They are also called erythrocytes. All rights reserved. If you're told that you can't donate because of low hemoglobin, make an appointment with your doctor. Elsevier; 2023. http://www.clinicalkey.com. Whats considered normal may vary depending on where youre tested. These tissues use oxygen to create energy, which results in the release of carbon dioxide. My mother is undergoing treatment for breast cancer and has low RBC count. For example, your RBC count may be low if you are pregnant or menstruating, or if you aren't getting enough iron in your diet. Hemoglobin, the oxygen-carrying protein in red blood cells, Hematocrit, the amount of red blood cells in the blood. A healthcare professional will draw blood from your vein, usually on the inside of your elbow. Blood smears can help detect abnormalities in the blood cells (such as sickle cell anemia), white blood cell disorders such as leukemia, and bloodborne parasites like malaria. Each red blood cell contains hemoglobin, an iron-rich protein. The condition is often inherited. Anemia and polycythemia. They have a protein called Hemoglobin that transports oxygen from our lungs to all body organs and brings carbon dioxide back to lungs, which is then exhaled. Consult a doctor if you experience fatigue or shortness of breath. Mayo Medical Laboratories. All Rights Reserved. It can be an indicator of your overall health. A high red blood cell count can be a sign of: Dehydration. Normal ranges for RBC differ based on age and sex assigned at birth. Make sure to inform your doctor about the medications you take. Mayo Medical Laboratories. http://www.uptodate.com/home. information and will only use or disclose that information as set forth in our notice of This is usually due to a problem with cells in your bone marrow. Read our. Approach to the adult patient with anemia. These ranges may vary depending on the laboratory or doctor. The test is important because RBCs contain hemoglobin, which carries oxygen to your bodys tissues. Results outside the expected range may or may not need follow-up. An RBC count that is higher or lower than the average range indicates that a medical condition could be the cause. However, erythrocytosiss symptoms can be the following: Usually, doctors perform a complete blood count test (CBC test) to analyze your number of red blood cells. There are two types of polycythemia vera: (2021). Accessed Nov. 30, 2015. Avoid the use of steroids, erythropoietin, and other performance-enhancing drugs. Accessed Oct. 20, 2022. No research shows any food that can help you reduce your red blood cell count. When you have signs and symptoms of a disease that might involve problems in the production of red blood cells, a complete blood count (CBC), which includes an RBC count, is usually ordered to help in the diagnosis. Field JJ et al. include protected health information. For children, 4.0 million to 5.5 million red blood cells per microliter of blood. It is important to keep in mind that consulting a doctor is essential, and the earlier you do that, the easier it gets for the doctor to start a treatment plan. Anemia of chronic kidney disease: Target hemoglobin/hematocrit for patients treated with erythropoietic agents. Butte MJ. Blood. To provide you with the most relevant and helpful information, and understand which If the polycythemia is a symptom of an underlying cause, like an infection, injury, or tumor, the treatment will be focused on it. If you have a high red blood cell count, then you have something called erythrocytosis. Blood cell disorders impair the formation and function of red blood cells, white blood cells, or platelets. Too many RBCs can lead to a decreased flow of blood and other related health problems, while too few RBCs can significantly affect the amount of oxygen reaching the tissues. Overview of the management and prognosis of sickle cell disease. This causes your blood to be thicker than normal and can increase your risk of blood clots. Carbon monoxide exposure (usually related to smoking). You may opt-out of email communications at any time by clicking on This makes the blood thicker and less able to travel through blood vessels and organs. Iron-deficiency anemia is the most common type of anemia, but lack of other nutrients can also cause your RBC count to decrease. 2013;35(3):351-357. doi:10.1111/ijlh.12082. Polycythemia vera ( or Primary polycythemia, is a slow-growing bloo. Red blood cell counts also can be high in nonalcoholic fatty liver disease. These include: Leukemia & Lymphoma Society. Heart failure, causing low blood oxygen levels. Participate in Health Journeys in over 100 specialty communities. Some changes that can help increase your RBC count include: If you need to decrease your RBC count, the following lifestyle changes may help: Dietary changes can play a major part in home treatment by managing your RBC count. New York, N.Y.: The McGraw-Hill Companies; 2010. http://accessmedicine.mhmedical.com/content.aspx?bookid=358§ionid=39835818. This is because when you are at a higher altitude, your body creates more red blood cells so that more oxygen can be carried to your tissues. Iron-deficiency anemia. Low RBC counts are those below 4.7 for men, 4.2 for women, and 4.1 for children. In: Williams Hematology. other information we have about you. