Gaisbock's Syndrome vs Polycythemia: Know the Differences

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Gaisbock'S Syndrome Vs Polycythemia: Gaisbock's Syndrome and Polycythemia are both illnesses caused by altered blood composition, although they have distinct underlying causes and presentations. Gaisbock's Syndrome, often referred to as erythropoietin-independent erythrocytosis, is a disorder marked by an increased red blood cell count (erythrocytosis) that is frequently linked to stress, smoking, obesity, and hypertension. Men in their middle years who have a history of heavy drinking and smoking are usually the ones who experience it. On the other hand, Polycythemia is an abnormal rise in the quantity of red blood cells in the blood. Polycythemia comes in two varieties: Primary Polycythemia, often known as Polycythemia Vera and Secondary Polycythemia. A myeloproliferative condition called Polycythemia vera is typified by an excess of red blood cells in the bone marrow. It results from an unchecked multiplication of blood cells due to a mutation in the JAK2 gene. Conversely, persistent hypoxia and other external stimuli that stimulate red blood cell formation outside of the bone marrow create Secondary Polycythemia.

Difference between Gaisbock's Syndrome and Polycythemia

In contrast to Polycythemia, which includes a variety of disorders causing abnormal increases in red blood cells, including primary conditions like Polycythemia Vera and secondary causes like chronic hypoxia or tumors, Gaisbock's Syndrome is characterized by elevated red blood cell count brought on by lifestyle factors like smoking and stress. The table below provides the differences between Gaisbock's Syndrome and Polycythemia.


Gaisbock's Syndrome



Elevated red blood cell count

Abnormal increase in red blood cell count

Underlying Cause

Lifestyle factors such as smoking, alcohol consumption, obesity, stress

Primary (Polycythemia vera) or Secondary (due to other factors like hypoxia, tumors, etc.)

Gender and Age

Middle-aged men, often associated with smoking and alcohol use

Can occur in both genders and various age groups

Primary Mechanism

Excessive production of red blood cells without underlying hematological disorder

Overproduction of red blood cells in the bone marrow (Polycythemia vera) or due to external factors (Secondary Polycythemia)

Genetic Mutations

Not typically associated with genetic mutations

Associated with mutations in the JAK2 gene (Polycythemia vera)

Hematological Disorder

No underlying hematological disorder

Can involve primary hematological disorders such as Polycythemia vera


Addressing lifestyle factors (smoking cessation, weight loss, stress management), managing hypertension

Treatment depends on the underlying cause and may involve phlebotomy, medication, or addressing the underlying condition


Generally good prognosis with lifestyle modifications

Variable depending on the underlying cause and response to treatment

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What is Gaisbock's Syndrome?

Gaisbock's Syndrome, also referred to as stress erythrocytosis, is a disorder marked by high levels of hemoglobin, hematocrit, and red blood cell count. The illness is primarily brought on by stress, hypertension, smoking, obesity, or excessive alcohol intake. 

Causes of Gaisbock's Syndrome 

  • Chronic Stress: Extended periods of stress cause the body to release stress hormones like cortisol, which can cause blood viscosity and vasoconstriction. Hematocrit levels rise as a result, and hemoconcentration is caused by a decrease in plasma volume relative to the quantity of red blood cells.
  • Hypertension: Gaisbock's syndrome is frequently linked to high blood pressure. Increased blood viscosity and hemoconcentration can be caused by hypertension, which can exacerbate the condition.
  • Smoking: One of the main risk factors for Gaisbock's Syndrome is tobacco use. Smoking can raise blood viscosity and produce vasoconstriction, which can result in hemoconcentration and higher hematocrit values.
  • Obesity: Being overweight, particularly in the central region, is associated with insulin resistance, heightened sympathetic nervous system activity, and chronic inflammation. These factors can all lead to stress erythrocytosis and hypertension.
  • Excessive Consumption of Alcohol: Prolonged alcohol intake can cause dehydration, liver damage, and changes in erythropoietin production, which is the hormone that promotes the creation of red blood cells. These conditions can all play a role in the onset of Gaisbock's syndrome.
  • Other Factors: By decreasing plasma volume, some drugs, such as diuretics, can also cause hemoconcentration. In addition, erythropoietin synthesis may be stimulated and higher red blood cell counts may result from sleep apnea and other hypoxic circumstances. 

Symptoms of Gaisbock's Syndrome 

  • Headache: Higher blood viscosity and red blood cell counts can cause headaches, especially in the morning or after vigorous activity.
  • Dizziness or Lightheadedness: Blood flow and oxygen delivery to the brain might be affected by a reduced plasma volume about the amount of red blood cells, which can cause dizziness or lightheadedness.
  • Fatigue: Reduced oxygen delivery to tissues due to decreased plasma volume and poor circulation can cause fatigue or weakness.
  • Blurred Vision: Temporary blurred vision can be caused by reduced blood flow to the eyes due to impaired circulation and elevated blood viscosity.
  • Skin Flushing or Redness: Due to increased blood flow and vasodilation, some people with Gaisbock's syndrome may have skin flushing or redness, especially in the face.

