Small size red blood cells. Microcytic Anemia: Understanding Small Red Blood Cells and Their Impact on Health
What are the symptoms of microcytic anemia. How is microcytic anemia diagnosed. What are the different types of microcytic anemia. How is microcytic anemia treated. What causes microcytic anemia. Can microcytic anemia be prevented. What are the long-term effects of untreated microcytic anemia.
The Basics of Microcytic Anemia: Defining Small Red Blood Cells
Microcytic anemia is a condition characterized by smaller-than-normal red blood cells and a reduced number of these cells in the body. This type of anemia occurs when the body struggles to produce sufficient hemoglobin, a crucial component of blood that transports oxygen to tissues and gives red blood cells their distinctive color.
To understand microcytic anemia, it’s essential to break down its key components:
- Microcytosis: The term used to describe red blood cells that are smaller than normal
- Anemia: A condition where the body has low numbers of properly functioning red blood cells
In microcytic anemia, both of these factors come into play, resulting in a decreased ability to transport oxygen effectively throughout the body.
Recognizing the Signs: Symptoms of Microcytic Anemia
Identifying microcytic anemia can be challenging in its early stages, as symptoms often manifest only when the condition has progressed significantly. However, being aware of the common signs can lead to earlier detection and treatment.
Common symptoms of microcytic anemia include:
- Fatigue and weakness
- Loss of stamina
- Shortness of breath
- Dizziness
- Pale skin
When should you seek medical attention for these symptoms? If you experience any of these signs and they persist for more than two weeks, it’s advisable to consult your doctor. In cases of severe dizziness or shortness of breath, immediate medical attention is warranted.
Unraveling the Causes: What Leads to Microcytic Anemia?
Microcytic anemia can stem from various underlying conditions, with iron deficiency being the most common cause. However, other factors can contribute to the development of this condition.
Iron Deficiency Anemia
Iron deficiency anemia is the primary cause of microcytic anemia. It can result from:
- Inadequate iron intake in the diet
- Impaired iron absorption due to conditions like celiac disease or Helicobacter pylori infection
- Chronic blood loss from heavy menstrual periods or gastrointestinal bleeding
- Increased iron demands during pregnancy
Thalassemia
Thalassemia is an inherited blood disorder characterized by abnormal hemoglobin production. This genetic condition can lead to microcytic anemia due to mutations in the genes responsible for normal hemoglobin synthesis.
Sideroblastic Anemia
Sideroblastic anemia can be either inherited (congenital) or acquired later in life. It affects the body’s ability to incorporate iron into hemoglobin components, resulting in iron accumulation within red blood cells.
Types of Microcytic Anemia: Understanding the Variations
Microcytic anemias can be further classified based on the amount of hemoglobin present in the red blood cells. This classification helps in understanding the specific characteristics of the condition and guides appropriate treatment strategies.
Hypochromic Microcytic Anemia
In hypochromic microcytic anemia, red blood cells contain less hemoglobin than normal, appearing paler in color. This is the most common type of microcytic anemia and includes conditions such as:
- Iron deficiency anemia
- Thalassemia
- Congenital sideroblastic anemia
Normochromic Microcytic Anemia
Normochromic microcytic anemia is characterized by red blood cells with normal hemoglobin levels but smaller size. This type is often associated with anemia of inflammation and chronic diseases, including:
- Infectious diseases (e.g., tuberculosis, HIV/AIDS)
- Inflammatory conditions (e.g., rheumatoid arthritis, Crohn’s disease)
- Kidney disease
- Cancer
Hyperchromic Microcytic Anemia
Although less common, hyperchromic microcytic anemia involves red blood cells with higher-than-normal hemoglobin levels. This type is rarely encountered in clinical practice and may be associated with specific genetic disorders.
Diagnosing Microcytic Anemia: The Path to Accurate Identification
Proper diagnosis of microcytic anemia is crucial for effective treatment. The diagnostic process typically involves a combination of clinical assessment, blood tests, and additional investigations to determine the underlying cause.
Complete Blood Count (CBC)
A CBC is the primary test used to diagnose microcytic anemia. It provides information on:
- Red blood cell count
- Hemoglobin levels
- Mean corpuscular volume (MCV) – a measure of red blood cell size
- Mean corpuscular hemoglobin (MCH) – the average amount of hemoglobin per red blood cell
In microcytic anemia, the MCV is typically below 80 femtoliters (fL).
Iron Studies
To assess iron status and differentiate between various causes of microcytic anemia, additional tests may be performed:
- Serum ferritin: A measure of iron stores in the body
- Serum iron: The amount of iron in the blood
- Total iron-binding capacity (TIBC): The blood’s capacity to bind transferrin with iron
- Transferrin saturation: The percentage of transferrin that is saturated with iron
Hemoglobin Electrophoresis
This test helps identify abnormal hemoglobin variants and is particularly useful in diagnosing thalassemia and other hemoglobinopathies.
Bone Marrow Examination
In some cases, a bone marrow biopsy may be necessary to evaluate iron stores and rule out other bone marrow disorders.
Treatment Approaches: Addressing Microcytic Anemia
The treatment of microcytic anemia depends on the underlying cause and severity of the condition. The primary goal is to restore normal red blood cell production and function.
Iron Supplementation
For iron deficiency anemia, oral iron supplements are the first-line treatment. These may include:
- Ferrous sulfate
- Ferrous gluconate
- Ferrous fumarate
In cases of severe anemia or poor absorption, intravenous iron therapy may be recommended.
