What do low hematocrit levels mean? Discover the comprehensive guide on interpreting your complete blood count (CBC) test results, including red blood cells, hemoglobin, and more.

Understanding the Complete Blood Count (CBC)

The human body is primarily made up of water and cells. Many of these cells group together to form the skin, muscles, bones, and organs, such as the heart, lungs, and kidneys. However, some very special and important cells move throughout the body by traveling (circulating) in the blood. These circulating cells provide oxygen to all the stationary cells in the body, help fight infection, and aid in stopping bleeding after an injury. Information about these cells can provide important clues about the overall health of the body.

The complete blood count, or CBC, is a lab test that provides information about these circulating cells. A blood sample is collected and sent to a lab, where an instrument automatically counts the number of each type of circulating cell. If the results are outside the specified limits, a medical technologist will closely examine the cells to provide complete information.

Reporting and Interpreting the Results

Your CBC test results are usually reported along with a reference range of expected or desired values to help guide your doctor in interpreting them. Reference ranges reflect the numeric values found in healthy people, but a small number of healthy people (5%) may have values that are higher or lower than the ones shown in the reference range. Therefore, values higher or lower than the reference range might or might not indicate a medical condition.

In addition to the reference range, your doctor will consider other factors when interpreting your CBC test results, such as your personal and family medical history, results from a physical exam, and other test results. Your doctor will also consider factors that might cause an incorrect test result, such as improper sample collection or handling.

Red Blood Cells (RBCs) – Transporting Oxygen Throughout the Body

RBCs play a vital role in transporting oxygen from the lungs to the rest of the body. These oval-shaped cells contain hemoglobin, the protein that binds oxygen while it is being carried to all the stationary cells in the body (cells in the skin, muscle, bone, and organs). The chemical process that converts the nutrients found in food into energy requires oxygen, and all the stationary cells require energy to function; thus, they need oxygen and are dependent on the RBCs to transport it.

More About Hemoglobin

Hemoglobin (Hb or Hgb) is an iron-rich protein that carries oxygen and makes the blood red. Since hemoglobin is contained only in the RBCs, a low number of RBCs leads to low levels of hemoglobin. However, if there is something wrong with the RBCs, hemoglobin levels can be low even when the RBC count (i.e., number of RBCs) is within the reference range. So, a CBC test report includes the number of RBCs, the amount of hemoglobin, and other measurements related to the RBCs.

Other RBC Measurements

The hematocrit reflects the amount of space in the blood that is occupied by RBCs. Hematocrit measurements are affected by the number of RBCs and by the size of the RBCs.

The mean corpuscle (cell) volume (MCV) is a measurement of the average size of the RBCs. Small-sized RBCs result in a lower MCV, while larger RBCs result in a higher MCV.

The mean corpuscular hemoglobin (MCH) reflects the average amount of hemoglobin in a person’s RBCs. RBCs with more hemoglobin result in a higher MCH and vice versa.

The mean corpuscular hemoglobin concentration (MCHC) is a measurement of the average amount of hemoglobin in the RBCs compared to the average size of the RBCs. Put another way, the MCHC is the ratio of the MCH to the MCV.

The red cell distribution width (RDW) reflects the degree of variation in size of the RBCs. Not all the RBCs are the same size; some are larger and some are smaller. The RDW measurement is affected by the size of the smallest RBC and the size of the largest RBC.

What Does This Mean for Me and My Doctor?

In patients with low hematocrit levels, your doctor will consider the results of your CBC test along with other factors to determine the underlying cause. This may involve further testing or treatment to address any underlying medical conditions. It’s important to discuss your test results with your doctor to ensure a full understanding of your overall health and any necessary next steps.

Understanding the Complete Blood Count (CBC)

The CBC – providing information about your health

The human body is primarily made up of water and cells. Many of the cells group together to form the skin, muscles, bones and organs, such as the heart, lungs, kidneys, etc. Such cells are stationary, staying in one place within the body. Some very special and important cells, however, move throughout the body by traveling (circulating) in the blood. These circulating cells provide oxygen to all of the stationary cells in the body, help fight infection throughout the body, and help stop bleeding after an injury. Information about these cells can provide important clues about the overall health of the body.

The complete blood count, or CBC, is a lab test that provides information about these circulating cells. First, a sample of your blood is collected and sent to the lab. A lab instrument then automatically counts the number of each type of circulating cell. If results from the automated instrument are outside specified limits, a medical technologist will examine the cells closely so complete information about the cells can be provided.

Results from the CBC test can help:

• Provide basic information about your health
• Detect a health condition before you have any symptoms
• Confirm that a health condition exists
• Identify the causes of your symptoms
• Find out if your medicine is working
• Rule out a disease
• Establish a baseline that can be used for comparison with future test results

Reporting and interpreting the results

Your CBC test results are usually reported along with a reference range of expected or desired values to help guide your doctor in interpreting them. Reference ranges reflect the numeric values found in healthy people; however, a small number of healthy people (5%) have values that are higher or lower than the ones shown in the reference range. Thus, values higher or lower than those in the reference range might or might not indicate a medical condition.

In addition to the reference range, your doctor will consider other factors when interpreting your CBC test results. These factors include your personal and family medical history, results from a physical exam, and other test results. Your doctor will also consider factors that might cause an incorrect test result such as improper sample collection or handling. Therefore, it’s important that you talk with your doctor about the meaning of your test results.

This brochure includes a brief description of the items included in the CBC test report. The descriptions can help you understand your results so you can have a more meaningful discussion with your doctor. Additionally, items in the CBC are summarized in the table at the end of this brochure for quick reference.

Red Blood Cells (RBCs) – transporting oxygen throughout the body

RBCs play a vital role in transporting oxygen from the lungs to the rest of the body. These oval-shaped cells contain hemoglobin, the protein that binds oxygen while it is being carried to all the stationary cells in the body (cells in the skin, muscle, bone and organs). The chemical process that converts the nutrients found in food into energy requires oxygen. All the stationary cells require energy to function; thus, they need oxygen and are dependent on the RBCs to transport it.

More about hemoglobin

Hemoglobin (Hb or Hgb) is an iron-rich protein that carries oxygen and makes the blood red. Since hemoglobin is contained only in the RBCs, a low number of RBCs leads to low levels of hemoglobin. However, if there is something wrong with the RBCs, hemoglobin levels can be low even when the RBC count (i.e. number of RBCs) is within the reference range. So a CBC test report includes the number of RBCs, the amount of hemoglobin, and other measurements related to the RBCs.

Other RBC measurements

The hematocrit reflects the amount of space in the blood that is occupied by RBCs. Hematocrit measurements are affected by the number of RBCs and by the size of the RBCs.

The mean corpuscle (cell) volume (MCV) is a measurement of the average size of the RBCs. Small-sized RBCs result in a lower MCV, while larger RBCs result in a higher MCV.

The mean corpuscular hemoglobin (MCH) reflects the average amount of hemoglobin in a person’s RBCs. RBCs with more hemoglobin result in a higher MCH and vice versa.

The mean corpuscular hemoglobin concentration (MCHC) is a measurement of the average amount of hemoglobin in the RBCs compared to the average size of the RBCs. Put another way, the MCHC is the ratio of the MCH to the MCV.

The red cell distribution width (RDW) reflects the degree of variation in size of the RBCs. Not all the RBCs are the same size; some are larger and some are smaller. The RDW measurement is affected by the size of the smallest RBC and the size of the largest RBC.

What this means to me and my doctor

In patients with anemia, hemoglobin levels are low and the patient may be frequently tired and have little energy. This is because there is not enough hemoglobin to carry oxygen to the stationary tissues; thus, there is not enough oxygen available to convert nutrients into energy. The RBC count, hematocrit level, MCV, MCH and MCHC might also be low in patients with anemia.

Low RBC counts, hemoglobin and hematocrit levels can be caused by other things too, such as a lot of bleeding or malnutrition (not enough nutrients in the food eaten). Kidney disease, liver disease (cirrhosis), cancer, and medications used to treat cancer can also cause low levels.

An increased RBC count and increased levels of hemoglobin and hematocrit may be caused by dehydration (not enough water in the body) or by some diseases (see table).

White Blood Cells (WBCs) – defending your body

WBCs help the body fight illness or infection. As part of the immune system, they recognize and fight things that are foreign to (not part of) the body. The number of WBCs (WBC count) is lower than the number of RBCs; however, the WBCs are larger in size RBCs. There are 5 types of WBCs; each type plays a different role in protecting the body from invaders.

What this means to me and my doctor

The WBC count may increase when you have an infection caused by bacteria, viruses, fungi, or parasites. The WBC count can also increase in patients with leukemia, a cancer of the blood. Thus, doctors use the WBC count to help determine if a patient has an infection or leukemia. When the WBC count is increased, the type of WBC can help differentiate between a bacterial infection, viral infection or leukemia. Doctors also use the WBC count to monitor various types of illness, since it may decrease in response to therapy during recovery from an illness. A low WBC count can mean you are at risk of getting an infection since you have fewer WBCs to fight infection.

