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Low hematocrit cause: Hematocrit test – Mayo Clinic

What it is, levels, high and low range

Hematocrit is the percentage of red blood cells in a person’s blood. A typical hematocrit range in healthy adults is 37–52%. This varies depending on a person’s sex and age.

Authors of a 2017 study identified the above typical range.

Low red blood cell levels indicate conditions such as anemia. High red blood cell levels could signal polycythemia, increasing a person’s chance of developing a blood clot.

If a person feels tired, dizzy, or short of breath, a doctor may want to test their hematocrit levels to see if those levels fall into a normal range or not.

Read on to learn more about what this measure of red blood cell volume means, symptoms of abnormal levels, and what low and high levels might indicate.

Hematocrit measures the percentage of red blood cells in the body. For example: if a person has 50 milliliters (ml) of red blood cells in 100 ml of blood, their hematocrit level is 50%.

Red blood cells transport oxygen around the body and give blood its characteristic red color. In addition to oxygen, they also contain hemoglobin, a protein that binds to oxygen molecules. This allows red blood cells to pick up oxygen from the lungs and deliver it throughout the body.

An adequate amount of red blood cells is essential to keep the body’s processes running smoothly.

Many conditions can affect red blood cell production or its life cycle. This can make it difficult for a medical professional to diagnose these conditions. A doctor will use a hematocrit test to confirm whether a person’s red blood cell count is affecting a health condition.

Doctors usually test hematocrit levels as part of a complete blood count (CBC).

A CBC is composed of a range of tests and may include:

  • red blood cell count
  • reticulocyte count (young red blood cells)
  • an analysis of hemoglobin levels
  • an analysis of red blood cells, including size and shape
  • white blood cell tests
  • platelet tests

A doctor will also consider a person’s sex, race, and age. It is important to note that certain blood-related conditions, such as sickle-cell anemia, affect particular demographic groups at higher rates.

Learn more about sickle cell anemia in African Americans here.

A doctor may request frequent hematocrit tests to monitor the effect of chemotherapy on a person’s bone marrow.

Both high and low hematocrit levels can be detrimental to a person’s health and result from various conditions and lifestyle factors.

What are normal hematocrit levels?

Different institutions will define normal hematocrit levels differently. However, a 2017 cross-population study found the following ranges to be typical.

  • Male: 42-52%
  • Female: 37-47%
  • Children: 30–44%, depending on their age and sex

Newborn babies have high hematocrit levels that gradually decrease as they get older.

If a person has recently received a blood transfusion, it may affect their results. Additionally, pregnant individuals may have lower levels than usual because the body increases its blood volume during pregnancy.

Other factors, such as smoking and chronic obstructive pulmonary disease (COPD), may push levels into a higher range.

Low levels

A hematocrit level below 35% in women and 41% in men is low. A level under this value can signify chronic anemia.

High levels

Hematocrit levels above the typical ranges can have adverse effects. It may indicate serious underlying health conditions.

Accuracy of results

Results from hematocrit tests are typically accurate and provide a clear reading of a person’s red blood cell levels.

However, the percentage of red blood cells in someone’s blood can change depending on various lifestyle factors and even environmental changes. According to research, red blood cell counts tend to increase at high altitudes.

Exercise, particularly strength training, may also affect hematocrit levels. A 2018 study found that females who participated in 16 weeks of strength exercise had lower levels at the end than when they started. However, the study had a small sample size of 26 middle-aged, sedentary Turkish women. This means that these findings aren’t necessarily representative of a wider population.

Dehydration can also raise hematocrit levels, so this test is useful if a doctor suspects severe dehydration is the cause of a person’s symptoms.

When a person has low hematocrit levels, they tend to present with the following symptoms:

  • pale complexion
  • weakness
  • fatigue
  • low energy
  • trouble breathing
  • irregular heartbeat
  • cold hands or feet

These symptoms also indicate anemia, a condition where hemoglobin levels are lower than normal. Hemoglobin is a protein found in red blood cells that carries oxygen around the body.

Mild anemia is treatable, and it is particularly common in women. Severe anemia could signal a more serious underlying health condition that requires more extensive treatment.

Doctors associate anemia with several health conditions, including:

Nutrient deficiency

A person may lack B12, folate, or iron in their diet.

Learn more about how nutrient deficiency anemia is diagnosed and treated.