Dietary Modifications
Incorporating iron-rich foods into the diet can help prevent and manage iron deficiency anemia. Some iron-rich foods include:
- Lean red meat
- Poultry
- Fish
- Beans and lentils
- Dark leafy greens
- Fortified cereals
Treating Underlying Conditions
For microcytic anemia caused by chronic diseases or genetic disorders, treatment focuses on managing the underlying condition. This may involve:
- Medications to control inflammation
- Blood transfusions for severe anemia
- Chelation therapy for iron overload in certain types of thalassemia
- Genetic counseling for inherited disorders
Prevention Strategies: Minimizing the Risk of Microcytic Anemia
While some causes of microcytic anemia cannot be prevented, there are steps you can take to reduce your risk:
Balanced Diet
Consuming a diet rich in iron and other essential nutrients can help prevent iron deficiency anemia. Include a variety of iron sources in your meals, such as:
- Animal-based sources: Red meat, poultry, fish
- Plant-based sources: Beans, lentils, tofu, spinach, fortified cereals
Vitamin C Intake
Vitamin C enhances iron absorption from plant-based sources. Consider pairing iron-rich foods with vitamin C-rich options like citrus fruits, bell peppers, or strawberries.
Regular Health Check-ups
Routine blood tests can help detect anemia early, allowing for prompt intervention. This is particularly important for individuals at higher risk, such as:
- Women of childbearing age
- Pregnant women
- Vegetarians and vegans
- Individuals with chronic health conditions
Managing Chronic Conditions
For those with chronic diseases that can lead to anemia, proper management of the underlying condition is crucial. This may involve:
- Adhering to prescribed medications
- Regular follow-ups with healthcare providers
- Lifestyle modifications as recommended by your doctor
Long-term Outlook: Understanding the Prognosis of Microcytic Anemia
The prognosis for microcytic anemia varies depending on the underlying cause and the timeliness of treatment. In many cases, particularly those related to iron deficiency, the outlook is positive with appropriate management.
Iron Deficiency Anemia
With proper iron supplementation and dietary changes, iron deficiency anemia typically resolves within 2-3 months. However, it’s essential to address the root cause to prevent recurrence.
Chronic Disease-Related Anemia
The prognosis for anemia related to chronic diseases depends on the management of the underlying condition. Effective treatment of the primary disease often leads to improvement in anemia symptoms.
Genetic Disorders
For inherited conditions like thalassemia, the long-term outlook varies based on the severity of the disorder. While there is no cure for these genetic conditions, advances in treatment have significantly improved quality of life and life expectancy for affected individuals.
Potential Complications
If left untreated, microcytic anemia can lead to various complications:
- Decreased cognitive function
- Impaired physical performance
- Increased susceptibility to infections
- Pregnancy complications (in cases of severe anemia)
- Heart problems, including an enlarged heart or heart failure (in long-standing, severe cases)
Regular monitoring and adherence to treatment plans are crucial for managing microcytic anemia effectively and preventing potential complications.
Emerging Research: New Frontiers in Microcytic Anemia Treatment
As our understanding of microcytic anemia continues to evolve, researchers are exploring new avenues for diagnosis and treatment. Some promising areas of investigation include:
Gene Therapy
For genetic disorders like thalassemia, gene therapy holds potential as a curative treatment. Clinical trials are underway to assess the safety and efficacy of various gene therapy approaches.
Novel Iron Formulations
Researchers are developing new iron formulations with improved bioavailability and fewer side effects. These innovations aim to enhance treatment outcomes for iron deficiency anemia.
Targeted Therapies
For anemia associated with chronic diseases, targeted therapies that address specific inflammatory pathways are being investigated. These treatments could potentially offer more effective management of anemia in complex medical conditions.
Artificial Intelligence in Diagnosis
The integration of artificial intelligence in analyzing blood test results and medical imaging could lead to more accurate and efficient diagnosis of microcytic anemia and its underlying causes.
As research progresses, these advancements may provide new hope for individuals affected by microcytic anemia, potentially offering more personalized and effective treatment options in the future.
Microcytic Anemia: Symptoms, Types, and Treatment
We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.
Healthline only shows you brands and products that we stand behind.
Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:
- Evaluate ingredients and composition: Do they have the potential to cause harm?
- Fact-check all health claims: Do they align with the current body of scientific evidence?
- Assess the brand: Does it operate with integrity and adhere to industry best practices?
We do the research so you can find trusted products for your health and wellness.
Read more about our vetting process.
Was this helpful?
Microcytic anemia means that you have smaller red blood cells than typical — and fewer of them.
It can result from an iron deficiency or a health condition.
Microcytic anemia definition
Microcytosis is a term used to describe red blood cells that are smaller than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body.
In microcytic anemias, your body has fewer red blood cells than normal. The red blood cells it does have are also too small. Several different types of anemias can be described as microcytic.
Microcytic anemias are caused by conditions that prevent your body from producing enough hemoglobin. Hemoglobin is a component of your blood. It helps transport oxygen to your tissues and gives your red blood cells their red color.
Iron deficiency causes most microcytic anemias. Your body needs iron to produce hemoglobin. But other conditions can cause microcytic anemias, too. To treat a microcytic anemia, your doctor will first diagnose the underlying cause.
You may not notice any symptoms of microcytic anemia at first.
Symptoms often appear at an advanced stage when the lack of normal red blood cells is affecting your tissues.
Common symptoms of microcytic anemias include:
- fatigue, weakness, and tiredness
- loss of stamina
- shortness of breath
- dizziness
- pale skin
If you experience any of these symptoms and they don’t resolve within two weeks, make an appointment to see your doctor.
You should make an appointment to see your doctor as soon as possible if you experience severe dizziness or shortness of breath.