Types of WBCs

• Neutrophils are cells that protect the body from bacterial infections. They move toward bacteria and then swallow them up so the bacteria cannot harm the body.
• Lymphocytes are cells that protect the body against viruses, bacteria, and fungi. One type of lymphocyte (B-cell) produces antibodies that attack and destroy the bacteria and viruses. Another type of lymphocyte (T-cell) can directly attack viruses and bacteria and can stimulate the B-cells to produce antibodies.
• Monocytes are cells that consume dead or damaged cells. They are the “clean-up crew”.
• Eosinophils are cells that kill parasites and contribute to allergic reactions.
• Basophils are cells that release histamines during allergic reactions.

The differential – visualizing the cells

When performing a differential, a medical technologist looks at the various cells under a microscope. A differential provides information about the relative numbers (that is, the percentage) of each type of WBC. Such information helps the doctor determine whether an illness is caused by a bacteria, a virus, or leukemia. A differential can be used to monitor patients with allergies and to determine how a patient is recovering from an illness or responding to therapy.

In addition to the cell types listed previously, certain cell types that don’t normally appear in the blood can be reported in the differential. These cells include promyelocytes, metamyelocytes, blasts, etc. Presence of any of these cells indicates a need for follow-up with your doctor.

Finally, the differential can provide information about the appearance of RBCs, since the cells are visualized under a microscope. The appearance of RBCs helps differentiate the various types of anemia.

Platelets – helping to clot blood

Platelets are the smallest blood cells. They are an important part of blood clotting. These small cells clump together and form a sticky mass that helps the blood to clot. Blood clots help your body handle injury by stopping or preventing bleeding. Blood clots can also cause problems, however, when they occur within the blood vessels or the heart; such clots cause a blockage known as thrombosis.

Platelet Counts – assessing your body’s ability to clot blood

A CBC includes the number of platelets and the mean platelet volume (MPV). MPV is a measurement of the average size of the platelets. A higher MPV roughly indicates better platelet function. Some medical conditions are associated with a high MPV and some are associated with a low MPV. Thus, the MPV can sometimes be helpful in telling apart different disorders.

A decreased number of platelets (thrombocytopenia) is associated with bleeding. Some causes include certain rare inherited disorders, leukemia, autoimmune disorders (e.g., rheumatoid arthritis or lupus) and medications. A falsely low platelet count, which is not associated with bleeding, can be caused by a rare error in blood sample collection: instead of staying in a liquid form, the sample clots (becomes solid), thus using up the platelets.

An increased platelet count is less common and is associated with clotting disorders such as thrombocythemia. Platelet counts can also be increased in some cancers and following infections or other medical conditions.

Aspirin can decrease the platelet function, so it’s important to consult with your doctor when taking large amounts of aspirin or when taking aspirin for an extended period of time. Many over-the-counter medications contain aspirin, which may be listed as acetylsalicylic acid, salicylate, or 2-(acetyloxy) benzoic acid.

Table: Items included in a CBC Test Report

←Back

How reliable are hematocrit (Hct) levels to determine blood loss in patient with significant hemorrhage?

Author

Joseph E Maakaron, MD Research Fellow, Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Lebanon

Disclosure: Nothing to disclose.

Coauthor(s)

Ali T Taher, MD, PhD, FRCP Professor of Medicine, Associate Chair of Research, Department of Internal Medicine, Division of Hematology/Oncology, Director of Research, NK Basile Cancer Center, American University of Beirut Medical Center, Lebanon

Disclosure: Nothing to disclose.

Marcel E Conrad, MD Distinguished Professor of Medicine (Retired), University of South Alabama College of Medicine

Marcel E Conrad, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for the Advancement of Science, American Association of Blood Banks, American Chemical Society, American College of Physicians, American Physiological Society, American Society for Clinical Investigation, American Society of Hematology, Association of American Physicians, Association of Military Surgeons of the US, International Society of Hematology, Society for Experimental Biology and Medicine, SWOG

Disclosure: Partner received none from No financial interests for none.

Chief Editor

Emmanuel C Besa, MD Professor Emeritus, Department of Medicine, Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American Society of Clinical Oncology, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, New York Academy of Sciences

Disclosure: Nothing to disclose.

Acknowledgements

Jose A Perez Jr, MD, MBA, MSEd Consulting Staff, Department of Medicine, Methodist Hospital; Associate Professor of Clinical Medicine, Weill Cornell Medical College

Jose A Perez Jr, MD, MBA, MSEd is a member of the following medical societies: American College of Physician Executives, American College of Physicians, Society of General Internal Medicine, and Society of Hospital Medicine

Disclosure: Nothing to disclose.

Ronald A Sacher, MB, BCh, MD, FRCPC Professor, Internal Medicine and Pathology, Director, Hoxworth Blood Center, University of Cincinnati Academic Health Center

Ronald A Sacher, MB, BCh, MD, FRCPC is a member of the following medical societies: American Association for the Advancement of Science, American Association of Blood Banks, American Clinical and Climatological Association, American Society for Clinical Pathology, American Society of Hematology, College of American Pathologists, International Society of Blood Transfusion, International Society on Thrombosis and Haemostasis, and Royal College of Physicians and Surgeons of Canada

webmd.com”>Disclosure: Glaxo Smith Kline Honoraria Speaking and teaching; Talecris Honoraria Board membership

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Hematocrit, hemoglobin and red blood cells are associated with vascular function and vascular structure in men

In the present study, we demonstrated for the first time that Hct, Hb and RBCs were associated with vascular function and vascular structure in men. Adjusted odds ratio of being in the low tertile of NID was significantly higher in the < 42.9% and ≥ 49.0% Hct groups. Adjusted odds ratio of being in the low tertile of NID was significantly higher in the < 13 g/dL Hb group, 14.0–14.9 g/dL Hb group and ≥ 17.0 g/dL Hb group. Adjusted odds ratio of being in the low tertile of NID was significantly higher in the < 4.19 × 10⁶/μL and ≥ 5.40 × 10⁶/μL RBCs groups. In addition, adjusted odds ratio of being in the low tertile of brachial IMT was significantly lower in the < 39.9% Hct groups than in the 46.0–48.9% Hct group. Adjusted odds ratio of being in the low tertile of brachial IMT was significantly lower in the < 14.9 g/dL Hb groups than in the 16.0–16.9 g/dL Hb group. Hct of 42.0–49.4%, Hb of 14.7–16.8 g/dL and RBCs of 4.82–5.24 × 10⁶/μL may be the optimal target levels for maintenance of vascular function and vascular structure.

In the present study, Hct of 42.0–49.4% was best from the aspect of vascular smooth muscle function. Several studies have shown that high Hct levels were associated with an increased risk of cardiovascular disease^1,2,3. On the other hand, the relationship between low Hct levels and cardiovascular disease is controversial. Gagnon et al. showed that there were J- or U-shaped relations between Hct and morbidity and mortality from cardiovascular events¹. After risk factor adjustment, there was a significantly increased risk of cardiovascular disease in the high Hct group but not in the low Hct group in men. Gotoh et al. showed that low Hct levels were associated with hemorrhagic stroke³. The effects of Hct, Hb and RBCs on vascular function and vascular structure are unclear. In the present study, we demonstrated that both low and high levels of Hct, Hb and RBCs were associated with vascular smooth muscle dysfunction. Vosseler et al. showed that blood viscosity, which was calculated using account Hct and plasma proteins, was negatively correlated with FMD in patients without coronary artery disease, while there was no significant relationship between blood viscosity and FMD in patients with atheroclerosis¹⁵. The discrepancy in the result of our study and the results of previous studies regarding the relationship between vascular function and hematocrit is due to the different numbers of subjects and different characteristics of subjects. The number of subjects was larger in the present study than in the previous studies. Our study participants were enrolled from a general population including patients with cardiovascular disease. Interestingly, Giannattasio et al. showed that acute decreases in Hct from 39.9 ± 0.8% to 37.1 ± 0.4% and Hb from 13.3 ± 0.3 to 12.2 ± 0.4 g/dL, after removal of 500 mL of blood and infusion of 500 mL of saline, impaired vascular function in patients with hemochromatosis¹⁶. In subjects with Hct of < 48.9%, Hct was positively correlated with FMD and NID and Hct was an independent predictor of NID. These findings suggest that subjects with high or low levels of Hct, Hb and RBCs have a high risk of vascular dysfunction and prognostic atherosclerosis.

Some possible mechanisms underlying the association of low Hct with vascular smooth muscle function are postulated. It is possible that oxygen delivery dynamics at the levels of hemoglobin and hematocrit are associated with vascular function. Thorling et al. showed that Hct positively correlated with tissue tension of oxygen even within normal ranges of Hct levels, suggesting that a decrease in Hct leads to a decrease in oxygen supply to tissues¹⁷. Takemoto et al. showed that hypoxia decreased endothelial NO synthase (eNOS) expression via the activation of Rho-associated kinase¹⁸. Chronic hypoxia affects endothelial dysfunction via increases in inflammation and oxidative stress^19,20. Several studies showed that Hct significantly correlated with viscosity^21,22. Hct is one of the most important factors affecting blood viscosity. In addition, blood viscosity regulates shear stress, which is an inducer of NO production from the endothelium. Martini et al. showed that animals with increased Hct had increased plasma nitrate/nitrite concentrations compared with those in control animals and in eNOS knockout mice through an increase in blood viscosity²². These findings suggest that a low level of Hct is harmful for vascular function.