Chronic bleeding

This commonly occurs due to digestive tract ulcers, which are sores caused by the bacteria H.pylori or chronic use of anti-inflammatory medications such as ibuprofen, other nonsteroidal anti-inflammatory drugs (NSAIDs), and aspirin. Many women also experience excessive blood loss from heavy menstrual bleeding.

Bone marrow disorder

This includes aplastic anemia, which damages stem cells in bone marrow.


These cancers spread to bone marrow, such as leukemia and lymphoma.

Learn more about bone marrow cancers here.

Kidney failure

Kidney disease can lower the production of red blood cells, reducing hematocrit levels.


When a person has this condition, their body does not produce enough hemoglobin.

Learn more about thalassemia here.

Sickle cell anemia

This condition changes the shape of red blood cells. These cells die earlier than normal, and they also clump together, which impairs blood flow.

Learn more about sickle cell anemia here.

Autoimmune disease

Conditions like rheumatoid arthritis and lupus may reduce red blood cell count.

Learn more about autoimmune diseases here.

When a person has high hematocrit levels, they tend to present with these symptoms:

  • flushed skin
  • dizziness
  • vision problems
  • headaches
  • enlarged spleen

These symptoms signal polycythemia, a condition where the body produces too many red blood cells. This means blood is thicker and clots more easily.

Doctors cannot cure polycythemia, so treatment focuses on symptom management. The main goal is to avoid stroke and deep vein thrombosis (DVT), which is a blood clot usually occurring in a deep vein in the leg.

In some cases, dehydration causes polycythemia. When a person does not drink enough, their plasma levels drop, increasing the proportion of red blood cells in their blood volume. A person can lower their red blood cell count by rehydrating.

Some conditions that can cause high hematocrit levels include:

Lung or pulmonary disease

When the lungs cannot absorb oxygen effectively, and oxygen levels drop, the body compensates by making more red blood cells. One common pulmonary disease causing this is COPD.

Learn more about COPD here.

Heart disease

If the structure of a person’s heart reduces its ability to pump blood around the body, it can no longer sustain vital organs with oxygen. To try and overcome the oxygen deficit, the body produces more red blood cells.

Learn more about heart disease here.

Kidney cancer

Sometimes kidney cancer cells create more erythropoietin. Erythropoietin is a hormone that tells the bone marrow to create more red blood cells.

Learn more about kidney cancer here.

Genetic disease

The JAK2 gene, which controls the number of blood cells made in the bone marrow, can affect certain conditions. When someone has a mutated JAK2 gene, the body could make a protein that signals the bone marrow to create more red blood cells than it needs.

Learn more about genetic disorders here.

A person should speak with a doctor if they are experiencing any of the symptoms listed above that could be a sign of high or low hematocrit levels, including fatigue, weakness, vision problems, and dizziness.

These symptoms can also indicate an underlying condition, so a person must contact a doctor promptly to prevent future complications.

If a person is receiving chemotherapy treatment, a doctor should perform regular hematocrit tests to monitor bone marrow health.

Hematocrit is the percentage of blood cells in a person’s blood volume. A doctor may test an individual’s hematocrit level due to certain symptoms.

A low hematocrit level means there are too few red blood cells in the body. In these cases, a person may experience symptoms that signal anemia. Common symptoms include fatigue, weakness, and low energy.

If a person has too many red blood cells, they have a high hematocrit level. A person may experience dizziness and headaches, which can be a sign of the condition polycythemia.

Demographic and lifestyle factors can influence a person’s hematocrit levels. For example, males tend to have higher levels than females. Pregnant individuals can experience a decrease in hematocrit levels, and strength training may also reduce levels.

There are also several health conditions that can cause hematocrit levels outside the normal range. Excessive bleeding, thalassemia, and kidney disease are causes of low levels. COPD and sickle cell anemia can cause high levels.

Read this article in Spanish.

What It Means to Get High or Low Results > Personalabs

The hematocrit or HCT blood test measures the proportion of red blood cells to white blood cells, platelets, and plasma. 

High HCT blood test values (usually over 44% to 50%) indicate dehydration and conditions that cause RBC overproduction. Alternatively, extremely low hematocrit results may indicate anemia or other blood disorders that affect RBC formation (erythropoiesis) or destruction (hemolysis). 

Know more about the concerning levels of HCT and what the test results tell you when you read on.

Pro Tip: Hematocrit and other parts of the complete blood count (CBC) reveal essential information about your health. If you wish to learn more about what your blood test means, book a virtual consultation to speak to a healthcare provider. 

