Health

Scary Symptoms of Polycythemia Vera You Might Be Ignoring

You might feel fine—just a little tired, maybe a few headaches here and there. But what if your body is quietly warning you about something much… Diana Yasinskaya - April 22, 2025

You might feel fine—just a little tired, maybe a few headaches here and there. But what if your body is quietly warning you about something much more serious? Polycythemia Vera, a rare form of blood cancer, often creeps in with subtle, everyday symptoms that are easy to brush off—until it’s too late. From mysterious itching and brain fog to strange sensations in your limbs, these signs can be terrifying once you know what they mean. This list isn’t meant to scare you—but it should wake you up. If you’ve been ignoring what your body is whispering, now’s the time to pay attention. Here are scary symptoms of Polycythemia Vera you might be ignoring—and why they matter more than you think.

Headaches and Brain Fog That Won’t Quit

That nagging headache you keep blaming on dehydration or screen time? It could be something more serious. People with Polycythemia Vera often experience frequent, pounding headaches due to increased blood thickness. Thicker blood struggles to flow through vessels efficiently, especially in the brain, leading to reduced oxygen delivery and pressure buildup. Unlike regular tension headaches, these can feel more intense, more frequent, and harder to treat with over-the-counter meds.

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To make things worse, brain fog often tags along. It’s that mental sluggishness where you forget names, lose focus mid-sentence, or feel like you’re thinking through a cloud. This fog is a direct result of poor oxygenation and circulation in the brain—classic signs of PV that many people dismiss as stress or burnout. If you’re battling both symptoms on a regular basis, it’s time to stop guessing and talk to your doctor.

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Fatigue and Shortness of Breath

Feeling like you’re running on empty—even after a full night’s sleep? Chronic fatigue is one of the most common and frustrating symptoms of Polycythemia Vera. Your blood’s extra thickness means your body has to work harder to deliver oxygen to your muscles and organs. That effort leaves you drained, physically and mentally, even after the most basic tasks. And unlike normal tiredness, this kind doesn’t go away with rest.

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Alongside that exhaustion, you may find yourself short of breath doing things that never used to wind you—walking upstairs, carrying groceries, even talking for long stretches. The heart has to push harder to circulate that thickened blood, and your lungs may struggle to keep up. If you’re feeling unusually winded and wiped out, it’s not just “being out of shape”—your blood could be holding you back.

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Itchy Skin and Night Sweats

An itch that flares up after a shower—without a rash—isn’t just weird, it’s potentially a hallmark symptom of PV. Known as aquagenic pruritus, this unique itch is triggered by water and linked to the abnormal activation of mast cells in the skin. It can feel like pins and needles, often unbearable, and no amount of lotion or scratching seems to help. If you find yourself dreading baths because of the aftermath, don’t ignore it.

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Then there’s the night sweats. Waking up in soaked sheets—even in a cool room—could mean your body is dealing with an underlying issue. In PV, your body may overproduce white and red blood cells, ramping up your metabolism and triggering intense nighttime sweating. It’s more than just an annoyance—it’s a red flag. If you’re sweating through your clothes at night and itching like crazy after a shower, your blood may be trying to tell you something.

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Dizziness and Blurred Vision

That sudden spell of dizziness when you stand up—or even while sitting still—might not just be low blood sugar or dehydration. In Polycythemia Vera, thickened blood has trouble flowing freely, especially to the brain, which can trigger lightheadedness or a sensation that the room is spinning. Many people chalk it up to stress or vertigo, but persistent dizziness deserves a second look.

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Blurred or double vision is another sneaky sign that oxygen isn’t reaching your eyes efficiently. The increased red blood cell mass in PV can cause circulation issues in the tiny vessels that support your vision. Some people even experience temporary vision loss or strange flashes of light. If you find yourself rubbing your eyes often, squinting at things that used to be clear, or feeling off-balance, don’t just book an eye exam—ask your doctor to check your blood.

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Ringing Ears and Tingly Limbs

That high-pitched ringing in your ears, also known as tinnitus, might not just be from loud music or aging. In PV, poor circulation can cause pressure changes in the blood vessels near your ears, leading to persistent ringing or buzzing sounds. It can be distracting, frustrating, and often gets worse at night when it’s quiet—yet most people never connect it to their blood health.

