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Red Blood Cell Count (RBC)

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Also Known As:

Erythrocyte Count,
RBC Count,
Red Blood Cell Count

This article was last modified on
November 9, 2021

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Test Quick Guide

Red blood cells (RBC) are made in the bone marrow and contain hemoglobin, a protein that carries
oxygen to the tissues in the body. These cells are also known as erythrocytes.

Red blood cell count is a blood test that measures your levels of erythrocytes. This test is most often
done as part of a complete blood count (CBC) that also measures other types of blood cells.

RBC count can help diagnose anemia and other conditions that affect red blood cells. If RBC count
results are abnormal, additional tests are usually done to diagnose the cause of the high or low level
of red blood cells.

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About the Test

Purpose of the test
The purpose of the RBC count is to find out if the number of red blood cells you have is normal or
abnormal. RBC count may be included in routine blood testing during a check-up, usually as part of a
complete blood count (CBC) measuring the number of red blood cells, white blood cells (WBCs), and
hemoglobin in a blood sample.

Measuring RBCs can help diagnose anemia, a condition in which the body doesn’t have enough
healthy red blood cells. There are different types of anemia with distinct causes. A low RBC count is
a key indicator of anemia, and additional tests can help determine its underlying cause.

RBC count may also be used to help diagnose other conditions that affect red blood cells, such as
kidney problems, a type of white blood cell cancer, or problems with the bone marrow.

What does the test measure?

RBC count is the number of RBCs contained in a sample of blood, usually expressed as millions of
cells per microliter (cells/mcL).

In a complete blood count, RBCs are measured along with white blood cells (WBCs) and platelets.
These cells are made in the bone marrow and released into the bloodstream as they mature. In the
blood, these cells are suspended in a fluid called plasma.

Blood consists of 45% red blood cells, less than 1% white blood cells and platelets, and 55% plasma.
RBCs contain hemoglobin, a protein that binds to oxygen. In this way, RBCs carry oxygen to the
body’s tissues and carry carbon dioxide from the tissues to the lungs to be expelled.

When should I get an RBC count?

RBC count is usually tested as part of a complete blood count, which is a common lab test that can
be used to detect or monitor many different health conditions. Your health care provider may order
this test:

As part of a routine check-up

If you are having symptoms of anemia, such as fatigue, headache, loss of appetite, or problems
concentrating
If you are having other symptoms of blood cell changes, such as fever, infection, or weakness
When you are receiving treatment that can affect your blood cell counts, such as chemotherapy

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To monitor a long-term health problem that may change your blood count results, such as
chronic kidney disease

Your health care provider can explain why an RBC count is being ordered for your situation and help
explain what the results mean.

Finding a RBC Count Test

How to get tested
A red blood cell count test is usually ordered by a doctor and requires a blood sample, which is
drawn by a health provider or a laboratory technician at an office, hospital, laboratory, clinic, or other
medical setting.

Can I take the test at home?

Most CBC and RBC tests are done in a medical setting, and limited options are available for taking
these tests at home.

In some cases, you may be able to take an RBC count with a self-collection test. In this type of test,
you use an at-home kit to prick your finger and place a drop of blood on a special test paper. You
then mail this blood sample to a laboratory where it can be analyzed, and your results are delivered
through a website or smartphone app.

How much does the test cost?

The cost of a RBC count depends on where you have the blood sample drawn, the charges by the
laboratory where your blood is analyzed, and whether you have insurance coverage. You can ask
your doctor, the laboratory, and/or your health insurance provider about costs and whether your plan
will cover the blood draw and laboratory testing.

Taking an RBC Count Test

The RBC test requires a blood sample. Most often, blood is drawn from a vein in the inside of the
elbow.

Before the test

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No preparation is required before having this test. Some medications can affect red blood cell count,
so make sure the doctor who ordered your test knows about all of the prescription and over-the-
counter medications you are taking.

During the test

There are several steps involved in the blood draw for a RBC count or CBC test:

1. The puncture site on your arm is cleaned to kill any germs and prevent infection.
2. An elastic band is tied around the upper arm to apply pressure so that the veins swell, making
them easier to locate. Making a fist also helps to make the veins swell.
3. A needle is inserted into a vein.
4. The blood flows into a vial or tube attached to the needle. Sometimes more than one vial of
blood is needed if multiple tests are being done.
5. The pressure is released on the upper arm and the elastic band is removed.
6. The needle is taken out and the spot is covered with a bandage to stop bleeding.

A blood draw usually takes less than 3 minutes. When the needle is inserted, there may be a brief
prick or sting of pain, which can range from mild to moderate.

Some people feel nervous or uncomfortable around needles or at the sight of blood. Be sure to tell
the person who is drawing blood if you feel nervous or woozy, and they can try to make you as
comfortable as possible. Looking away or talking to someone to distract you can sometimes help.

After the test

Once the blood draw is complete, a piece of gauze or bandage is placed over the spot where the
needle is taken out. You may be asked to apply gentle pressure to help stop any bleeding. This may
also help prevent swelling and bruising.

You can usually remove the pressure after a minute or two. Any pain or throbbing where the needle
was removed usually goes away quickly. You may want to keep a bandage on for a few hours, but
you can usually go back to your usual activities once the test is over.

Red Blood Cell Count Test Results

Receiving test results
Results can take anywhere from a few hours to a few business days to come back. Results may be
sent directly to you and to your doctor. The results may also be available on an online health portal.

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You can ask the health care provider who ordered your test for more details about how and when you
will receive the results.

