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Vitamin B9 (Folic Acid) Folic acid helps your body make red blood cells. Dietary sources include leafy green vegetables (like kale and spinach), beans, peanuts, liver, and seafood.

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Your red blood cells circulate within your blood vessels to deliver oxygen to all of your body's tissues and organs and to carry carbon dioxide from your cells to your lungs. Oxygen is vital for the energy and survival of every cell in your body. If you have a low number of red blood cells, or if your red blood cells aren’t functioning as they should, this can cause low energy and may harm your body. Your healthcare provider will recommend lifestyle modifications, and possibly medical intervention if you have a low red blood cell count. This article will discuss symptoms and causes of low red blood cells (RBCs), nutrition and lifestyle measures to support healthy blood cells, and when to see the doctor.

Red Blood Cells and Anemia

Anemia is a condition in which the red blood cells are low in number, too small, too large, or not healthy.

Anemia Symptoms

The effects of anemia can develop quickly or slowly, depending on the cause. The symptoms of anemia can range from mild to severe, depending on the extent of the anemia and your overall health.

Common symptoms of anemia include:

Lack of energy

Sleepiness

Pale skin

Headaches

Dizziness

Irritability

Trouble concentrating

Tachycardia (rapid heart rate)

Hypotension (low blood pressure)

Severe anemia can cause fainting, shortness of breath, heart failure, organ damage, or organ failure.

Causes

There are many different causes of anemia. Generally, this condition is caused by diminished production of red blood cells or by damage or loss of red blood cells.

Common causes include:

Vitamin B12 deficiency

Iron deficiency

Chronic bleeding, such as gastrointestinal (stomach and intestinal) bleeding

Gastrointestinal problems that affect nutrient absorption

Chemotherapy (medicine used to kill cancer cells)

Bone marrow disorders, such as aplastic anemia (your body stops producing enough red blood cells)

Cancer, especially bone marrow cancer

Kidney disease

Severe malnutrition

Hemolysis (breakdown of red blood cells) such as from malaria (a parasitic blood infection)

Acute bleeding, such as due to trauma

Blood loss from surgery

Anemia can be diagnosed based on a red blood cell count, hemoglobin, hematocrit, and red blood cell indices, which are part of a complete blood count (CBC):

Red blood cell count is the number of red blood cells.

Hemoglobin is a protein in the red blood cells that carries oxygen.

is a protein in the red blood cells that carries oxygen. Hematocrit is the percentage of blood that is composed of red blood cells. is the percentage of blood that is composed of red blood cells. Red blood cell indices measure characteristics of the red blood cells. They include mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW).

Nutrients to Increase Your Red Blood Cell Count

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Sometimes nutritional deficits are the cause of anemia. When this is the case, you may be able to restore a normal red blood cell count by consuming enough of the lacking nutrient.

Verywell / Zoe Hansen

Vitamin B9 (Folic Acid)

Folic acid helps your body make red blood cells. Dietary sources include leafy green vegetables (like kale and spinach), beans, peanuts, liver, and seafood.

Iron

Iron is an important component of hemoglobin. Some dietary sources are red meat, seafood, leafy green vegetables, and beans.

Vitamin B12

Vitamin B12 is involved with the production of red blood cells. Some dietary sources are beef, chicken fish, diary, and eggs.

Copper

Copper helps the body make hemoglobin. Dietary sources include leafy green vegetables, nuts, mushrooms. organ meats, and oysters.

Vitamin A

Vitamin A helps with production of red blood cells. Some dietary sources are carrots, potatoes, fish, liver, and leafy green vegetables.

Vitamin C

Vitamin C helps with iron metabolism, which is important for hemoglobin production. Some dietary sources include tomatoes, citrus fruit, strawberries, broccoli, and leafy green vegetables.

Vitamin E

Vitamin E helps protect the red blood cells. Some dietary sources are almonds, pine nuts, avocado, and bell pepper. Excess Not Used Usually, excess amounts of nutrients will not increase your red blood cell count above optimal levels because your body will eliminate the extra amount of nutrients consumed.

Lifestyle Changes to Increase Your Red Blood Cell Count

There are also a few non-dietary lifestyle strategies you can use to increase your red blood cell count if it is low. These strategies will only be effective if you are also getting the nutrients your body needs to make enough healthy red blood cells.

Exercise

In general, exercise stimulates erythropoiesis (production of red blood cells). Your body normally breaks down red blood cells after approximately three to four months, and it constantly makes new ones to replace them. Exercising may also cause your older red blood cells to break down so they can be recycled more quickly, but the new red blood cells will be better able to carry oxygen than the older ones, so this natural process improves your health overall.

Reduce Alcohol

Drinking alcohol contributes to anemia through multiple different mechanisms. Alcohol interferes with your body’s absorption or nutrients, and it also affects the process of red blood cell production. Furthermore, high amounts and prolonged alcohol use can damage the liver and kidneys, interfering with their roles in red blood cell production.

When to See a Doctor

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You should see a doctor if you experience any symptoms of anemia. Sometimes anemia is caused by medical problems that can become more serious and less treatable if they progress without treatment (like kidney disease or cancer). Often, anemia is related to issues such as diet or gastrointestinal problems (like ulcerative colitis) that prevent proper absorption of nutrients. You can get treatment for your anemia, and you can also get effective treatment for the underlying problem. And because the symptoms of anemia are nonspecific, it’s possible that your doctor may diagnose another health problem as the cause of your symptoms.

Medications

The medications used to treat low red blood cells depend on the cause. Sometimes people who are low in iron, vitamin B12, or another nutrient need to take supplements, especially if the nutritional deficiency is caused by an absorption problem. Often, the underlying disorder has to be treated. For example, if cancer is the cause, it will need appropriate treatment. In some situations, particularly in the setting of kidney disease, erythropoietin is prescribed. This is a natural hormone produced by the kidneys that stimulates red blood cell production. For some people, a blood transfusion is necessary to provide adequate blood for survival. And when bleeding is the cause of anemia, treatment may include options such as medication to heal an ulcer or surgical repair of the damaged area.

Summary

Low red blood cells can be a problem in many different chronic diseases and acute medical conditions. It’s important for everyone to have habits that help maintain a normal red blood cell count. These include getting the nutrients your body needs for healthy red blood cell production, exercising regularly, and avoiding excess alcohol.

A Word From Verywell

A low red blood cell count is one of the signs of an underlying health problem. There are many causes and solutions. If you have a medical illness that’s causing you to have reduced number of red blood cells, you will need treatment. It’s also very important that you incorporate lifestyle habits that will help you maintain a healthy amount of red blood cells and that you keep up these habits for the long term to avoid a recurrence of anemia.

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