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
  • Non-Hodgkin's Lymphoma
  • Leukemia
  • Bone Marrow Suppression
  • Anemia
  • Chronic Renal Insufficiency

Step 2: Build a Symptom Checklist

Identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
frequent unexplained fevers
back-of-neck lymph node problems
elevated B12 levels
easy bruising
low hematocrit
major fatigue for over 12 months
often/always feeling unusually cold
regular postprandial somnolence
recent onset vomiting
frequent infections
regular unexplained nausea
constant fatigue
... and more than 40 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
Leukemia 98% Confirm
Polycythemia Vera 55% Possible
Bone Marrow Suppression 21% Unlikely
Non-Hodgkin's Lymphoma 4% Ruled out
Anemia 3% Ruled out
Chronic Renal Insufficiency 3% 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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