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Another commonly ignored symptom is tingling or numbness in the hands, feet, or fingers. This happens because sluggish, thickened blood isn’t delivering oxygen as efficiently to your extremities. You might chalk it up to bad posture or “sleeping on your arm,” but if the tingling keeps returning or starts without clear reason, it could be a clue that your blood is out of balance.

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Ruddy Complexion and Burning Feet

Ever looked in the mirror and noticed your face seemed unusually red, even when you’re not hot or flushed? A ruddy complexion—particularly in the face or hands—is a classic symptom of Polycythemia Vera. It happens because there’s an excess of red blood cells circulating close to the skin, giving you a flushed, almost sunburned appearance. People often mistake it for rosacea or high blood pressure, but in PV, it’s a blood-related issue.

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Then there’s erythromelalgia—a burning, hot, or tingling sensation in the feet and sometimes hands. It may come on randomly or after being on your feet for too long, and it’s not just uncomfortable—it can be excruciating. This symptom stems from abnormal blood flow and vessel constriction, both of which are common in PV. If your feet feel like they’re on fire, even when they’re not warm to the touch, it’s worth bringing up with your doctor.

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Easy Bruising and Nosebleeds

Getting bruises you don’t remember earning? That’s a red flag. Polycythemia Vera can affect platelet function, making it easier for small blood vessels to break and cause visible bruising—especially on the arms and legs. You might even notice more frequent marks after minor bumps, or find bruises that seem to appear out of nowhere. It’s more than just clumsiness; it could be a sign of compromised blood flow or clotting.\

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Frequent nosebleeds are another unexpected symptom. They may be light or heavy, spontaneous or triggered by dry air—but if you’re getting them more often than usual, pay attention. PV can cause irregularities in how blood clots, and the delicate vessels in the nose are especially vulnerable. If your tissues are seeing more red than usual, your blood might be to blame.

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Abdominal Fullness and Left-Side Discomfort

Feeling bloated or overly full after eating just a few bites? That’s not just sluggish digestion—it could be your spleen. In PV, the spleen often enlarges (a condition called splenomegaly) as it works overtime to filter the extra blood cells. The pressure from that swelling can press on your stomach, causing early satiety and a feeling of tightness in your abdomen even when you haven’t eaten much.

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Alongside that full feeling, you might notice a dull ache or discomfort on the upper left side of your abdomen—right where the spleen sits. It’s easy to confuse this with muscle pain or bloating, but if it lingers or worsens, it could be a sign that your spleen is working too hard. Don’t ignore these subtle pressure cues—they may be your body trying to alert you to a serious imbalance.

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Nausea and Loss of Appetite

Feeling queasy for no clear reason? Nausea is one of those vague symptoms that’s easy to ignore or blame on something you ate—but it can also be tied to an enlarged spleen, a common complication of PV. As the spleen grows, it pushes against other abdominal organs, affecting digestion and creating a subtle, persistent feeling of discomfort or nausea.

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At the same time, many people with PV begin to lose their appetite. This isn’t just picky eating—it’s often due to pressure in the abdomen or altered metabolism caused by the disease. If you find yourself skipping meals, feeling full quickly, or simply not wanting food the way you used to, it’s worth paying attention. Appetite changes may be your body’s quiet warning sign that something deeper is going on.

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Constipation and Abdominal Cramping

Constipation is more than an inconvenience—it can be a symptom of poor circulation or splenic pressure in PV patients. When your digestive system isn’t getting adequate blood flow, things can slow down, leading to bloating, discomfort, and infrequent bowel movements. It’s also common for PV medications to contribute to this side effect, making it a double-edged issue.

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Abdominal cramping, meanwhile, can accompany constipation or occur on its own due to the enlarged spleen pressing on the intestines. If you’re experiencing frequent cramps that don’t seem tied to food or your menstrual cycle, your blood condition may be a contributing factor. Regular hydration, light movement, and fiber can help—but if these symptoms persist, it’s time to look deeper.

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Joint Pain and Gout Flares

Aching joints might sound like aging, but they’re also a symptom of elevated uric acid—something many PV patients struggle with. When your body breaks down excess cells (especially red ones), it releases more uric acid into the bloodstream. This buildup can lead to inflammation and pain in the joints, particularly in the feet, knees, and hands.

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Gout attacks are especially common in people with PV. If you’ve ever had sudden, intense pain in your big toe or other joints—especially if it appears red, hot, and swollen—it could be more than just an isolated incident. Managing uric acid levels with dietary changes, hydration, and medical support is essential for anyone with PV to avoid these painful flares.

