Part of
Full blood count
Red Cell Distribution Width
Basophils are white blood cells that play a role in the body’s immune response, particularly to allergens.
Red Cell Distribution Width
Normal range
Normal range
11.5-14.5%
11.5-14.5%
Normal range
11.5-14.5%
11.5-14.5%
Normal range
Red Cell Distribution Width
Red Cell Distribution Width
Basophils are white blood cells that play a role in the body’s immune response, particularly to allergens.
Red Cell Distribution Width
Normal range
11.5-14.5%
Normal range
11.5-14.5%
11.5-14.5%
Normal range
Red Cell Distribution Width
Red Cell Distribution Width
Basophils are white blood cells that play a role in the body’s immune response, particularly to allergens.
Red Cell Distribution Width
Normal range
11.5-14.5%
Normal range
11.5-14.5%
11.5-14.5%
Normal range
Red Cell Distribution Width
Red Cell Distribution Width
Basophils are white blood cells that play a role in the body’s immune response, particularly to allergens.
Red Cell Distribution Width
Normal range
11.5-14.5%
Normal range
11.5-14.5%
11.5-14.5%
Normal range
Red Cell Distribution Width
Dr. Yiannis Balanos
MBBS MRCGP
Your Blood's Uniformity Indicator
Your Blood's Uniformity Indicator
Your Blood's Uniformity Indicator
Your red blood cells should maintain remarkable consistency in size and shape, working together like a well-coordinated team to transport oxygen efficiently throughout your body. Red Cell Distribution Width (RDW) measures how uniform your red blood cells are, detecting when some cells become unusually large or small compared to others. When your RDW is elevated, it reveals that your red blood cells vary significantly in size—a condition called anisocytosis—often providing the first clue that your bone marrow is struggling to produce healthy, consistent blood cells.
Think of RDW as a quality control measure for your blood cell production line. Normally, your bone marrow produces red blood cells that are remarkably similar in size, typically 6-8 micrometers in diameter. When this production process becomes disrupted by nutrient deficiencies, chronic diseases, or bone marrow problems, it begins creating a mixed population of cells—some normal-sized, others unusually large or small. This variation shows up as an elevated RDW, often before other blood tests reveal abnormalities, making it a valuable early warning system for various blood disorders.
Your red blood cells should maintain remarkable consistency in size and shape, working together like a well-coordinated team to transport oxygen efficiently throughout your body. Red Cell Distribution Width (RDW) measures how uniform your red blood cells are, detecting when some cells become unusually large or small compared to others. When your RDW is elevated, it reveals that your red blood cells vary significantly in size—a condition called anisocytosis—often providing the first clue that your bone marrow is struggling to produce healthy, consistent blood cells.
Think of RDW as a quality control measure for your blood cell production line. Normally, your bone marrow produces red blood cells that are remarkably similar in size, typically 6-8 micrometers in diameter. When this production process becomes disrupted by nutrient deficiencies, chronic diseases, or bone marrow problems, it begins creating a mixed population of cells—some normal-sized, others unusually large or small. This variation shows up as an elevated RDW, often before other blood tests reveal abnormalities, making it a valuable early warning system for various blood disorders.
When RDW Levels Signal Blood Cell Problems
When RDW Levels Signal Blood Cell Problems
When RDW Levels Signal Blood Cell Problems
When RDW Levels Signal Blood Cell Problems
Discover how elevated RDW indicates inconsistent red blood cell production and what this means for your blood health and oxygen delivery.
Read more
What Causes Your RDW to Rise
What Causes Your RDW to Rise
What Causes Your RDW to Rise
What Causes Your RDW to Rise
From iron deficiency to vitamin shortages, learn what can disrupt your bone marrow's ability to produce uniform, healthy red blood cells.
Read more
The RDW-Anaemia Connection
The RDW-Anaemia Connection
The RDW-Anaemia Connection
The RDW-Anaemia Connection
Understanding how this measurement reveals crucial information about different types of anaemia and guides targeted treatment approaches.
Read more
Understanding Your Results
Understanding Your Results
Understanding Your Results
Understanding Your Results
Decode your numbers and know exactly what your RDW levels mean for your blood health and what diagnostic steps might follow.
Read more
When RDW Levels Signal Blood Cell Problems
Elevated RDW levels indicate that your red blood cells vary significantly in size, suggesting your bone marrow is producing an inconsistent population of cells rather than the uniform cells characteristic of healthy blood. Normal RDW range is 11.5 to 14.5%, with values above this range indicating increasing variation in red blood cell size that warrants further investigation.
When your RDW rises, it reflects disrupted red blood cell production where your bone marrow simultaneously creates cells of different sizes—some may be normal, others unusually small (microcytic) or large (macrocytic). This mixed population suggests that whatever process normally ensures consistent cell production has become compromised, often due to nutritional deficiencies, chronic disease, or inherited blood disorders.