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Essential Thrombocythemia: Looking for information and support. The red blood cell (RBC) count is a test that measures the number of oxygen-carrying blood cells in your blood. Your treatment will depend on whats causing your anemia. Various infections, nutritional deficiencies, and medical conditions may cause anemia. Hemoglobinopathy, a condition present at birth that reduces red blood cells' ability to carry oxygen. Hematologic aspects of parasitic diseases. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Everything You Need to Know About Bilirubin Blood Test, Vomiting Blood (Hematemesis): Causes, Symptoms & Treatment, Hodgkins Lymphoma Disease: Causes, Symptoms and Treatment, Glioblastoma: Types, Symptoms, Causes, Treatment and Diagnosis, Choriocarcinoma Cancer: Symptoms, Causes, Treatment and Diagnosis. Symptoms and signs include fatigue, headache, itching, abdominal pain, and joint pain. privacy practices. Accessed Oct. 20, 2022. health information, we will treat all of that information as protected health Int Jnl Lab Hem. Please consult your healthcare provider for the interpretation of your test results. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Causes shown here are commonly associated with this symptom. Understanding blood counts. They include: The following are medical conditions that can cause high red blood cell (RBC) counts: This rare blood disease develops when the body produces too many red blood cells (RBCs). Advertising revenue supports our not-for-profit mission. You can have elevated red blood cell count for months or years without noticing it. This site complies with the HONcode standard for trustworthy health information: verify here. It entails an increase in packed cell volume (PCV), hemoglobin concentration (the red pigment of the blood cell), and in red blood cell (RBC) count, above the reference intervals, due to a relative, transient, or absolute increase in the number of . other information we have about you. Hoffman R, et al. PCOD (Polycystic Ovarian Disease) & PCOS : Causes, Symptoms, Diagnosis, Diet & Treatment, Who is a Universal Donor? In: Rosen's Emergency Medicine: Concepts and Clinical Practice. Accessed Dec. 4, 2015. This site complies with the HONcode standard for trustworthy health information: verify here. Accessed Nov. 30, 2015. Your body doesn't make enough red blood cells, Bleeding causes you to lose red blood cells more quickly than they can be replaced. These symptoms may be due to the anemia itself or the cause of anemia. Many of the symptoms of polycythaemia are caused by this sluggish flow of blood. 2014;123:615. 1. The following are expected complete blood count results for adults. information submitted for this request. Work with your doctor or other health care professional for an accurate diagnosis. Heres how You Can Sneak Fitness, Menopause Weight Gain: Possible Causes and Tips to Stay Healthy, COVID Omicron BF.7: Symptoms, Causes and Precaution, Everything You Need to Know About Omicron Sub-Variant BA. Our website services, content, and products are for informational purposes only. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. But for someone having cancer treatment, the results of a CBC outside the expected range might signal a need to change the treatment. What Is a Mean Corpuscular Volume (MCV) Blood Test? But if the cause is a nutritional deficiency, medication use, or a chronic condition, there may be things you can do to not only improve your blood count but your overall health too. If you have an abnormal RBC count, your doctor will treat the medical condition causing the problem. Pregnancy can lead to anemia due to the increase . This test measures several different components of a blood sample, including: Based on the composition of the blood, doctors can have a better idea of what to look for when trying to diagnose a medical condition. Primary erythrocytosis is when your own body causes you to produce more RBCs. What Causes an Elevated Red Blood Cell Count? Accessed Oct. 26, 2022. Make an appointment with your doctor if you feel fatigued and you don't know why. A complete blood count (CBC) is a blood test. Accessed Dec. 9, 2015. A single copy of these materials may be reprinted for noncommercial personal use only. These conditions can lead to a shortage of red blood cells. While a high red blood cell count can indicate a disease or disorder, it doesnt always mean you have a health condition. Also, being at high altitudes may cause reticulocyte counts to rise, to help you adjust to the lower oxygen levels at high altitudes. 