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Back Pain and Muscle Weakness

Back pain might seem unrelated to blood issues, but in PV, it can result from splenomegaly (enlarged spleen), kidney strain, or even referred pain from abdominal pressure. The discomfort typically settles in the lower back or flanks and can worsen with prolonged sitting or after meals. If it doesn’t respond to normal stretching or pain relievers, your blood condition might be the real culprit.

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Muscle weakness is another subtle but serious sign. Thickened blood can reduce oxygen flow to muscles, making everyday tasks feel more tiring or even shaky. You might notice difficulty lifting grocery bags, opening jars, or climbing stairs. While it’s easy to brush off, consistent weakness without a clear cause deserves attention—especially when paired with other PV symptoms.

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Pale Skin and Flushed Face

Here’s an odd combo: looking both too pale and too red at the same time. People with PV sometimes experience pallor in areas like the lips, nail beds, or under the eyes, especially during fatigue. This happens when blood isn’t circulating evenly or oxygen is being poorly distributed—even though there’s an overproduction of red cells.

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On the flip side, many people also report a ruddy or flushed face. That’s because of excess red blood cells congregating near the surface of the skin. It’s a confusing mix of symptoms that can leave you looking—and feeling—off balance. If your skin tone seems to shift frequently, or you look overly flushed in photos, it’s worth investigating.

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Mood Swings and Anxiety

Feel like you’re on an emotional rollercoaster lately? Mood swings can stem from oxygen deprivation in the brain and the physical stress of your body trying to compensate for imbalances. One moment you’re irritable, the next you’re weepy—and it doesn’t seem to make sense. This isn’t “just stress”—your blood chemistry may be part of the problem.

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Anxiety often sneaks in alongside these swings. The sensation of being short of breath, jittery, or on edge may feel psychological, but it can also come from physical symptoms of PV like thickened blood or hormonal disruption. If your mental health has taken a nosedive with no obvious trigger, it’s time to consider whether the root cause is more than emotional.

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Depression and Trouble Sleeping

Depression in PV isn’t just about feeling sad—it can also come from chronic fatigue, reduced oxygen flow to the brain, and the emotional weight of living with unexplained symptoms. Many people describe a deep lack of motivation, disinterest in daily activities, or a sense of heaviness that won’t lift. Left unaddressed, it can spiral into something more serious.

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Add to that sleep disturbances—another common but underrated PV symptom. Whether it’s trouble falling asleep, waking in the middle of the night, or feeling unrested in the morning, poor sleep compounds everything else. If your mood and sleep are both out of whack, it’s not “just in your head.” Your blood may be impacting your mental health more than you realize.

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Irritability and Restlessness

Do you find yourself snapping at people over small things—or feeling constantly on edge for no clear reason? Irritability is a subtle but powerful symptom of PV. When your body is under stress from thickened blood and reduced oxygen flow, your mood can easily spiral. It may feel like you’re just “having a bad day,” but persistent irritability is often a red flag your body is struggling internally.

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Restlessness tends to go hand-in-hand with this. You might feel agitated, unable to sit still, or experience racing thoughts that keep you from relaxing—even when you’re physically exhausted. Many PV patients report that this jumpy, unsettled feeling builds over time. If your nerves feel frayed and your patience is thin without an obvious cause, your blood could be part of the reason.

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Confusion and Memory Issues

Everyone forgets things from time to time—but if you’re consistently struggling to remember names, appointments, or why you walked into a room, it might not just be aging or distraction. In PV, poor oxygenation in the brain can lead to cognitive fog and short-term memory lapses. It may feel like you’re mentally “not quite there,” even though you’re trying to focus.

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Confusion can be even more alarming. Some people experience moments where they feel lost, disoriented, or unable to process what’s happening around them. This may last just a few minutes or linger throughout the day. If mental clarity is slipping and it’s happening alongside other symptoms, don’t chalk it up to stress—get your blood checked.

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Daytime Drowsiness and Insomnia

Feeling drowsy all day but wide awake at night? That frustrating flip in your sleep-wake cycle is surprisingly common in PV. Daytime sleepiness can stem from chronic fatigue, poor blood flow to the brain, or disrupted sleep quality. Even with enough hours in bed, your body might not be getting the rest it needs—leading to excessive yawning, low energy, and sluggish thinking.

