Your Red Blood Cell Count

What Causes Abnormal Red Blood Cell Count?

In order to deal properly with abnormal red blood cell count we need to understand and — if possible — remove the underlying causes and risk factors.  We need to ask: "What else is going on inside the body that might allow abnormal red blood cell count to develop?"

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Accurate diagnosis of the factors behind abnormal red blood cell count consists of three steps:

Step 1: List the Possible Causative Factors

Identify all disease conditions, lifestyle choices and environmental risk factors that can lead to abnormal red blood cell count.  Here are six possibilities:
  • Polycythemia Vera
  • Anemia
  • Bone Marrow Suppression
  • Chronic Renal Insufficiency
  • Leukemia
  • Non-Hodgkin's Lymphoma

Step 2: Build a Symptom Checklist

Identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
recent onset vomiting
frequent postprandial somnolence
recent onset nausea
elevated eosinophil count
non-Hodgkin's lymphoma
chronic dry cough
fatigue after slight exertion
regular unexplained vomiting
major fatigue for 3-12 months
night sweats
low lymphocyte count
... and more than 30 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of abnormal red blood cell count:
Cause Probability Status
Polycythemia Vera 92% Confirm
Leukemia 62% Possible
Anemia 27% Unlikely
Chronic Renal Insufficiency 4% Ruled out
Non-Hodgkin's Lymphoma 4% Ruled out
Bone Marrow Suppression 4% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate having had recent lab tests, The Analyst™ will ask further questions including this one:
Red Blood Cell count (RBC). Unit: x10^6/uL or x10^12/L. NOTE: If your results show large numbers, divide by 1000 (i.e. 3900 becomes 3.9).
Possible responses:
→ Don't know
→ Under 3.2 (very low)
→ 3.2 to 4.2 (low)
→ 4.3 to 5.4 (normal)
→ Over 5.4 (high)
Based on your response to this question, which may indicate low red blood cell count, normal red blood cell count or high red blood cell count, The Analyst™ will consider possibilities such as:

Anemia also suggests the following possibilities:

Chronic Renal Insufficiency

Anemia is almost always present in cases of chronic renal failure, and can occur through any of the basic mechanisms (blood loss, excessive destruction of red blood cells, or low production of red blood cells.) However, the typical anemia associated with CRF results from decreased production of red blood cells by the bone marrow: failing kidneys no longer produce sufficient erythropoietin, a hormone that stimulates the production of oxygen-carrying red blood cells (RBCs).  In addition to decreased levels of RBCs, patients often begin to accumulate toxic metabolites, which shorten the lifespan of existing RBCs.


The red blood cell deficiency caused by leukemia leads to anemia and the symptoms of anemia, including severe fatigue, pallor, and breathing difficulty.

... and also rule out issues such as:
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