing liver cancer? Is this risk increased because of his generally poor health or is it determined by other factors? Please, please, any information at all would be of great help. I know that all these questions should be directed to his doctor, but my husband refuses to let me meet her, and he himself seems to live in denial and doesn't want to know anything about his disease. This is my reality, and any information you could provide would be gratefully accepted. Thankyou for reading all the way through this long question.

   • ANSWER:
     Lena, an alcoholic is THE most difficult of all patients to help, especially when you want to do so much. ALL that you describe is due to alcohol. At first alcohol causes liver cells to fill with fat and produce an enlarged fatty liver which alone has caused sudden death. In time, as liver cells die, scarring results and can then progress (under the microscope) to produce a smaller scarred liver called alcoholic cirrhosis. The liver then produces inadequate clotting factors which can produce skin and other hemorrhages, as well as leak fluid into the belly (ascites), and change blood circulation to overload and damage an eenlarging heart under strain as well as dilated, thin-walled esophageal veins (varices) which can anytime suddenly rupture as great quantities of blood are coughed up. Hepatitis c also damages the liver and is believed to be a cause of liver cancer. As long as your husband continues to drink alcohol, he will continue to go downhill and die in spite of your efforts. Try the phone book or call Al-Anon, an organization for spouses of alcoholics for much more information on how to deal with your extremely difficult situation. You cannot go it alone and expect and success.

8. QUESTION:
   Should I stop Medication? Possible Liver problems, cant get to doctor until Monday...?
   Okay, here's my problem.

   I've been on this medicine, Rocephin (IV medication) for a month exactly. I was supposed to stop medicine today according to my last doctors visit, but my doctor's office seems to have forgotten to tell the nurses and the care provider sending my medicine... they tell me they cannot have me stop until my doctor contacts them.

   My doctor's office closed at 1 today and is not open again until monday.. its friday. I tried to call just now because I've been nauseas for 2 days now, and today I've been throwing up. I just found that these are symptoms of liver problems, like liver cirrhosis. They had tested me before, 2 weeks in, and my liver was fine.

   I'm not sure if I should consider this an emergency (not showing advanced symptoms according to yahoo health's information on liver cirrhosis) and go to a hospital, or if i should just temporarily stop my medicine now like the doctor had planned, even though the nurse and people said no?? Any thoughts are great...
   Oh, I forgot to mention a couple of things... Nausea and vomiting are listed as possible reactions to my medicine, so it might not even be liver stuff really. I'm just wondering mostly if I should wait to see if i get the more tell tale symptoms like jaundice or if that would be pretty much screwing myself over...

   • ANSWER:
     Even if your doctor office is closed, they still are on call. Have the service page the doctor to call you or the visiting nurse service. The antibiotic that was ordered should have the Rx included on the meds. (example being 5mg in 100ml 2x day for 7days) if not, There is a doctors order written in your chart. The visiting nurse must have access to the order and should follow it. Maybe the doctor told you 1 week but wrote 2 weeks and thats why the nurse is still giving you the meds.
     As far as liver falure from the meds, I guess its possible, but if your lab work came back ok, then i would suspect the nausea is from the meds on an empty stomach (even though its IV) or from your infection. If the whites of your eyes start turning yellow, then you have liver failure
     Hope this helps, good luck

9. QUESTION:
   Have you had a family member suddenly die of cirrhosis without a previous diagnosis?
   My father, age 57, died suddenly (to our knowledge) from cirrhosis at the end of last year (2010). One morning he was vomiting blood, was taken to the ER, immediately given a TIPS procedure, and from then on, for the next 12 days in the ICU, he had a breathing tube and was kept sedated. He died on the 12th day. He was given 15 units of blood and 12 units of plasma, and developed SEPSIS. Several other emergency procedures were performed, including placing a stent, which ultimately failed because of a mistake on their part, and a tracheotomy. We have read that a patient with symptoms like his (sepsis, active bleeding), it is NOT recommended to place a stent. Can anyone else (please only accounts that ended in mortality will be helpful), explain what happened in the journey from sudden vomiting of blood, to rushed to the ER, to each procedure performed, if anything failed or had to be redone, and also what procedure helped the most...? I'm trying to understand his death. Is there anyone else out there that went through this? Thanks in advance.

   • ANSWER:
     I'll try and help what I can on this. Even though your father was not diagnosed with cirrhosis according to you, he certainly had it for a very long time even though he may not have known it. Is there a reason for him having it such as alcohol abuse or a viral hepatitis? There are many conditions that can cause cirrhosis, but those two are the most common. His cirrhosis was far advanced when he started this bleeding.

