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

When a person does not have enough functioning red blood cells (RBCs), they have anemia. A low RBC count can cause a variety of symptoms and health complications.

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.

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.

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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RBCs are the most common component of human blood. The cells contain hemoglobin, a protein that carries oxygen around the body. Hemoglobin is also responsible for blood’s red color.

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

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, 42% 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 for weight loss are also at risk of having a low RBC count. This is common in young females.

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 that they or a loved one has an eating disorder can contact the National Eating Disorders Association for advice and support via:

  • phone or text at 800-931-2237
  • online chat, by going to this link

These services are only open during specific hours. Someone in crisis can text “NEDA” to 741741 at any time to get support from a trained volunteer at the Crisis Text Line.

Alternatively, the Substance Abuse and Mental Health Services Administration (SAMHSA) runs a Disaster Distress Helpline that people can contact on 800-985-5990 for 24-7 support.

Many other resources are available, including:

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

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 nourish the blood. 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

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 in the United States, 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.

Exercising

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
males4.7–6.1
females4.2–5.4
children4.0–5.5

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.

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, and in some cases, prescription medication.