Microcytic anemias can be further described according to the amount of hemoglobin in the red blood cells. They can be either hypochromic, normochromic, or hyperchromic:
1. Hypochromic microcytic anemias
Hypochromic means that the red blood cells have less hemoglobin than normal. Low levels of hemoglobin in your red blood cells leads to appear paler in color. In microcytic hypochromic anemia, your body has low levels of red blood cells that are both smaller and paler than normal.
Most microcytic anemias are hypochromic. Hypochromic microcytic anemias include:
Iron deficiency anemia: The most common cause of microcytic anemia is an iron deficiency in the blood. Iron deficiency anemia can be caused by:
- inadequate iron intake, usually as a result of your diet
- being unable to absorb iron due to conditions like celiac disease or Helicobacter pylori infection
- chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or inflammatory bowel disease
- pregnancy
Thalassemia: Thalassemia is a type of anemia that’s caused by an inherited abnormality. It involves mutations in the genes needed for normal hemoglobin production.
Sideroblastic anemia: Sideroblastic anemia can be inherited due to gene mutations (congenital). It can also be caused by a condition acquired later in life that impedes your body’s ability to integrate iron into one of the components needed to make hemoglobin.
This results in a buildup of iron in your red blood cells.
Congenital sideroblastic anemia is usually microcytic and hypochromic.
2. Normochromic microcytic anemias
Normochromic means that your red blood cells have a normal amount of hemoglobin, and the hue of red is not too pale or deep in color. An example of a normochromic microcytic anemia is:
Anemia of inflammation and chronic disease: Anemia due to these conditions is usually normochromic and normocytic (red blood cells are normal in size). Normochromic microcytic anemia may be seen in people with:
- infectious diseases, such as tuberculosis, HIV/AIDS, or endocarditis
- inflammatory diseases, such as rheumatoid arthritis, Crohn’s disease, or diabetes mellitus
- kidney disease
- cancer
These conditions can prevent red blood cells from functioning normally. This can lead to decreased iron absorption or utilization.
3. Hyperchromic microcytic anemias
Hyperchromic means that the red blood cells have more hemoglobin than normal.
High levels of hemoglobin in your red blood cells makes them a deeper hue of red than normal.
Congenital spherocytic anemia: Hyperchromic microcytic anemias are rare. They may be caused by a genetic condition known as congenital spherocytic anemia. This is also called hereditary spherocytosis.
In this disorder, the membrane of your red blood cells doesn’t form correctly. This causes them to be rigid and improperly spherical shaped. They are sent to be broken down and die in the spleen because they don’t travel in the blood cells properly.
4. Other causes of microcytic anemia
Other causes of microcytic anemia include:
- lead toxicity
- copper deficiency
- zinc excess, which causes copper deficiency
- alcohol use
- drug use
Microcytic anemias are often first spotted after your doctor has ordered a blood test known as a complete blood count (CBC) for another reason. If your CBC indicates that you have anemia, your doctor will order another test known as a peripheral blood smear.
This test can help spot early microcytic or macrocytic changes to your red blood cells. Hypochromia, normochromia, or hyperchromia can also be seen with the peripheral blood smear test.
Your primary care doctor may refer you to a hematologist. A hematologist is a specialist who works with blood disorders. They may be able to best diagnose and treat the specific type of microcytic anemia and identify its underlying cause.
Once a doctor has diagnosed you with microcytic anemia, they will run tests to determine the cause of the condition. They may run blood tests to check for celiac disease. They may test your blood and stool for H. pylori bacterial infection.
Your doctor might ask you about other symptoms you’ve experienced if they suspect that chronic blood loss is the cause of your microcytic anemia. They may refer you to a gastroenterologist if you have stomach or other abdominal pain. A gastroenterologist might run imaging tests to look for different conditions.
These tests include:
- abdominal ultrasound
- upper GI endoscopy (EGD)
- CT scan of the abdomen
For women with pelvic pain and heavy periods, a gynecologist may look for uterine fibroids or other conditions that could cause heavier flows.
Treatment for microcytic anemia focuses on treating the underlying cause of the condition.
Your doctor may recommend that you take iron and vitamin C supplements. The iron will help treat the anemia while the vitamin C will help increase your body’s ability to absorb the iron.
Your doctor will focus on diagnosing and treating the cause of the blood loss if acute or chronic blood loss is causing or contributing to microcytic anemia. Women with iron deficiency from severe periods may be prescribed hormonal therapy, such as birth control pills.
In cases of microcytic anemia so severe that you’re at risk for complications like cardiac failure, you may need to get a blood transfusion of donor red blood cells.
This can increase the number of healthy red blood cells that your organs need.
Treatment can be relatively straightforward if simple nutrient deficiencies are the cause of microcytic anemia. As long as the underlying cause of the anemia can be treated, the anemia itself can be treated and even cured.
In very severe cases, untreated microcytic anemia can become dangerous. It can cause tissue hypoxia. This is when the tissue is deprived of oxygen. It can cause complications including:
- low blood pressure, also called hypotension
- coronary artery problems
- pulmonary problems
- shock
These complications are more common in older adults who already have pulmonary or cardiovascular diseases.
The best way to prevent microcytic anemia is to get enough iron in your diet. Increasing your vitamin C intake can also help your body absorb more iron.
You can also consider taking a daily iron supplement. These are often recommended if you already have anemia.
You should always talk to your doctor before you start taking any supplements.
You can also try to get more nutrients through your food.
Foods rich in iron include:
- red meat like beef
- poultry
- dark leafy greens
- beans
- dried fruits like raisins and apricots
Foods rich in vitamin C include:
- citrus fruits, especially oranges and grapefruits
- kale
- red peppers
- Brussels sprouts
- strawberries
- broccoli
Microcytic Anemia: Symptoms, Types, and Treatment
We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.
