Hi Meri, I have seen that website. I prefer the American Society of Hematologists site. They have a online journal called Blood. Look up Dec. 2002, Vol 100, No. 13 Polycythemia vera: myths, mechanisms and management. It is a 56 page article. I don't have the focus to understand all of it. What is interesting is page 5 of 56. Discusses IGF-1. The second article I have is: Blood, Vol. 89, No.6, 1997 Insulin-Like Growth Factor Binding Protein-1 is elevated in Patients with Polycythemia Vera and Stimulates Erythroid Burst Formation in Vitro. You and Minnie might like this website. Good for looking up blood tests and disorders. The info is more specific. I appoligize, I should have mentioned that I am probably talking about secondary polycythemia which is different from primary. Also, with primary and secondary are subcategories of metabolic and respiratory. Treatment appears to be similiar and easy to manage no matter what the cause. I also have found that spenlomegaly can be involved which goes to acromegaly which can cause splenomegaly. I have just started working on this so I don't really have a good grasp. I had the weird fatigue after the shower thing on occassion two years ago. It went away. No idea anyone else has that. I assumed my low blood pressure had dropped. Meri, you take good care of your self and get plenty of rest. By the way, those blood tests (rbc,hgb,hct) are very standard tests for any kind of doc. Check it out. Could be a possibility. Jean | 