Red blood cells in a complete blood count (RBC, Er, Er)
Red blood cells (RBC) are red blood cells that carry oxygen from the lungs to the tissues and carbon dioxide back to the lungs. They make up to 45% of blood volume and contain the protein hemoglobin, which binds and carries oxygen.
RBCs are formed in the red bone marrow, live for about 120 days, and are then destroyed primarily in the spleen and liver. Abnormalities in RBC count (too many or too few) can be a sign of anemia, dehydration, and pulmonary and cardiovascular diseases.
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The primary and vital function of blood is accomplished by the circulation of red blood cells. These cells contain the protein hemoglobin, which can bind oxygen where it is most concentrated (i.e., in the lungs) and release it where oxygen is depleted (in the tissues). Similarly, hemoglobin can also bind carbon dioxide, transporting it in the opposite direction (although this is not the primary method of CO2 utilization).
RBCs are formed in the red bone marrow (RBM) from the precursors of the red blood cell lineage. They function for approximately 120 days and are then destroyed in the spleen, RBM, and partially in the liver. They perform their function as long as their unique elastic biconcave shape is preserved. This shape allows the cells to pass through the smallest blood capillaries, which are smaller than the diameter of a red blood cell. Only here, in close contact, does gas exchange occur.
Red blood cell count directly reflects the body's ability to supply oxygen, so determining this indicator in a general blood test is essential. For men, the normal range is 4.0-5.6 x 1012 L, and for women, 3.4-5.0 x 1012 L. A decrease in Er (erythropenia) is more common. These are the manifestations of:
- Iron, vitamin B12, and folate deficiencies (dietary deficiency, inadequate absorption, increased consumption during pregnancy, in athletes, and during periods of active growth)
- Bleeding (traumatic, postoperative)
- Chronic blood loss (uterine, from decaying malignant tumors, from the gastrointestinal tract due to colitis, ulcers, and hemorrhoids)
- Hemolytic poisoning
- Accelerated hemolysis due to splenic pathology
- Hereditary and genetic diseases (sickle cell anemia and other conditions accompanied by a change in the normal biconcave shape)
Low levels are manifested by the following symptoms:
- Pale skin and mucous membranes
- Increased fatigue
- Weakness
- Frequent dizziness
- Tinnitus
- Hereditary and genetic diseases (sickle cell anemia and other conditions accompanied by a change in the normal biconcave shape)
- Palpitations
- Shortness of breath
More specific signs may also appear, such as cold, clammy sweat with acute blood loss, yellowing of the skin with increased breakdown of red blood cells, discomfort in the upper abdomen with splenomegaly or hepatomegaly, weight loss.
Erythrocytosis (increased count) is less common. Physiologically, it occurs during adaptation to hypoxia when living in high-altitude areas. Sometimes it occurs due to dehydration (vomiting, diarrhea, burns). More serious conditions that manifest as erythrocytosis include:
- Kidney tumors (hypersecretion of erythropoietins, which stimulate hematopoiesis), malignant lesions of the hematopoietic lineages of the bone marrow
- Lung diseases (emphysema, atelectasis, COPD, asthma) and heart defects during the hypoxia compensation stage
Red blood cell count testing is recommended for everyone at least once a year for preventative purposes or at the first signs of anemia, which will allow for early detection and treatment.
Red blood cell norms
The red blood cell count on the test form is designated as RBC and is measured in ×10¹²/L.
Red blood cell count in adults
In adult men and women, the normal platelet count is usually within the following ranges:
| Category | Normal RBC Count, ×10¹²/L |
|---|---|
| Men 18–45 years old | 4.0–5.6 |
| Women 18–45 years old | 3.7–5.1 |
The ranges are based on typical reference values: for men, the normal range is approximately 4.0–5.6×10¹²/L, and for women, approximately 3.7–5.1×10¹²/L.
An increased level of red blood cells in the blood is called erythrocytosis.
Possible causes:
- Dehydration (fluid loss due to vomiting, diarrhea, high fever)
- Living or staying at high altitudes for extended periods (compensating for oxygen deficiency)
- Smoking and chronic lung diseases (COPD, emphysema, bronchial asthma)
- Congenital or acquired heart defects, chronic heart failure
- Kidney tumors with increased erythropoietin production
- Polycythemia (true erythremia) is a disease of the hematopoietic system
Mild erythrocytosis is sometimes a normal variant in people living in the mountains or actively involved in sports, but requires a physician's evaluation.
A decreased red blood cell count is called erythropenia and is often associated with decreased hemoglobin (anemia).
Main causes:
- Iron, vitamin B12, or folate deficiency
- Chronic blood loss (gastrointestinal ulcers, hemorrhoids, heavy menstruation)
- Bone marrow diseases and hematopoietic disorders
- Chronic infections and inflammatory diseases
- Kidney disease with insufficient erythropoietin production
- Hemolysis – accelerated destruction of red blood cells (hereditary hemolytic anemia, poisoning)
Symptoms of abnormal red blood cell levels
With low red blood cells (anemia)
Typical complaints:
- Pale skin and mucous membranes
- Fatigue, weakness, decreased performance
- Shortness of breath during exertion, palpitations
- Dizziness, tinnitus, headaches
- Brittle hair and nails, dry skin due to iron deficiency
With high red blood cells
- Flushed face, feeling of heat
- Headache, spots before the eyes
- High blood pressure
- Increased risk of thrombosis
What to do if red blood cells are abnormal
- Check for errors in preparation for the test (dehydration, intense exercise before the test)
- Assess other blood parameters: hemoglobin, hematocrit, MCV, MCH, leukocytes, platelets
- Consult a physician or hematologist to interpret the results, taking into account your symptoms and medical history.
- If necessary, undergo additional tests (ferritin, vitamin B₁₂, folic acid, blood biochemistry, organ ultrasound)
Self-prescribing iron supplements or "hematopoietic" agents without an examination is not recommended, as excess iron is also harmful.
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General information
Red blood cells during pregnancy
During pregnancy, plasma volume increases, so the relative number of red blood cells may decrease (physiological hemodilution). This often manifests as a moderate decrease in hematocrit and mild anemia, which requires monitoring and sometimes correction with iron.
A significant decrease in red blood cell count in a pregnant woman increases the risk of fetal hypoxia, pregnancy complications, and childbirth, so it is important to promptly correct the deficiency.
FAQ
What does RBC mean in a blood test?
What are the dangers of low red blood cell counts?
Can red blood cells be increased through diet?
What if your red blood cell count is slightly higher than normal?
Is the normal red blood cell count different for women than for men?
How often per year should I have a complete blood count (CBC)?
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