Q) my husband has been diagnosed with polycythemia vera. he produces too many red blood cells.

Tell me what to expect in your expert opinion. our doctors don’t tell us too much, except that he should be OK.

A) Polycythemia vera is a blood disorder in which bone marrow produces too many red blood cells. in some cases, it may also cause an overproduction of white blood cells and platelets.

Whatever the reason, an excess of red blood cells causes the blood to thicken. Your husband may have had the condition for a number of years without ever knowing it.

It’s likely he either finally developed symptoms or had laboratory work performed for another reason or as part of a routine annual examination.

As the disorder progresses, patients develop symptoms and may experience headaches, fatigue, dizziness, shortness of breath, tingling of the extremities and more.

Blood is composed of three types of cells and a liquid known as plasma. The cells are erythrocytes (red blood cells) that carry oxygen throughout the body, white blood cells that fight infection and platelets that help the blood to clot.

Under ordinary circumstances, the body regulates blood cells and the ratio of each type within the body; however, in cases such as your husband’s, that control becomes impaired, and his bone marrow is producing an abnormal amount of specific cells.

His blood test likely revealed an elevated level of hemoglobin and hematocrit, a low level of erythropoietin (a kidney hormone that stimulates the development of red blood cells in bone marrow) and oxygen levels lower than the normal range found in healthy people.

Treatment may include medications to suppress his bone marrow’s ability to produce those blood cells, the use of low-dose aspirin, drawing off blood to reduce his blood volume and the number of blood cells he has (phlebotomy), and a recommendation by his physician or hematologist for an antihistamine, H2 receptor blocker or ultraviolet-light treatment to reduce any itching he may experience as a side effect of the polycythemia.

He should avoid temperature extremes and the use of tobacco, exercise as much as his physician allows and be sure to watch for skin ulcers, particularly of the hands and feet, which can result from poor circulation.

Readers who would like additional information can order my Health Report “Blood: Donations & Disorders” by sending a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167.

Be sure to mention the title or print an order form off my website’s direct link at AskDrGottMD.com/order_form.pdf.

Write to Peter Gott, c/o United Media, 200 Madison Ave., Fourth Floor, New York, NY 10016.

Gene therapy for the blood disorder beta-thalassemia will be carried out in Thailand for the first time by the end of this year.

A team of doctors at Ramathibodi Hospital is studying the gene therapy technology alongside experts in Paris under a collaboration programme between the Mahidol University led by Prof Suthat Fucharoen and French-American researcher Philippe Leboulch of Harvard Medical School and the University of Paris.

The Thai doctors expect to return to Thailand to conduct a trial around December, said Dr Suradej Hongeng, of Ramathibodi Hospital’s department of pediatrics.

The collaboration came about after the world’s first successful treatment of beta-thalassemia with gene therapy.

A 21-year-old Frenchman treated with the therapy in 2007 now no longer has the need for blood transfusions. He previously had required transfusions every month since birth.

The successful treatment was published in the journal Nature last September.

Beta-thalassemia is caused when a patient cannot produce enough of the beta-globin component of haemoglobin, the protein used by red blood cells to carry oxygen around the body. This can cause life-threatening anaemia, leading to severe damage of the body’s major organs.

Gene therapy is generally the insertion, alteration or removal of genes within a patient’s cells and biological tissues to treat disease.

“This success justifies the hopes placed in the use of gene therapy to treat blood diseases,” said Dr Suradej, a haematology specialist.

“It is also the first time an effective technology has been developed to improve the quality of life for people with thalassemia.”

An estimated 20 million Thais are carriers of thalassemia. It is one of the world’s most common genetic disorders, putting an enormous financial strain on Thailand and countries located in the “Thalassemia Belt”, which stretches from the Mediterranean through the Middle East and Central Asia to Southeast Asia.

About three in 800 children born in Thailand are affected by the severest form of the disorder, beta-thalassemia, requiring regular blood transfusions.

However, blood transfusions carry the risk of contracting HIV and hepatitis B and C from donors, or iron overloading.

The only known cure for the condition is through a bone marrow transplant.

However, this process is dangerous and it can be very difficult to find a matching bone marrow donor, Dr Suradej said.

He hoped the gene therapy for thalassemia treatment would eliminate the problems posed by bone marrow transplants, as well as lead doctors to adapt the technology to treat the symptoms of beta-thalassemia, such as as neurological problems and muscle disabilities.

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