Healthline only shows you brands and products that we stand behind.
Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:
- Evaluate ingredients and composition: Do they have the potential to cause harm?
- Fact-check all health claims: Do they align with the current body of scientific evidence?
- Assess the brand: Does it operate with integrity and adhere to industry best practices?
We do the research so you can find trusted products for your health and wellness.
Read more about our vetting process.
Was this helpful?
Microcytic anemia means that you have smaller red blood cells than typical — and fewer of them. It can result from an iron deficiency or a health condition.
Microcytic anemia definition
Microcytosis is a term used to describe red blood cells that are smaller than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body.
In microcytic anemias, your body has fewer red blood cells than normal. The red blood cells it does have are also too small. Several different types of anemias can be described as microcytic.
Microcytic anemias are caused by conditions that prevent your body from producing enough hemoglobin. Hemoglobin is a component of your blood. It helps transport oxygen to your tissues and gives your red blood cells their red color.
Iron deficiency causes most microcytic anemias. Your body needs iron to produce hemoglobin. But other conditions can cause microcytic anemias, too.
To treat a microcytic anemia, your doctor will first diagnose the underlying cause.
You may not notice any symptoms of microcytic anemia at first. Symptoms often appear at an advanced stage when the lack of normal red blood cells is affecting your tissues.
Common symptoms of microcytic anemias include:
- fatigue, weakness, and tiredness
- loss of stamina
- shortness of breath
- dizziness
- pale skin
If you experience any of these symptoms and they don’t resolve within two weeks, make an appointment to see your doctor.
You should make an appointment to see your doctor as soon as possible if you experience severe dizziness or shortness of breath.
Microcytic anemias can be further described according to the amount of hemoglobin in the red blood cells. They can be either hypochromic, normochromic, or hyperchromic:
1. Hypochromic microcytic anemias
Hypochromic means that the red blood cells have less hemoglobin than normal.
Low levels of hemoglobin in your red blood cells leads to appear paler in color. In microcytic hypochromic anemia, your body has low levels of red blood cells that are both smaller and paler than normal.
Most microcytic anemias are hypochromic. Hypochromic microcytic anemias include:
Iron deficiency anemia: The most common cause of microcytic anemia is an iron deficiency in the blood. Iron deficiency anemia can be caused by:
- inadequate iron intake, usually as a result of your diet
- being unable to absorb iron due to conditions like celiac disease or Helicobacter pylori infection
- chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or inflammatory bowel disease
- pregnancy
Thalassemia: Thalassemia is a type of anemia that’s caused by an inherited abnormality. It involves mutations in the genes needed for normal hemoglobin production.
Sideroblastic anemia: Sideroblastic anemia can be inherited due to gene mutations (congenital). It can also be caused by a condition acquired later in life that impedes your body’s ability to integrate iron into one of the components needed to make hemoglobin. This results in a buildup of iron in your red blood cells.
Congenital sideroblastic anemia is usually microcytic and hypochromic.
2. Normochromic microcytic anemias
Normochromic means that your red blood cells have a normal amount of hemoglobin, and the hue of red is not too pale or deep in color. An example of a normochromic microcytic anemia is:
Anemia of inflammation and chronic disease: Anemia due to these conditions is usually normochromic and normocytic (red blood cells are normal in size). Normochromic microcytic anemia may be seen in people with:
- infectious diseases, such as tuberculosis, HIV/AIDS, or endocarditis
- inflammatory diseases, such as rheumatoid arthritis, Crohn’s disease, or diabetes mellitus
- kidney disease
- cancer
These conditions can prevent red blood cells from functioning normally.
This can lead to decreased iron absorption or utilization.
3. Hyperchromic microcytic anemias
Hyperchromic means that the red blood cells have more hemoglobin than normal. High levels of hemoglobin in your red blood cells makes them a deeper hue of red than normal.
Congenital spherocytic anemia: Hyperchromic microcytic anemias are rare. They may be caused by a genetic condition known as congenital spherocytic anemia. This is also called hereditary spherocytosis.
In this disorder, the membrane of your red blood cells doesn’t form correctly. This causes them to be rigid and improperly spherical shaped. They are sent to be broken down and die in the spleen because they don’t travel in the blood cells properly.
4. Other causes of microcytic anemia
Other causes of microcytic anemia include:
- lead toxicity
- copper deficiency
- zinc excess, which causes copper deficiency
- alcohol use
- drug use
Microcytic anemias are often first spotted after your doctor has ordered a blood test known as a complete blood count (CBC) for another reason.
If your CBC indicates that you have anemia, your doctor will order another test known as a peripheral blood smear.
This test can help spot early microcytic or macrocytic changes to your red blood cells. Hypochromia, normochromia, or hyperchromia can also be seen with the peripheral blood smear test.
Your primary care doctor may refer you to a hematologist. A hematologist is a specialist who works with blood disorders. They may be able to best diagnose and treat the specific type of microcytic anemia and identify its underlying cause.
Once a doctor has diagnosed you with microcytic anemia, they will run tests to determine the cause of the condition. They may run blood tests to check for celiac disease. They may test your blood and stool for H. pylori bacterial infection.
Your doctor might ask you about other symptoms you’ve experienced if they suspect that chronic blood loss is the cause of your microcytic anemia. They may refer you to a gastroenterologist if you have stomach or other abdominal pain.
A gastroenterologist might run imaging tests to look for different conditions. These tests include:
- abdominal ultrasound
- upper GI endoscopy (EGD)
- CT scan of the abdomen
For women with pelvic pain and heavy periods, a gynecologist may look for uterine fibroids or other conditions that could cause heavier flows.