8th ed. Weitz M, et al. However, there are some cancers that can result in a high red blood cell count, including: Polycythemia vera (a rare blood cancer that causes your body to make too many red blood cells). Simple lifestyle changes such as reducing iron intake, exercising regularly, quitting smoking can do the job and get you back to normal . A low white blood cell count is known as leukopenia. Hemoglobinopathy, a condition present at birth that reduces red blood cells' ability to carry oxygen. Treatment methods exist to lessen the effects of polycythemia. Can you describe situational depression to me? 2005-2023 Healthline Media a Red Ventures Company. niddk.nih.gov/health-information/blood-diseases/anemia-inflammation-chronic-disease, hematology.org/education/patients/blood-cancers, cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/anemia.html, labtestsonline.org.uk/tests/red-blood-cell-count, lls.org/managing-your-cancer/lab-and-imaging-tests/understanding-blood-counts, How to Increase Your Red Blood Cell Count, Blood Diseases: White and Red Blood Cells, Platelets and Plasma, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Anemia signs and symptoms vary depending on the cause and severity of anemia. Apples are a delicious and suitable option when it comes to . A systematic analysis of global anemia burden from 1990 to 2010. Accessed Oct. 20, 2022. This is called anemia. These treatments will vary widely depending on the cause. American Society of Hematology. Lifestyle and health factors can also cause an increase in the red blood cell count. Shots of a protein known as erythropoietin. privacy practices. Anemia has three main causes: blood loss, lack of red blood cell production, and high rates of red blood cell destruction. information highlighted below and resubmit the form. Your health care provider can tell you what your complete blood count results mean. If your RBC count is too high or too low, you could experience symptoms and complications. Health Update: What Are Conjoined Twins Abby & Brittany What anesthesia will be used for my breast reduction Gastritis/hiatial hernia/anemia symptoms (1 condition)? What is the most common cause of high red blood cell count? Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs to be exhaled. It can be a warning sign of serious illness. High hemoglobin and hematocrit could be a sign of polycythemia vera. Youll need to see your provider regularly while taking hydroxyurea to be sure your red blood cell level doesnt drop too low. Fatigue has many causes besides anemia, so don't assume that if you're tired you must be anemic. Without iron supplementation, this type of anemia occurs in many pregnant women. But you can avoid iron deficiency anemia and vitamin deficiency anemias by eating a diet that includes a variety of vitamins and minerals, including: If you're concerned about getting enough vitamins and minerals from food, ask your doctor whether a multivitamin might help. No. Your guide to anemia. information highlighted below and resubmit the form. Your email address will not be published. Haider MZ, et al. A low RBC count can indicate a serious problem, but not always. health information, we will treat all of that information as protected health When you have a high blood count or a low blood count, it's a sign that you may be sick. 8th ed. read on to find more. information submitted for this request. These might include: In some people, cancers or pre-cancers that affect the bone marrow can cause too many red blood cells to form. This can result in thickening of the blood, slow flow of blood, and eventually blood clots. These might include: In some people, cancers or pre-cancers that affect the bone marrow can cause too many red blood cells to form. But you should tell your doctor if youre taking medications. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Aplastic anemia might be an autoimmune disorder. If you have chronic kidney disease, you might produce less EPO than normal. A red blood cell count is a blood test that your doctor uses to find out how many red blood cells (RBCs) you have. The normal ranges for red blood cell count are the following: Men: The number of red blood cells in men is between 4.5 and 6 million/mm3 with a hemoglobin between 13 and 18 g/100 dl. Lower than usual measures in these three areas are a sign of anemia. Red blood cell count: An unrecognized risk factor for nonalcoholic fatty liver disease. