High red blood cell count: what should I know?

So, I've been dealing with nausea a few times lately, especially when pushing myself physically. My blood pressure hit 140/80 during those bouts, though it usually sits at a steady 120/80. It spiked once like that even without any exertion. I stay active and haven't had issues before. Just got my bloodwork back, and my red blood cell count is 5.78—just over the limit. Also, my W-SCR % and W-MCR % are slightly elevated. Bilirubin is up too. Total bilirubin is 48, which is way too high.

Can anyone tell me what these numbers actually mean, what might be causing this, and what my next move should be?

Thanks.

An elevated red blood cell count can stem from several different factors. In your case, this doesn't appear to be a primary disorder, but rather a secondary or relative erythrocytosis... Potential causes could include hypoxic conditions—such as being at a high altitude or having lung capacity that struggles to meet your body's demands during intense workouts—as well as relative erythrocytosis caused by dehydration and hemoconcentration.

So, I'm finally over this virus, but since I had such a nasty, lingering cough, I decided to get some blood work done
. Everything looks totally fine, except my red blood cell count came back at 5.21 (the lab range is > 10e12/L 3.86 - 5.08). I’m honestly confused about how I could be dehydrated because I’ve been drinking water like it's my job, basically chugging it like a marathon runner 😕. Plus, about two weeks ago, when I was dealing with what turned out to be a sinus infection and they put me on some antibiotics, my count was 5.12. 🤷 Is this actually something I should be worried about? 🤷

Just so you know, I took an effervescent iron tablet yesterday, if that matters for the lab results.

Don't even sweat it. Honestly, forget about those reference ranges for a second... I'm actually working on my own stuff right now, but if you're looking for answers on lab results, there’s already a massive megathread pinned at the top of the forum to help out.