Treatment for microcytic anemia focuses on treating the underlying cause of the condition.
Your doctor may recommend that you take iron and vitamin C supplements. The iron will help treat the anemia while the vitamin C will help increase your body’s ability to absorb the iron.
Your doctor will focus on diagnosing and treating the cause of the blood loss if acute or chronic blood loss is causing or contributing to microcytic anemia. Women with iron deficiency from severe periods may be prescribed hormonal therapy, such as birth control pills.
In cases of microcytic anemia so severe that you’re at risk for complications like cardiac failure, you may need to get a blood transfusion of donor red blood cells.
This can increase the number of healthy red blood cells that your organs need.
Treatment can be relatively straightforward if simple nutrient deficiencies are the cause of microcytic anemia. As long as the underlying cause of the anemia can be treated, the anemia itself can be treated and even cured.
In very severe cases, untreated microcytic anemia can become dangerous. It can cause tissue hypoxia. This is when the tissue is deprived of oxygen. It can cause complications including:
- low blood pressure, also called hypotension
- coronary artery problems
- pulmonary problems
- shock
These complications are more common in older adults who already have pulmonary or cardiovascular diseases.
The best way to prevent microcytic anemia is to get enough iron in your diet. Increasing your vitamin C intake can also help your body absorb more iron.
You can also consider taking a daily iron supplement. These are often recommended if you already have anemia.
You should always talk to your doctor before you start taking any supplements.
You can also try to get more nutrients through your food.
Foods rich in iron include:
- red meat like beef
- poultry
- dark leafy greens
- beans
- dried fruits like raisins and apricots
Foods rich in vitamin C include:
- citrus fruits, especially oranges and grapefruits
- kale
- red peppers
- Brussels sprouts
- strawberries
- broccoli
Erythrocyte indices – what is a color index
Erythrocytes
Erythrocytes (red blood cells) – blood cells that carry oxygen from the lungs to tissues and organs, and transport carbon dioxide back.
Normally, erythrocytes look like discs, concave on both sides. Due to this shape, they are more elastic and penetrate even the narrowest vessels.
Unlike most other cells, erythrocytes do not have a nucleus: 98% of their volume is occupied by hemoglobin is a protein that binds oxygen.
In one day, the red blood cells of an adult carry about 800 liters of oxygen and 200 liters of carbon dioxide.
In addition, these cells are involved in the transport of nutrients and help maintain acid-base balance.
In the form of a blood test, erythrocytes are designated by the Latin letters RBC – red blood cells (red blood cells).
What are erythrocyte indices
Red blood cell indices are indicators that measure the size of red blood cells and their hemoglobin content. Indices are considered fairly stable parameters, since they characterize not the number of erythrocytes, but their physiological properties.
Color value
Color indicator reflects the degree of saturation of the erythrocyte with hemoglobin: the more hemoglobin, the more red the erythrocyte will be.
Normal: 0.85 – 1.00. The indicator is measured in calculation units.
If the color index is above the norm, it is considered hyperchromic. The color index is below normal – hypochromic.
Main causes of hyperchromia
Pernicious anemia (megaloblastic, B12-deficient) is a pathology in which the maturation of red blood cells in the bone marrow is impaired due to poor absorption of vitamin B12.
Folate deficiency anemia is a disorder of hematopoiesis in the bone marrow associated with folic acid deficiency. The disease is often diagnosed together with iron deficiency anemia. It is especially dangerous for pregnant women, as it can lead to impaired development of the fetal nervous system.
Myelodysplastic syndrome is an oncological disease in which the normal maturation of all blood cells in the bone marrow is disturbed. Risk factors for the development of the disease: radiation therapy, chemotherapy, smoking, exposure to heavy metals (mercury, lead).
Main causes of hypochromia
Posthemorrhagic anemia is a condition associated with acute or chronic blood loss.
The main symptoms are: pallor, shortness of breath, darkening of the eyes, and in severe cases – lethargy, thready pulse, loss of consciousness.
Acute posthemorrhagic anemia is associated with rapid massive blood loss in trauma, surgery, gastric and duodenal ulcers, ectopic pregnancy. Chronic – due to frequent loss of a small amount of blood. This happens with gastrointestinal, nasal, uterine bleeding, as well as with diseases associated with impaired blood clotting.
Frequent nosebleeds can lead to chronic posthemorrhagic anemia
Iron deficiency anemia is a condition in which there is not enough iron in the body, which is necessary for the normal synthesis of hemoglobin. Most often, such anemia develops due to chronic blood loss or impaired iron intake. In addition, iron deficiency anemia occurs in people with increased iron consumption: women of reproductive age (due to monthly blood loss during menstruation), pregnant women, as well as children and adolescents (due to intensive body growth).
Anemia associated with lead toxicity is a condition commonly found in industrial workers. Lead is a heavy toxic metal. It blocks the enzymes necessary for the synthesis of hemoglobin. As a result, the hemoglobin content in the erythrocyte decreases.
Deviation towards hyperchromia (oversaturation with hemoglobin) is often combined with an increase in the size of red blood cells. This condition is called macrocytosis or megalocytosis. Conversely, with hypochromia (lack of hemoglobin), the size of red blood cells is usually lower: this is microcytosis.
Recently, instead of studying the color index, the determination of MCH is increasingly used – the average hemoglobin content in the erythrocyte.
Mean erythrocyte hemoglobin (MCH)
The mean concentration of hemoglobin in one erythrocyte (MCH) shows the mass of iron-containing protein in one red cell. Measured in picograms (pg): 1 pg is one trillionth of a gram.
The indicator depends on the gender and age of the patient. The highest values are observed in newborns under the age of 14 days. Then, as they grow older, MCH gradually decreases and equalizes with the norm for adults.