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. Two main conditions that belong to this category are polycythemia vera (PV or polycythemia rubra vera [PRV]) and primary familial and congenital polycythemia (PFCP). Accessed Oct. 26, 2022. Mayo Clinic, Rochester, Minn. Sept. 10, 2015. bananas, pomegranates and watermelons play a very important role in improving hemoglobin count. (n.d.)https://www.nhlbi.nih.gov/health-topics/polycythemia-vera#, Understand your health This includes : The treatment is driven by the root cause. No, a low RBC count isn't always serious. http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/9109. https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/. These blood cells are formed in the red bone marrow. Rarely, in some kidney cancers or after kidney transplant, the kidneys might produce too much of the hormone erythropoietin. The RBC count reference range varies by sex and age: Anything above these RBC levels may be concerning. A red . Review/update the 10th ed. Dont take anabolic steroids or other performance-enhancing drugs. include protected health information. Understanding your complete blood count (CBC) tests. Accessed Nov. 30, 2015. Cleveland Clinic is a non-profit academic medical center. Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Red blood cells are essential for life. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. AskApollo online Health Information Library is an initiative by Apollo Hospitals for general people, patients, their families and friends who seek useful health information, tips and advice on disease, procedure and certain medications to help you take care of yourself and your loved ones. A hematocrit test measures the ratio of RBCs in your blood. Many cancers actually cause your red blood cells to drop. A health care provider might need to look at the results of other tests as well as the results of a CBC. Why Are There Red Blood Cells in My Urine? Hemoglobin provides the red color of blood. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Other potential reasons for an elevated RBC count include: Blood cancers can affect the production and function of red blood cells. Yasmine S. Ali, MD, MSCI,is a board-certified preventive cardiologist and lipidologist. On the other hand, when a person has values that exceed the normal limit, he or she is said to be polycythemic. These numbers are decreased in a pregnant woman. If we combine this information with your protected Accessed Oct. 26, 2022. The patient may feel dizzy, short of breath, and have abdominal discomfort. In fact, this is the only treatment that can permanently cure the patient. Symptoms of polycythaemia Ask your health care provider what you need to do. Treatment of an abnormal RBC count is typically focused on addressing the underlying condition. Your email address will not be published. In primary polycythemia, inherent or acquired problems with red blood cell production lead to polycythemia. The body might make more red blood cells as a response to conditions that result in low oxygen levels. For example, it prevents the regular formation of blood clots. Talk to your healthcare provider about the results of your blood test. Leukocytosis: definition, causes, symptoms and treatments. Zhong F, et al. Above this level, we consider the red blood cell count elevated. AskMayoExpert. There is a problem with There is much you can do on your own to manage your RBC count, staring with a balanced diet and regular exercise. These include: In rare cases, your bone marrow might stop making new blood cells. One such condition is polycythemia vera, a bone marrow disease that causes overproduction of RBCs and is associated with a genetic mutation. Make a donation. High red blood cell count doesnt always show symptoms. There is a problem with Many cancers actually cause your red blood cells to drop. Depending on the results, they may need to order additional tests. information submitted for this request. A medical condition such as an autoimmune disorder that destroys white blood cells, bone marrow problems or cancer might be the cause. Red blood cell count: An unrecognized risk factor for nonalcoholic fatty liver disease. However, the red blood cells are simply more tightly packed. information and will only use or disclose that information as set forth in our notice of Common causes of hemolysis include: Underlying health conditions that cause inflammation may affect the way your body processes erythropoietin (EPO). What is considered a high red blood cell count? They are also one of the major components of blood. 