A low red blood cell (RBC) count increases the risk of anemia. Ways of boosting RBCs include eating foods that contain iron, vitamins B12 and B9, vitamin C, vitamin A, and copper. Increasing exercise levels and reducing alcohol intake may also help.

In this article, we look at dietary and lifestyle changes that support RBC production, as well as give an overview of how to understand RBC count and recognize the symptoms of low levels.

When a person does not have enough functioning RBCs, they have a higher chance of developing anemia. This means that not enough oxygen is being transported by the blood throughout the body.

Is a low RBC count and anemia the same?

The RBCs in the human body contain an iron-rich protein known as hemoglobin. This protein helps the blood deliver oxygen to the various tissues. A low level of hemoglobin often indicates anemia. Hemoglobin is also responsible for blood’s red color.

Doctors typically diagnose anemia when a person’s blood hemoglobin is 13.5 grams (g) per deciliter (dL) (g/dl) in males or less than 12.0 g/dl in females. That said, anemia can also develop when a person’s existing RBCs are not functioning properly.

Generally, a low RBC count can cause a variety of symptoms and health complications, though these may be less obvious if a person’s levels are only mildly low compared to moderately or severely low.

Learn more about anemia.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Having a low RBC count can cause symptoms that may include:

Anemia can lead to serious complications that may be life-threatening without treatment.

Several conditions can cause a person to have a low RBC count. These include:

Malnutrition can also cause a person to have a low RBC count. The bone marrow continuously produces RBCs. If the body does not receive a regular supply of necessary nutrients, the RBCs may become malformed or die off faster than the body can replace them.

Who may have a low RBC count?

Anyone can develop anemia. However, certain people may be at a higher risk of developing the condition, including:

  • pregnant people
  • people experiencing heavy periods
  • people over 60 years old
  • young children
  • people taking blood thinners
  • people with eating disorders, especially anorexia

Heavy periods can cause iron deficiency anemia due to increased blood loss, but iron deficiency anemia in pregnancy is usually the result of a deficiency of iron in the diet.

Anemia is also common in young children. This is also often due to a lack of iron in their diet. The World Health Organization (WHO) estimates that globally, 40% of children under the age of 5 years old are anemic. Older adults may also be more likely to have a low RBC count due to malnutrition.

People following restrictive diets as a means of weight loss are also at risk of having a low RBC count. This is common in young females.

Help is available

Eating disorders can severely affect the quality of life of people living with these conditions and those close to them. Early intervention and treatment greatly improve the likelihood of recovery.

Anyone who suspects they or a loved one may have an eating disorder can contact the National Alliance for Eating Disorders, which offers a daytime helpline staffed by licensed therapists and an online search tool for treatment options.

For general mental health support at any time, people can call the Substance Abuse and Mental Health Services Administration 24 hours a day at 1-800-662-4357 (or 1-800-487-4889 for TTY).

Many other resources are also available, including:

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A low RBC count usually occurs when a person does not eat enough essential nutrients. Eating more nutrient-dense foods can give the body the necessary tools to create functional RBCs.

People can also take these essential vitamins and minerals as supplements, although it is best to get nutrients from foods in the diet if possible. It is best to consume foods that provide the following nutrients:


Iron deficiency anemia is the most common form of anemia. The body uses iron to make hemoglobin, which stores oxygen in the blood cells. Without iron, these cells may die or become unable to send oxygen around the body.

Eating foods with plenty of iron can help prevent symptoms of anemia and bolster the making of hemoglobin. Good sources of iron include:

Vitamin B12

Vitamin B12 is important for brain function and creating new RBCs. Low vitamin B12 levels can prevent RBCs from fully maturing.

A B12 deficiency can trigger the development of abnormal RBCs called megaloblasts, which may lead to a condition doctors call megaloblastic anemia.

Vitamin B12 binds to protein in food and naturally occurs in red meat, fish, and shellfish. Dairy products such as milk and cheese also contain vitamin B12.

Manufacturers often fortify breakfast cereals, milk substitutes, and nutritional yeast with vitamin B12. Eating these foods can supplement a person’s daily intake, particularly if they do not eat meat or dairy.

Vitamin B9

Vitamin B9 is also known as folic acid or folate. It is an essential nutrient for the nervous system. Folate also helps to create new cells in the body.