     Anyone having cirrhosis usually develops unwanted veins called varices or varix. These develop because of poor blood flow to the liver. They are not like the veins we are born with. They can be weak, leak and cause internal bleeding. If they become very large and burst, a person can actually bleed to death in a very short period of time. This can be the reason death occurs in some people with cirrhosis. There is a high risk for bleeding and also infection just like you father had. Many people with advanced cirrhosis die this way. I had cirrhosis and used to get checked every 3-6 months for varix. They can do a procedure called "banding" which gets rid of these unwanted veins which greatly lowers any risk of bleeding. The TIPS procedure helps to lower the high pressure in these veins thus reducing the risk of bleeding and bursting. They did an emergency one on your dad because of his hemmhorage which he really needed. It's a stented shunt. Look it up on Wikipedia and you can learn all about it. They were trying to get this bleeding under control.

     It seems that the emergency team did everything they could to try and save his life. His cirrhosis was very advanced. Having varices is proof of that. One grew so large that is caused a massive internal bleed. They pumped him full of blood trying to replace what he had lost and also tried to lessen the pressure in the varices through the TIPS procedure. Your father might not have been breathing on his own and had to be put on a ventilator. They will do a trach sometimes for that since a ventilator is very damaging to the trachea. I had one when I received a liver transplant for cirrhosis. The sepsis and loss of blood both contributed to his death in my opinion. Both can be fatal and it's not unusual for either one of them to take the life of someone with cirrhosis. The only cure for cirrhosis is a liver transplant. I believe they did what they could for him. You can look up cirrhosis on Wikepedia that will explain all the physiology behind the disease.

     If you are wondering why they could not give him a transplant, the answer would be that he was not stable enough to withstand the surgery and possible would not qualify to receive one. There is quite a lot to go through in order to qualify for a transplant. Your father would have just been too sick and physically unstable. If he would have gotten through his bleeding crisis, then maybe they would have sent him to a transplant center to be evaluated. It's a long process that takes time. There are emergency transplants done such as accident victims and such, but most often, it takes time to get evaluated and accepted.

10. QUESTION:
    Cirrhosis questions...?
    I have been told that my latest blood test shows that my liver function test is abnormal. I've now been sent for more tests and a scan. I have been having Sharp pain in my right side of the rib cage for over a year now. Was told a year ago that it was just muscle spasms but now there thinking different. Can anyone please tell me the symptoms.. I don't drink ( well a shandy at the most if its sunny lol) I don't do drugs. Also does anyone know the normal range of liver function tests ? Thanks in advance Xx

    • ANSWER:
      There are differents tests that the doctor does to check the liver...therefore,
      there would be many different "reference ranges" for each of these tests.

      No one blood testing is 100% accurate. More blood tests and a scan would
      provide a more thorough look at what may be going on.

      Some of the testing done and what is shows, is as follows:
      1]The Liver Enzyme blood tests (known as the ALT,AST,GGT,ALP,etc)
      would give the doctor an "idea" that there is liver cell damage.
      2]The Liver Function blood tests (known as the Bilirubin, INR, Pt, Ptt, Albumin)
      would give the doctor an "idea" how well the liver cells are still able to
      perform all the functions of the liver.
      3]The Liver Viral blood tests would check to see if a virus has entered
      the body and is using the liver cells to replicate itself (like Hep A,B,C,etc)
      4]The Liver blood cancer test known as the Alpha Feto protein.

      There may be no symptoms of having liver problems at the beginning,
      other than feeling tired, flu like symptoms, or discomfort in the liver/biliary area.

      Let me explain what happens when there is liver cell damage:
      The immune system would respond to this and cause inflammation to
      develop inside the liver. This would cause the liver to enlarge in size.
      (this can be seen on an ultrasound or Ct scan)

      There are many causes of liver cell damage:
      alcohol consumption, medication toxification,
      chemical exposure, mushroom poisoning,
      fatty liver disease, hereditary conditions,
      metabolic disorders, viral or parasite infection,
      biliary obstruction/malformation/infection,
      cardiac/vascular problems, cancer/cyst/growth/tumors,
      and others.

      If the cause can be found and stopped...then the liver cells
      may heal and the problem can be reversed.
      However, if it progresses to where the liver cells start to
      die off and form scar tissue inside the liver...then it becomes
      a progressive disease (that cannot be reversed) known as
      Cirrhosis of the liver.