High HCT Meaning 

If your HCT blood test result shows high hematocrit, over 50% for men and 44% for women, it suggests that you have more red blood cells or erythrocytes due to an underlying health condition. It could also indicate that blood plasma is in critically low volume. 

Symptoms of high hematocrit include:

  • Fatigue
  • Dizziness 
  • Headaches
  • Vision problems
  • Skin blushing or flushing

Causes of High HCT


If you have high HCT, you are likely to be dehydrated. In this case, you may not necessarily be producing too many RBCs. Instead, your blood has a low volume of plasma which stems from a lack of proper hydration. 

Lung Disease

Conditions affecting lung function, such as chronic obstructive pulmonary disease (COPD), can affect the organ’s ability to obtain oxygen. To compensate for the oxygen shortage, your body will produce more RBCs. If you have symptoms of pulmonary disorders, your doctor may order additional laboratory tests, including lung function blood tests. 

Heart Disease

People with heart disease are prone to high hematocrit and hemoglobin. As the heart cannot function fully to facilitate blood circulation, your body will counteract the said loss with increased erythrocyte production. Thus, an HCT blood test also provides additional information about your risk for cardiovascular diseases, making it a key part of heart health blood tests. 


The primary cancer type that drives your bone marrow to produce excessive red blood cells is called polycythemia vera. Although extremely rare, this blood cancer slows down blood circulation, and leads to an enlarged spleen, increased blood clotting, and other life-threatening blood-related complications. Naturally, it also elevates your normal hematocrit levels. 

On the other hand, kidney cancer also influences erythrocyte production since it releases the protein (erythropoietin) that prompts the process. This can be further confirmed by additional tests, such as a red blood cell count, biopsy, MRI, etc. 

Did You Know? Several cancers can be detected by biomarkers screened through a blood test. In some cases, these cancers are first spotted through routine exams. Learn more about the types of cancer diagnosed through blood testing

Treatment for Elevated HCT

Lowering your high HCT will depend on its cause. For example, if it’s due to dehydration, your healthcare provider may recommend rehydration therapy. If your test result goes extremely above the normal range for HCT, your doctor may push for phlebotomy, wherein blood is extracted to reduce red blood cell count.  

Low HCT Meaning 

To get an HCT below the normal hematocrit range (less than 41% for men and 36% for women) indicates low red blood production or a high rate of destruction, potentially due to an underlying illness. 

The most common cause of low hematocrit is anemia, characterized by a reduced number of healthy red blood cells. You may spot anemia through the following symptoms:

  • Fatigue
  • Dizziness 
  • Chest pain
  • Headaches 
  • Pale complexion
  • Trouble breathing
  • Cold hands and feet
  • Irregular heartbeat (arrhythmia) 

Causes of Low HCT


As mentioned above, low HCT typically signals anemia, which can be due to a lack of nutrients, such as that in iron-deficiency anemia, or genetic factors like what’s causing sickle cell anemia and aplastic anemia. Additional blood tests are needed to verify the condition, including the anemia profile blood test. 

Blood Loss

Women who experience excessive menstrual bleeding are likely to have low HCT. In the same way, those who suffer from bacterial ulcers caused by H. pylori and other similar disorders leading to internal bleeding can also expect decreased HCT in their blood test. 

Did You Know? It’s possible to experience blood loss without seeing blood in your stool, as the naked eye does not easily detect it. Get the fecal occult blood test to determine if you have chronic digestive bleeding.


Thalassemia is an inherited blood disorder wherein your body fails to produce enough hemoglobin, a crucial protein in the red blood cell. As a result, RBCs are low, indicated by low HCT and erythrocyte count.  

Kidney Problems

Your kidneys don’t just filter wastes from the blood. They also produce the protein erythropoietin, which signals the production of RBCs. Hence, disorders like chronic kidney disease (CKD) and other significant kidney problems lead to low secretion of erythropoietin, resulting in inadequate RBCs.  

Inflammatory Diseases

Conditions like lupus and rheumatoid arthritis, characterized by increased inflammatory activities, negatively influence RBC formation and maturation. Similarly, inflammatory bowel disease (IBD) may also promote anemia leading to low HCT as it affects the absorption of iron, copper, vitamin B12, and other fundamental nutrients for erythropoiesis.  


Leukemia and lymphoma are two types of cancers that directly impact bone marrow function. Hence, with these underlying conditions, you may likely get low HCT in your blood test and undergo further testing. 