Higher RDW values indicate greater variation in size, and if anaemia is observed, RDW test results are often used together with mean corpuscular volume (MCV) results to determine the possible causes of the anaemia.
Your bone marrow produces approximately 2.5 million red blood cells every second, and this remarkable production line normally maintains strict quality control. When RDW becomes elevated, it signals that this quality control has been compromised, potentially affecting your blood's ability to transport oxygen efficiently and maintain optimal tissue function.
When RDW Levels Signal Blood Cell Problems
Elevated RDW levels indicate that your red blood cells vary significantly in size, suggesting your bone marrow is producing an inconsistent population of cells rather than the uniform cells characteristic of healthy blood. Normal RDW range is 11.5 to 14.5%, with values above this range indicating increasing variation in red blood cell size that warrants further investigation.
When your RDW rises, it reflects disrupted red blood cell production where your bone marrow simultaneously creates cells of different sizes—some may be normal, others unusually small (microcytic) or large (macrocytic). This mixed population suggests that whatever process normally ensures consistent cell production has become compromised, often due to nutritional deficiencies, chronic disease, or inherited blood disorders.
Higher RDW values indicate greater variation in size, and if anaemia is observed, RDW test results are often used together with mean corpuscular volume (MCV) results to determine the possible causes of the anaemia.
Your bone marrow produces approximately 2.5 million red blood cells every second, and this remarkable production line normally maintains strict quality control. When RDW becomes elevated, it signals that this quality control has been compromised, potentially affecting your blood's ability to transport oxygen efficiently and maintain optimal tissue function.
When RDW Levels Signal Blood Cell Problems
Elevated RDW levels indicate that your red blood cells vary significantly in size, suggesting your bone marrow is producing an inconsistent population of cells rather than the uniform cells characteristic of healthy blood. Normal RDW range is 11.5 to 14.5%, with values above this range indicating increasing variation in red blood cell size that warrants further investigation.
When your RDW rises, it reflects disrupted red blood cell production where your bone marrow simultaneously creates cells of different sizes—some may be normal, others unusually small (microcytic) or large (macrocytic). This mixed population suggests that whatever process normally ensures consistent cell production has become compromised, often due to nutritional deficiencies, chronic disease, or inherited blood disorders.
Higher RDW values indicate greater variation in size, and if anaemia is observed, RDW test results are often used together with mean corpuscular volume (MCV) results to determine the possible causes of the anaemia.
Your bone marrow produces approximately 2.5 million red blood cells every second, and this remarkable production line normally maintains strict quality control. When RDW becomes elevated, it signals that this quality control has been compromised, potentially affecting your blood's ability to transport oxygen efficiently and maintain optimal tissue function.
When RDW Levels Signal Blood Cell Problems
Elevated RDW levels indicate that your red blood cells vary significantly in size, suggesting your bone marrow is producing an inconsistent population of cells rather than the uniform cells characteristic of healthy blood. Normal RDW range is 11.5 to 14.5%, with values above this range indicating increasing variation in red blood cell size that warrants further investigation.
When your RDW rises, it reflects disrupted red blood cell production where your bone marrow simultaneously creates cells of different sizes—some may be normal, others unusually small (microcytic) or large (macrocytic). This mixed population suggests that whatever process normally ensures consistent cell production has become compromised, often due to nutritional deficiencies, chronic disease, or inherited blood disorders.
Higher RDW values indicate greater variation in size, and if anaemia is observed, RDW test results are often used together with mean corpuscular volume (MCV) results to determine the possible causes of the anaemia.
Your bone marrow produces approximately 2.5 million red blood cells every second, and this remarkable production line normally maintains strict quality control. When RDW becomes elevated, it signals that this quality control has been compromised, potentially affecting your blood's ability to transport oxygen efficiently and maintain optimal tissue function.
What Causes Your RDW to Rise
Iron deficiency represents one of the most common causes of elevated RDW, as insufficient iron prevents your bone marrow from producing healthy, uniform red blood cells. It aids in distinguishing between uncomplicated Iron Deficiency Anaemia (elevated RDW, normal to low MCV) and uncomplicated heterozygous thalassemia (normal RDW, low MCV). Iron deficiency creates a characteristic pattern where your body initially produces normal-sized cells but gradually begins creating smaller, less haemoglobin-rich cells as iron stores become depleted.
Vitamin deficiencies, particularly B12 and folate deficiency, cause RDW elevation through a different mechanism, leading to the production of abnormally large red blood cells alongside normal-sized ones. It can also help distinguish between Megaloblastic Anaemia such as folate and B12 deficiency, where the bone marrow produces oversized, immature cells due to impaired DNA synthesis.
Chronic diseases including kidney disease, inflammatory conditions, and autoimmune disorders can elevate RDW by disrupting normal red blood cell production. These conditions often create an environment where the bone marrow struggles to maintain consistent cell production, leading to increased size variation even when other blood parameters remain relatively normal.