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Ironically, when bedtime comes, you might still find yourself tossing and turning. Insomnia can be driven by discomfort, itching, night sweats, or general restlessness—all common in PV. This combination of fatigue and sleep trouble can create a vicious cycle. If your nights are sleepless and your days feel like a fog, it’s time to explore what’s going on under the surface.

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Rapid Heartbeat and Chest Tightness

Have you noticed your heart racing even while sitting still? A rapid or irregular heartbeat is one of the body’s ways of compensating for oxygen-starved tissues. When the blood is thicker than normal, your heart works overtime trying to push it through your system. Over time, this strain can cause palpitations or even put you at risk for heart complications.

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Chest tightness is another common and concerning symptom. It may feel like pressure, heaviness, or a mild squeezing sensation—not always the sharp pain people expect. While this could be anxiety-related, it can also signal real cardiovascular stress related to PV. If you’re experiencing both symptoms, don’t wait it out—get evaluated right away.

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Leg Cramps and Swelling

Those middle-of-the-night leg cramps that jolt you awake might be more than just dehydration. PV increases the risk of blood clots, especially in the legs (a condition known as deep vein thrombosis, or DVT). Cramping, particularly in one leg, could be a warning sign of poor circulation or early clot formation.

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Swelling in the ankles or calves is another subtle symptom to watch. This can happen when blood isn’t flowing efficiently, causing fluid to pool in the lower limbs. If one leg appears more swollen than the other or you notice tenderness and warmth, don’t ignore it. These could be early signs of a dangerous clot that requires immediate medical attention.

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Cold Extremities and Numb Fingers

Ever feel like your fingers or toes are cold no matter how warm it is? In PV, thicker blood can slow circulation to the extremities, leaving your hands and feet constantly chilled. It’s more than just discomfort—it’s a sign that your body isn’t delivering oxygen efficiently where it’s needed most.

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Numbness or a “pins and needles” feeling in the fingers or toes is also common. This can happen after sitting or lying in one position too long or even during daily activities. If numbness occurs frequently and without a clear cause, it could be a vascular issue linked to PV’s impact on microcirculation.

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Flushed Skin and Facial Redness

If your face often looks bright red or flushed, especially without exertion or emotional stress, it could be a symptom of PV. This ruddy complexion occurs when there’s an overabundance of red blood cells near the skin’s surface—especially around the cheeks, nose, and ears. It’s not just blushing—it’s your blood signaling something’s off.

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This redness may also come and go in waves, especially in warm environments or after eating. While it’s easy to blame rosacea or sun exposure, a persistently flushed face with no obvious cause deserves a second look. Paired with other symptoms like headaches or fatigue, it could point toward PV.

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Swollen Spleen and Side Pain

An enlarged spleen—common in PV—often goes unnoticed until it starts pressing on nearby organs. This can cause a vague sense of fullness, a dull ache in the upper left abdomen, or even discomfort after eating small meals. Some people describe it as a “heavy” feeling that’s hard to pinpoint.

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This splenic swelling is more than just annoying—it’s a sign that your body is under stress from excess blood cells. If you’re experiencing unexplained abdominal discomfort that’s persistent and localized on the left side, especially if accompanied by appetite changes, it’s worth a closer evaluation.

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Bleeding Gums and Frequent Bruising

Brushing your teeth shouldn’t lead to bleeding—so if your gums are routinely sore or bleeding during oral care, don’t overlook it. In PV, abnormal platelet function can make it harder for the blood to clot properly, leading to frequent bleeding even from small cuts or irritation.

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Similarly, unexplained bruises—especially ones that appear without any clear bump or injury—can be another early warning. The same clotting dysfunction that causes gum bleeding can lead to easy bruising, particularly on the arms, legs, or torso. If your body seems overly sensitive to minor trauma, it might be a deeper issue with your blood.

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Clotting Issues and Slow Wound Healing

If your cuts seem to take forever to stop bleeding—or worse, to heal—that’s a sign your clotting system might be out of balance. In PV, blood can paradoxically become both more prone to clotting and slower to heal. That’s because the overproduction of blood cells interferes with normal clotting mechanisms, creating unpredictable responses to injuries, no matter how small.

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You might also notice that wounds scab over oddly, bruise more deeply, or reopen easily. This sluggish healing isn’t just a skin issue—it’s your circulatory system signaling a dysfunction. If you find yourself constantly reapplying bandages or dealing with lingering scrapes, it’s worth questioning what’s going on beneath the surface.