Treatment for Low HCT

If low HCT is due to iron-deficiency anemia, your doctor may recommend supplements and certain lifestyle adjustments. Learn more about iron deficiency anemia and its physical impact, especially among women. 

On the other hand, if the condition is linked to more complex disorders like cancer, blood disease, CKD, etc., your healthcare provider will need more information to form an accurate diagnosis, entailing other types of assessment. Only then will your doctor prescribe a treatment that covers the process in which HCT is brought to its normal range.

How Is Hematocrit Measured?

Calculating hematocrit involves measuring the ratio of red blood cells through a reading device. When using a capillary tube, the length of the RBC packed length volume is compared to the total length of the blood sample. 

It is imperative to have the analysis within 10 minutes of the sample collection, as the erythrocyte layers can mix with the other blood components and platelets begin to clot. 

How and When Is It Done?

Your doctor will likely order an HCT blood test if you exhibit symptoms of anemia, blood loss, dehydration, and other blood disorders. As part of the CBC test, it also provides critical information on other disorders, such as cancer, lung disease, kidney disease, liver problems, and cardiovascular diseases. 

Unlike the other tests involved in CBC, wherein the blood samples can be collected through finger pricking, an HCT blood test will require a venous blood sample. This is drawn from the veins at the back of your elbow and should only be performed by a licensed phlebotomist. HCT measurement needs more volume of blood for accurate processing and analysis. 

Additionally, an HCT blood test alone does not require fasting or other special preparations prior to blood collection. But if it is part of a more extensive test or if you’re taking another test simultaneously, you may have to abstain from consuming food, drinks, and certain medications. 

Pro Tip: Venipuncture, the process of inserting a syringe needle into your vein for blood collection, can be a little discomforting. If you are anxious about your lab test appointment, read our tips on how to calm yourself when getting blood drawn

Frequently Asked Questions

What level of HCT is concerning?

The normal hematocrit range for men is 41% to 50%, while women should have 36% to 44%. HCT test values that go above or below these ranges signal problems in the blood ranging from anemia to blood loss for low HCT percentage and dehydration to blood cancer for high lab values. Either way, see your doctor for a proper diagnosis and additional lab tests. 

Can high HCT cause fatigue?

Feeling exhausted all the time is part of the symptoms of high HCT. The increased volume of RBCs causes the blood to be thicker and move slower, affecting the rate of oxygen distribution to cells. As a result, your brain receives less oxygen, making you tired and sleepy. 

Does low HCT mean dehydration?

It’s the other way around. Low HCT suggests conditions like anemia and other blood disorders, but it’s high HCT that indicates dehydration. The lack of sufficient fluid in your body results in blood plasma having less volume, which increases the percentage of RBC. 

Did You Know? Aside from an HCT blood test, other ways to detect dehydration include a urinalysis and the electrolyte blood test panel. Treatment for severe dehydration includes administering IV fluids and oral rehydration solution (ORS).  

The Bottom Line 

An HCT blood test helps detect various health conditions, especially blood disorders. However, without fully understanding what your test results mean may lead to misconceptions about the severity of the abnormality. In addition, it’s important to understand that a hematocrit blood test alone will not suffice as far as diagnosis goes. It’s always the best course of action to speak to your doctor whether by setting up an appointment, either for a physical or virtual consultation.

“Hematocrit below normal – what does it mean in an adult?” — Yandex Q

In this article we consider what to do if the hematocrit is below normal, what does this mean in an adult?

Determination of the hematocrit value is included in the extended complete blood count. The criterion allows you to evaluate the work of the hematopoietic system. The functioning of other organs directly depends on its full functional activity, since it is erythrocytes that deliver oxygen to organs and tissues.

A decrease in hematocrit may occur without the manifestation of pronounced clinical symptoms. A person can attribute increased fatigue to high workload and lack of time for rest. However, a decrease in hematocrit is one of the first symptoms of anemia that requires treatment. The article also addresses the issue of the danger of a long-term decrease in hematocrit.


  • 1 What does hematocrit show?

  • 2 Hematocrit is below normal – what does it mean?

  • 3 Causes of Decreased Hematocrit in Adults

  • 4 Is low hematocrit dangerous?

  • 5 Methods for increasing hematocrit

What does hematocrit show?

