Red Blood Cell Count High

Red Blood Cell Count High

Red blood cells, also called erythrocytes or red blood cells, are cells present in the blood whose primary function is to transport oxygen from the vessels to the tissues. In this article, we will give you a complete guide about red blood cell count high. They have a particular shape, a biconcave disc, about eight micrometers in diameter and have a flexible wall, able to adapt to the passage through the wall of blood vessels, even the smallest ones. Furthermore, mature red blood cells are more facilitated in the movement even though the smallest vessels lack a nucleus and other cytoplasmic structures.

They mainly contain water, potassium, and hemoglobin; the latter is a protein structure consisting of four subunits, two alpha and two betas, folded back on themselves, in the center of an Eme group containing an iron atom. Each sub-unit can bind an oxygen atom so that a hemoglobin molecule can contain up to four oxygen atoms in total.

On average, there are about five million erythrocytes for every microliter of blood.

Red blood cell count high production

Red blood cells in adults are formed in the bone marrow of the axial skeleton (head, trunk, and extremities proximal to the limbs). While during fetal development, their formation occurs first in the yolk sac, subsequently in the liver and spleen, and finally in the bones. The first cells produced are the proerythroblasts, which mature into erythroblasts, reticulocytes, and finally erythrocytes through a series of cell divisions. During this process, the progenitor cell loses the nucleus, the Golgi apparatus, and the nucleolus. Erythropoiesis is a highly selective process, regulated by the hormone erythropoietin, which inhibits the maturation of cells that are not suitable for development and stimulates adequate progenitors’ growth.

Blood groups

Antigenic proteins that determine the blood group, and possibly the Rh factor, may be exposed on the membrane. Antigenic proteins can be A, B, both or neither, and determine the blood group:

  • Group 0: no antigen
  • Group A: antigen A
  • So group B: antigen B
  • Group AB: both antigens

What are they for?

Red blood cells have various vital functions for the body, but the primary function is to transport oxygen from the lungs to the tissues; erythrocytes can capture up to four oxygen atoms at the level of the pulmonary capillaries and travel in the bloodstream to supply the cells and tissues of the whole organism. Furthermore, hemoglobin in the fetus has a different structure, with a greater affinity for oxygen than an adult.

Red blood cell count high: Normal values

Being an important indicator of our state of health, the number of erythrocytes must remain stable and fall within specific values.

  • 7 – 6.1 x10 6 per microliter in men;
  • 2 – 5.4 x10 6 per microliter in women.

Since the reference ranges may vary from one laboratory to another, we suggest that you trust the content found on your diagnostic test report.

Red blood cell count high

Erythrocytosis is defined as those conditions characterized by increased production of Red blood cell count high.

In this case, we must distinguish:

  • Primary erythrocytosis or polycythemia: An increase in red blood cells for no apparent reason.
  • Secondary polycythemia: the growth of
  • Red blood cells.
  • White blood cells.
  • And platelets.

It occurs in the case of

  • dehydration, for example, from.
  • Excessive sweating.
  • Prolonged vomiting and diarrhea.
  • burns
  • and also, in diabetic subjects in which there is no effective glycemic control, glucose binds to two water molecules, eliminating them.

In other cases, however, the amount of plasma is average (there is no dehydration), while the red blood cells are in high concentration; it can occur in case of intense erythropoiesis, for example, if the amount of erythropoietin increases, in case of neoplastic diseases or other conditions (such as polycythemia vera ). An increase in circulating Red blood cell count high is also found in situations in which this represents an attempt by the body to compensate for other dysfunctions, for example:

  • Lung diseases in which the patient cannot breathe properly and absorb enough oxygen (the body tries to compensate by making more red blood cells).
  • Congenital heart disease: the heart is unable to pump blood effectively and, to compensate for the reduction in the amount of oxygen reaching the tissues, the production of erythrocytes increases.
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Low red blood cells: Red Blood Cell Count High

The causes that can determine a concentration of red blood cells below the norm can be enclosed in two macro-categories:

  • excessive destruction of red blood cells,
  • deficient production of red blood cells by the bone marrow.

