What is RDW?
RDW, or red blood cell distribution width, measures how red blood cells differ in size from each other. The normal size of the red blood cells should be between 6 and 8 µm [1].
Clinically, RDW is part of a standard blood examination. On its own, it is not used to interpret blood test results [1]. RDW is a complementary measure that gives more context to parameters like mean corpuscular volume [1].
Normal RDW results can vary slightly in different laboratories. However, the common range for RDW is 9.5 to 11.5 [2].
Increased results can indicate conditions like nutrient deficiency or anemia [1].
RDW can be used by doctors for the prognosis of cardiovascular diseases, post-operative outcomes, cancer, and life expectancy in older people [3].
What is MCHC?
MCHC is an abbreviation for mean corpuscular hemoglobin concentration, which measures the concentration of hemoglobin in red blood cells. It is part of the standard blood examination, the complete blood count [4, 5].
In clinical settings, it is used alongside parameters like mean corpuscular volume and mean corpuscular hemoglobin content in diagnosing anemia. It allows doctors to detect anemic changes early and indicate their origin [6].
For adults, the normal MCHC reference ranges from 33.4 to 35.5 g/dL [7].
What does it mean when I have high RDW and low MCHC?
If your RDW is above 11.5 [2] and MCHC below 33.4 g/dL, it typically indicates anemia.
High RDW shows that the red blood cells differ from each other in size. It is indicative of anemia or other blood-related conditions [1].
Low MCHC means that the hemoglobin concentration in the red blood cells is decreased. It is a sign of anemia, but it could also be another problem, like thalassemia [7].
High RDW and low MCHC commonly correlate with iron deficiency anemia or anemia caused by chronic disease. Iron deficiency can cause red blood cells to be smaller and more varied in size, leading to high RDW and low MCHC.
Should I see a doctor with high RDW and low MCHC?
Yes, with low RDW and high MCHC, you should consult a doctor. This result most frequently indicates anemia, which may require treatment and further investigation.
However, other conditions can also contribute to such blood results. For example, high RDW is also linked to cardiovascular diseases, such as atherosclerosis [8].
Typically, low MCHC is due to iron deficiency anemia [5].
Deviations from the normal range in RDW and MCHC, even when small, must be investigated by the doctor, as they may indicate early anemia or a combination of health conditions.
What is the treatment for anemia?
The treatment depends on the type and degree of the anemia. In mild cases, no specific treatment is often needed. Sometimes, anemia can be a side effect of a medication. In such cases, the dosage will need adjustment [9].
The most common anemia types are iron, vitamin B12, and folate deficiency anemias. Treatment for these conditions is mostly based on supplementation of the missing nutrient [10, 11].
However, in severe cases of anemia, to quickly improve the state of the patient, blood transfusions may be necessary [12].
If the blood anemia results from a problem with the bone marrow, either a bone marrow transplant or bone marrow stimulation drugs are needed [11, 13]. Medications that can promote red blood cell production in the bone marrow are, for instance, Aranesp and Epogen [13].