Well, I am not a medical professional, but it sure does sounds like something peculiar is going on in your bone marrow. Meaning, you have rising RBC, WBC, but also anemia. I don't think I've ever read about a person having both polycythemia AND anemia. Have you?

I met with a different MD this week. My hematocrit tends to run about 54, which is just over the male hematocrit upper limit of 50.3. My physician has ordered phlebotomy anytime I go over 52.

He said not to worry, that in fact athletes 'dope' themselves up to achieve these higher limits without problem. He also said that the sort of polycythemia signs and symptoms I fear don't hit until the hematocrit gets into the 60s. That's when doctors begin to worry. So, basically, he told me not to worry too much.

The female hematocrit upper limit is something like 44.3 on our reference range, which is significantly lower than that for a male. May I ask what you hematocrit level runs pre-phlebotomy? And, at what point do you go for phlebotomy? I am just wondering how high they let you go before phlebotomy.

What I find most interesting about your story is your mention of being "beyond fatigued." Sounds like how I was up until a month or two ago. I was diagnosed with Chronic Fatigue Syndrome (yes, it's a real 'thing' now), which appears to result from inferior cellular respiration. Mitochondria in cells don't make enough energy -> exhaustion.