MCH norm for children under 18
Age of the child | MCH reference values, pg |
| 9 0098 1 day after birth | 27–33 |
2 to 13 days after birth | 27–33 |
14 to 23 days after birth | 27–33 |
24 to 30 days after birth | 27-33 |
1-3 months 9000 7 | 26.3–32.3 |
4–5 months | 25–29 |
6–7 months | 26–30 | 8-11 months | 25-31 |
12 months — 2 years | 22-32 |
2-3 years | 22. |
4-9 years | 22.7–32.7 |
10-14 | 25-35 |
15-18 | 26-34 |
15-18 | 27- 32 |
3-32.3MCH norm for women
Woman’s age | MCH reference values, pg 0098 18-44 | 27-34 |
45-64 | 27-34 | |
65 and over | 27-35 |
Male age | MCH reference values, pg 0098 18-44 | 27-34 |
45-64 | 27-35 | |
65 and over | 27-34 |
blood 140 ₽
blood 140 ₽
Age of the child | Reference MCHC values, g/l |
1 day – 1 month | 316–375 |
2-5 months | 306-324 |
6-7 months | 307-324 |
8 months – 1 year | 297-324 |
2 years | 307-344 |
3-9 years | 3 36–344 |
10–14 years | 336–354 |
15-18 | 300-380 |
In adults (men and women), normal MCHC values are independent of age and range from 300-380 g/l.
The reasons for the lower and higher MCHC index are the same as for the previous indicator, MCH.
Mean erythrocyte volume (MCV)
Erythrocyte index MCV (mean cell volume) characterizes the size of red blood cells contained in the blood. The indicator is measured in femtoliters (fl).
A femtoliter is a unit of volume equal to one cubic micrometer (one millionth of a metre).
If the erythrocytes are too large in size, then it is difficult for them to pass through the small capillaries. If they are too small, they cannot carry enough oxygen. In both cases, the risk of hypoxia, i.e. oxygen starvation of tissues, increases significantly.
MCV norm for children under 18
Child’s age | MCV reference values, fl |
1 day – 1 month | |
1 month | 84-96 |
2-3 months | 74-86 |
4-7 months | |
8 months – 1 year | 72-84 |
2-9 years | 77-83 | 10-14 years old | 81-87 |
15- 17 years old | 80–100 |
In adults (men and women), normal MCV values do not depend on age and are 80-100 fl.
Reducing the size of red blood cells is called microcytosis.
Main causes of microcytosis
Iron deficiency anemia is a condition in which there is not enough iron in the body, which is necessary for the normal synthesis of hemoglobin.
Hereditary anemias are hereditary diseases in which the synthesis of red blood cells is impaired, and their life span is significantly less than that of normal red blood cells.
Hemoglobinopathy is a congenital pathology in which the structure of the hemoglobin protein is disturbed and it can no longer transport oxygen normally from the lungs to the tissues.
Main causes of macrocytosis
Pernicious anemia (megaloblastic, B12-deficient) is a violation of the formation of red blood cells in the bone marrow, provoked by vitamin B12 deficiency.
Folate deficiency anemia is a violation of the synthesis of red blood cells associated with a lack of folic acid.
This condition can be caused by liver diseases (hepatitis, cirrhosis), oncological diseases, long-term use of drugs, such as anticonvulsants, cytostatics, certain antibiotics, etc.
RBC heterogeneity index by volume (RDW)
The RDW (red cell distribution width) index of erythrocyte heterogeneity by volume shows how erythrocytes differ from each other in size. The indicator is measured as a percentage.
In children under the age of 6 months, the normal value of RDW is 14.9-18.7%. In children older than 6 months, adolescents and adults – 11.6–14.8%.
A decrease in the RDW index has no clinical significance. And an increase, as a rule, is observed at iron deficiency anemia – a pathological condition in which the synthesis of red blood cells and hemoglobin is impaired due to a lack of iron in the body.
Erythrocyte indices: indications for testing
The study of erythrocyte indices is included in the general blood test, which is prescribed in a planned manner: during the annual preventive examination, as well as when anemia is suspected.
The test is repeated for patients who are being treated for anemia.
Complete blood count without leukocyte formula (venous blood)
Ven. blood (+140 ₽) 21 1 day
21 bonus
210 ₽
Add to cart
1 day
Ven. blood 140 ₽
Complete blood count extended with leukocyte formula and reticulocytes (only venous blood)
Ven. blood (+140 ₽) 53 1 day
53 bonuses
530 ₽
Add to cart
1 day
Ven. blood 140 ₽
Clinical blood test with leukocyte formula and ESR (with microscopy of a blood smear when pathological changes are detected) (venous blood)
Ven. blood (+140 ₽) 43 1 day
43 bonuses
430 ₽
Add to cart
1 day
Ven. blood 140 ₽
Diagnosis of causes of anemia
If anemia is detected by the deviation of erythrocyte indices from the norm, it is necessary to establish the cause of its development. To do this, the therapist can prescribe additional tests or refer the patient to another doctor, for example hematologist – a specialist in the treatment of diseases of the blood and blood-forming organs.
Iron deficiency anemia
If iron deficiency anemia is suspected, it is advisable to investigate the indicators of iron metabolism: ferritin, transferrin, total serum iron-binding capacity (TIBC), serum iron level and transferrin iron saturation coefficient.
