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Low RBC Count: A Comprehensive Guide to Causes and Remedies

By Dr. Shubham Pandey +2 more

Key Highlights:

  • Red blood cells (RBCs) are critical for transporting oxygen throughout the body.
  • A low RBC count can indicate anaemia, leading to various symptoms and complications
  • Causes of low RBC count include nutritional deficiencies, hemolysis, bone marrow failure, chronic conditions, and medications
  • Managing low RBC counts may involve a balanced diet, supplements, exercise, and addressing medical conditions
  • Consult with a healthcare professional if experiencing symptoms indicative of low RBC count

Introduction

Every part of our body needs red blood cells (RBCs). As they bring oxygen from the lungs to all cells, they make sure we work well and feel good. Anaemia or low RBC count occurs when our body doesn’t make enough  RBCs, or it gets rid of them too quickly. 

In this article, we will discuss red blood cells, what makes RBC count to decrease, and explore dangers linked with this issue. We will tell you in detail how low RBC count is detected and how it may be managed. 

low rbc count

What are Red Blood Cells?

Red blood cells (RBCs) have an important job: to carry oxygen all through our body. The main part of RBCs is a protein called haemoglobin. It grabs oxygen in our lungs and delivers it to the various tissues in our body. 

Functions of red blood cells

 Their main functions are as follows. 

  • Taking oxygen from the lungs to the body’s tissues.
  • Moving carbon dioxide from the tissues back to the lungs to be exhaled out.
  • Keeping the right acid-base balance in the body

Normal RBC count range

The RBC count changes based on age and if you’re male or female. The normal values are as follows. 

  • Males: 4.7 – 6.1 million cells/µL
  • Females: 4.2 – 5.4 million cells/µL

Did you know?

  • Abnormal RBC indices can indicate iron deficiency anemia, liver disease, or hereditary spherocytosis. medlineplus.gov
  • The reference range for red blood cells in males is 4.3-5.9 million/mm3, and in females is 3.5-5.5 million/mm3. Source: ncbi

Low Red Blood Cell Count ( Anaemia)

 Anaemia means that you have few RBCs or haemoglobin. This reduces how much oxygen moves through your body. This can lead to several symptoms and damage your health. 

Definition

Anaemia is when the number of RBCs, the amount of haemoglobin, or the amount of hematocrit falls below normal.

Symptoms

Some common symptoms are as follows. 

  • Feeling tired all the time
  • Feeling weak
  • Being short of breath
  • Skin looking pale or yellow
  • Heartbeat not regular
  • Feeling dizzy or lightheaded
  • Pain in your chest
  • Hands and feet feeling cold
  • Headaches

Researchers have found that a low RBC count might indicate malnutrition (when a person’s diet is deficient in nutrients to meet their body’s demands), or internal bleeding.

Dr. Siddharth Gupta, B.A.M.S, M.D

Causes of Low RBC Count

The RBC count may be low because your body doesn’t make enough RBCs, it gets rid of them too quickly, or you lost a lot of blood. Many illnesses and conditions can lead to these issues and result in anaemia. These are as follows.

1. Nutritional deficiency

If you don’t get enough of key nutrients, your body might not produce enough RBCs. This can cause anaemia.

2. Iron deficiency

Iron is key for making haemoglobin. If your body is short on iron, it can lead to iron deficiency anaemia, the most common type of anaemia.

3. Vitamin B12 deficiency

Vitamin B12 is key for making RBCs and DNA. Not getting enough of it can cause megaloblastic anaemia or pernicious anaemia.

4. Folic acid deficiency

Folic acid, which is vitamin B9, is needed to make RBCs. A shortage of it can lead to megaloblastic anaemia.

5. Copper deficiency

Copper helps our bodies use the iron needed to create RBCs. If we don’t have enough copper, it can stop this process and cause anaemia.

6. Vitamin A deficiency

Vitamin A helps our body get to the iron it needs to make RBCs. A shortage of vitamin A can slow down the production of RBCs.

7. Hemolysis

This is when your RBCs break down too fast, which can cause anaemia. Some things that can cause hemolysis include a large spleen or blood conditions that you were born with, like sickle cell anaemia.

8. Bone marrow failure

Bone marrow failure, including diseases like aplastic anaemia or leukaemia, gets in the way of the body making RBCs.

9. Chronic conditions

Long-term health problems, such as kidney disease or cancer, can cause problems for RBC production which can lead to anaemia.

10. Medications

Certain drugs can slow down how the body produces RBCs or they can speed up how fast the body destroys them. Examples include chemotherapy, and some drugs used to manage HIV.

Risk factors for developing low RBC count

1. Age

Older adults run a higher risk of getting anaemia. This is due to long-term health conditions and being short on certain nutrients.

2. Sex and gender

Women might run a higher risk of getting anaemia because they lose blood every month through their period or during delivery. Men can get anaemia because of some long-term health conditions.

3. Lifestyle factors

If your diet doesn’t have enough important nutrients and if you don’t live a healthy life, you run a higher risk of getting anaemia.

4. Medical conditions

Some diseases that attack your body’s immune system, problems with your gut, and long-term kidney disease can cause anaemia.

Complications of Low RBC Count

  • Fatigue

Severe anaemia can make you extremely tired. This can make it hard to do daily tasks.

  • Organ damage

Anaemia can result in not enough oxygen going to your organs. This can result in organ damage.

  • Pregnancy complications

Anaemia during pregnancy, especially due to a shortage of folate, can increase the chance of early birth and other problems.

  • Growth issues

In children, anaemia can slow down growth and how they develop.

Diagnosis of Low RBC Count

If your doctor thinks you might have anaemia, they will run some tests to check if your RBC count is low.