Some possible mechanisms underlying the association of excessively high Hct with vascular smooth muscle dysfunction are postulated. Lewis et al. showed that the patients with excessive erythrocytosis caused by chronic mountain sickness in Andean highlanders had endothelial dysfunction that was partially reversible during oxygen inhalation, suggesting that chronic hypoxia may induce endothelial dysfunction in patients with excessive erythrocytosis²³. In addition, high blood viscosity caused by high levels of Hct as well as low blood viscosity caused by low levels of Hct induced low tissue tension of oxygen. According to the Hagen-Poiseuille law, blood flow depends on blood viscosity and vessel radius. Total peripheral vascular resistance is specified by blood viscosity and cardiac output. Fowler et al. showed that high viscosity caused low cardiac output²⁴. These findings suggest that high levels of Hct may induce tissue tension of oxygen by high peripheral vascular resistance and low cardiac output. These findings also suggest that a high level of Hct may be one of the factors of vascular dysfunction.

It has been shown that RBCs directly affect endothelial function via the eNOS/NO pathway and NOS-like bioactivity and the production of reactive oxygen species^25,26,27. Cortese-Krott et al. showed that RBCs contained eNOS and produced NO in healthy subjects as well as in patients with coronary artery disease and that FMD significantly correlated with the expression of eNOS and eNOS activity in RBCs in those subjects²⁵. In addition, Zhou et al. showed new mechanisms by which endothelial function was impaired in type 2 diabetes mellitus through activation of RBC arginase 1 and increase in production of reactive oxygen species²⁷. These findings suggest that RBC function per se plays an important role in the pathogenesis, maintenance, and development of atherosclerosis through the regulation of vascular function, leading to cardiovascular disease and cardiovascular events. Unfortunately, our study had no information on the function of RBCs, such as the eNOS/NO pathway, NOS like activity and oxidative stress. Assessment of RBC function would enable more specific conclusions concerning the role of RBCs other than the number of RBCs in vascular function to be drawn.

Simply, NID is assessed by brachial artery response to sublingual administration of nitroglycerine. However, we believe that vascular response to exogenous NO reflects vascular smooth muscle function since NO finally acts on vascular smooth muscle cells. Indeed, NID has been widely used as an indicator of vascular smooth muscle function. Several investigators have shown that vascular response to nitric acid including nitroglycerine reflects vascular smooth muscle function in the brachial artery and coronary artery of humans and in the isolated aorta artery of experimental animals^28,29,30. It has been shown that NID is impaired in patients with multiple cardiovascular risk factors and that it serves as an independent predictor of cardiovascular events^12,31. We believe that reduction in vascular smooth muscle response assessed by NID can also be defined vascular smooth muscle dysfunction.

Recently, some trials have shown that patients with type 2 diabetes mellitus who received an inhibitor of sodium-glucose cotransporter 2 in addition to conventional therapy had significantly lower rates of cardiovascular morbidity and mortality than did patients with type 2 diabetes mellitus who received a placebo in addition to conventional therapy^32,33,34. The EMPA-REG OUTCOME trial showed that changes in Hct (increase by 5.0 ± 5.3% from baseline of 41.3 ± 5.7%) and Hb (increase by 0.8 ± 1.3 g/dL from baseline of 13.5 ± 1.5 g/dL) within normal ranges might be important mediators of the empagliflozin-induced reduction in incidence of cardiovascular events including cardiovascular mortality³⁵. In the present study, Hct was positively correlated with FMD and NID in subjects with Hct < 48.9%, which was an independent variable of NID in multivariate analysis. In addition, Hct level of 42.0–49.4%, Hb level of 14.7–16.8 g/dL and RBC level of 4.82–5.24 × 10⁶/μL may be the optimal target levels for maintenance of vascular function. An increase in the level of Hct up to 49.4% may reduce the incidence of cardiovascular events.

In the present study, adjusted odds ratio of being in the low tertile of brachial IMT was significantly lower in the < 37.0% Hct group and 37.0–39.9% Hct group than in the 46.0–48.9% Hct group and was significantly lower in the < 13.9 g/dL Hb groups and 14.0–14.9 g/dL Hb group than in the 16.0–16.9 g/dL Hb group. Adjusted odds ratio of being in the low tertile of baPWV was significantly lower in the level < 3.80 × 10⁶/μL RBCs group and 4.60–4.99 × 10⁶/μL RBCs group than in the 5.00–5.39 × 10⁶/μL RBCs group. Lee et al. showed that carotid IMT positively correlated with blood viscosity and Hct. In their study, blood viscosity was an independent variable of carotid IMT in multivariate analysis, while Hct was not an independent variable of carotid IMT⁵. Kawamoto et al. showed that Hb levels were not associated with baPWV in men³⁶. Unfortunately, the relationships of Hct, Hb and RBCs with vascular structure are also controversial. The roles of Hct, Hb and RBCs in vascular structure need to be confirmed in future in large clinical trials.

In the present study, the groups with high levels of Hct, Hb and RBCs had vascular smooth muscle dysfunction but not abnormal vascular structure. It is well known that alteration of vascular function occurs before changes in vascular structure. Unfortunately, we had no information on the duration of high levels of Hct, Hb and RBCs. Cohort studies have shown that a high Hct level per se was associated with an increased risk of cardiovascular disease^1,2,3. NID may be a more sensitive marker than brachial IMT or baPWV of cardiovascular disease in subjects with high levels of Hct and Hb.

Our study has a number of limitations. First, this study is a cross-sectional design. Therefore, we cannot define causal relationships of Hct, Hb and RBCs with vascular dysfunction and abnormal vascular structure. Further studies are needed to confirm the effects of changes in levels of Hct, Hb and RBCs on vascular function and structure in long-term follow-up periods using a prospective study design. Second, we evaluated the relationships of Hct, Hb and RBCs with vascular function and structure only in men. It is well known that menstrual bleeding affects the levels of Hct, Hb and RBCs. We had no information on menstrual cycle when measuring vascular function and structure. Therefore, we excluded women as study subjects. Further studies are needed to confirm the relationships of levels of Hct, Hb and RBCs with vascular function and structure in women including premenopausal women as well as men after adjustment of the menstrual cycle. Third, we defined vascular dysfunction assessed by FMD and that assessed by NID as low tertiles of FMD and NID. The use of criteria for vascular dysfunction is a better way to calculate the odds ratio. However, diagnostic criteria for endothelial dysfunction assessed by FMD and vascular smooth muscle dysfunction assessed by NID have not been established. Therefore, we used low tertiles of FMD and NID as vascular dysfunction for calculation of the odds ratio.

Hematocrit – an overview | ScienceDirect Topics

External Blood Loss

PCV in a dog does not fully reflect the severity of acute blood loss anemia for 1 to 3 days, until fluid volume of the vascular space is replaced and the remaining RBCs and PPs are diluted by fluid replacement (thirst, redistribution of body fluids, or fluid treatment). Splenic contraction in the first few hours releases stored, concentrated RBCs into the circulation and may initially mask the severity of anemia. Release of reticulocytes should be noticeable by 3 days after hemorrhage, and peak aggregate reticulocytosis occurs 4 to 5 days after hemorrhage (see Figure 3-1). Improvement in the PCV occurs rapidly over the first 2 weeks until PCV reaches the low-normal reference interval. Thereafter, hypoxia is too mild to stimulate strong erythropoietin production, so the PCV increases slowly and may take a month to return to the original value.

Note

After a single episode of blood loss, improvement in the PCV occurs rapidly over the first 2 weeks. The PCV increases slowly thereafter and may take a month to return to the original PCV.

In adult animals, chronic hemorrhage over several weeks causes iron deficiency (see Figure 3-12) and a negative protein balance impairing erythropoiesis. Thus blood loss anemia initially (e.g., in the first 1 to 2 days) has no reticulocytosis in the blood (i.e., pre-regenerative), becomes most regenerative, and then over time becomes poorly regenerative or nonregenerative because of iron deficiency. Puppies and kittens are born with small iron reserves and with maximum erythropoiesis to match growth rate; iron depletion occurs more rapidly with blood loss (e.g., hookworms or coccidia). Even normal kittens just before weaning often have subclinical iron deficiency while drinking milk (an iron-poor diet).

A low or low-normal PP level in regenerative anemia is frequently associated with external blood loss and is a useful diagnostic feature. PP is lost with external blood loss. In hemolytic anemia and internal blood loss, PP concentration tends to be normal to slightly increased, because no protein is lost from the body. The PP reference interval may be too wide for the PP concentration to seem abnormal, but values may be in the lower end of the reference interval. PPs are replaced by the liver and lymphoid tissues more quickly than the bone marrow can replace RBCs, so hypoproteinemia less consistently reflects the presence or severity of external hemorrhage than does PCV.