Ferritin
Ven. blood (+140 ₽) 48 1 day
48 bonuses
480 ₽
Add to cart
1 day
Ven. blood 140 ₽
Transferrin
Ven. blood (+140 ₽) 45 1 day
45 bonuses
450 ₽
Add to cart
1 day
Ven. blood 140 ₽
OZhSS (serum iron, LZhSS)
Ven. blood (+140 ₽) 22 1 day
22 bonuses
220 ₽
Add to cart
1 day
Ven. blood 140 ₽
Serum iron
Ven. blood (+140 ₽) 21 1 day
21 bonus
210 ₽
Add to cart
1 day
Ven. blood 140 ₽
Transferrin saturation coefficient
Ven. blood (+140 ₽) 52 1 day
52 bonuses
520 ₽
Add to cart
1 day
Ven.
blood 140 ₽
Anemia of chronic disease
In order to diagnose anemia of chronic disease, it is common not only to perform a complete blood count and serum iron test, but also to measure the amount of ferritin, transferrin, and reticulocytes.
Complete blood count extended with leukocyte formula and reticulocytes (only venous blood)
Ven. blood (+140 ₽) 53 1 day
53 bonuses
530 ₽
Add to cart
1 day
Ven. blood 140 ₽
Ferritin
Ven. blood (+140 ₽) 48 1 day
48 bonuses
480 ₽
Add to cart
1 day
Ven. blood 140 ₽
Transferrin
Ven. blood (+140 ₽) 45 1 day
45 bonuses
450 ₽
Add to cart
1 day
Ven. blood 140 ₽
Serum iron
Ven. blood (+140 ₽) 21 1 day
21 bonus
210 ₽
Add to cart
1 day
Ven. blood 140 ₽
Tests will help determine the severity of the general condition with anemia.
Biochemistry 8 indicators
Ven. blood (+140 ₽) 116 1 day
116 bonuses
1,160 ₽
Add to cart
1 day
Ven. blood 140 ₽
Biochemistry 13 indicators
Ven. blood (+140 ₽) 193 1 day
193 bonuses
1,930 ₽
Add to cart
1 day
Ven. blood 140 ₽
Biochemistry 21 indicators (extended)
Ven. blood (+140 ₽) 375 1 day
375 bonuses
3,750 ₽
Add to cart
1 day
Ven. blood 140 ₽
C-reactive protein
Ven. blood (+140 ₽) 33 1 day
33 bonuses
330 ₽
Add to cart
1 day
Ven. blood 140 ₽
Urinalysis
Urine 24 1 day
24 bonuses
240 ₽
Add to cart
1 day
Urine 0 ₽
Folate deficiency anemia
To diagnose folate deficiency anemia, in addition to a complete blood count with reticulocytes, a blood test for folate is prescribed to establish the fact of folate deficiency.
Complete blood count extended with leukocyte formula and reticulocytes (only venous blood)
Ven. blood (+140 ₽) 53 1 day
53 bonuses
530 ₽
Add to cart
1 day
Ven. blood 140 ₽
Folates
Ven. blood (+140 ₽) 80 1 day
80 bonuses
800 ₽
Add to cart
1 day
Ven. blood 140 ₽
B12 deficiency anemia
To make a diagnosis of “B12-deficiency anemia”, together with a general blood test, an analysis for vitamin B12 is prescribed, which allows to detect its deficiency in the blood serum.
Complete blood count extended with leukocyte formula and reticulocytes (only venous blood)
Ven. blood (+140 ₽) 53 1 day
53 bonuses
530 ₽
Add to cart
1 day
Ven. blood 140 ₽
Vitamin B12
Ven. blood (+140 ₽) 63 1 day
63 bonuses
630 ₽
Add to cart
1 day
Ven. blood 140 ₽
Anemia
Anemia is a pathological condition caused by a decrease in the number of red blood cells and / or a decrease in the concentration of hemoglobin in the red blood cells themselves.
Erythrocytes (red blood cells, red blood cells, RBC) – the most numerous population of blood cells. Red blood cells contain hemoglobin (Hb), which in the lungs attaches oxygen molecules and delivers them to tissues. In the opposite direction – from the tissues to the lungs – hemoglobin carries carbon dioxide molecules. In other words, hemoglobin provides the process of respiration. The erythrocyte has the shape of a disc, concave on both sides. Such a device significantly increases the surface area on which gas exchange occurs. Erythrocytes are small in size, which allows them to pass through the narrowest blood vessels (capillaries, arterioles, venules). One erythrocyte lives on average up to 120 days.
Low hemoglobin is one of the criteria that you need to pay attention to not only when diagnosing anemia itself, but also to assess their severity. A decrease in the amount of hemoglobin in erythrocytes occurs when there is insufficient supply of iron during the maturation of cells in the red bone marrow.
There are several classifications of anemia depending on the causes, on the mechanisms of development of anemia and on the severity of changes in blood parameters. They are necessary for the doctor to understand what the current condition is connected with. This helps to choose the best tactics for further examination, to conduct a differential diagnosis and prescribe an effective treatment.
Anemia is diagnosed and treated by general practitioners, general practitioners, and family physicians. In the case of a severe or malignant course of the disease, the intervention of a hematologist may be required, as well as a more detailed and specialized examination.
There are many reasons for the development of anemia. Anemia is often a complication of an underlying chronic disease.
Iron deficiency anemia develops either when there is insufficient intake of iron in the body, or when the body has an increased need for iron.
Both factors are often present to varying degrees.
The causes of insufficient iron intake can be diseases of the gastrointestinal tract, in which the processes of digestion and absorption of food are disturbed. The use of foods containing low amounts of iron or iron in a form that is difficult to digest (only a plant-based diet). Some foods (alcohol, milk, coffee) or drugs (antibacterials, antacids) interfere with the absorption of iron from food.
The body’s need for iron (“iron consumption”) increases significantly in children during periods of active growth, in women during pregnancy and lactation.
