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While the needle is inserted you may feel a sharp but short sting, and some people may experience lightheadedness or feel faint. After the sample is removed, the needle is removed and pressure applied to the puncture wound. A dressing is then applied to keep the area clean and reduce any bleeding. As soon as your blood is drawn, you will be able to return home. Potential side effects may include:.
If your clinic has a lab associated with it, most often you will receive your results shortly after they are completed. In some cases, the blood sample will be sent out to a lab and your healthcare provider will call with results when they are available.
When you receive your results, it's helpful to ask for the exact numbers, including that of your RDW. Reference ranges for RDW can vary somewhat by the laboratory doing the test. Normal red blood cells average between 6 and 8 micrometers in diameter.
RDW estimates the variation in sizes of the cells and is given as a percentage. The normal range for RDW is roughly Examples of anemias in which RDW is most often normal include:.
A few types of anemia associated with an elevated RDW include:. Using the combination of RDW and MCV is very helpful in differentiating some types of anemia which would otherwise be difficult to tell apart. For example, both iron deficiency anemia and thalassemia are usually associated with a low MCV microcytic anemias , but the two conditions are treated differently.
Checking the RDW can help distinguish between these. Similarly, megaloblastic anemias such as vitamin B12 deficiency and folate deficiency and non-megaloblastic anemias such as anemia related to liver disease are both associated with a high MCV macrocytic anemias , but again are treated differently. In this case, the megaloblastic anemias usually have a high RDW and non-megaloblastic a low RDW, helping to make the distinction.
RDW can also be very helpful in mixed anemias. For example, a combination of iron deficiency microcytic anemia and folate deficiency anemia macrocytosis may have a normal MCV normocytic anemia , but the RDW will be very high. It's important to note that there are exceptions to these general rules—for example, sometimes anemia of chronic disease is associated with a low MCV, and sometimes iron deficiency anemia will show a normal MCV.
In addition to a CBC, other tests that may be done to help identify anemia include:. The RDW can be a very helpful number even if there is no evidence of anemia if the red blood cell count and hemoglobin levels are normal.
The RDW can predict the overall risk of mortality in people over the age of 45 people with a high RDW are more likely to die earlier on than those who have a lower RDW. Many studies have been done in the last several years looking at the predictive value of RDW in a wide range of diseases. A mean corpuscular hemoglobin concentration MCHC test measures the ratio of hemoglobin to cell size.
These tests are important in that they can show the presence of anemia — a condition that arises when the hemoglobin content in regular red blood cells is too low to provide the body with sufficient oxygen. This condition is defined according the size of red blood cells and the amount of hemoglobin the cells carry. Red blood cell indices on the lab tests help to determine if anemia is present, by establishing normal hemoglobin ranges for males and females, generally within a range of 12 to 17 grams per deciliter.
The following steps describe what happens:. The RBC indices can help your doctor determine the cause if your doctor thinks you have anemia. Your doctor will see if your MCV is low, normal, or high to help determine what is causing your anemia. The MCV is higher than normal when red blood cells are larger than normal.
This is called macrocytic anemia. The MCV will be lower than normal when red blood cells are too small. This condition is called microcytic anemia. If you have a normal MCV, it means that your red blood cells are normal in size. You can have a normal MCV and still be anemic if there are too few red blood cells or if other RBC indices are abnormal. This is called normocytic anemia. Normocytic anemia occurs when the red blood cells are normal in size and hemoglobin content, but there are too few of them.
This can be caused by:. If you have a high MCHC, this means that the relative hemoglobin concentration per red blood cell is high. MCHC can be elevated in diseases such as:. If you have a low MCHC, it means that the relative hemoglobin concentration per red blood cell is low.
The red blood cells will take on a lighter color when viewed under the microscope. Individuals with anemia and a corresponding low MCHC are said to be hypochromic.
A high RDW also provides clues to an early nutritional deficiency which may not be noted with the other tests alone. Finally, it a good test for determining if further testing is needed, such as a peripheral blood smear. An example of some causes include:. It's important to note that these are only a few examples, and there are many possibilities. A CBC is a standard blood test and includes the red blood cell count in addition to white blood cell count and platelets.
The red blood cell count can tell healthcare providers about the number of red blood cells you have but says little about the reason for any abnormalities.
RBC indices, by looking at the characteristics of red blood cells, are helpful in not only figuring out the cause of anemia but in diagnosing medical conditions even when the red blood cell count is normal.
The combination of these indices also gives important clues in narrowing down anemia. The examples given above are only a few of the possible causes, and determining the precise cause of anemia is sometimes very challenging.
These blood tests are best used in combination with a careful history, a thorough physical exam, and any imaging tests which are indicated. Learning about these blood tests can help you ask your healthcare provider questions so that you thoroughly understand either a diagnosis she has made, or further testing she is recommending.
Increasingly, people are being called on to be an active participant in their health care, and learning how to make informed decisions about their health. Taking the time to learn about your lab values can help you be empowered in making the choices that are best for you alone.
Red blood count RBC indices are four measures of the size and quality of red blood cells. This can help diagnose certain health conditions. Anemia is caused by a lack of healthy red blood cells, which are needed to deliver oxygen to the body. A person with anemia might feel more tired or cold than usual, or appear especially pale. A high mean corpuscular volume MCV does not definitively indicate cancer. However, it can provide useful information when cancer is present. For example, it can predict how chemotherapy might affect a person with rectal cancer.
Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. George-gay B, Parker K. Understanding the complete blood count with differential. J Perianesth Nurs. Comput Math Methods Med.
Diagnosis and management of iron deficiency anemia in the 21st century. Therap Adv Gastroenterol. High hematocrit as a risk factor for venous thrombosis. Cause or innocent bystander? Prognostic implications of relative hypochromia in ambulatory patients with chronic systolic heart failure. Congest Heart Fail. Cryohemolysis, erythrocyte osmotic fragility, and supplementary hematimetric indices in the diagnosis of hereditary spherocytosis. Blood Res. Iron overload cardiomyopathy: better understanding of an increasing disorder.
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