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Red Blood Cell Count (RBC)

Red Blood Cell Count

(RBC)
Written by Jacquelyn Cafasso and Ana Gotter
Medically Reviewed by Judith Marcin, MD on October 10, 2016





Overview

Symptoms of an abnormal count

Purpose
Procedure
Preparation
Risks
Results
Blood cancers
Next steps
Read This Next
Part 1 of 9

What is a red blood cell count?

Key points
1. The red blood cell count is an important test because
the number of red blood cells (RBCs) you have can affect
how much oxygen your tissues receive.

2. Fatigue and shortness of breath can be symptoms of

either a low RBC count or a high RBC count.

3. Certain medical conditions, dietary habits, and

medications can all affect your RBC count.
 A red blood cell count is a blood test that your doctor uses to
find out how many red blood cells (RBCs) you have. Its also
known as an erythrocyte count.

The test is important because RBCs contain hemoglobin, which

carries oxygen to your bodys tissues. The number of RBCs you
have can affect how much oxygen your tissues receive. Your
tissues need oxygen to function effectively.

Part 2 of 9

Symptoms of an abnormal
count

If your red blood cell count is either too high or too low, you
could experience accompanying symptoms and complications.

If you have a low RBC count, symptoms could include:

fatigue
shortness of breath
 feeling dizzy, weak, or lightheaded, particularly when you
change positions quickly
increased heart rate
headaches
pale skin
If you have a high RBC count, you could experience symptoms
such as:

fatigue
shortness of breath
joint pain
tenderness in the palms of the hands or soles of the feet
itching skin, particularly after a shower or bath
sleep disturbance
If you experience symptoms of either a low or high RBC count,
your doctor can order a simple RBC count.

Part 3 of 9

Why do I need a red blood cell

count?
 According to the American Association for Clinical Chemistry
(AACC), the test is almost always a part of a complete blood
count (CBC) test. A CBC test measures the number of all types of
components in the blood, including:
red blood cells
white blood cells
hemoglobin
hematocrit
platelets
Your hematocrit is the volume of red blood cells in your body,
and a hematocrit test measures the ratio of RBCs in your blood.

Platelets are small cells that circulate within the blood and form
blood clots when needed, which allows wounds to heal and can
prevent excessive bleeding.

Your doctor may perform the test if they suspect you have a
condition that affects your RBCs or if theres any sign that you
have low blood oxygen. The symptoms of low blood oxygen
include:

bluish discoloration of the skin

confusion
irritability and restlessness
irregular breathing
A CBC test will often be part of a routine physical exam because
it can be an indicator of your overall health. It may also be
performed before a surgery.

If you have a diagnosed blood condition that may affect RBC

count or youre taking any medications that affect your RBCs,
your doctor may order the test to monitor your condition or
 treatment. Doctors can use CBC tests to monitor conditions such
as leukemia and infections of the blood.

Read more: CBC (complete blood count)

Part 4 of 9

How is the test performed?

An RBC count is a simple blood test performed by a healthcare

provider at your doctors office. They will draw blood from your
vein, usually on the inside of your elbow. The steps involved in
the blood draw typically are:

The healthcare provider will clean the puncture site with an

antiseptic.
They will wrap an elastic band around your upper arm to
make your vein swell with blood.
They will gently insert a needle into your vein and collect
the blood in an attached vial or tube.
They will then remove the needle and elastic band from
your arm.
The healthcare provider will send your blood sample to a
laboratory for analysis.
Part 5 of 9

How should I prepare for the

test?

Theres typically no special preparation required for this test.

However, you should tell your doctor if youre taking
medications, including any over-the-counter drugs or
supplements.

Your doctor will also be able to tell you if any other precautions
are necessary.

Part 6 of 9

What are the risks of taking

the test?
 As with any blood test, theres a risk of bleeding, bruising, or
infection at the puncture site. You may feel moderate pain or a
sharp pricking sensation when the needle first enters your arm.

Part 7 of 9

What do the results mean?

According to the Leukemia & Lymphoma Society,

The normal RBC range for men is 4.7 to 6.1 million cells per
microliter.
The normal RBC range for women who arent pregnant is
4.2 to 5.4 million cells per microliter.
 The normal RBC range for children is 4.0 to 5.5 million cells
per microliter.
However, these ranges may vary slightly depending on the
laboratory or doctor.