  • Blood tests

In a full blood count (CBC), your doctor checks for your RBC count, for how much  haemoglobin is in your blood, and for your hematocrit. This helps to find out if you have  anaemia and how serious it is.

  • Bone marrow biopsy

In some cases, your doctor might need to look at a small piece of your bone marrow. This helps to figure out what caused your  anaemia. This is usually done when your doctor thinks that there might be a blood disorder.

  • Additional tests

Your doctor might also do other tests, such as an image scan and laboratory tests. This helps them find out what caused your anaemia.

Management Options for Low RBC Count

Addressing underlying causes

Taking care of diseases that cause  anaemia improves the count. For example, managing autoimmune diseases or kidney disease can make the  anaemia  improve.

1. Medical  therapy

  • Iron supplements

If you have anaemia from iron shortage, doctors might prescribe iron pills. If the case is severe, they could give you parenteral iron.

  • Vitamin B12 injections

If your body can’t take in vitamin B12 through food, you might have to get IM injection of vitamin B12 .

  • Blood transfusions

If anaemia is extreme due to lost blood or another reason, you might need to get a blood transfusion.

2. Erythropoietin

Your healthcare provider might prescribe a medicine called erythropoietin-stimulating agent. This would be for anaemia that results from long-term kidney disease.

3. Dietary changes

A balanced diet that has enough key nutrients like iron, vitamin B12, and folic acid also helps improve RBC count.

4. Lifestyle changes

Regular physical activity could help make more RBCs. Limiting how much alcohol you drink may help avoid anaemia from alcohol use.

Preventing Low RBC Count

  • Balanced diet

A good diet with key nutrients like iron, vitamin B12, and folic acid may help make RBCs.

  • Supplements

Getting enough of the required nutrients can be hard. Taking supplements can make it easier, especially if your body has trouble absorbing nutrients or if you can’t eat some foods. Always start any supplement only after running it by your doctor. 

  • Regular exercise

Doing more physical activities may help make more RBCs. This is because it pushes the body’s need for oxygen.

  • Addressing medical conditions

Taking care of and managing diseases that could cause anaemia, such as kidney disease, reduces rick of low RBC counts.

When to Seek Medical Help?

  • Signs and symptoms to watch out 

If you notice signs or symptoms of low RBC count like tiredness, feeling dizzy, pale skin, and being short of breath, please  consult your healthcare provider.

  • Importance of timely  management

Early detection and management  of  anaemia will help reduce the progression. 

Conclusion

If you want to feel good, maintaining a healthy RBC count is critical. To manage  RBC count, managing the root cause, eating a good diet, getting exercise, and getting medical help when needed are paramount. Remember, managing early can keep you from long-term health problems and improve your life.

Frequently Asked Questions (FAQs)

What is the most common cause of low red blood cell count?

The most common cause of low RBC count is  anaemia due to iron shortage. This could be from not eating enough iron, not absorbing it well, or losing blood.

What should I do if my red blood count is low?

If your RBC count is low, please  consult your healthcare provider. They might tell you to eat better, to take supplements, or to get other medical therapies.

What are the 3 main causes of  anaemia?

The three main causes of  anaemia are not making enough RBCs, RBCs breaking apart too  quickly, or losing blood.

What level of low RBC is concerning?

If your RBC count is a lot less than it should be, you have anaemia. This needs medical help. Even if anaemia is mild, it should be looked into. If not, it could get worse.

When should I contact a doctor?

You should call a healthcare provider if you see symptoms linked to a low RBC count, such as feeling tired all the time, being short of breath, feeling dizzy, or skin looking pale. You can avoid health problems and improve your health if you are checked quickly.

References:

  1. PubMed. Effects of exercise training on red blood cell production: implications for anaemia [Internet]. [cited 2024 Feb 13]. Available from: https://pubmed.ncbi.nlm.nih.gov/22301865
  2. National Center for Biotechnology Information (NCBI). How I Treat: How I treat cobalamin (vitamin B12) deficiency – PMC [Internet]. [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532799
  3. PubMed. Effect of vitamin A supplementation on iron status in humans: A systematic review and meta-analysis [Internet]. [cited 2024 Feb 13]. Available from: https://pubmed.ncbi.nlm.nih.gov/29336593
  4. JAMA Network. Red Blood Cell Distribution Width and the Risk of Death in Middle-aged and Older Adults [Internet]. [cited 2024 Feb 13]. Available from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/414843
  5. National Center for Biotechnology Information (NCBI). Anaemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499994
  6. National Center for Biotechnology Information (NCBI). Secondary Polycythemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562233
  7. American Cancer Society. Low Red Blood Cell Counts (Anaemia) [Internet]. [cited 2024 Feb 13]. Available from: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/anaemia.html
  8. National Center for Biotechnology Information (NCBI). Polycythemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526081
  9. National Health Service (NHS). Iron deficiency anaemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/iron-deficiency-anaemia
  10. World Health Organization (WHO). Anaemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.who.int/health-topics/anaemia#tab=tab_1
  11. National Center for Biotechnology Information (NCBI). Megaloblastic Anaemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537254
  12. PubMed. Copper deficiency anaemia: review article [Internet]. [cited 2024 Feb 13]. Available from: https://pubmed.ncbi.nlm.nih.gov/29959467
  13. American Heart Association. What Exercise Is Right for Me? [Internet]. [cited 2024 Feb 13]. Available from: https://www.heart.org/en/healthy-living/go-red-get-fit/what-exercise-is-right-for-me
  14. National Health Service (NHS). Red blood cell count [Internet]. [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/red-blood-count
  15. World Health Organization (WHO). Anaemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.who.int/health-topics/anaemia
  16. National Health Service (NHS). Erythrocytosis [Internet]. [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/polycythaemia

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