What increases erythrocyte (red blood cell) count?

From the Guidelines

To increase red blood cell count, iron supplementation is essential, and intravenous iron is superior to oral iron, as evidenced by studies showing its effectiveness in conjunction with erythropoietic therapy 1. When considering ways to boost red blood cell production, it's crucial to focus on iron-rich foods and supplements, as iron is vital for hemoglobin production. Key dietary sources include lean red meat, beans, spinach, and fortified cereals. Additionally, vitamins B12 and folate, found in animal products, leafy greens, and legumes, play significant roles. Staying well-hydrated is also important, and supplements like ferrous sulfate (325 mg daily) may be recommended for iron deficiency. In more severe cases, medications such as erythropoietin (EPO) may be prescribed to stimulate red blood cell production. Regular moderate exercise can naturally boost red blood cell production over time. It's also important to avoid smoking and limit alcohol consumption, as these can impair red blood cell production. If symptoms of low red blood cell count (anemia), such as fatigue, weakness, or shortness of breath, are experienced, consulting a healthcare provider for proper diagnosis and treatment is necessary, as the underlying cause needs to be addressed for effective treatment. The body requires adequate iron, vitamins, and proteins to produce hemoglobin and red blood cells in the bone marrow, making addressing nutritional deficiencies the first step in treatment.

Some key points to consider:

• Iron monitoring and supplementation are critical, especially when using erythropoietin, as rapid erythropoiesis can lead to functional iron deficiency 1.
• The choice between oral and intravenous iron supplementation should be based on the severity of the condition and the patient's ability to absorb iron, with intravenous iron being more effective in certain cases 1.
• Evaluating iron availability through serum iron, TIBC, and serum ferritin measurements is essential to determine the need for supplemental iron 1.
• Absolute iron deficiency can be indicated by a TSAT of less than 16% and/or a serum ferritin value of less than 12 ng/mL, and treating iron deficiency can improve or correct anemia in some patients 1.

From the FDA Drug Label

PROCRIT stimulates erythropoiesis by the same mechanism as endogenous erythropoietin. PROCRIT increases the reticulocyte count within 10 days of initiation, followed by increases in the RBC count, hemoglobin, and hematocrit, usually within 2 to 6 weeks.

A good way to increase red blood cell count is by using epoetin alfa (IV), which stimulates erythropoiesis and increases RBC count, hemoglobin, and hematocrit. The dose and administration of epoetin alfa should be individualized to achieve and maintain the target hemoglobin level 2.

From the Research

Increasing Red Blood Cell Count

To increase red blood cell count, it is essential to address the underlying causes of low red blood cell count, such as iron, vitamin B12, and folate deficiencies.

• Iron deficiency can be treated with oral iron supplements, which can also increase serum folate and vitamin B12 levels 3.
• Vitamin B12 and folate deficiencies can be treated with dietary changes or supplements, and it is crucial to evaluate serum vitamin B12 levels in patients with iron deficiency anemia, especially those over 60 years old 4.
• A full blood count test can help diagnose anaemia and suggest the underlying cause, such as a nutritional deficiency of B12, folate, or iron 5.

Dietary Changes

Dietary changes can also help increase red blood cell count, including:

• Consuming foods rich in iron, vitamin B12, and folate, such as meat, poultry, fish, and fortified cereals.
• Avoiding foods that inhibit iron absorption, such as tea and coffee.

Prevalence of Deficiencies

The prevalence of iron, vitamin B12, and folate deficiencies varies among different populations, with a study in Turkey finding a high prevalence of these deficiencies in community-dwelling elderly individuals 6.

• Iron deficiency was found in 7.1% of the study population.
• Vitamin B12 deficiency was found in 64.2% of the study population.
• Folic acid deficiency was found in 10.9% of the study population.

Combined Deficiencies

Combined deficiencies of iron and vitamin B12 can also cause anaemia, and it is essential to consider these combined-deficiency states in all cases of anaemia 7.

• Simultaneous deficiencies of cobalamin and iron may be a more common cause of combined-deficiency anaemia.
• Variability in red blood cell morphologic characteristics can reflect the relative degree of deficiency of each of these substrates.