People with low levels of folate may develop anemia. Foods high in folic acid include:

  • beef liver
  • asparagus
  • brussels sprouts
  • green, leafy vegetables, such as spinach and mustard greens
  • oranges and orange juice
  • peanuts
  • black-eyed peas
  • kidney beans
  • enriched breads and grains

Vitamin C

While vitamin C does not directly affect RBCs, it is still important because it helps the body absorb more iron. Iron increases the body’s ability to make RBCs.

Vitamin C occurs in a variety of foods, including:

Discover 20 foods high in vitamin C here.


Copper is an essential mineral that helps the body use iron in the blood. If someone is deficient in copper, their body may have difficulties utilizing iron for functioning, and they may develop an imbalance of the level of iron in the body.

The following foods are good sources of copper:

Vitamin A

Retinol, also called vitamin A, appears to support a person’s RBC count by working with iron. Vitamin A may help the body to better utilize iron by helping it move into hemoglobin within RBCs.

Foods that can supply vitamin A include:

Making simple lifestyle changes can have a significant impact on a person’s RBC count.

Reducing alcohol consumption

It may be helpful to eliminate or reduce drinks containing alcohol from the diet, as drinking too much alcohol may lower a person’s RBC count.

According to Dietary Guidelines for Americans 2020-2025, moderate drinking for adult males is two or fewer alcoholic drinks a day. For adult females, moderate drinking is one or fewer alcoholic drinks a day.


Moderate exercise can provide benefits for any person who practices it. However, it is especially important for creating healthy RBCs.

Sustained vigorous exercise that raises the heart rate increases the body and brain’s need for oxygen. This is why the heart beats faster, and the lungs breathe deeper and quicker.

This need for oxygen stimulates the body to produce more hemoglobin. Regular exercise alongside a balanced, nutritious diet means the bone marrow has the best tools to create those cells.

Possible workouts include:

  • running
  • jogging
  • cycling
  • swimming
  • guided exercise classes, such as spinning or aerobics

However, even taking the stairs instead of an elevator, going for a walk, or doing some gardening can count toward a daily or weekly exercise requirement.

The American Heart Association (AHA) recommends engaging in 150 minutes of moderate to intense physical activity each week.

Doctors measure RBC counts in terms of cells per microliter (µL) of blood.

Average ranges include:

DemographicMillion cells per µL of blood

These ranges can vary between individuals and may change depending on the lab performing the tests.

If a person has an RBC count outside these ranges, they may be at risk of health complications.

A low RBC count can be dangerous. However, several disorders can cause an RBC count to be higher than expected. The medical terms for this are polycythemia or erythrocytosis.

Causes of a high RBC include:

In some people, dietary and lifestyle changes will not be enough to manage RBC levels.

A doctor may prescribe certain medications to stimulate the production of RBCs. They may recommend hormone treatment to people with anemia due to cancer, kidney disease, or any other disorder that may have caused a hormonal malfunction.

If tests show that the person’s low RBC count is due to a different cause, doctors will attempt to treat the underlying condition. Treatment may help the RBC count improve on its own. Diet and lifestyle choices can also support specific treatments.

A doctor may rarely recommend a red blood cell transfusion if RBC levels do not respond to medications and lifestyle changes.

What is the most common cause of low red blood cell count?

A low RBC count is often caused by blood loss or by inadequate RBC production, often due to low iron. It can also be caused by kidney disease, dehydration, and various other diseases.

What should I do if my red blood count is low?

There are several diet and lifestyle changes people can make to help the body increase its RBC count. However, if symptoms continue, it is important to contact a doctor.

What are the 3 main causes of anemia?

Anemiacan be caused by blood loss, low or lack of RBC production, and a high rate of RBC destruction. There are many conditions or diseases that can cause one of these to develop. This includes pregnancy, a diet low in iron, or certain genetic diseases.

A low RBC count, also known as anemia, can affect the body’s ability to transport oxygen and nutrients around the cardiovascular system. It can cause fatigue, dizziness, and heart palpitations.

The most common form of anemia is iron deficiency anemia. This can result from blood loss, malnutrition, or kidney problems.

Children, pregnant people, and older adults are at the most risk of iron deficiency anemia.

High or low RBC levels can lead to severe health complications. A person may be able to manage their RBC levels through diet, exercise, oral iron supplementation, prescription medications, and, if necessary, a blood transfusion.