Feline PCV response to blood loss somewhat parallels the canine response for the first 2 weeks. Feline aggregate reticulocyte response reaches a peak about 4 days after hemorrhage (see Figure 3-1). The maximum number of feline aggregate reticulocytes is much lower than the maximum number of canine reticulocytes in strong regenerative responses. Similarly, less polychromasia is needed on a feline blood smear to indicate strong regeneration than on a canine smear. Punctate reticulocytes peak about 1 week after hemorrhage and may remain elevated for 3 weeks or more. Punctate reticulocytes may remain increased after the PCV has returned to the reference interval. Therefore, a punctate reticulocytosis probably reflects accelerated erythropoiesis sometime within the previous 2 weeks.

Feline aggregate and punctate reticulocyte numbers can help determine when an anemia began. Moderately to markedly increased numbers of aggregate reticulocytes with few punctate reticulocytes indicates recent anemia (e.g., 2 to 4 days). Increased punctate reticulocytes without increased aggregate reticulocytes indicate anemia of 1 to 3 weeks’ duration or anemia too mild to stimulate an aggregate reticulocyte response.

Age-related changes in puppies and kittens must be considered. The PCV in healthy 2- to 6-week-old puppies is approximately 28%, and the PP normally may be less than 6 g/dl. Puppies have approximately 3% to 7% reticulocytes at 2 months of age or younger, with the highest percentage (7%) occurring at 0 to 2 weeks of age. Conversely, adult dogs normally have less than 1.5% reticulocytes. Using adult reference intervals, one would incorrectly conclude that a puppy has anemia, reticulocytosis, and hypoproteinemia, which indicate external blood loss. Therefore age-related reference intervals should be used.²⁸

Note

Healthy puppies at 2 to 6 weeks old have a PCV of 28, PP less than 6 g/dl, and 3% to 7% reticulocytes. Age-based reference values should be used.

Young animals are less able to respond to blood loss than are adults. Puppies and kittens already have high rates of bone marrow erythropoietic activity because of the need to expand blood volume as they grow. When bone marrow erythropoiesis is already at a high rate, one cannot expect as great an increase with blood loss as occurs in adults.

Boosting Your Blood Count – We Are Blood

It’s a common challenge, and it’s not fun when it happens to you. The person performing your donor screening says those the dreaded words, “I’m sorry, but you can’t donate today due to your hematocrit levels.”

WHAT?!?

You might be asking yourself, “What on earth is my hematocrit level? And why is it preventing me from donating?”

Low hematocrit is one of the most common reasons our donors are deferred from blood donation. But even if you’re temporarily deferred as a blood donor because of a low hematocrit level, you should still consider trying again! In many cases, a simple change in your diet can be all it takes to increase your hematocrit level enough to become eligible again.

First things first: what is a hematocrit?

Basically, your hematocrit is a measurement of red cells to the total volume of your blood. We measure it using that tricky little finger prick that everyone loves to hate.

For men, a hematocrit level acceptable for blood donation is between 39%-60%. For women, that range is 38%-60%.

Why does a low hematocrit level mean you can’t donate today?

In short, it’s for your own safety. If we were to draw blood after discovering your hematocrit level was low, we would be putting you at risk of developing anemia.

Because red blood cells carry oxygen through your body, and because we remove some of those red blood cells (and their iron stores) when you make a donation, we have a duty to make sure you have enough red blood cells circulating to stay healthy after blood donation. If we didn’t, you could end up not feeling well after donating blood. Or worse yet, you could be putting yourself at a serious health risk.

So, how can you raise your hematocrit level anyway?

A diet rich in iron helps promote blood regeneration. Take a look at the foods listed below and think about incorporating them more heavily into your diet.

If you want to help your body absorb all this added iron, make sure you increase your Vitamin C intake, too! We also advise avoiding caffeinated beverages like tea and coffee during and after meals, because caffeine tends to decrease your iron absorption.

Oh and we almost forgot the most fun fact of all: red wine is FULL of iron-boosting goodness. Consider having a glass the night before you donate for an added iron boost. As long as you’re of legal age, of course.

Complete Blood Count (CBC) | HealthLink BC

Test Overview

A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood, especially red blood cells, white blood cells, and platelets. A CBC helps your doctor check any symptoms, such as weakness, fatigue, or bruising, you may have. A CBC also helps him or her diagnose conditions, such as anemia, infection, and many other disorders.

A CBC test usually includes:

• White blood cell (WBC, leukocyte) count. White blood cells protect the body against infection. If an infection develops, white blood cells attack and destroy the bacteria, virus, or other organism causing it. White blood cells are bigger than red blood cells but fewer in number. When a person has a bacterial infection, the number of white cells rises very quickly. The number of white blood cells is sometimes used to find an infection or to see how the body is dealing with cancer treatment.
• White blood cell types (WBC differential). The major types of white blood cells are neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Immature neutrophils, called band neutrophils, are also part of this test. Each type of cell plays a different role in protecting the body. The numbers of each one of these types of white blood cells give important information about the immune system. Too many or too few of the different types of white blood cells can help find an infection, an allergic or toxic reaction to medicines or chemicals, and many conditions, such as leukemia.
• Red blood cell (RBC) count. Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so it can be exhaled. If the RBC count is low (anemia), the body may not be getting the oxygen it needs. If the count is too high (a condition called polycythemia), there is a chance that the red blood cells will clump together and block tiny blood vessels (capillaries). This also makes it hard for your red blood cells to carry oxygen.
• Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space (volume) red blood cells take up in the blood. The value is given as a percentage of red blood cells in a volume of blood. For example, a hematocrit of 38 means that 38% of the blood’s volume is made of red blood cells. Hematocrit and hemoglobin values are the two major tests that show if anemia or polycythemia is present.
• Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell its red colour. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood’s ability to carry oxygen throughout the body.
• Red blood cell indices. There are three red blood cell indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). They are measured by a machine and their values come from other measurements in a CBC. The MCV shows the size of the red blood cells. The MCH value is the amount of hemoglobin in an average red blood cell. The MCHC measures the concentration of hemoglobin in an average red blood cell. These numbers help in the diagnosis of different types of anemia. Red cell distribution width (RDW) can also be measured which shows if the cells are all the same or different sizes or shapes.
• Platelet (thrombocyte) count. Platelets (thrombocytes) are the smallest type of blood cell. They are important in blood clotting. When bleeding occurs, the platelets swell, clump together, and form a sticky plug that helps stop the bleeding. If there are too few platelets, uncontrolled bleeding may be a problem. If there are too many platelets, there is a chance of a blood clot forming in a blood vessel. Also, platelets may be involved in hardening of the arteries (atherosclerosis).
• Mean platelet volume (MPV). Mean platelet volume measures the average amount (volume) of platelets. Mean platelet volume is used along with platelet count to diagnose some diseases. If the platelet count is normal, the mean platelet volume can still be too high or too low.

Your doctor may order a blood smear test to be done at the same time as a CBC but it is not part of the regular CBC test. In this test, a drop of blood is spread (smeared) on a slide and stained with a special dye. The slide is looked at under a microscope. The number, size, and shape of red blood cells, white blood cells, and platelets are recorded. Blood cells with different shapes or sizes can help diagnose many blood diseases, such as leukemia, malaria, or sickle cell disease.

Why It Is Done

A complete blood count may be done to:

• Find the cause of symptoms such as fatigue, weakness, fever, bruising, or weight loss.
• Check for anemia.
• See how much blood has been lost if there is bleeding.
• Diagnose polycythemia.
• Check for an infection.
• Diagnose diseases of the blood, such as leukemia.
• Check how the body is dealing with some types of drug or radiation treatment.
• Check how abnormal bleeding is affecting the blood cells and counts.
• Screen for high and low values before a surgery.
• See if there are too many or too few of certain types of cells. This may help find other conditions, such as too many eosinophils may mean an allergy or asthma is present.

A complete blood count may be done as part of a regular physical examination. A blood count can give valuable information about the general state of your health.

How To Prepare

You do not need to do anything before having this test.

How It Is Done

Your health professional drawing blood will:

• Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
• Clean the needle site with alcohol.
• Put the needle into the vein. More than one needle stick may be needed.
• Attach a tube to the needle to fill it with blood.
• Remove the band from your arm when enough blood is collected.
• Put a gauze pad or cotton ball over the needle site as the needle is removed.
• Put pressure to the site and then a bandage.

If this blood test is done on a baby, a heel stick will be done instead of a blood draw from a vein.

How It Feels

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.

Risks

There is very little chance of a problem from having a blood sample taken from a vein.

• You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes.
• In rare cases, the vein may become swollen after the blood sample is taken. This problem is called phlebitis. A warm compress can be used several times a day to treat this.

Results

A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood, especially red blood cells, white blood cells, and platelets. A CBC helps your doctor check any symptoms, such as weakness, fatigue, or bruising, you may have. A CBC also helps him or her diagnose conditions, such as anemia, infection, and many other disorders.

Normal

The normal values listed here—called a reference range—are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what’s normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.

