Check the drug list before acting on a raised haematocrit. Diuretics, testosterone and dehydration are established causes of a relative rise, and SGLT2 inhibitors now belong on that list.
The reverse also matters: a haemoglobin that is normal on treatment may have been low before it, so look at the pre-treatment value when anaemia is suspected.
- Review medicines, including SGLT2 inhibitors, diuretics and testosterone, before investigating a raised haematocrit.
- Compare with the pre-treatment haemoglobin when anaemia is suspected.
- Check ferritin and transferrin saturation if iron deficiency is possible, regardless of the haemoglobin.
- Refer for haematology review if the rise is large, persistent or accompanied by other abnormal counts.
Why it matters
A drug-related rise can trigger a needless work-up, or hide a real anaemia.
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