What is Polycythemia?

Polycythemia is a blood condition characterized by an overabundance of red blood cells in the bloodstream, which causes increased blood viscosity. Primary Polycythemia, also known as Polycythemia vera, is caused by abnormalities in the bone marrow that result in excessive red blood cell production, whereas Secondary Polycythemia is caused by situations such as chronic hypoxia or certain tumors.

Causes of Polycythemia

  • Polycythemia is classified into two types: primary (sometimes called Polycythemia vera) and secondary.

Primary Polycythemia: Primary Polycythemia (Polycythemia Vera) is caused by a genetic abnormality in bone marrow cells, which produce red blood cells. This mutation causes an overproduction of red blood cells. The specific source of this mutation is unknown, however it is thought to be a combination of genetic and environmental causes.

Secondary Polycythemia: Secondary Polycythemia develops when an underlying illness or external event causes the body to create extra red blood cells. Some common causes are:

  • Chronic Hypoxia: Chronic Hypoxia (low oxygen levels) can be caused by illnesses such as Chronic Obstructive Lung Disease (COPD), sleep apnea, or living at altitude.
  • Kidney Disorders: Kidney disorders, especially when there is insufficient oxygen transport to the tissues.
  • Smoking: Smoking can increase carbon monoxide levels in the blood, lowering oxygen levels and increasing the formation of red blood cells.
  • Heart Disorders: Congenital heart disease or other heart disorders result in persistent hypoxia. 

Symptoms of Polycythemia

  • Fatigue: Excessive tiredness or weakness.
  • Headaches: Chronic or severe headaches that are frequently described as throbbing or pounding.
  • Dizziness or Lightheadedness: Feeling faint or dizzy, particularly after getting up fast.
  • Shortness of Breath: Difficulty breathing, particularly while exercising or laying flat.
  • Itching: Especially after a bath or exposure to warm water.
  • Blurred Vision or Visual Disturbances: Examples include seeing dots or flashes of light.
  • Reddened or Flushed Complexion: Especially on the face and ears.
  • Splenomegaly: An enlarged spleen can produce discomfort or fullness in the upper left abdomen.

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Similarities between Gaisbock's Syndrome and Polycythemia

  • Elevated Red Blood Cell Count: An increase in the number of red blood cells circulating in the blood is a characteristic shared by Polycythemia and Gaisbock's syndrome. Fatigue, headaches, and dizziness are some of the symptoms that may result from this increase in red blood cell count.
  • Elevated Hematocrit: The proportion of red blood cells in the total volume of blood is known as the hematocrit. Hematocrit levels are higher in both circumstances, indicating a higher proportion of red blood cells about plasma volume.
  • Symptoms: Polycythemia and Gaisbock's syndrome share certain symptoms, such as headache and dizziness. Itching, tingling, and blurred vision are examples of circulation-related symptoms that can be brought on by either illness. 

In conclusion, although both Polycythemia and Gaisbock's syndrome entails an increase in red blood cell count, Polycythemia is a collection of disorders characterized by an increase in red blood cells, including both primary and secondary causes. Gaisbock's syndrome is linked to lifestyle factors and stress, without a primary hematological disorder.

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What is Gaisbock's Syndrome?

Gaisbock's Syndrome is a disorder marked by increased blood pressure, elevated hematocrit levels, and low-grade erythema with no symptoms of inflammation or thrombosis. It usually affects middle-aged men who have a history of smoking, drinking alcohol, and experiencing chronic stress.

What is Polycythemia?

Polycythemia is defined as an excessively high concentration of red blood cells in the bloodstream. This may be the result of secondary Polycythemia, which is a reaction to illnesses such as persistent hypoxia or specific malignancies, or Primary Polycythemia (Polycythemia vera), a bone marrow disease causing an excessive synthesis of red blood cells.

What are the symptoms of Gaisbock's Syndrome?

Gaisbock's syndrome symptoms can include headache, lightheadedness, blurred vision, exhaustion, flushing of the face, and itching, especially after drinking or under stress. Polycythemia and hypertension are other possible symptoms.

What are the symptoms of Polycythemia?

Headaches, lightheadedness, itching (particularly after a warm bath), facial redness, exhaustion, weakness, dyspnea, and, in more severe cases, chest pain and eyesight issues are some of the symptoms of Polycythemia.

What are the similarities between Gaisbock's Syndrome and Polycythemia?

An elevated red blood cell count is a feature of both polycythemia and Gaisbock's syndrome, which can result in consequences including thrombosis and hypertension.

What are the differences between Gaisbock's Syndrome and Polycythemia?

Gaisböck's Syndrom, is characterized by an increase in red blood cell count caused by stress and dehydration, whereas Polycythemia is characterized by an increase in red blood cell production, with Primary Polycythemia being a myeloproliferative disorder and Secondary Polycythemia occurring as a result of conditions that stimulate erythropoietin production.