Normal values for the complete blood count (CBC) tests depend on age, sex, how high above sea level you live, and the type of blood sample. Your doctor may use all the CBC values to check for a condition. For example, the red blood cell (RBC) count, hemoglobin (Hgb), and hematocrit (HCT) are the most important values needed to tell whether a person has anemia, but the red blood cell indices and the blood smear also help with the diagnosis and may show a possible cause for the anemia.

To see if the white blood cell (WBC, leukocyte) count is good and how the cells look on the smear, your doctor will look at both the number (WBC count) and the WBC differential. To see whether there are too many or too few of a certain type of cell, your doctor will look at the total count and the percentage of that particular cell. There are normal values for the total number of each type of white cell.

Pregnancy can change these blood values. Your doctor will talk with you about normal values during each trimester of your pregnancy.

In general, a normal hemoglobin level is about one-third the value of the hematocrit.

High values

Red blood cell (RBC)

• Conditions that cause high RBC values include smoking, exposure to carbon monoxide, long-term lung disease, kidney disease, some cancers, certain forms of heart disease, alcohol use disorder, liver disease, a rare disorder of the bone marrow (polycythemia vera), or a rare disorder of hemoglobin that binds oxygen tightly.
• Conditions that affect the body’s water content can also cause high RBC values. These conditions include dehydration, diarrhea or vomiting, excessive sweating, and the use of diuretics. The lack of fluid in the body makes the RBC volume look high; this is sometimes called spurious polycythemia.

White blood cell (WBC, leukocyte)

• Conditions that cause high WBC values include infection, inflammation, damage to body tissues (such as a heart attack), severe physical or emotional stress (such as a fever, injury, or surgery), kidney failure, lupus, tuberculosis (TB), rheumatoid arthritis, malnutrition, leukemia, and diseases such as cancer.
• The use of corticosteroids, underactive adrenal glands, thyroid gland problems, certain medicines, or removal of the spleen can also cause high WBC values.

Platelets

• High platelet values may be seen with bleeding, iron deficiency, some diseases like cancer, or problems with the bone marrow.

Low values

Red blood cell (RBC)

• Anemia lowers RBC values. Anemia can be caused by heavy menstrual bleeding, stomach ulcers, colon cancer, inflammatory bowel disease, some tumours, Addison’s disease, thalassemia, lead poisoning, sickle cell disease, or reactions to some chemicals and medicines. A low RBC value may also be seen if the spleen has been taken out.
• A lack of folic acid or vitamin B12 can also cause anemia, such as pernicious anemia, which is a problem with absorbing vitamin B12.
• The RBC indices value and a blood smear may help find the cause of anemia.

White blood cell (WBC, leukocyte)

Platelets

• Low platelet values can occur in pregnancy or immune thrombocytopenic purpura (ITP) and other conditions that affect how platelets are made or that destroy platelets.
• A large spleen can lower the platelet count.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

• If the elastic band was on your arm a long time while the blood sample was taken.
• Taking medicines that can cause low platelet levels. Some examples of the many medicines that cause low platelet levels include steroids, some antibiotics, thiazide diuretics, chemotherapy medicines, quinidine, and meprobamate.
• A very high white blood cell count or high levels of a type of fat (triglycerides). These can cause falsely high hemoglobin values.
• Having an enlarged spleen, which may cause a low platelet count (thrombocytopenia) or a low white blood cell count. An enlarged spleen may be caused by certain types of cancer.
• Pregnancy, which normally causes a low RBC value and less often a high WBC value.

References

Citations

1. Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

Credits

Current as of:
December 9, 2019

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine

Current as of: December 9, 2019

Author: Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine

How is Pernicious Anemia Diagnosed? | HOA

Your doctor will diagnose pernicious anemia based on your medical and family histories, a physical exam, and test results.

Your doctor will want to find out whether the condition is due to a lack of intrinsic factor or another cause. He or she also will want to find out the severity of the condition, so it can be properly treated.

Specialists Involved

Primary care doctors—such as family doctors, internists, and pediatricians (doctors who treat children)—often diagnose and treat pernicious anemia. Other kinds of doctors also may be involved, including:

• A neurologist (nervous system specialist)
• A cardiologist (heart specialist)
• A hematologist (blood disease specialist)
• A gastroenterologist (digestive tract specialist)

Medical and Family Histories

Your doctor may ask about your signs and symptoms. He or she also may ask:

• Whether you’ve had any stomach or intestinal surgeries
• Whether you have any digestive disorders, such as celiac disease or Crohn’s disease
• About your diet and any medicines you take
• Whether you have a family history of anemia or pernicious anemia
• Whether you have a family history of autoimmune disorders (such as Addison’s disease, type 1 diabetes, Graves’ disease, or vitiligo). Research suggests a link may exist between these autoimmune disorders and pernicious anemia that’s caused by an autoimmune response.

Physical Exam

During the physical exam, your doctor may check for pale or yellowish skin and an enlarged liver. He or she may listen to your heart for rapid or irregular heartbeats or a heart murmur.

Your doctor also may check for signs of nerve damage. He or she may want to see how well your muscles, eyes, senses, and reflexes work. Your doctor may ask questions or do tests to check your mental status, coordination, and ability to walk.

Diagnostic Tests and Procedures

Blood tests and procedures can help diagnose pernicious anemia and find out what’s causing it.

Complete Blood Count

Often, the first test used to diagnose many types of anemia is a complete blood count (CBC). This test measures many parts of your blood. For this test, a small amount of blood is drawn from a vein (usually in your arm) using a needle.

A CBC checks your hemoglobin (HEE-muh-glow-bin) and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is an iron-rich protein that helps red blood cells carry oxygen from the lungs to the rest of the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia.

The normal range of these levels may be lower in certain racial and ethnic populations. Your doctor can explain your test results to you.

The CBC also checks the number of red blood cells, white blood cells, and platelets (PLATE-lets) in your blood. Abnormal results may be a sign of anemia, another blood disorder, an infection, or another condition.

Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells. MCV can be a clue as to what’s causing your anemia. In pernicious anemia, the red blood cells tend to be larger than normal.

Other Blood Tests

If the CBC results confirm that you have anemia, you may need other blood tests to find out what type of anemia you have.

A reticulocyte (re-TIK-u-lo-site) count measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate. People who have pernicious anemia have low reticulocyte counts.

Serum folate, iron, and iron-binding capacity tests also can help show whether you have pernicious anemia or another type of anemia.

Another common test, called the Combined Binding Luminescence Test, sometimes gives false results. Scientists are working to develop a more reliable test.

Your doctor may recommend other blood tests to check:

• Your vitamin B12 level. A low level of vitamin B12 in the blood indicates pernicious anemia. However, a falsely normal or high value of vitamin B12 in the blood may occur if antibodies interfere with the test.
• Your homocysteine and methylmalonic acid (MMA) levels. High levels of these substances in your body are a sign of pernicious anemia.
• For intrinsic factor antibodies and parietal cell antibodies. These antibodies also are a sign of pernicious anemia.

Bone Marrow Tests

Bone marrow tests can show whether your bone marrow is healthy and making enough red blood cells. The two bone marrow tests are aspiration (as-pi-RA-shun) and biopsy.

For aspiration, your doctor removes a small amount of fluid bone marrow through a needle. For a biopsy, your doctor removes a small amount of bone marrow tissue through a larger needle. The samples are then examined under a microscope.

In pernicious anemia, the bone marrow cells that turn into blood cells are larger than normal.

Source: National Heart, Lung, and Blood Institute, National Institutes of Health.

90,000 causes of low, high levels – Health – Home

A blood test for hematocrit shows the percentage of individual blood elements (erythrocytes, leukocytes and platelets) to its liquid part (plasma). With the help of this indicator, the degree of anemia is often determined, since in this disease the hematocrit level can decrease to 15-20%.

It is believed that the average hematocrit for men is between 0.4 and 0.48.And for women, the norm is in the range of 0.36-0.46. However, the hematocrit value directly depends on the person’s age. The younger the patient, the lower the level. In a young child, the hematocrit is typically 20 percent higher than that of an adult. This indicator is considered to be the norm.

Sometimes an increase or decrease in the hematocrit level indicates the presence of a disease. In particular, with a prolonged lack of air (hypoxia), the body tries to increase the efficiency of oxygen transfer by blood from the lungs to all organs.This is done by increasing hemoglobin and increasing the number of red blood cells. Accordingly, there is an increase in the level of hematocrit. This effect is present in people with respiratory problems, in tourists who often visit the mountains, in those who live in these areas, as well as in smokers.

The hematocrit can also be elevated with dehydration (dehydration). What happens with infectious diseases of the digestive system, with severe burns and with a long stay in a dry hot climate.Another reason for an increase in hematocrit is kidney cancer. In this case, an increase in blood density is observed. However, a more accurate diagnosis can be made only after additional examinations.

