Low Red Blood Cell Count Symptoms, Treatment, and Recovery
What are the symptoms of low red blood count?
The typical signs of anemia are extreme fatigue and shortness of breath, but a low red blood count can cause a host of different symptoms. A patient's skin may be pale or clammy, or he may have a rapid heart rate, chest pain, or difficulty staying warm. Because low oxygen in the blood can affect the brain as well, he may feel dizzy and light-headed or have difficulty concentrating or remembering things. He may also have headaches.
How low does someone's red blood count need to go before the doctor recommends treatment?
This is a very individual decision, and the doctor will make it based more on symptoms (such as fatigue or shortness of breath) than on a particular number. It's likely the doctor will take a wait-and-watch attitude for as long as possible before recommending medication or a transfusion, because he's hoping the red blood count will rise on its own. Also, keep in mind that red blood count won't drop dramatically right after chemo; it usually takes one to two weeks for the blood count to reach what doctors call the nadir, the point at which it drops to its lowest point. Cutoff rates vary according to different labs, but if a patient's hemoglobin drops below eight, most doctors will recommend either growth factors or a transfusion.
How long does it take for the red blood count to rise again?
Red blood cells have a long life -- up to 120 days -- so rebuilding someone's red blood count is a long, slow process. The speed with which bone marrow makes new red blood cells is also affected by factors such as the type of cancer, type of treatment -- particularly the type and dosage of chemo -- and the patient's general state of health.
One thing to keep in mind is that red blood counts won't drop immediately after chemo but will start dropping after a week or two, and will then continue to fall for several more weeks. This is because chemo doesn't kill off the red blood cells already in the bloodstream, which are mature and aren't dividing rapidly. It kills off the cells forming in the marrow, and therefore there's a delayed response that corresponds with the rate at which the marrow is creating new cells. The rate of regeneration can be affected by the patient's age and overall health. Also, some types of cancer and some types of treatment (such as radiation and some medications) suppress the production of red blood cells, so the rebuilding process can be much slower.