The value reflects the volume of the liquid part of the blood, which in the bloodstream contains formed elements (erythrocytes, leukocytes, platelets). The hematocrit value is measured as a percentage. So, if the analysis indicates that the hematocrit is 40%, this means that 40% of red blood cells, platelets, etc. are present in 100 ml of blood.

Low blood hematocrit is observed in patients with a low number of red blood cells in the bloodstream. The indicator also takes into account the size of blood cells. Their decrease is naturally reflected in the results of the analysis.

Measurement of hematocrit is useful in the diagnosis of anemia and hyperproteinemia, as well as in assessing the effectiveness of the selected treatment methods. The test is performed on patients with dehydration to assess the severity of their condition. Included in the list of obligatory determinable indicators for people who are scheduled for blood transfusion, and for pregnant women.

Main article: What is hematocrit, why is it needed and what are its norms?

Hematocrit is below normal – what does it mean?

A low hematocrit in an adult indicates a decrease in the number of red blood cells in the blood. In this case, the doctor will prescribe additional laboratory tests and instrumental diagnostic methods. Among the laboratory parameters, it is important to determine: the level of iron and ferritin, as well as to evaluate the biochemical parameters of the blood. Of the instrumental methods, it is preferable to conduct an ultrasound examination of the digestive organs, liver and small pelvis. Based on the results of a comprehensive examination and the collected history of the patient, the doctor determines the cause of the low hematocrit.

It should be borne in mind that if a woman gave biomaterial for analysis during menstruation, then the hematocrit is below normal – this is a standard phenomenon. During this period, a woman loses a certain amount of blood, which means that the level of red blood cells is somewhat reduced.

It is important to follow the rules of patient preparation, as well as the collection and transport of biomaterial. During venipuncture, destruction of red blood cells in vitro (hemolysis) can occur. For example, due to strong or prolonged squeezing of the site of taking the biomaterial with a tourniquet or at the wrong temperature for storing the collected blood. The obtained indications cannot be considered reliable, and the patient will definitely need to re-take the biomaterial.

Causes of Decreased Hematocrit in Adults

Only the attending physician after a complete diagnosis can determine the exact cause in each specific case. Consider the main causes of low hematocrit in adults.

Anemia (anemia) describes a group of similar syndromes, united on the basis of a total decrease in the level of hemoglobin and the number of red blood cells. It should be noted that the isolated term “anemia”, without clarifying explanations, does not describe a specific disease. In this case, it is only a separate symptom of a disease.

The decrease in the number of erythrocytes is mainly accompanied by changes in their qualitative composition. Which leads to a deterioration in respiratory activity and the gradual development of oxygen starvation of the tissues of all organs. The main symptoms of anemia are:

  • pale skin;
  • increased weakness and fatigue;
  • desire to eat chalk, earth, raw meat;
  • hair loss, brittle nails, dry skin;
  • decreased memory and performance;
  • bluish or yellowish sclera;
  • earthy skin tone;
  • persistent drowsiness;
  • frequent headaches and dizziness;
  • shortness of breath even with little physical activity;
  • tachycardia.

The main causes of anemia

There are many known mechanisms for the development of anemia. Consider the main ones:

  • Malfunctions in the process of synthesis of red blood cells and hemoglobin due to lack of iron and vitamins B 9 in the human bodyand 12, as well as for pathologies of the red bone marrow.
  • Deficiency of red blood cells due to large blood loss, for example, in serious injuries or during surgery. A similar condition occurs in people with chronic bleeding (hemorrhoidal bleeding, intercycle blood loss in women, etc.). The main mechanism is a decrease in the concentration of iron, and not a decrease in the number of red blood cells.
  • Mechanism of enhanced destruction of blood cells. The average lifespan of red blood cells is 4 months. With the manifestation of pathologies affecting the hematopoietic system, blood cells begin to degrade at an accelerated rate. The decay process is also influenced by external factors, for example, the use of vinegar in large quantities.

The prognosis of the outcome of iron deficiency anemia is extremely favorable. The condition is stopped by taking iron and vitamins. The outcome of other forms of anemia depends on their severity.

Fluid in the body

The hematocrit is also reduced with an increased fluid content in the body of an adult. This condition is not associated with excessive fluid intake, but with its retention in the body. Causes: kidney pathology, viral or bacterial infection. There is an increase in blood plasma volumes, while the number of red blood cells does not increase. This naturally leads to a decrease in the hematocrit value.