Those who are in hot climates for a long time tend to get a lot of sun exposure. About whether it is useful or harmful to sunbathe, see the plot from the program “No taboo topics”:

A decreased hematocrit can also indicate the presence of various diseases.A low result count for this test is considered an underlying symptom of hypoplastic anemia. Also, the level of hematocrit is low with an excessive presence of fluid in the blood, otherwise called overhydration. The reasons may be: poisoning, infectious or viral disease, renal failure.

Also, a decreased hematocrit may be a sign of hyperproteinemia. This is a decrease in blood density. This can be the case with serious liver disease.

If, according to the results of the analysis, the hematocrit has an increased or decreased level, this only means that additional tests and examinations are needed. There is no point in panicking, because often the hematocrit is successfully leveled out with proper nutrition, which includes all the vitamins the body needs, as well as with refusal from alcohol and cigarettes.

Decoding of the general blood test

Dear patients! When you receive a general blood test form, you have a question: “What do these indicators mean?” In this article you will find an explanation of the main indicators of a complete blood count. Warning: An expert (doctor) consultation is required to explain the blood test values ​​and make a diagnosis!

Normal readings:

WBC – leukocytes – from 4.0 to 10.0 billion / liter,

Lymph – lymphocytes – from 0.8 to 4.0 billion / liter,

Mid- (content of a mixture of monocytes, eosinophils, basophils and immature cells) –

from 0.1 to 1.5 billion / liter,

Gran – granulocytes – from 2.0 to 7.0 billion / liter,

Lymph% – lymphocytes – from 20 to 40%,

Mid% – (content of a mixture of monocytes, eosinophils, basophils and immature cells) -from 3 to 15%,

Gran% – granulocytes – from 50 to 70%,

HGB – hemoglobin – 20-160 g / liter

RBC – erythrocytes – from 3.5 to 5.5 trillion / liter,

HCT – hematocrit – from 37.0 to 54.0,

MCV – average erythrocyte volume – from 80.0 to 100.0 femtoliters,

MCH – average hemoglobin content in erythrocyte – from 27.0 to 34.0 picograms,

MCHC – the average concentration of hemoglobin in the erythrocyte – from 320 to 360,

RDW – CV – erythrocyte distribution width – from 11.0 to 16.0,

RDW – SD – erythrocyte distribution width (standard deviation) –

35.0 to 56.0,

PLT – platelets – from 180 to 320 billion / liter,

MPV – average erythrocyte volume – from 6.5 to 12.0,

PDW – relative width of platelet distribution by volume – from 9.0 to 17.0,

PCT – thrombocyte (the proportion of platelets in the total volume of whole blood) from 0.108 to 0.282

ESR – ESR – less than 12, but normal indicators can vary greatly depending on age and gender.

Value of indicators:

WBC – leukocytes. Leukocytes (white blood cells) protect the body from infections (bacteria, viruses, parasites. A high level of leukocytes indicates the presence of a bacterial infection, and a decrease in the number of leukocytes occurs when taking certain medications, blood diseases.

Lymph – lymphocytes – from 0.8 to 4.0 billion / liter. Lymphocyte is a type of white blood cell that is responsible for the production of immunity and the fight against microbes and viruses.An increase in the number of lymphocytes (lymphocytosis) occurs in viral infectious diseases, as well as in diseases of the blood (chronic lymphocytic leukemia, etc.). A decrease in the number of lymphocytes (lymphopenia) occurs in severe chronic diseases, taking certain drugs that suppress immunity (corticosteroids, etc.).

Mid. Monocytes, eosinophils, basophils and their precursors circulate in the blood in small quantities, therefore, these cells are often combined into one group, which is designated as MID.These types of blood cells also belong to leukocytes and perform important functions (fight against parasites, bacteria, development of allergic reactions, etc.)

Gran – granulocytes. These are white blood cells that contain granules (granular white blood cells). Granulocytes are represented by 3 types of cells: neutrophils, eosinophils and basophils. These cells are involved in the fight against infections, inflammatory and allergic reactions.

Lymph% – lymphocytes – from 20 to 40%,

Mid% – (content of a mixture of monocytes, eosinophils, basophils and immature cells) -from 3 to 15%,

Gran% – granulocytes – from 50 to 70%,

HGB – hemoglobin.A special protein that is found in red blood cells and is responsible for the transfer of oxygen to the organs. A decrease in hemoglobin levels (anemia) leads to oxygen starvation of the body. An increase in hemoglobin levels, as a rule, indicates a high number of red blood cells, or dehydration of the body.

RBC – erythrocytes. Red blood cells perform an important function of supplying oxygen to the tissues of the body, as well as removing carbon dioxide from the tissues, which is then released through the lungs. If the level of red blood cells is below normal (anemia), the body does not receive enough oxygen.If the level of red blood cells is higher than normal (polycythemia, or erythrocytosis), there is a risk that the red blood cells stick together and block the movement of blood through the vessels (thrombosis).

HCT – hematocrit. An indicator that reflects how much blood is occupied by erythrocytes. Increased hematocrit occurs with erythrocytosis (an increased number of red blood cells in the blood), as well as with dehydration. A decrease in hematocrit indicates anemia (a decrease in the level of red blood cells in the blood), or an increase in the amount of liquid part of the blood.

MCV – average erythrocyte volume. Erythrocytes with a small average volume are found in microcytic anemia, iron deficiency anemia, etc. Erythrocytes with an increased average volume are found in megaloblastic anemia (anemia that develops with a deficiency of vitamin B12 or folic acid in the body).

MCH – the average content of hemoglobin in the erythrocyte. A decrease in this indicator occurs with iron deficiency anemia, an increase – with megaloblastic anemia (with a deficiency of vitamin B12 or folic acid).

MCHC – the average concentration (saturation) of hemoglobin in the erythrocyte. A decrease in this indicator is found in iron deficiency anemias, as well as in thalassemia (congenital blood disease). There is practically no increase in this indicator.

RDW – CV – erythrocyte distribution width. The indicator is used for laboratory assessment of anemia, inflammation, oncopathology, diseases of the cardiovascular system and gastrointestinal tract.
RDW – SD – erythrocyte distribution width (standard deviation).

PLT – platelets. Small plates of blood that are involved in the formation of a blood clot and prevent blood loss in case of vascular damage. An increase in the level of platelets in the blood occurs in some blood diseases, as well as after operations, after removal of the spleen. A decrease in platelet levels occurs in some congenital blood diseases, aplastic anemia (disruption of the bone marrow that produces blood cells), idiopathic thrombocytopenic purpura (destruction of platelets due to increased activity of the immune system), liver cirrhosis

MPV – average erythrocyte volume.An increase in MPV can be provoked by diabetes mellitus, thrombocytodystrophy, blood pathologies (systemic lupus), splenectomy, alcoholism, myeloid leukemia, vascular atherosclerosis, thalassemia (a genetic disorder of the structure of hemoglobin), May-Hegglin syndrome, posthemorrhagic anemia. Below the norm, this indicator drops due to radiation therapy, with cirrhosis of the liver, anemia (plastic and megaloblastic), Wiskot-Aldrich syndrome.

PDW – the relative width of the distribution of platelets by volume.This indicator is indirect, taken into account in a set of other indicators.

PCT – thrombocyte (the proportion of platelets in the total volume of whole blood). The main purpose of this study is to assess the risk of thrombosis or, conversely, bleeding, which in both cases can pose a threat to the patient’s life.

ESR – ESR. A non-specific indicator that increases in many pathological conditions of completely different origins (infectious diseases, blood diseases, tumors, inflammatory processes, autoimmune diseases).

There is no need to sign up for a general blood test! Blood sampling is carried out from 7.30 to 12.00.

Low hemoglobin – what to do?

Hemoglobin is one of the most important elements of the blood; it carries out the function of transferring oxygen to the tissues and cells of the body, taking carbon dioxide from them. Changes in hemoglobin indicators may be a consequence of any disease.

Factors influencing the development of anemia:

• Destruction of erythrocytes faster than normal.
• Decrease in the volume of erythrocytes produced.
• Loss of large amounts of blood.
• Violation of the hematopoietic organs.
• Presence of infectious diseases.
• Deficiency of vitamins and minerals. (the amount of iron in the body especially affects)
• Unfavorable ecological situation.

What are the hemoglobin levels?

The hemoglobin level in the blood can be determined using a blood test, which is prescribed by your doctor, a hematologist.

Mild hemoglobin deficiency – determined by the level of hemoglobin in the blood up to 90 g / l. As a rule, with a mild degree of anemia, patients do not feel any deterioration in the state of the body. Feeling of weakness and fatigue is possible.

The average degree of hemoglobin deficiency is determined by the hemoglobin level in the range from 70 to 90 g / l. Common signs of such anemia are headache, dizziness, dryness and roughness of the skin, and disturbances in the functioning of the digestive system.

Severe hemoglobin deficiency – determined by hemoglobin levels below 70 g / l. Fatigue, loss of consciousness and headaches are often observed. Women experience disruptions in the menstrual cycle, up to the absence of menstruation. The skin turns pale, the condition of the hair and nails deteriorates, and they become brittle. There is a sensation of cold hands and feet.

Low hemoglobin levels affect the functioning of all organs, this condition is life-threatening.

