This page helps you to understand blood test results for Red Cell Indices and gives you the reference range to determine if your lab test results mean that you have a high, low or normal Red Cell Count.
We outline the risk factors associated with both raised and lower Red Cell Indices.
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What are Red Blood Indices
Red blood cell indices are calculations that provide information on the physical characteristics of the RBCs:
- Mean corpuscular volume (MCV) is a measurement of the average size of a single red blood cell.
- Mean corpuscular hemoglobin (MCH) is a calculation of the average amount of hemoglobin inside a single red blood cell.
- Mean corpuscular hemoglobin concentration (MCHC) is a calculation of the average concentration of hemoglobin inside a single red blood cell.
- Red cell distribution width (RDW) is a calculation of the variation in the size of RBCs .
Function of Red Cell Indices
If your red cell count is low, you are likely to have some form of anemia. Your doctor can use RBC indices to help diagnose the cause of anemia
Possible causes of anemia include:
- diets lacking in iron, vitamin B-12, folate, or folic acid
- chronic diseases like diabetes, inflammatory bowel disease, kidney disease, or thyroiditis, which is an inflammation of your thyroid gland
- significant blood loss or hemorrhage
- diseases affecting your bone marrow
- certain genetic diseases, such as thalassemia, which is an inherited form of anemia, or sickle cell disease, which occurs when your RBCs can’t carry oxygen well because they’re sickle-shaped
- Iron deficiency anemia is the most common kind of anemia 
- The symptoms of anemia can be very mild at first. Many people aren’t even aware that they’re anemic. The most common early symptoms of anemia include:
- lack of energy
- pale skin 
Risk factors associated Red Cell Indices
Below are some of the types of anemia indicated by results for the different indices:
- MCV below normal – Microcytic anemia (may be due to low iron levels, lead poisoning, or thalassemia).
- MCV normal – Normocytic anemia (may be due to sudden blood loss, long-term diseases, kidney failure, aplastic anemia, or man-made heart valves).
- MCV above normal – Macrocytic anemia (may be due to low folate or B12 levels, or chemotherapy).
- MCH below normal – Hypochromic anemia (often due to low iron levels).
- MCH normal – Normochromic anemia (may be due to sudden blood loss, long-term diseases, kidney failure, aplastic anemia, or man-made heart valves).
- MCH above normal – Hyperchromic anemia (may be due to low folate or B12 levels, or chemotherapy) .
Generally, a low MCV and a low MCHC will be found together. Anemias in which both MCV and MCHC are low are called microcytic, hypochromic anemia .
Notable variations by demographic group
More research is required here