Interpreting test results

RBC count is written as a number value in cells per microliter (cells/mcL). The normal range for red
blood cells depends on factors like age and sex. RBC can also be affected by elevation in the area
where testing is conducted.

Because multiple factors can affect RBC count, it’s important to talk to your doctor to understand
what your test results mean.

Normal value ranges may vary slightly among different laboratories. Some labs use different
measurements or test different samples. In general, reference ranges for adults typically fall between
4 and 6 million cells per microliter of blood. Males typically have a higher reference range.

The expected RBC count in babies, children, and adolescents can vary significantly based on their
age. RBC counts are often highest in newborns and decrease through infancy before reaching levels
similar to adults during childhood and adolescence.

The typical lifespan of an RBC is 120 days, so they have to be replaced constantly. Erythropoietin is
a hormone that is made in the kidneys and is released to stimulate the bone marrow to make more
red blood cells. Health conditions that disrupt the normal creation and function of RBCs can cause
abnormal RBC count.

A high RBC count may be due to:

Dehydration
Stress
High altitude
Smoking
Cardiovascular disease
Polycythemia vera, which is a disorder of the bone marrow that causes too many red blood cells
to be made
A type of kidney cancer called renal cell carcinoma and other cancers that produce
erythropoietin

A low RBC count may be caused by a number of conditions, including:

Anemia
Malnutrition
Pregnancy

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Overhydration
Hemolysis, which is the breakdown of red blood cells
Chronic kidney failure
Severe bleeding or hemorrhage
Failure of normal blood cell production in bone marrow

Some types of medications can also contribute to an increase or decrease in RBC count.

An RBC count test alone often cannot determine the reason why RBC levels are high or low. Other
blood cell counts may be considered in interpreting the significance of RBC levels, and further tests
are often needed to diagnose a specific cause of an abnormal RBC count.

Because many different conditions can affect your RBC count, it is important to review your test
results with your doctor who can address the most likely explanations for your RBC level.

Do I need follow-up tests?

RBC count is only one test used to help identify a health issue affecting red blood cells. A number of
other blood tests may be ordered if your RBC count is abnormal.

For example, if the RBC count is low, test results for hemoglobin and hematocrit, which is the percent
of the blood taken up by RBCs, may help to diagnose anemia. If anemia is suspected, RBC indices
are tests that help to determine the cause of the anemia.

If the RBC count is high, results of the complete blood count (CBC) can help to diagnose
polycythemia, a condition in which there is an increased concentration of hemoglobin and/or
hematocrit in the blood.

Follow-up tests are tailored to your situation based on your health history, symptoms, and test
results. Your doctor can describe the follow-up tests that may be most appropriate in your case.

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Hematocrit
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Elsewhere on the Web

MedlinePlus Medical Encyclopedia: RBC count
MedlinePlus Medical Encyclopedia: CBC
National Heart, Lung and Blood Institute: Blood Tests

Sources

A.D.A.M. Medical Encyclopedia. Polycythemia vera. Updated January 29, 2019. Accessed August
10, 2021. https://medlineplus.gov/ency/article/000589.htm

A.D.A.M. Medical Encyclopedia. Venipuncture. Updated April 26, 2019. Accessed August 10, 2021.
https://medlineplus.gov/ency/article/003423.htm

A.D.A.M. Medical Encyclopedia. Erythropoietin test. Updated July 11, 2019. Accessed August 10,
2021. https://medlineplus.gov/ency/article/003683.htm

A.D.A.M. Medical Encyclopedia. RBC count. Updated January 13, 2020. Accessed August 10, 2021.
https://medlineplus.gov/ency/article/003644.htm

A.D.A.M. Medical Encyclopedia. Red blood cell production. Updated January 13, 2020. Accessed
August 10, 2021. https://medlineplus.gov/ency/anatomyvideos/000104.htm

A.D.A.M. Medical Encyclopedia. Anemia. Updated February 6, 2020. Accessed August 10, 2021.
https://medlineplus.gov/ency/article/000560.htm

A.D.A.M. Medical Encyclopedia. Hemolysis. Updated February 6, 2020. Accessed August 10, 2021.
https://medlineplus.gov/ency/article/002372.htm

A.D.A.M. Medical Encyclopedia. CBC blood test. Updated October 16, 2020. Accessed August 10,
2021. https://medlineplus.gov/ency/article/003642.htm

Means R, Brodsky R. Diagnostic approach to anemia in adults. In: Mentzer W, ed. UpToDate.
Updated June 10, 2021. Accessed August 10, 2021. https://www.uptodate.com/contents/diagnostic-
approach-to-anemia-in-adults

National Heart, Lung, and Blood Institute. Blood tests. Date unknown. Accessed August 20, 2021.
https://www.nhlbi.nih.gov/health-topics/blood-tests
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Panchbhavi V. Bone marrow anatomy. Gest T, ed. Medscape. Updated November 29, 2017.
Accessed August 10, 2021. https://emedicine.medscape.com/article/1968326-overview#showall

Tefferi A. Diagnostic approach to the patient with polycythemia. In: Larson R, ed. UpToDate. Updated
October 2, 2020. Accessed August 10, 2021. https://www.uptodate.com/contents/diagnostic-
approach-to-the-patient-with-polycythemia

Curry CV. Erythrocyte count (RBC). Wheeler T, ed. Medscape. Updated September 28, 2020.
Accessed August 10, 2021. https://emedicine.medscape.com/article/2054474-overview#a2

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