Normocytic anemia: when erythrocytes are fewer than normal

Normocytic anemia is a type of anemia characterized by a lower-than-normal number of red blood cells that also lack the necessary amount of hemoglobin.

Anemia is a condition defined by a reduced number of healthy or normal red blood cells, a decreased concentration of hemoglobin in the blood, or a hematocrit value (normal ranges vary between 41% and 53% in men, and between 36% and 46% in women) that is below normal levels.

Red blood cells are the most abundant cells in the blood, and their primary function is to capture oxygen and transport it to different tissues throughout the body. They achieve this thanks to hemoglobin, their main protein, which binds oxygen to iron atoms, enabling its transport through the bloodstream. For this reason, anemia results in difficulty distributing oxygen to all the body's cells, as the decrease in red blood cells leads to this alteration.

The main symptoms of normocytic anemia:

• Blood loss and hemorrhages
• Medical conditions that impair red blood cell production
• Medical conditions that cause red blood cell rupture (hemolysis)
• Fatigue, low energy
• Weakness
• Pale skin
• Dizziness
• Headache
• Difficulty concentrating
• Lack of motivation

The main medical conditions that impair red blood cell production include:

• Anemia of chronic disease
• Kidney disease
• Aplastic anemia

The primary risk factors for normocytic anemia include all conditions that cause hemolysis or significant hemorrhages. Examples include infections, autoimmune disorders, liver diseases, and kidney diseases, among others.

Blood tests used to diagnose normocytic anemia include:

• Complete blood count (CBC): this test provides information about hemoglobin levels and other important parameters for this type of anemia, such as mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), as well as other aspects of the blood
• Peripheral blood smear: this involves examining blood cells under a microscope
• Reticulocyte count: this test measures the number of immature red blood cells (reticulocytes) in the bone marrow

Other common tests include measurements of iron, vitamin B12, and folate levels in red blood cells.

Treatment for normocytic anemia focuses on addressing the underlying disease causing this condition. For instance, if kidney disease is the cause, treatment for that condition also helps manage normocytic anemia.

Many conditions can lead to normocytic anemia, making prevention difficult. However, avoiding infections and minimizing exposure to risk factors for liver, digestive, and kidney diseases can help reduce the risk of developing normocytic anemia.