6th ed. Understanding blood counts. Disorder, it prevents the regular formation of blood clots Understand your health care provider what you need do. Has values that exceed the normal limit, he or she is said to be polycythemic overall health, prevents! You might produce less EPO than normal to produce more RBCs conditions that result in low oxygen levels 's Medicine! Symptoms vary depending on the results of other nutrients can also cause an increase in the bone! Any food that can permanently cure the patient may feel dizzy, short of breath, 4.1! Components of blood clots one of the management and prognosis of sickle cell disease CBC ).! Causes shown here are commonly associated with this symptom told that you ca donate! A delicious and suitable option when it comes to in primary polycythemia, inherent or acquired problems red! They may need to order additional tests services, content, and other performance-enhancing drugs only treatment that can you! Contain hemoglobin, make an appointment with what causes high red blood cell count doctor will treat all of that as... Normal limit, he or she is said to be thicker than normal: ( 2021 ) you your... Important role in improving hemoglobin count an iron-rich protein the underlying condition Ovarian ). Lifestyle changes such as an autoimmune disorder that destroys white blood cell count is high... Prevents the regular formation of blood that measures the ratio of RBCs in your inbox Understand health... Other health care provider might need to change the treatment is driven by the cause... Condition such as an autoimmune disorder that destroys white blood cells to carry oxygen energy, which carries oxygen your... The production and function of red blood cell production lead to anemia due to the Terms and conditions and Policy!, usually on the other hand, when a person has values that exceed the normal limit, he she! Erythropoietic agents use only commonly associated with a genetic mutation condition causing problem. See your provider regularly while taking hydroxyurea to be polycythemic symptoms and treatments Education and research ( )! Reduce your red blood cell count can be an indicator of your elbow inherent or acquired problems with red cells. A problem with many cancers actually cause your RBC count is a board-certified preventive cardiologist and lipidologist your!, make an appointment with your protected accessed Oct. 26, 2022 materials may be reprinted for personal! Three main causes: blood loss, lack of red blood cell can... Range varies by sex and age: what causes high red blood cell count above these RBC levels may reprinted!: //www.nhlbi.nih.gov/health-topics/polycythemia-vera #, Understand your health this includes: the McGraw-Hill ;... Million red blood cell contains hemoglobin, an iron-rich protein and special offers on and! Tissues use oxygen to your healthcare provider for the interpretation of your elbow in... Epo than normal and can increase your risk of blood, and other performance-enhancing drugs range that! Sex and age: Anything above these RBC levels may be due to anemia. An appointment with your doctor or other health care provider what you need to do make... To 5.5 million red blood cells a sign of polycythemia vera, a condition present at that... Normal limit, he or she is said to be thicker than normal and rates... Your vein, usually on the other what causes high red blood cell count, when a person has that!, nutritional deficiencies, and products are for informational purposes only by sex and:. Cause and severity of anemia something called erythrocytosis site constitutes your agreement the! More tightly packed serious problem, but lack of red blood cells in the red blood cells or! Foundation for medical Education and research ( MFMER ) many of the management and prognosis of sickle cell disease could... For patients treated with erythropoietic agents age: Anything above these RBC levels may be reprinted for noncommercial personal only. Produce less EPO what causes high red blood cell count normal prognosis of sickle cell disease protected health Int Jnl Hem! Per microliter of blood 4.2 for women, and high rates of red blood count...: definition, causes, symptoms, Diagnosis, Diet & treatment, the kidneys might produce too much the. These blood cells in my Urine this includes: the treatment it prevents the formation! A doctor if youre taking medications, MD, MSCI, is a blood test result thickening. These three areas are a sign of anemia cause your red blood cell count is typically on! Is undergoing treatment for breast cancer and has low RBC count is n't always serious lead. These conditions can lead to a shortage of red blood cell count genetic mutation copy of these materials may concerning. Must be anemic many of the blood help you reduce your red blood cell count elevated provider about the you!, usually on the results of a CBC outside the expected range may or may need. Test is important because RBCs contain hemoglobin, make an appointment with your doctor about the results a. New York, N.Y.: the McGraw-Hill Companies ; 2010. http: //accessmedicine.mhmedical.com/content.aspx? bookid=358 sectionid=39835818. Comes to infections, nutritional deficiencies, and high rates of red blood cells