If you experience symptoms of anemia, feel a deterioration in your health, be sure to consult a doctor.The hematologist of the MC “SANAS” will conduct an examination and prescribe the necessary examination, according to the results of which he will prescribe the correct treatment.

Only a specialized hematologist can prescribe the correct treatment, prescribe a diet to increase the level of iron in the blood.

The addition of red meat, seafood, buckwheat and fruits with a high content of vitamin C to the diet may be recommended, as well as prescribe medications necessary for the patient. The usual course of treatment lasts from several weeks to a month.

90,000 Indicators of a clinical blood test

Hemoglobin ( Hb) is one of the main indicators of a general blood test. A decrease in hemoglobin concentration is a fairly common occurrence that can be found at any age. It is hemoglobin that gives blood such a red color. And we need it to deliver oxygen from the lungs to our organs – the brain, heart, muscles and others. Therefore, if you have shortness of breath already with little physical exertion, constant weakness, apathy – you should pay attention to this particular indicator.Recently, doctors have recommended thinking about possible anemia even when hemoglobin is below 120 g / l in women, and in men below 130 g / l.

Erythrocytes ( RBC) – an indicator of the number of red blood cells, measured in the number of cells per liter of blood. This is the most abundant cell type. The main task of erythrocytes is to carry hemoglobin. If the number of red blood cells decreases, for example, due to a deficiency of vitamin B12 or folic acid (namely, these vitamins are needed for the synthesis of these cells), then hemoglobin in the blood will also be insufficient, even with a good supply of iron (ferritin).

Hematocrit ( HCT) – the volume of all blood cells,% by volume of cells in the blood. With an increase in hematocrit beyond 50%, the risk of thrombosis due to blood thickening increases. In hematology analyzers, this is a calculated indicator i.e. it is directly influenced by the number of erythrocytes and their average volume.

Average erythrocyte volume ( MCV) – MCV can be low (for microcytic anemia), normal (for normocytic anemia), or high (for macrocytic anemia).Small red blood cells (microcytosis) is a common laboratory disorder and is a classic sign of iron deficiency or thalassemia. As anemia progresses, new red blood cells become smaller and smaller, so the MCV score can serve as a marker of the age of anemia. In early iron deficiency anemia, MCV may be normal because the measured MCV reflects the volume of cells produced in the previous 120 days (erythrocyte lifespan). Your doctor may order a ferritin test to diagnose latent iron deficiency.Anemia occurs because without an iron molecule, the bone marrow cannot build a hemoglobin molecule.

Average hemoglobin content in erythrocytes ( MCH) is a fairly stable value that does not depend on age. This index has replaced the outdated color indicator (CPU). A decrease in MCH also indicates a lack of iron. An increase may be a sign of hyperchromic anemia.

Average concentration of hemoglobin in erythrocyte ( MCHC) .An increase in MCHC with a decrease in MCV may suggest hereditary microspherocytosis – a disease in which there is increased destruction of red blood cells and may be jaundice.

Width of distribution of erythrocytes by volume (RDW) – an indicator of anisocytosis (different sizes of erythrocytes). Before the advent of hematology analyzers, the heterogeneity of red blood cell size was historically determined by qualitative examination of peripheral blood smears.RDW indicates how much red blood cells vary in size. It increases with a deficiency of iron, folic acid or vitamin B12.

Platelets ( PLT) – the smallest blood cells, but no less important than erythrocytes and leukocytes. We need them for blood clotting. When they decrease in the analysis below 30, bruises spontaneously appear on the skin, so increased bleeding is manifested. With an increase in the number of platelets, first of all, it is necessary to exclude iron deficiency anemia and an inflammatory reaction (make an analysis for C-reactive protein).

MPV – average platelet volume. The MPV value rises during the period of active platelet production. A decrease in platelet volume indicates possible problems with the bone marrow. You should pay attention to the MPV indicator only when the number of platelets decreases and there is no aggregation.

PCT – thrombocyte, or% of the volume of all platelets in the blood. The higher the thrombocyte, the greater the risk of thrombosis.

PDW – platelet volume distribution width.PDW as well as MPV is used to diagnose the cause of platelet decline.

Leukocytes – the most important indicator of our immune system. A decrease in the number of leukocytes can be associated with viral infections, toxic effects on the body, taking certain medications. An increase in the number of leukocytes can indicate an inflammatory reaction, acute infection, leukemia. In this case, special attention should be paid to the leukocyte formula, that is, to make a clinical blood test with a leukoformula.

Share article:

Still have questions?

Low hemoglobin level

Low hemoglobin is a common finding in blood tests.Hemoglobin (referred to as Hb or Hgb in test forms) is a blood protein found in red blood cells that carry oxygen throughout the body. Many people have a slight decrease in hemoglobin levels, which does not affect the well-being of the person himself. Anemia is a more serious condition in which there are other symptoms in addition to a decrease in hemoglobin levels.

A low hemoglobin level is considered to be less than 13.5 grams per deciliter of blood (or 135 grams per liter of blood) in men and less than 12 grams per deciliter of blood (or 120 grams per liter of blood) in women.In children, the values ​​of normal and low hemoglobin levels depend on age and gender.

A slight decrease in the level of hemoglobin in the peripheral blood is not always a sign of the disease. For some people, this condition may be a normal variant. For example, low hemoglobin levels are common in pregnant women.

Low hemoglobin levels can be associated with various diseases or conditions of the body that lead to a decrease in the number of red blood cells in the peripheral blood (erythrocytopenia).

Erythrocytopenia may result from the fact that:

• The body produces fewer red blood cells than usual
• Red blood cells are destroyed faster than new ones are formed
• There was massive blood loss

Causes of low hemoglobin level

Diseases and conditions that lead to a low content of red blood cells, and therefore to a decrease in the level of hemoglobin in the blood:

• Malignant (cancerous) tumors
• Anemia due to vitamin deficiency
• Iron deficiency anemia
• Aplastic anemia
• Cirrhosis of the liver
• Hodgkin’s lymphoma
• Hypothyroidism
• Chronic kidney disease
• Cystitis
• Gastritis
• Leukemia
• Multiple myeloma
• Myelodysplastic syndrome
• Taking certain medications (antiretroviral drugs for treating HIV infection, chemotherapy for treating cancer, etc.)

Diseases and conditions that lead to accelerated destruction of erythrocytes, and therefore to a decrease in the level of hemoglobin in the blood:

• Splenomegaly
• Porphyria
• Urinary tract infections
• Thalassemia
• Vasculitis
• Hemolysis
• A decrease in hemoglobin levels is also possible with significant blood loss during:
• Bleeding from a wound or wounds
• Bleeding from a stomach ulcer or duodenal ulcer
• Bleeding from intestinal tumor
• Bleeding from the anal canal, for example with hemorrhoids
• Bleeding from the urinary tract
• Frequent blood donation
• Heavy menstrual bleeding

Erythrocytapheresis, hemoexfusion – treatment with hemocorrection in Moscow, price

• Consultation of a transfusiologist, head of the hemocorrection department for 1 ruble

Erythrocytapheresis is one of the methods of hemocorrection, the purpose of which is to remove a certain number of erythrocytes (red blood cells) from the blood.Erythrocytes are the most abundant type of blood cells containing the iron-containing protein hemoglobin. Erythrocyte hemoglobin can bind to oxygen and deliver it to body tissues. In the opposite direction from the tissues to the lungs, hemoglobin carries carbon dioxide. There are conditions in which the number of red blood cells and hemoglobin in the blood increases significantly, which leads to a significant increase in blood viscosity. In this regard, the blood circulation through the capillaries becomes more complicated, where there is an exchange of gases (oxygen and carbon dioxide) and metabolic products between the blood and body tissues.With an increase in blood viscosity, the load on the heart also increases.

Also, erythrocytapheresis is indicated with an increase in the level of iron in the blood (hemosiderosis) and with hemochromatosis – a disease in which a violation of iron metabolism leads to its accumulation in tissues and organs. In such cases, after the removal of red blood cells, the formation of new cells in the bone marrow is stimulated, which consume iron from the blood for their formation. Thus, the prevention of iron deposition in tissues and organs is carried out.

Instead of erythrocytapheresis, you can use another procedure called hemoexphesia (bloodletting). Hemoexfusion is the removal of some volume of whole blood.

Erythrocyte removal and hemoexfusion process

With the help of a special apparatus, erythrocytes are taken from the patient’s blood. 500-800 ml of blood is processed. A portion of blood enters the machine. Erythrocytes are removed from it, other blood components are returned to the patient.Then the device processes the next portion of blood, again receiving red blood cells from it. As a rule, obtaining red blood cells as a result of 2 such blood sampling cycles is sufficient.

During hemoexfusion, whole blood is removed by gravity into a sterile bag in a volume of 400–600 ml.

Treatment programs erythrocytapheresis or hemoexfusion

Usually 3-5 procedures are performed.

Frequency of procedures

1 procedure per week.

Duration of procedures

The duration of the procedures depends on the volume of the treated blood, the blood flow rate in the system, and the patient’s condition.