Anemia often complicates the course of diseases accompanied by prolonged blood loss (especially against the background of malabsorption of food):
- peptic ulcer of the stomach and duodenum;
- inflammatory bowel disease;
- uterine fibroids, endometriosis;
- malignant neoplasms;
- bleeding disorders;
- helminthic infestations.
The human body cannot synthesize iron! We get iron only from food.
What matters is not only the amount of iron in foods, but also its availability for absorption by the body. Animal products (beef, lamb, liver) contain heme iron. It is absorbed by the body most effectively. Plant foods (vegetables, fruits, cereals) contain non-heme iron. The human body does not absorb non-heme iron well.
The main reason for the development of iron deficiency anemia, according to experts from the World Health Organization (WHO), is an unhealthy (unbalanced) diet. If you do not eat meat products, then you must remember that iron is absorbed much worse from vegetable products. Plan your diet wisely to prevent iron deficiency.
Improve iron absorption:
| Impair iron absorption:
|
Another type of anemia is a disease caused by vitamin B12 deficiency.
B12 deficiency anemia develops due to a lack of cyanocobalamin.
Deficiency can be caused by:
- Insufficient intake of vitamin B12 from food (strict vegetarianism), since cyanocobalamin is found only in meat products, milk, eggs, fish and seafood.
- Violation of the secretion of the stomach “intrinsic factor Castle”;
- Malabsorption of vitamin B12 in the small intestine;
- Competitive consumption of vitamin B12;
- Increased consumption of vitamin B12;
- Decreased vitamin B12 stores;
- Violation of vitamin B12 transport;
- Absence or antibodies to transcobalamin.
Anemia symptoms:
- Paleness of the skin, cracks, “bites” in the corners of the mouth
- Brittle nails, thinning and striation of nails
- Hair loss, brittleness, structure disorder
- Increased fatigue, reduced performance
- Palpitations, dizziness, shortness of breath accompany even slight physical activity
Iron deficiency anemia is characteristic
- Taste perversion: addiction to inedible foods – raw meat, frozen semi-finished products; desire to eat inedible substances – chalk, earth, ice, clay.
- Perversion of smell: addiction to unpleasant odors, e.g. gasoline, acetone, paint, etc.
What tests can be done for those who suspect anemia? The most accessible and simplest is a complete blood count
- Complete blood count (without leukocyte formula and without ESR), venous blood.
If the analysis reveals changes in the number of erythrocytes, hemoglobin, hematocrit, erythrocyte indices (MCV, MCH, MCHC, RDW), then it is necessary to consult a doctor to prescribe further examination and treatment.
For reference:
Hematocrit (Ht) is an indicator that characterizes the number of cells per unit volume of whole blood. The value of hematocrit depends on the number and shape of red blood cells. A decrease in hematocrit also characterizes a decrease in the content of red blood cells in the blood.
MCV ( mean corpuscular volume) In the presence of long-term iron deficiency, maturing red blood cells become small, microcytes appear in the blood, and the MCV decreases.
If there is a deficiency of vitamins B12 and B9maturing cells become large, macrocytes appear in the blood, and this indicator increases. Both conditions negatively affect the main function of red blood cells – the transport of oxygen and carbon dioxide. In the case of macrocytic anemia, their ability to pass through small-diameter vessels is reduced, and their life span is reduced.
MCH ( mean corpuscular hemoglobin) – the average content of hemoglobin in the erythrocyte, reflects the same processes as the previous MCV indicator. With a prolonged iron deficiency, erythrocytes enter the bloodstream, which, in the process of growth and maturation, lacked this microelement, and they become not only small, but also insufficiently saturated with hemoglobin. MCH begins to decrease, a state of hypochromia develops. Erythrocytes become pale, their functioning worsens. Previously, to assess the state of hemoglobin saturation of erythrocytes, a color indicator was calculated, MCH is its modern, more accurate analogue and allows differentiating anemia into normochromic, hypochromic and hyperchromic.
In case of deficiency of vitamins B12 and B9the reverse situation occurs. Ripening erythrocytes are supersaturated with hemoglobin, this indicator begins to increase, a state of hyperchromia develops. Together, these two indicators will help the doctor only on the basis of the results of a general blood test to suggest the nature of anemia.
MCHC mean corpuscular hemoglobin concentration) Reflects the concentration of hemoglobin in the erythrocyte. It decreases with iron deficiency hypochromic anemia and diseases accompanied by impaired hemoglobin synthesis at any stage. Increases with hyperchromic B12 and B9deficiency anemia.
red blood cell distribution width This indicator depends on the average volume of the erythrocyte, therefore, with an increase or decrease in MCV, its increase is observed, which indicates in favor of the fact that there are cells of different volumes in the blood, for example, macrocytes and normocytes, or microcytes and normocytes.
For a comprehensive examination, when the cause of anemia is unknown, you can use the program Biochemical diagnosis of anemia, which includes parameters reflecting the metabolism and stock of iron in the body, the supply of vitamin B9(folic acid) and vitamin B12 (cyanocobalamin), as well as erythropoietin, a hormone that triggers erythropoiesis (the maturation of new red blood cells).
- Transferrin – carries out extracellular transport of iron to all cells of the human body.
- Soluble transferrin receptors (sTfR). One of the important diagnostic criteria, on the basis of which a true iron deficiency can be established. The entry of iron into the cell occurs after the interaction of the “iron-transferrin” complex with specific proteins – receptors on the cell membrane. The concentration of transferrin receptors depends on two factors – the amount of iron deposited in ferritin and the proliferative activity of the cell. The amount of soluble transferrin receptors is a sensitive indicator of both erythropoiesis activity and iron deficiency.
