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What Are Red Blood Cell Indices?


The CBC is used to measure the quantity and physical characteristics of different types of cells found in your blood. Red blood cell (RBC) indices are individual components of a routine blood test called the complete blood count (CBC).

Along with the total RBC count, the RBC indices provide information about the size and quality of your red blood cells. This can be used to diagnose the cause and severity of anemia and provide vital clues about other health conditions you may have.

RBC Indices

RBC indices are calculated parameters that are part of an automated blood count report. RBC indices have two primary uses:

  1. Assist with the differentiation of anemia
  2. Serve as quality control checks

RBC indices include:

  • Mean cell (or corpuscular) volume (MCV)
  • Mean cell hemoglobin (MCH)
  • Mean cell hemoglobin concentration (MCHC)

There are four types of red blood cell indices:

Mean corpuscular volume (MCV), which measures the average size of your red blood cells

Mean corpuscular hemoglobin (MCH), which measures the average amount of hemoglobin in a single red blood cell. Hemoglobin is a protein in red blood cells that carries oxygen.

Mean corpuscular hemoglobin concentration (MCHC), which also measures hemoglobin in red blood cells. In addition, it includes a calculation of the size and volume of your red blood cells.

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Red cell distribution width (RDW), which measures differences in the volume and size of your red blood cells.

RBC count

Why do I need to have RBC indices?

Your RBC indices and RBC count are used to diagnose different types of anemia. You have some form of anemia if you have a low RBC count or abnormal RBC indices.

Anemia is a condition in which the number of RBCs or the amount of hemoglobin in your blood falls below normal levels. This deprives tissues throughout your body of oxygen. You may feel fatigued, lightheaded, short of breath, or have other symptoms if your body doesn’t get all the oxygen it requires to function properly.

Anemia can occur if:

Too few rbcs are created, which is called aplastic anemia

Rbcs are destroyed prematurely, which is called hemolytic anemia

A significant blood loss occurs, such as in cases of hemorrhage.

What are the red blood cell indices and what tests are diagnostic for Ida?

Initial testing for IDA typically includes an assessment of hemoglobin (Hb), hematocrit (Hct), and red blood cell (RBC) indices such as mean corpuscular volume (MCV), followed by serum ferritin (SF) if Hb levels are 2 standard deviations below normal for age and sex.

Red Cell Indices

What happens if MCHC is low?

When MCHC levels are very low, your body could struggle to provide enough oxygen to all its tissues. As a result, these tissues are deprived of oxygen and unable to get rid of carbon dioxide. This can actually become life-threatening.

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What level of anemia is severe?

Mild anemia corresponds to a level of hemoglobin concentration of 10.0-10.9 g/dl for pregnant women and children under age 5 and 10.0-11.9 g/dl for nonpregnant women. For all of the tested groups, moderate anemia corresponds to a level of 7.0-9.9 g/dl, while severe anemia corresponds to a level less than 7.0 g/dl.

How do you treat high MCV?

The first line of treatment for many people is correcting nutrient deficiencies. This can be done with supplements or foods like spinach and red meat. You may be able to take supplements that include folate and other B vitamins. You may also need vitamin B-12 injections if you don’t absorb oral vitamin B-12 properly.

Is high MCV serious?

An average MCV score is between 80 and 95. If the MCV goes up to an extreme of 125, it may indicate vitamin B12, folate deficiencies, or cold agglutinin disease. A higher MCV value indicates that the red blood cells are larger than the average size.

CBC Test

After the test

Your doctor may also perform other tests to make a diagnosis. Treatment for any anemia depends on the underlying cause. For example, if your anemia is caused by iron deficiency, your doctor may advise you to take iron supplements or change your diet to include more foods that are rich in iron. If you have an underlying disease that’s causing anemia, treatment for that disease can often also improve the anemia.

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Talk to your doctor if you’re experiencing any of the symptoms of anemia or if you have any concerns about the results of your CBC or RBC indices.