What is a normal Red Cell Distribution Width (RDW) value in a Complete Blood Count (CBC)?

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Normal RDW Values in a Complete Blood Count

Normal RDW (Red Cell Distribution Width) is generally ≤14.0%, which represents the 95th percentile in reference populations, with typical laboratory ranges spanning 11.0-14.0%. 1

Standard Reference Range

  • The normal RDW range is 11.0-14.0%, with values ≤14.0% considered within normal limits 1
  • RDW is calculated by dividing the standard deviation of red blood cell volume by the mean corpuscular volume (MCV) and multiplying by 100 to express as a percentage 1
  • A normal RDW indicates a homogeneous red cell population without significant anisocytosis (variation in red blood cell size) 1

Clinical Interpretation of Normal Values

When RDW is normal (≤14.0%):

  • Combined with normal MCV: Suggests absence of early iron deficiency or vitamin deficiencies 1
  • Combined with low MCV (microcytosis): A normal RDW with microcytosis helps differentiate thalassemia minor from iron deficiency anemia, as thalassemia typically presents with normal or only mildly elevated RDW while iron deficiency shows elevated RDW (>14.0%) 1
  • Indicates uniform erythrocyte size: Reflects absence of significant heterogeneity in circulating red blood cells 1

Important Clinical Caveats

  • Laboratory variation exists: RDW values can vary slightly between different laboratory instruments, so values should always be interpreted according to your specific laboratory's reference range 1
  • Context matters: Even with normal RDW, if anemia is present, a minimum workup should include red blood cell indices, reticulocyte count, differential blood cell count, serum ferritin, transferrin saturation, and CRP concentration 1
  • Clinical suspicion overrides normal values: If clinical suspicion for iron deficiency exists despite normal RDW, additional tests such as serum ferritin and transferrin saturation should be pursued 1
  • Not used in isolation: RDW should always be interpreted alongside other hematologic parameters including hemoglobin, MCV, and other red cell indices 1

Historical Context

The mean RDW in normal male subjects has been documented as 11.3% in reference populations, confirming the lower end of the normal range 2

References

Guideline

Interpreting Red Cell Distribution Width (RDW) Values

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Red blood cell distribution width index in some hematologic diseases.

American journal of clinical pathology, 1985

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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