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Hot Flashes and Temperature Swings

Ever feel like you’re burning up for no reason? Sudden temperature changes—especially hot flashes not related to hormones—can be a sign of underlying blood flow issues. With PV, thickened blood affects circulation and thermoregulation, making your internal “thermostat” go haywire. You might feel fine one moment and drenched in sweat the next.

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On the flip side, you could suddenly feel freezing—even in warm environments. These temperature swings often come with flushed skin, fatigue, or rapid heartbeat. If you’re frequently adjusting the thermostat, bundling up indoors, or throwing off your covers in the middle of the night, it may not just be your environment—it could be your blood acting out.

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Vision Flashes and Eye Pressure

Seeing flashing lights, floaters, or zigzag lines in your vision? These aren’t just annoying—they could be warning signs. PV often affects the small blood vessels in the eyes, and as the blood thickens, it can briefly cut off circulation to the retina. This can lead to visual disturbances that feel sudden, weird, and hard to describe.

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Eye pressure is another symptom that can sneak up on you. It might feel like a dull ache behind your eyes or mild throbbing that comes and goes. Many people mistake this for screen fatigue or sinus issues, but in PV, it’s often a result of increased blood volume straining delicate vessels. If your eyes feel heavy or your vision gets strange, it’s time to take it seriously.

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Hoarseness and Throat Tightness

That scratchy, hoarse voice that never quite goes away could be linked to blood congestion in the throat area. PV can cause engorgement in the veins of the neck and upper chest, leading to vocal cord irritation and a persistent roughness in your voice. It may feel like a lingering cold—but it sticks around far too long.

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Throat tightness is another symptom some PV patients report, especially when lying down. It can feel like a mild pressure or lump that makes swallowing uncomfortable, but without actual soreness. If your throat often feels “off” and other causes have been ruled out, it’s worth exploring whether blood flow is playing a role.

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Discolored Fingernails and Nail Weakness

Take a good look at your fingernails. Are they unusually pale, bluish, or even purplish at times? Discoloration in the nail beds can be a sign of poor oxygen delivery—one of the hallmark effects of Polycythemia Vera. The body’s extremities are often the first to show signs when blood is struggling to circulate efficiently.

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Nail weakness is another clue. Brittle, peeling, or slow-growing nails can reflect nutrient deficiencies caused by poor absorption, inflammation, or chronic disease. If your nails have changed texture or color recently, it’s more than just a cosmetic issue—it could be a window into what’s happening inside your bloodstream.

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Frequent Infections and Slow Recovery

Does it feel like you’re always fighting off something? Frequent colds, lingering coughs, or recurrent infections might be a sign your immune system is overworked—or misfiring. PV alters how your body produces white blood cells, which can weaken your immune response or trigger inflammatory reactions that make healing harder.

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You might also notice that when you do get sick, it takes longer to bounce back. What used to be a two-day bug might now drag out for a week or more. If you’re constantly under the weather or feel like you’re never fully recovering, your immune function might be compromised by more than just a seasonal virus.

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Frequent Yawning and Lightheadedness

Yawning a lot—even when you’re not tired? That could be your body’s way of begging for more oxygen. In Polycythemia Vera, thick blood has a harder time transporting oxygen efficiently, especially to the brain. Frequent yawning is one of those strange, subtle clues your body may not be getting the air it needs—even if you’re breathing just fine.

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Lightheadedness often tags along, especially when standing up quickly or during physical activity. That woozy, floating sensation can stem from poor blood flow and inconsistent oxygen delivery. If you find yourself yawning all day and feeling faint or foggy, don’t just brush it off—it may be a vascular issue hiding in plain sight.

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Swollen Feet and Ankle Pain

Swelling in the feet or ankles might seem like a result of standing too long or salty food—but in PV, it can indicate poor blood circulation or fluid retention caused by your heart working overtime to push thickened blood. It’s especially concerning if only one leg is swollen, which may signal a blood clot.

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Ankle pain is another overlooked sign. Achiness, pressure, or tenderness in the joint could be a result of vascular strain or inflammation from elevated red blood cell counts. If your lower legs feel stiff, sore, or swollen on a regular basis, your circulatory system might be under stress.

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Dark Urine and Dehydration Sensitivity

Notice your urine looking darker than usual—even when you’ve been drinking water? Dehydration can worsen PV symptoms dramatically. When you’re not hydrated, your blood becomes even more viscous, increasing the risk of clots and reducing oxygen delivery. Dark urine is often the first sign your hydration levels are dipping too low.

