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Reticulocyte Count: Purpose, Procedure, and Results

What is a reticulocyte count?

Key points

  1. A reticulocyte count can help your doctor tell if your bone marrow is producing enough red blood cells.
  2. It’s likely that your blood will be taken from a vein in your inner elbow or the back of your hand.
  3. Normal levels of reticulocytes can vary. But low levels and high levels can be signs of several different conditions.

Reticulocytes are immature red blood cells. A reticulocyte count is a test your doctor can use to measure the level of reticulocytes in your blood. It’s also known as a retic count, corrected reticulocyte count, or reticulocyte index.

A reticulocyte count can help your doctor learn if your bone marrow is producing enough red blood cells. If your red blood cell count is too low or too high, your body will try to achieve a better balance by producing and releasing more or less reticulocytes. Your doctor can tell whether your body is creating and releasing them properly by ordering a reticulocyte count.

A reticulocyte count can help your doctor diagnose a variety of conditions, such as anemia and bone marrow failure. They will likely order additional tests to develop their diagnosis.

What is a reticulocyte count used for?

Your doctor may recommend a reticulocyte count if they want to learn how your bone marrow is functioning, including production of enough red blood cells. They may also order a reticulocyte count to help diagnose and distinguish between different types of anemia.

They may also use it to help monitor your progress and health after you undergo chemotherapy, radiation therapy, a bone marrow transplant, or treatment for iron deficiency anemia.

How should you prepare for the test?

To conduct a reticulocyte count, your doctor will need to collect a sample of your blood to send to a laboratory for testing.

Your doctor may ask you to take certain steps to prepare for your blood draw. For example, they may ask you to fast for a specific period of time beforehand. They may ask you to avoid eating anything, drinking anything, or both. They may also ask you to avoid taking certain medications beforehand, such as blood thinners.

Ask your doctor if you should take any steps to prepare for your blood draw. Tell them if you have hemophilia, a history of fainting, or any other medical conditions beforehand. You should also tell them about any medications that you’re taking, including prescription and over-the-counter drugs.

How will your blood be drawn?

Your doctor, nurse, or technician will draw a sample of your blood for testing. They will likely take it from a vein in your inner elbow or the back of your hand.

First, they will sterilize the area with an antiseptic. Then, they will wrap a plastic band around your arm to apply pressure and help your vein swell with blood. They will insert a sterile needle into your vein and use it to collect a sample of your blood in an attached vial.

Once they have collected enough blood, they will remove the needle and untie the plastic band from your arm. Then they will clean the injection site and, if necessary, bandage it.

They will send the sample of your blood to a laboratory for testing. Your doctor will let you know when your test results are available.

Infants and young children

For infants or young children, the testing process may be different. Rather than use a needle to collect their blood, your child’s doctor may make a small cut in their skin. When the cut starts to bleed, they will use a test strip or slide to collect a small sample of your child’s blood. Then they will clean the area and, if necessary, bandage it.

Alternative testing methods

In some cases, you may not need to have your blood drawn. Instead, a simple finger prick may suffice. In this case, your doctor will prick your finger with a needle. When it starts to bleed, they will use a test strip or slide to collect a sample of your blood. Then they will clean the area and, if needed, bandage your finger.

What risks are involved?

Blood draws are common procedures. They are generally safe for most people, but they do involve some risks.

You may experience mild to moderate pain from the needle prick. If your doctor, nurse, or technician has trouble collecting a blood sample, they may need to inject you with the needle several times. It’s common for the injection site to throb afterwards. Some bleeding and bruising are also common. 

In rare cases, you may experience other side effects, such as:

  • fainting
  • excessive bleeding at the puncture site
  • accumulation of blood under your skin, known as a hematoma
  • development of an infection where your skin is broken by the needle
  • inflammation of your vein, known as phlebitis

Your doctor can help you understand the potential benefits and risks of having your blood drawn. For most people, the potential benefits outweigh the risks.

What do the test results mean?

Normal levels of reticulocytes vary, due to differing laboratory procedures and levels of hemoglobin in people’s blood. Your doctor may need to order additional tests to help interpret your reticulocyte count.

High reticulocyte levels could be a sign of:

  • acute bleeding
  • chronic blood loss
  • hemolytic anemia
  • erythroblastosis fetalis, also called hemolytic disease in a newborn, a potentially fatal blood disorder that affects some fetuses and newborns
  • kidney disease

Low reticulocyte levels could indicate:

  • iron deficiency anemia
  • aplastic anemia
  • folic acid deficiency
  • vitamin B-12 deficiency
  • bone marrow failure caused by drug toxicity, infection, or cancer
  • kidney disease
  • cirrhosis of the liver
  • side effects from radiation therapy

Ask your doctor for more information about your test results. They can help you understand what your results mean. They can also recommend appropriate follow-up steps, which may include additional tests or treatments.

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