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Reticulocyte count

Definition

Reticulocytes are slightly immature red blood cells. A reticulocyte count is a blood test that measures the amount of these cells in the blood.

How the Test is Performed

A blood sample is needed.

How to Prepare for the Test

No special preparation is necessary.

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.

Why the Test is Performed

The test is done to determine if red blood cells are being created in the bone marrow at an appropriate rate. The number of reticulocytes in the blood is a sign of how quickly they are being produced and released by the bone marrow.

Normal Results

A normal result for healthy adults who are not anemic is 0.5% to 2.5%.

The normal range depends on your blood level of hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen. The range is higher if hemoglobin is low, from bleeding or if red cells are destroyed.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your health care provider about the meaning of your specific test results.

What Abnormal Results Mean

A higher than normal reticulocyte count may indicate:

• Anemia due to red blood cells being destroyed earlier than normal (hemolytic anemia)

• Bleeding

• Blood disorder in a fetus or newborn (erythroblastosis fetalis)

• Kidney cysts or tumors, with increased production of a hormone called erythropoietin

• Pregnancy

A lower than normal reticulocyte count may indicate:

• Anemia caused by low iron levels, or low levels of vitamin B12 or folate

• Bone marrow failure (for example, from a certain medicine, tumor, radiation therapy, or infection)

• Chronic kidney disease, due to decreased amounts of a key hormone

• Cirrhosis of the liver

Risks

There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding

• Fainting or feeling lightheaded

• Multiple punctures to locate veins

• Hematoma (blood buildup under the skin)

• Infection (a slight risk any time the skin is broken)

References

Culligan D, Watson HG. Blood and bone marrow. In: Cross SS, ed. Underwood's Pathology. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 23.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Blood disorders. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 124.

Lin JC. Benz EJ Jr. Approach to anemia in the adult and child. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 35.

Means RT Jr. Approach to the anemias. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 144.

Review Date: 3/11/2024

Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.