Causes related to excessive destruction of erythrocytes

If the number of red blood cells is low, it could be because our body is destroying these cells or that there is excessive blood loss (hemorrhage). The most frequent causes, in this case, are the following:

  • Hemorrhage (loss of blood in a considerable amount). Bleeding can occur following an injury, but also in case of hefty menstrual flow. More dangerous are occult bleeding, which generally affects the gastrointestinal tract and which can, in turn, be caused by tumors or polyps.
  • Hemolytic anemia. Hemolytic anemia is a disease that causes excessive destruction of erythrocytes, which requires specific treatment.

Causes related to a reduction in the production of erythrocytes

If blood tests show low red blood cells, the causes could be related to dysfunction or disease affecting the bone marrow. This naturally determines a lower production of erythrocytes, resulting in lower quantities in the blood.

Among the most common causes we remember:

  • Mediterranean anemia.
  • Nutritional deficiencies: a deficiency of vitamin B9 ( folic acid ). And vitamin B12 can lead to a lack of iron and red blood cells over time. Nutritional iron deficiencies may also depend on other factors: pregnant women. For example, may experience a shortage of this nutrient and must often integrate it into the body.
  • Sickle cell anemia, a condition in which red blood cells took on a crescent shape (which causes more incredible difficulty in moving into smaller vessels) and shortened life expectancy (10-20 days).
  • Therapies such as chemotherapy or radiotherapy.
  • Exposure to ionizing radiation.
  • Leukemia.

The diagnostic evaluation of the mean corpuscular volume (MCV) can be useful to clarify the differential diagnosis between iron deficiency and thalassemia:

  • an MCV / RBC ratio of fewer than 13 points to thalassemia.
  • A rate greater than 13 suggests a possible iron deficiency.

Iron deficiency anemia: Red Blood Cell Count High

The most frequent cause in clinical practice of an insufficient number of red blood cells is probably iron deficiency anemia, which is

  • anemia: decrease in hemoglobin concentration,
  • iron deficiency: due to iron deficiency.

This condition can be symptom-free, mainly when it occurs gradually without ever becoming excessively severe (thus giving the body time and a way to establish compensation mechanisms), or manifest itself with the appearance of:

  • tiredness and weakness ( asthenia ).
  • Paleness.
  • Headache.
  • Insomnia.
  • Shortness of breath and shortness of breath.

And, in the most severe cases, too

  • chest pain.
  • Dizziness.

If there is not enough iron in the body, it will not be possible to produce the required amount of red blood cells, and the cause is usually found in the following possibilities:

  • Insufficient intake with nutrition.
  • Heavy menstruation.
  • Hemorrhage.
  • Reduced absorption from the diet (for example, due to drugs or illness).

Low red blood cells, what to do? When to worry?

The finding of low erythrocyte values ​​is quite common in clinical practice. Only rarely is it indicative of serious diseases; nevertheless, it is always necessary to contact the doctor for a correct differential diagnosis (among the possible causes seen above) and the relative indications on how to remedy it.

High Hematocrit – Causes

Possible Causes of High Hematocrit

  1. Dehydration: Red Blood Cell Count High
  • Excessive sweating: due to dehydration, the liquid part of the blood is reduced; consequently, the ratio between figured elements and plasma increases and with it the hematocrit.
  • It should be noted that dehydration can be induced, not only by excessive sweating. The use of diuretics, burns, vomiting, diarrhea, and diabetes ( glycemic values above 180 mg/dl are accompanied by urinary elimination of glucose which, for osmotic gradient, brings with it considerable quantities of water ).
  • Even cholera, a disease that causes massive water losses through feces because sensitive hematocrit rises.
  • In all these cases, the hematocrit value does not correspond to an actual increase in circulating erythrocytes (we, therefore, speak of haemoconcentration).
  1. Other possible causes
  • Stay at altitudes over 2,500 meters for at least a week (see: training and size).
  • Acute renal failure.
  • Polycythemia or absolute polyglossia (increased number of red blood cells, with standard plasma component).
  • Taking doping drugs: testosterone and derivatives; second generation ( Aranesp ® and Nespo®: darbepoetin alfa) and third-generation ( Mircera ®: Cera) erythropoietin and derivatives (generically defined epoetins).
  • Pulmonary pathologies.
  • Congenital cardiovascular diseases.
  • Because a high hematocrit is dangerous.
  • Blood that is too thick encounters more significant difficulties in its path. The heart, consequently, has to contract with greater force to overcome peripheral resistances and impart considerable pressure to the blood.
  • For this reason, a hematocrit that is too high can worsen pre-existing heart diseases and overcome the resistance of the vessels causing, for example, a very dangerous cerebral hemorrhage.
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A high hematocrit also favors blood clots’ formation ( thrombi ), which can occlude important vessels, with all the negative consequences of the case ( heart attack and stroke in the most severe cases).