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People with PV are also more sensitive to fluid loss. Hot weather, exercise, or even a mild fever can create serious discomfort because of how blood volume and viscosity shift. Staying well-hydrated isn’t just a general health tip—it’s a critical part of managing your symptoms and preventing complications.

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Chest Heaviness and Irregular Pulse

That tight, heavy feeling in your chest shouldn’t be ignored. PV puts extra strain on the cardiovascular system, and over time, your heart can begin to struggle with pumping thicker blood. Chest heaviness may feel mild at first—like someone resting a book on your chest—but it can become a serious warning sign if left unchecked.

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Alongside this, an irregular pulse might show up: heart palpitations, skipped beats, or fluttering sensations. These changes can signal your heart is overworked or not getting the oxygen it needs. If these two symptoms appear together—even occasionally—they deserve immediate medical attention.

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Cold Sweats and Weak Grip Strength

Cold sweats—sudden clamminess even without exertion or fever—can signal an internal imbalance, often tied to cardiovascular strain or even pre-syncope (near-fainting). In PV, your body may struggle to regulate blood flow properly, leading to sudden sweat episodes, especially when your system feels overloaded.

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At the same time, many people with PV notice a weakening of grip strength. Tasks like opening jars or carrying groceries may feel harder than usual. This can be due to poor circulation, nerve involvement, or even muscle fatigue from low oxygen delivery. If your hands feel weaker and you’re sweating without reason, something’s off—and it may start with your blood

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Unexplained Soreness and Skin Sensitivity

Waking up sore when you haven’t exercised? That kind of unexplained body pain can be linked to inflammation caused by PV. When blood vessels are overworked or stressed, muscles may become oxygen-deprived, triggering soreness that mimics post-workout aches—without the workout.

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Skin sensitivity is another overlooked sign. You might notice your skin hurts to the touch, feels itchy, or becomes irritated by fabrics and friction. These symptoms may relate to poor microcirculation or histamine activity—both of which are common with PV. If your body feels hypersensitive or sore without reason, your blood could be to blame.

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Difficulty Climbing Stairs and Muscle Cramps

Getting winded or weak after just a flight of stairs? That’s not always about age or fitness—it may be due to how hard your body has to work to push oxygen-rich blood through thickened vessels. For people with PV, physical exertion can feel more intense, and stamina may decline even if you’re otherwise healthy.

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Muscle cramps are another red flag. If you’re waking up with tight calves or cramping during mild exercise, it could be due to poor circulation and oxygen starvation in muscle tissue. These symptoms are easy to brush off—but if they’re happening regularly, your body is waving a red flag.

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Throbbing Hands and Swollen Fingers

If your hands feel like they’re pulsing or throbbing, especially after activity or in warm weather, this could be a circulation issue tied to PV. Blood tends to pool in the extremities when vessels are under pressure, and the hands are one of the first places to show symptoms. This discomfort may be constant or come in waves.

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Swollen fingers are also common and often dismissed as “just water retention.” But in PV, this can be the result of poor blood flow, increased pressure, or inflammation. If your rings feel tighter, your fingers puffier, or you notice a throbbing sensation after minor tasks, don’t ignore it—your circulatory system might be overloaded.

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Loss of Coordination and Shaky Hands

Feeling clumsy lately? If you’re dropping things, bumping into furniture, or struggling with fine motor tasks, it could be more than just distraction. In PV, poor oxygen delivery to the brain and muscles can interfere with coordination. It’s not uncommon for people to feel “off balance” or like their body just isn’t responding the way it used to.

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Shaky hands often show up right alongside this. Whether it’s a mild tremor when holding objects or noticeable shaking during daily tasks, this symptom can reflect neurological involvement or circulation issues. If your hands are trembling and your coordination is slipping, it’s time to consider what might be going on beneath the surface.

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Frequent Hiccups and Voice Changes

This one might surprise you—frequent hiccups can actually be a sneaky symptom of an enlarged spleen or pressure on the diaphragm, both of which are linked to PV. If you’re getting hiccups multiple times a day for no obvious reason (like eating too fast or drinking carbonated beverages), it could be due to internal pressure disrupting nerve signals.

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Another unusual but telling sign is a change in your voice. Some people with PV report their voice becoming hoarse, weak, or easily strained. This can happen when enlarged blood vessels or organs press on vocal nerves, or when overall fatigue impacts vocal strength. If your hiccups seem endless and your voice is suddenly unreliable, your blood may be behind it.

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