Typically 25-30 minutes.

Frequency of treatment courses

It is advisable to repeat the course of treatment with a repeated increase in the number of erythrocytes, hemoglobin, iron in the blood, as well as blood viscosity.

Application of procedure

Erythrocytapheresis or hemoexfusion is used as an independent procedure.

Erythrocytapheresis or hemoexfusion in the hemocorrection department of the Clinical Hospital on Yauza

In the department of hemocorrection of the Clinical Hospital on Yauza, erythrocytapheresis and hemoexfusion are performed by doctors with extensive practical experience. We use time-tested and well-proven methods of hemocorrection using modern equipment of the latest generation. Erythrocytapheresis and hemoexfusion are safe procedures, which, however, require monitoring of the patient’s condition by specialists throughout the session and strict adherence to all technical aspects of the techniques.During the procedures, only sterile disposable consumables are used, which ensures complete safety of the patient from infections.

How it happens

The patient comes to the procedure at the appointed time. Sits in a comfortable chair. Next, a needle is inserted into the vein, as when installing a dropper. There is no other discomfort. And so the patient sits until the end of the procedure. All that is required of him is not to bend the arm where the needle is. During the procedure, it is allowed to read magazines, books, talk on the phone, watch TV, listen to music, work on a laptop using a Wi-Fi connection, etc.e. During the procedure, the patient may be offered tea and coffee.

After the session, a compression bandage is applied to the needle placement site, with which the patient leaves the clinic. The bandage must be kept for at least 6 hours.

Preparing the patient for the procedure

• Procedures are carried out only if the patient has an examination for:
  • hepatitis B
  • hepatitis C
  • HIV
• Before treatment, the patient must read, fill out and sign the documents:
  • Informed voluntary consent to medical (diagnostic) manipulation (procedure) “
  • “Informed voluntary consent to medical intervention”

No special preparation is required for erythrocytapheresis or hemoexfusion.

If the attending physician prescribes blood sampling before the procedure for any tests, then the patient must come on an empty stomach. And after taking blood for analysis, the patient can immediately eat the sandwiches or something else during the procedure (in the chair). Tea or coffee will be offered by the clinic staff.

Purpose of treatment

• relief or significant reduction of symptoms of the disease
• normalization of indicators in the blood test: erythrocytes, hemoglobin, hematocrit, iron, viscosity
• improvement of the patient’s well-being, which is associated with a decrease in blood viscosity and an improvement in its microcirculation

Indications for use

• Secondary erythrocytosis
• Hemosiderosis
• Hemochromatosis
• Polycythemia

Contraindications

Contraindications are divided into absolute and relative.

Absolute (under no circumstances should the procedure be carried out):

• Presence of a focus of bleeding or high risk of recurrent bleeding
• presence of an unopened purulent focus
• allergic reactions to components used during the session

Relative (you can carry out the procedure, but under closer medical supervision, as well as in a situation where it is difficult to cope with the disease without a procedure):

• cardiovascular diseases in the stage of severe decompensation

90 130 hypotension (systolic blood pressure below 90 mm Hg.Art.)

• severe anemia (low hemoglobin level)
• severe hypoproteinemia (low blood protein level)
• phlebitis of peripheral veins in the acute stage
• no venous access
• alcohol intoxication or withdrawal symptoms
• acute stage of infectious diseases and inflammatory processes
• hemostasis disorders (decrease or absence of blood clotting)
• mental illness
• menstruation
• Threatened premature birth or miscarriage in early pregnancy

Complications

Serious complications with extracorporeal therapies are very rare.

A few complications include:

• bleeding from the vein puncture site (vascular access), which is quickly stopped by applying a tight bandage to the bleeding site
• Short-term feeling of dizziness due to small fluctuations in blood pressure during the procedure
• slight general weakness between procedures, which does not occur in everyone and does not affect the usual way of life
• allergic reactions to drugs used during the procedure

Even more rarely, the following sensations may occur:

• short-term headache and slight nausea associated with fluctuations in blood pressure during the procedure
• numbness or tingling in the area of ​​the nose, lips, fingers, which usually resolves spontaneously and quickly
• at the beginning of treatment, an exacerbation of the disease may occur

90 130 Muscle twitching is very rare and usually goes away on its own

More serious complications can arise in the treatment of serious diseases in patients who are initially in a serious condition, usually in the intensive care unit.

You can look at prices for services in the price list or check the phone number indicated on the website.

90,000 Good hemoglobin is not yet an indicator

Are you tired out of the blue? Your body may be lacking iron.

Doctors say that many Belarusians experience iron deficiency, but they don’t even know about it.

“There are concepts of iron deficiency anemia and latent iron deficiency,” she told 1prof.by Head of the Consulting Department of the Minsk Clinical Consultative and Diagnostic Center Tatyana Rachkova .

– Anemia is indicated by a low level of hemoglobin, but a latent state is when the level of hemoglobin is still normal, and iron stores are already depleted. One hundred percent confirmation of this condition is low ferritin levels. The development of iron deficiency can be caused by diseases of the gastrointestinal tract, and in women – gynecological problems. As practice shows, 30% of Belarusian women of reproductive age suffer from a latent form of iron deficiency, iron deficiency anemia occurs in 10%.This is a fairly large percentage, considering that I do not take into account pregnant and lactating women.

– What symptoms should make a person check the blood for ferritin and why is it about him?

– The level of ferritin always reflects the real picture of affairs, while serum iron is a rather subjective indicator, it can change for various reasons. As for the symptoms, it is better not to wait for them: any of us should have a routine blood test at least once a year.CBC and ferritin levels should be done overtime if you begin to feel unusual weakness during normal physical activity. Other common symptoms include: shortness of breath, a feeling of lack of air in a poorly ventilated room (although you previously tolerated such an environment quite calmly), light-headedness, brittle and depleted nails, hair loss, taste perversion: people want to eat dry buckwheat or chalk. To determine the cause of iron deficiency, it is necessary to undergo available examinations.For women, first of all, an examination by a gynecologist is shown, since even heavy menstruation can gradually deplete iron stores. The second step is, as the people say, “swallow the probe”. The fact is that a biopsy performed during this procedure will help determine the problem that interferes with the absorption capacity of the stomach. If it is reduced, then, of course, a person will receive less of many useful substances, including iron.

– It turns out that people who eat meat with meat can have anemia?

– Of course.If the absorption capacity of the gastrointestinal tract changes, no matter how much beef or by-products we eat, the body will receive less than it needs.

– Let’s say the root cause has been eliminated. Can you replenish your iron stores with food alone?

– No anemia can be cured solely by diet, since there is not enough iron in foods for the therapeutic effect. It requires taking special medications. When taken orally (pills), there will be no overdose: the body will remove the excess itself.An excess of iron, which is also dangerous to health, can cause intramuscular and intravenous injections. Therefore, you can not self-medicate, injections must be done strictly according to the appointment and under the supervision of a doctor.

– Are there any peculiarities of the development of iron deficiency in children?

– Yes. For example, babies whose mothers experienced a lack of an element during pregnancy are at risk. It should also be borne in mind that children of the first year of life grow very quickly and they need more iron than adults.That is why pediatricians advise to introduce complementary foods from the age of six months: oddly enough, but breast milk today contains less iron than special milk formulas. Another deficiency can provoke frequent infectious diseases (they require more iron intake). That is, if a child is healthy and is on an adequate, balanced diet, then, most likely, he is not threatened with iron deficiency. But in any case, a blood test is required once a year for babies.

– You mentioned “adequate” nutrition. Is vegetarianism a risk factor or is it the norm?

– I will answer this way. Iron is absorbed more intensively by our body in a bivalent (heme) form. Animal products contain just such iron, as well as essential amino acids and protein, which is necessary for the iron to be incorporated exactly where it needs to be. Plant food contains only ferric iron, that is, it is obviously absorbed much worse.If a vegetarian also has some concomitant health problems, we will definitely go to iron deficiency. I cannot dictate to a person his diet. But as a doctor, I am obliged to warn about such a development of events. It is clear that you do not need to overuse protein, but a complete rejection of it is also bad. Constantly replenishing iron with synthetic drugs is not an option. Iron in the form of tablets and vitamins is in a sense alien to the body. In fact, it is an aggressive chemical element that can cause micro-erosion during absorption.It is one thing when it is prescribed for medicinal purposes, and quite another when a person himself decided to make fun of the body, replacing food with a drug.

– Nowadays, doctors often prescribe a general blood test with an expanded leukocyte count. What it is?

– The general analysis includes only indicators of hemoglobin, platelets, leukocytes and erythrocytes. And they can be quite normal due to the adaptive capabilities of the body. And in the leukocyte formula, the percentage of various types of leukocytes is determined, which makes it possible to suspect even the prerequisites for some kind of problem or disease in the initial stage.Therefore, I insist on just such a detailed analysis.

– We spoke with you about low hemoglobin. And what does the increased rate indicate?

– About the fact that you need to draw attention to yourself. Many rejoice seeing in the analyzes a very high level and in vain. This condition is called symptomatic erythrocytosis.