      The liver cells are what does all the functions of the liver
      (over 500 of them). When the cells are damaged or
      they start to die off...these functions start to deteriorate.
      (This is the starting of what is known as "liver failure")
      The first true sign of this happening is when a person
      becomes Jaundice, due to the fact that the liver isn't
      able to the amount of Bilirubin in the blood to convert
      it to a soluble form to become part of the bile. Bilirubin
      is a pigment (greenish/brownish substance that colors
      other things). This Bilirubin will go higher in the blood
      and when it reaches a certain amount will cause the
      yellowing of the whites of the eyes and skin. Since it
      is higher in the blood and the Kidneys filter the blood,
      it can cause the urine to become darker in color.

      I know it is hard to wait and see what these tests results
      will show. But, if you do have any kind of liver problem...
      ask to be referred to either a gastroenterologist or
      hepatologist.

      They usually do blood test, then film testing like an ultrasound,
      ct scan, and then if they think it has advanced some...may
      do a liver biopsy. The liver biopsy is the best test because
      they are looking directly at the tissue of the liver and not
      just pictures of it. However, it is invasive, so they try not
      to until the last resort.

      I'm giving you information that may have gone alot farther than
      were you are at, at this moment. That is because I may not be
      able to tell you later. It may help you decide what questions
      to ask your doctor. Best wishes to you.

      LINKs to click on:
      http://www.medicinenet.com/cirrhosis/article.htm
      http://www.mayoclinic.com/health/cirrhosis/DS00373
      http://yourtotalhealth.ivillage.com/cirrhosis.html

11. QUESTION:
    how long to people with portal hypertension and cirrhosis and liver cancer have to live if they have all of?
    these symptoms this "person" also has hep c and has been an alcholic for years she doesn't drink everyday but she does often she sleeps all the time she coughs all the time she coughs up blood too she hardley eats she has fluid in her lungs because she smokes all the time its called something but i don't remember her body is swallon because of all of the fluid that has built up in her stomach i was just wandering with all these bad things that have happened how long does she have left? she been seeing doctors for all of these things but doesn't really talk to me about it thank all of you in advance
    she doesn't take good care of herself either she has depression issues and is on anxiety meds she sets around and does nothing to help herself everyone has told her what she needs to do she just doesn't want to do it

    • ANSWER:
      People in this situation usually just have their symptoms controlled.......for example, for the swelling to the abdomen called ascites, the docs can regularly drain the excess fluid by inserting a small drain thru the skin called a paracentesis. Portal hypertension is probably causing esophageal varices, which is why she is coughing up blood. These can be treated if they rupture, but its a big emergency.
      With regards to the liver cancer, it all depends where it is and what typre of cancer. Is the liver the primary site or a metastatic site. Would your friend be well enough for surgery/ radiation/ chemo.
      It sounds like your friend is very sick.It would be impossible to know how long she would live like this. If she takes good care of herself, doesn't drink, and seeks regular and prompt medical care for control of her symptoms she may have a few months or even years. Hope this helps. Sorry your friend is so sick.

12. QUESTION:
    Is there a doctor in the house......?
    If a 4 y/o has a very high hemoglobin level and the test is repeated and a test for ferritin levels is added... what might the doctor be looking for?

    I read on webmd that high ferritin levels may be caused by liver disease (cirrhosis or hepatitis), Hodgkin's disease, leukemia, infection, inflammatory conditions (such as arthritis or lupus), or a diet that is too high in iron. The test is used to find the cause of anemia, especially iron deficiency anemia.

    I know he does not have a diet that is too high in iron.

    Question #2: Can you have anemia but have a high hemoglobin level?
    (I thought it was the other way around)

    The main symptoms that prompted the tests: extreme fatigue, headaches, bruising, night sweats

    Thanks in advance
    Kati.....Polycythemia vera... would a ferritin test help diagnose this? This is the one thing his doctor did mention but said it's very, very rare in children so he didn't think that was it. Would a ferritin test help diagnose it though??

    • ANSWER:
      Higher than normal levels of hemoglobin may also be caused by:

      Congenital heart disease.
      Cor pulmonale. (pulmonary heart disease)
      Polycythemia vera. (blood disorder where the bone marrow makes to many red blood cells)
      Increased red blood cell production caused by an excess of erythopoeitin.

      Hemoglobin is measured in grams per deciliter of blood. The normal levels are for a child are: 11 to 16 g/dl

      Q2: Low haemoglobin levels are more likely to cause anemia.

      EDIT: Yes it can help to diagnose Polycythemia Vera. And your doctor is right it is very rare in children. A good website about this test and Polycythemia tells you all about it.
      http://emedicine.medscape.com/article/957470-diagnosis