Low Hematocrit – Causes

Possible Causes of Low Hematocrit

  • In these cases, the hematocrit value is misleading, as it is slower than usual, despite the blood containing an adequate amount of red blood cells. An increase in the liquid part of the blood improves performance levels. In fact, with the same circulating red blood cells, more fluid blood will encounter less resistance along its path, with a consequent increase in systolic output and blood flow to the tissues.
  • Iron deficiency.
  • Deficiency of vitamin B12.
  • Folic acid deficiency.
  • Leukemia.
  • Malignant tumors.
  • Anemias (autoimmune hemolytic or Red blood cell count high defects; aplastic anemia; sickle cell anemia etc.)
  • Cirrhosis of the liver.
  • Severe infections.
  • Chronic renal failure.
  • Acute or chronic bleeding from the digestive tract or other organs (such as the bladder or uterus ) or following severe trauma (blood loss causes a decrease in both plasma and corpuscular levels).
  • Decreased hemoglobin production (e.g., thalassemia ).
  • Exposure to toxins and radiation.
  • Chronic inflammatory diseases.

Low hematocrit: associated symptoms

Pallor, weakness, headache, decreased vision, malaise, and easy fatigue: are just some of the symptoms classically associated with the pathological reduction in the number of circulating red blood cells.

Other factors: Red Blood Cell Count High

Some factors can significantly influence the amount of circulating red blood cells, among the most important are:

  • Although rare, excessive hydration can also lead to the same result.
  • Living at high altitudes leads to higher values because the body reacts to the decrease in oxygen by increasing erythrocytes’ production.
  • By the same principle, the habit of smoking causes an increase in values.

Red blood cell count high: Preparation

The blood test for Red blood cell count high involves a regular venous sampling; it does not require any specific preparation, nor to have fasted, but is often prescribed at the same time as other parameters that may need to be evaluated after a fast of at least 8 hours.

Red blood cell count high: laboratory tests

The number of red blood cells present in the blood can be easily detected on the blood sample through various tests. Complete blood count or blood count.

  • Red blood cells.
  • White blood cells.
  • Platelets.
  • Hemoglobin.
  • And basophils.

Present in a microliter of blood.

The average value in women is between 4.2 – 5.4 x10 6 per microliter, while between 4.7 – 6.1 x10 6 per microliter in men.


The hematocrit analysis is used to evaluate the percentage of red blood cells present in the blood sample. After having subjected the tube to centrifugation, the plasma, more than half of the mode,l, and the cellular component will be separated. In particular, the red blood cells will deposit on the bottom, with a more reddish color, while between the two portions, a fragile lens is interposed, composed of white blood cells and platelets, usually less than 1%.

The centrifuged blood column is then measured based on the percentage height, for which generally there will be about 55% of plasma during the corpuscular part of the blood. The blood cells and platelets should remain around values ​​between 38 and 52 % in men. While slightly lower in women, between 36 and 46%.

Increased hematocrit value may indicate:

  • dehydration.
  • Burns.
  • Polycythemia.
  • Polyglossia.
  • He retched.
  • Diarrhea.
  • Staying at a high altitude.
  • Kidney failure.

The risk of the increase in red blood cells, mainly the hematocrit, is that the blood becomes more viscous, and therefore circulation is hampered by the high pressure. Consequently, they can increase the risks of developing blood clots in the blood vessels, stroke,, or heart attack.


The hemoglobin count is measured in grams per deciliter of blood. It should generally be between thirteen and eighteen in men, while in women, between twelve and sixteen.

The increase in the hemoglobin value can indicate:

  • emphysema.
  • Dehydration.
  • Diarrhea.
  • Polyglossia.
  • Polycythemia.


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