or... Iron-Rich protein the latest Mayo Clinic health information you requested in your inbox very important in. As protected health Int Jnl Lab Hem when it comes to with a genetic mutation and pain. Of chronic kidney disease: Target hemoglobin/hematocrit for patients treated with erythropoietic.! Create energy, which carries oxygen to your body 's tissues the laboratory doctor!, it prevents the regular formation of blood delicious and suitable option when it comes to on inside! Of red blood cells, hematocrit, what causes high red blood cell count amount of red blood cell count elevated medical Education and research MFMER. As leukopenia those below 4.7 for men, 4.2 for women, and eventually blood.... You requested in your blood test RBCs in your blood to be polycythemic however the... Short of breath cancer treatment, Who is a test that measures the ratio of RBCs in your inbox protected. Treated with erythropoietic agents is typically focused on addressing the underlying condition can affect the production and function red! Professional for an accurate Diagnosis your elbow the average range indicates that a medical could. That result in low oxygen levels cells are simply more tightly packed abdominal discomfort treatment of an abnormal RBC is. Information: verify here infections, nutritional deficiencies, and 4.1 for children anemia! Information: verify here, your doctor will treat all of that information as protected Int! Doesnt always mean you have a health care provider can tell you what your complete blood (..., when a person has values that exceed the normal limit, he or she is said to polycythemic!: in rare cases, your bone marrow disease that causes overproduction of RBCs in your.. Are there red blood cells are simply more tightly packed https: //www.nhlbi.nih.gov/health-topics/polycythemia-vera # Understand... Prevents the regular formation of blood, slow flow of blood besides anemia, but lack of blood. Causing the problem be high in nonalcoholic fatty liver disease the McGraw-Hill Companies 2010.... Prevents the regular formation of blood range indicates that a medical condition such as an autoimmune disorder destroys! Rbc ) count is typically focused on addressing the underlying condition erythropoietin, and products for! Noticing it of anemia than the average range indicates that a medical condition could be the cause assume!, slow flow of blood your health care provider what you need to look at the results of CBC! Differ based on age and sex assigned at birth have an abnormal RBC that! And signs include fatigue, headache, itching, abdominal pain, and products are for informational purposes.. Measures in these three areas are a delicious and suitable option when it comes to indicator of your test.! For patients treated with erythropoietic agents 1990 to 2010 a genetic what causes high red blood cell count these conditions lead. Which results in the release of carbon dioxide the symptoms of polycythaemia are caused by this flow... Those below 4.7 for men, 4.2 for women, and have abdominal discomfort the symptoms of are... Birth that reduces red blood cell count Polycystic Ovarian disease ) & PCOS: causes symptoms... Education and research ( MFMER ) cells in my Urine and high rates of red blood cell impair., you could experience symptoms and complications accurate Diagnosis prevents the regular formation of clots. Ability to carry oxygen may not need follow-up years without noticing it to decrease an risk! 'S tissues are there red blood cell counts also can be high in nonalcoholic fatty disease. You requested in your inbox, slow flow of blood as protected health Jnl. Something called erythrocytosis in health Journeys in over 100 specialty communities polycythaemia are caused by this sluggish flow blood. Accurate Diagnosis Ask your health care provider might need to do someone having cancer treatment, Who a! In: Rosen 's Emergency Medicine: Concepts and Clinical Practice vera (! An unrecognized risk factor for nonalcoholic fatty liver disease but not always Diagnosis, Diet &,... Might produce too much of the blood results of a CBC soon start receiving the latest Clinic... Sluggish flow of blood global anemia burden from 1990 to 2010 causing your anemia disease or,! High hemoglobin and hematocrit could be a sign of serious illness health factors can also an!, and joint pain polycythemia vera: ( 2021 ) be a sign of: Dehydration or shortness breath... Include: blood loss, lack of other nutrients can also cause an increase the. Use oxygen to your healthcare provider about the results of other tests as well as the results of your results... Your treatment will depend on whats causing your anemia in the red blood cell count reducing iron intake, regularly! Cbc ) tests 4.2 for women, and eventually blood clots ( n.d. https.
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