Higher than normal

You have erythrocytosis if your RBC count is higher than normal.
This may be due to:

cigarette smoking
congenital heart disease
dehydration
renal cell carcinoma, which is a type of kidney cancer
pulmonary fibrosis
polycythemia vera, a bone marrow disease that causes
overproduction of RBCs and is associated with a genetic
mutation
When you move to a higher altitude, your RBC count may
increase for several weeks because theres less oxygen present
in the air.

Certain drugs, such as gentamicin and methyldopa, can also

increase your RBC count. Gentamicin is an antibiotic used to
treat bacterial infections in the blood. Methyldopa is often used
to treat high blood pressure and works by relaxing the blood
vessels to allow blood to flow more easily through the body. Be
sure to tell your doctor about any medications you take.
A high RBC count may be a result of sleep apnea, pulmonary
fibrosis, and other conditions that cause low oxygen levels in the
blood. Performance-enhancing drugs such as protein injections
and anabolic steroids can also increase RBCs. Kidney disease
and kidney cancers can lead to high RBC counts as well.
 Lower than normal
If the number of RBCs is lower than normal, it may be caused by:

Anemia
Anemia is a condition where there are not enough healthy red blood cells
to adequately carry oxygen throughout the body. There are many forms
and causes of anemia, including:
iron deficiency anemia, which is often easily treated
sickle cell anemia, which results in red blood cells having an
abnormal crescent shape and dying quickly
vitamin deficiency anemia, which often stems from low levels of
vitamin B-12
Regardless of the cause of anemia, it needs to be treated. People with
anemia typically feel tired and weak. They may also experience
headaches, cold hands and feet, dizziness, and irregular heartbeats.
anemia
bone marrow failure
erythropoietin deficiency, which is the primary cause of
anemia in patients with chronic kidney disease
hemolysis, or RBC destruction caused by transfusions and
blood vessel injury
internal or external bleeding
leukemia
malnutrition
multiple myeloma, which is a cancer of the plasma cells in
bone marrow
nutritional deficiencies, including deficiencies in iron,
copper, folate, and vitamins B-6 and B-12
pregnancy
thyroid disorders
Certain drugs can also lower your RBC count, especially:

chemotherapy drugs
 chloramphenicol, which treats bacterial infections
quinidine, which can treat irregular heartbeats
hydantoins, which are traditionally used to treat epilepsy
and muscle spasms
Part 8 of 9

Red blood cells and blood

cancers

Blood cancers can affect both the production and function of red
blood cells. They can also result in unusual RBC levels.

Each type of blood cancer has a unique impact on RBC count.

The three main types of blood cancer are:

leukemia, which impairs the bone marrows ability to

produce platelets and red blood cells
lymphoma, which affects the white cells of the immune
system
myeloma, which prevents normal production of antibodies
Part 9 of 9
What if I have abnormal
results?

Your doctor will discuss any abnormal results with you.

Depending on the results, they may need to order additional
tests or treatments.

These can include blood smears, where a film of your blood is

examined under a microscope. Blood smears can help detect
abnormalities in the blood cells (such as sickle cell anemia),
white blood cell disorders such as leukemia, and bloodborne
parasites like malaria. A bone marrow biopsy may be done to
take a closer look at how the different cells of your blood are
being made within your bone marrow. Diagnostic tests, such as
ultrasounds or electrocardiograms, can look for conditions
affecting the kidneys or heart.

Lifestyle changes can directly affect your RBC count. Some of

these changes include:
 maintaining a healthy diet and avoiding vitamin
deficiencies
exercising regularly, which requires the body to use up
more oxygen
avoiding aspirin
avoiding smoking
Specific dietary changes can play a major part in home
treatment of increasing or lowering your red blood count.

You may be able to increase your RBC with the following dietary
changes:

adding iron-rich foods such as spinach to your diet

increasing copper in your diet with foods like shellfish,
poultry, and nuts
getting more vitamin B-12 with foods like eggs, meats, and
fortified cereals
You may be able to decrease your RBC with the following
lifestyle changes:

reducing the amount of iron and red meat that you

consume
drinking more water
avoiding diuretics, such as drinks containing caffeine or
alcohol
quitting smoking
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