Hyperproteinemia and nutrition

Another reason is hyperproteinemia. Pathology is characterized by an excess content of proteins in the bloodstream. It occurs due to a violation of the normal functioning of the liver. Proteins begin to “attract” an excess amount of water, while the number of red blood cells does not increase. Thus, their percentage with blood plasma decreases.

In adult patients, the hematocrit is also reduced with a sharp change in diet, prolonged fasting and blood loss.


During pregnancy, especially in the second trimester, a decrease in the value in question is considered normal. In women, the level of plasma volume increases, and red blood cells are not synthesized at an accelerated pace. Thus, the percentage of plasma-erythrocytes is shifted towards a decrease in the latter. The decrease in hematocrit value begins from the fourth week, reaching a peak by 31-35 weeks.

However, a long-term decrease in the index should not be ignored, it is necessary to conduct additional diagnostics in order to exclude the possible development of pathological conditions. Thus, a decrease in hematocrit up to 30% can cause the development of intrauterine fetal hypoxia, impaired fetoplacental circulation, fetal growth retardation, etc. An indicator of 15 to 25% indicates the need for immediate hospitalization of a pregnant woman, followed by continuous monitoring.

Other reasons

Also, low hematocrit in adults can be observed with:

  • lead intoxication;
  • splenomegaly;
  • leukemias;
  • conditions after chemotherapy;
  • acute infectious processes;
  • severe intoxications.

Is low hematocrit dangerous?

The main function of red blood cells is the sufficient supply of cells and tissues with molecular oxygen. With their decrease, there is an insufficient supply of oxygen to the organs. This has a particularly negative effect on the functional activity of the brain. A person has a decrease in concentration, memory and mental activity.

Adults with a low hematocrit are more susceptible to infectious diseases, are unable to function fully, get tired more quickly and lose concentration. In the future, a lack of red blood cells can lead to the development of pathologies of the cardiovascular system, liver and kidneys.

Methods for increasing hematocrit

Do not try to increase the level of red blood cells on your own. The necessary treatment will be selected by a specialist based on the results of laboratory and instrumental studies. In case of prolonged starvation or dehydration, it is necessary to restore the normal diet and the amount of fluid consumed per day. In this case, the patient can do without drug therapy. It is also important to establish a daily routine and plan enough time for rest and walks in the fresh air.

If there is a shortage of iron or other elements, the doctor will select the necessary drugs, their dosage and determine the duration of their course. You should not interrupt the course of treatment yourself, even if the symptoms of anemia no longer bother you. Iron-rich foods should be included in the diet. For example, beef liver, seafood, lentils, red meat, nuts and pomegranate.

The use of traditional methods of treatment without prior agreement with the doctor is unacceptable. It should be emphasized that these methods cannot be a sufficient alternative to the methods of official medicine. They can only complement the treatment, provided that the selected components do not block the action of the medicinal components.

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prognosis, treatment, symptoms in the international clinic Medica24

Anemia is a common accompanying symptom of oncological diseases. In another way, it is called anemia. Its cause is a decrease in the level of hemoglobin in the blood. This is a protein found in red blood cells (erythrocytes) and is responsible for oxygen transport and oxygen supply to tissues. It also takes away carbon dioxide, which is formed in the process of metabolism.

Transfusion of blood and blood substitutes for cancer patients

Metabolism is impossible without oxygen, which means life itself. A decrease in hemoglobin leads to oxygen starvation, which is manifested by weakness, high fatigue, dizziness, and headache. Other signs of anemia are pallor, rapid pulse, shortness of breath, tinnitus, swelling, and chest pain. Separate symptoms indicate a deficiency of vitamin B12 and iron.

Anemia, oxygen starvation weakens the body and worsens the prognosis of cancer treatment. On the one hand, anemia depresses the human immune system, does not allow it to fight cancer cells in full force.

On the other hand, low hemoglobin reduces the effectiveness of chemotherapy drugs, as well as radiation therapy, which has been proven by clinical studies. The general weakness of the body limits the possibilities of surgical treatment. That is why the treatment of anemia, increasing the level of hemoglobin is one of the primary tasks in oncological diseases.

Especially often a decrease in hemoglobin occurs with cancer of the kidney, lung, ovary, uterus, bladder, with lymphomas, myelomas.

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Low hemoglobin levels can be associated with both the oncological disease itself and its treatment.

