Dark circles/veins under eyes

Hey everyone.

I've got visible veins under my eyes and some pretty heavy bags. Can anyone tell me what might be causing this? Any ideas on how to fix them? I’ve read that creams with Vitamin K actually work for cosmetic purposes.
It isn't a sleep issue—even when I get a full night's rest, they're still there. Honestly, I've basically had dark circles since birth. They're even more noticeable on my brother, though nobody else in my family deals with these veins. I don't smoke, and I don't touch coffee. I am a potential heart patient due to having hyperglobulism, so I'm trying to figure out if there's a connection between the veins and my heart...

Thanks in advance.

What does polycythemia actually signal? Which primary diseases are we looking at? Is it Cushing? Are you dealing with high blood pressure?
Those bags under your eyes could stem from various issues—genetics (you mentioned your father has them too), kidney disease (impaired renal function), or perhaps hypothyroidism...
Dark circles can also be a sign of anemia, or they might just be hereditary.....

Get a complete blood count, check your thyroid levels, and have your kidney function evaluated.

Kate Garcia2,

My blood pressure is lower than average. It used to be high about 6 or 7 years ago, but I brought it down by losing weight and getting serious about fitness.

The first time I got blood work done, it was right after an allergy test. I'm basically allergic to everything—dust, mites, pollen, you name it. Even cat hair. Everything except food. After those tests, I went for the blood panel. Since my initial results showed polycythemia (I think that's what they call hyperglobulinemia, hopefully we're talking about the same thing), my doctor sent me for a chest X-ray and spirometry. The X-ray showed my lungs were perfectly clear (aside from some minor issues with a rib—never even felt it crack🙂), and my spirometry results showed phenomenal lung capacity.
After consulting with a pulmonologist, he actually praised my lifestyle. Back then (the tests were done in late November last year), I was running almost every single day through 2.5 miles. A week before the blood draw, I had gone to the mountains for a run. He told me to redo the tests three weeks later, but this time I needed to scale back the exercise for about 4 or 5 days before the draw.
So, I kept up with the running and the gym. After taking a five-day break before the second round of tests, the results showed my hemoglobin was just 0.2 above the upper limit, and my red blood cell count was also slightly elevated, though still well above the threshold.
I wanted to ask, could these levels be linked to my fitness routine?
Lately, during this winter stretch, I've been focusing on cardio and hitting the gym...
Also, about a year ago, I had a full abdominal ultrasound, and the doctor gave me a perfect 10 out of 10.
As for veins: I had one under my left eye back in high school. Now that I'm in college, three have appeared under that same eye—they're pretty noticeable.

It was 22 on the 22nd (if that's what this means).

I don't think any patient ever gives their doctor this much detail.😁

It could be linked to dehydration from intense training—essentially relative hyperglobulinemia due to hemoconcentration—or perhaps an increase in erythropoietin levels if you’ve been spending significant time running at high altitudes.
Unfortunately, what you've shared still isn't quite enough for me to go on.

Is it just an isolated elevation in red blood cells, or are your white blood cell and platelet counts elevated alongside the erythrocytosis?
What is your hematocrit level? (Apple)
Have they checked your arterial oxygen saturation?
Did they measure your erythropoietin levels?
I see they've already performed scans on your lungs and abdomen.

Have you seen a hematologist yet? And if not, why haven't you?

The causes for an elevated blood cell count are endless, ranging from the aforementioned hemoconcentration and high-altitude living to hypoxia caused by lung or kidney issues, or even various types of anemia stemming from defective erythrocyte or hemoglobin structures.
There is also a rare hereditary condition involving elevated blood cell counts where the cause remains unknown. Does anyone else in your family have this diagnosis? Your father, perhaps?

Furthermore, this increased cellularity in your blood could be the culprit behind those veins under your eyes—are you certain they are veins, and how large are they? They might actually be capillaries which (if I am finally understanding you correctly) are engorged, thrombosing, bursting, and bleeding...

Sclerotherapy might address them, but if I were in your shoes, I would insist on a full evaluation by a hematologist. It is entirely possible that these are merely symptoms of your diagnosed hyperglobulinemia; if you don't treat the root cause, you'll never truly get rid of them, as new ones will simply continue to form.

Kate Garcia2,

I'm planning to get some blood work done in the next few days, so I'll let you know how things look. I need to check my current levels and see where I stand. Honestly, my dad dealt with similar issues... I'm worried it might be polycythemia vera, though our family history shows we tend to live long lives—it's just that everyone eventually succumbs to blood clotting complications. I'm stepping up to be the first one to figure out why my blood is getting too thick. They already confirmed it for my dad, but their "solution" was just to have him donate blood, which he actually did throughout his life (about 30 times).
Those veins under my eyes aren't bleeding. You can see them on the edge of the bag—they aren't super prominent unless I'm exhausted, but the color is unmistakable: blueish. When I look toward the eye from either side, there's this tiny little capillary visible.
It's possible the culprit is just the weather; Asheville (where I live in the US) gets pretty freezing compared to other cities around here. It sits at nearly 2,600 feet. Who knows what the actual cause is? Doctors say they're seeing more and more young people showing up with hyperglobulemia lately.

Anyway, I'll be getting those labs done tomorrow or the day after. I'll keep you posted...

Fine

A friend mentioned to me the other day—why are my veins showing under my eyes? I’ve always had dark circles, not even super dark right now, but they definitely count—no matter how much sleep I get. It's not anemia; I just have really low blood pressure and a fast metabolism. But you've got me thinking now 🙂

Kate Garcia2,

RBC: 61.2 (ref 65.7)
HCT: 51.3 (ref 55.6)
HGB: 179

I’ll probably be seeing a hematologist this Monday. Those numbers in parentheses? Just the baseline from my labs back in November.

That hematocrit level suggests we might be looking at pseudopolycythemia—essentially just relative erythrocytosis triggered by dehydration or hemoconcentration from intense exercise.
Regardless, please see a hematologist. You’ll need a full battery of tests, including red cell mass, arterial oxygen saturation, and potentially erythropoietin levels if they suspect true polycythemia vera.
Do let me know what they say; perhaps I might actually learn something new. 😉

You should also ask them about those capillaries under your eyes. If they aren't caused by hemoconcentration or increased blood viscosity, you really ought to consult a dermatologist. Have you noticed them appearing more frequently during the winter months? Are they strictly under the eyes, or are your blood vessels generally fragile? Have they ever faded on their own?

So, here’s the update.

Kate Garcia2, I finally went through most of the tests. The blood work showed nothing major, just some slightly elevated creatinine levels; everything else was pretty much within range (and I didn't even bother with a full lipid panel or minerals...). An abdominal ultrasound showed my spleen is working a bit too hard, but nothing I can't handle, and all my other organs look fine. I also had a chest X-ray and an EKG—turns out I've got that "athlete's heart" thing going on.
The plan: redo the whole battery in 20 to 30 days to see if this is actually my baseline.
My theory? It’s probably just the altitude and the intense training messing with the numbers.

You really ought to start increasing your fluid intake to help thin out that blood a bit, wouldn't you agree? 😉