  1. Chemotherapy with cytotoxic drugs destroys rapidly dividing cells in the body, not only cancer cells, but also bone marrow cells. They are responsible for the process of erythropoiesis – the formation of red blood cells (erythrocytes). The production of red blood cells decreases, their volume in the blood (hematocrit) decreases, and anemia develops.

    Chemotherapy with platinum drugs inhibits the functioning of the kidneys and their production of the hormone erythropoietin. This hormone stimulates the process of erythropoiesis – the formation of red blood cells. Its level decreases, erythropoiesis slows down, hematocrit decreases, and anemia develops.

    Radiation therapy can negatively affect the bone marrow, which also leads to a decrease in the production of red blood cells.

  2. Many cancers metastasize to the bone, which affects the red bone marrow. Cancer cells replace normal, active bone marrow cells, resulting in reduced red blood cell production.
  3. Anemia is associated with internal bleeding. For example, with cancer of the intestines, stomach. Constant blood loss causes a decrease in the volume of red blood cells and the development of oxygen starvation.
  4. Functional disorders of the gastrointestinal tract and / or poor appetite lead to a deficiency of vitamin B12, iron, necessary for normal hematopoiesis and maintaining hemoglobin levels in the blood.
  5. A malignant tumor has a toxic effect on the body. Cancer intoxication leads to damage and destruction of red blood cells – pathological hemolysis. In addition, intoxication negatively affects the functioning of the bone marrow, which leads to impaired erythropoiesis.
  6. A person’s own immune system, reacting to a malignant tumor, can provoke a decrease in hemoglobin. Its active cells, cytokines, inhibit the production of erythropoietin by the kidneys. In addition, cytokines attack red blood cells – erythrocytes, reducing their life expectancy by one and a half to two times. This leads to a decrease in hematocrit and the development of anemia.

Often a combination of these factors is the cause of low hemoglobin and anemia in cancer.


It is easy to detect low hemoglobin levels and diagnose anemia. For this, a general blood test is sufficient. It is much more difficult to establish the cause or reasons why this is happening in order to prescribe the appropriate treatment.

The normal hemoglobin level is 135-160 g per liter of blood in men and 120-140 g per liter of blood in women. At its level below 100 g / l, moderate anemia is diagnosed, below 80 g / l – severe, below 65 g / l – severe.

To find out the reason for the decrease in hemoglobin level, a biochemical blood test, iron, vitamin B12 tests are performed. Computed tomography and scintigraphy help to detect metastases in the bone marrow. If it is necessary to obtain an exhaustive picture, endoscopic and other instrumental and laboratory examinations are performed.

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Red cell transfusion

There are many ways to increase hemoglobin. First of all, to influence the cause of anemia. But such treatment can be lengthy, and the margin of time is limited. For example, it may be necessary to quickly increase the level of hemoglobin in order to prepare the patient for surgery.

Therefore, in some cases, a decision is made about a symptomatic increase in hemoglobin. The fastest and most effective way is red blood cell transfusion. To do this, donor blood is processed in a centrifuge, the content of red blood cells in it rises, and it is transfused to the patient.

Red blood cell transfusion is used not only in preparation for surgery, but also as part of chemotherapy premedication. This method is used in severe forms of anemia, when you need to quickly raise the level of hemoglobin.

Red blood cell transfusion can also be used to recover from an operation that has caused major blood loss.

Medical nutrition

In the international clinic Medica24 we pay great attention to the proper nutrition of patients, especially those suffering from oncological diseases. The daily diet contains foods rich in proteins, iron, folic acid, vitamin B12, which are necessary for normal blood formation and maintaining hemoglobin levels. In severe lesions of the gastrointestinal tract, when the patient cannot eat normally, parenteral nutrition is used.


For iron deficiency anemia, we prescribe iron preparations. They can be taken as tablets, but a more effective method of administration is intravenous, using a dropper. Complex preparations containing folic acid, vitamin B12, intramuscular injections of vitamin B12 are also used.

Erythropoietin preparations, a synthetic analog of a hormone produced by the kidneys, are prescribed to stimulate the hematopoietic process. The question of the use of such drugs is decided individually, since in case of oncological diseases they can negatively affect the patient’s condition and the prognosis of the disease. However, in some cases, it is erythropoietin preparations that serve as an effective means of increasing hemoglobin.

Correction of chemotherapy

If it turned out that chemotherapy drugs were the cause of anemia, the question arises of its correction. It is always decided individually, based on a specific case. Stopping drugs can do more harm than good.