Inherited blood disorders such as thalassaemia, sickle cell disease, and hereditary spherocytosis can cause RDW elevation, though the pattern varies depending on the specific condition. The RDW can also be elevated in patients with sickle cell anaemia for example, demonstrating how genetic blood disorders create characteristic RDW patterns.
What Causes Your RDW to Rise
Iron deficiency represents one of the most common causes of elevated RDW, as insufficient iron prevents your bone marrow from producing healthy, uniform red blood cells. It aids in distinguishing between uncomplicated Iron Deficiency Anaemia (elevated RDW, normal to low MCV) and uncomplicated heterozygous thalassemia (normal RDW, low MCV). Iron deficiency creates a characteristic pattern where your body initially produces normal-sized cells but gradually begins creating smaller, less haemoglobin-rich cells as iron stores become depleted.
Vitamin deficiencies, particularly B12 and folate deficiency, cause RDW elevation through a different mechanism, leading to the production of abnormally large red blood cells alongside normal-sized ones. It can also help distinguish between Megaloblastic Anaemia such as folate and B12 deficiency, where the bone marrow produces oversized, immature cells due to impaired DNA synthesis.
Chronic diseases including kidney disease, inflammatory conditions, and autoimmune disorders can elevate RDW by disrupting normal red blood cell production. These conditions often create an environment where the bone marrow struggles to maintain consistent cell production, leading to increased size variation even when other blood parameters remain relatively normal.
Inherited blood disorders such as thalassaemia, sickle cell disease, and hereditary spherocytosis can cause RDW elevation, though the pattern varies depending on the specific condition. The RDW can also be elevated in patients with sickle cell anaemia for example, demonstrating how genetic blood disorders create characteristic RDW patterns.
What Causes Your RDW to Rise
Iron deficiency represents one of the most common causes of elevated RDW, as insufficient iron prevents your bone marrow from producing healthy, uniform red blood cells. It aids in distinguishing between uncomplicated Iron Deficiency Anaemia (elevated RDW, normal to low MCV) and uncomplicated heterozygous thalassemia (normal RDW, low MCV). Iron deficiency creates a characteristic pattern where your body initially produces normal-sized cells but gradually begins creating smaller, less haemoglobin-rich cells as iron stores become depleted.
Vitamin deficiencies, particularly B12 and folate deficiency, cause RDW elevation through a different mechanism, leading to the production of abnormally large red blood cells alongside normal-sized ones. It can also help distinguish between Megaloblastic Anaemia such as folate and B12 deficiency, where the bone marrow produces oversized, immature cells due to impaired DNA synthesis.
Chronic diseases including kidney disease, inflammatory conditions, and autoimmune disorders can elevate RDW by disrupting normal red blood cell production. These conditions often create an environment where the bone marrow struggles to maintain consistent cell production, leading to increased size variation even when other blood parameters remain relatively normal.
Inherited blood disorders such as thalassaemia, sickle cell disease, and hereditary spherocytosis can cause RDW elevation, though the pattern varies depending on the specific condition. The RDW can also be elevated in patients with sickle cell anaemia for example, demonstrating how genetic blood disorders create characteristic RDW patterns.
What Causes Your RDW to Rise
Iron deficiency represents one of the most common causes of elevated RDW, as insufficient iron prevents your bone marrow from producing healthy, uniform red blood cells. It aids in distinguishing between uncomplicated Iron Deficiency Anaemia (elevated RDW, normal to low MCV) and uncomplicated heterozygous thalassemia (normal RDW, low MCV). Iron deficiency creates a characteristic pattern where your body initially produces normal-sized cells but gradually begins creating smaller, less haemoglobin-rich cells as iron stores become depleted.
Vitamin deficiencies, particularly B12 and folate deficiency, cause RDW elevation through a different mechanism, leading to the production of abnormally large red blood cells alongside normal-sized ones. It can also help distinguish between Megaloblastic Anaemia such as folate and B12 deficiency, where the bone marrow produces oversized, immature cells due to impaired DNA synthesis.
Chronic diseases including kidney disease, inflammatory conditions, and autoimmune disorders can elevate RDW by disrupting normal red blood cell production. These conditions often create an environment where the bone marrow struggles to maintain consistent cell production, leading to increased size variation even when other blood parameters remain relatively normal.
Inherited blood disorders such as thalassaemia, sickle cell disease, and hereditary spherocytosis can cause RDW elevation, though the pattern varies depending on the specific condition. The RDW can also be elevated in patients with sickle cell anaemia for example, demonstrating how genetic blood disorders create characteristic RDW patterns.
The RDW-Anaemia Connection
RDW serves as a crucial diagnostic tool when combined with other blood parameters, particularly mean corpuscular volume (MCV), to classify different types of anaemia. This combination helps distinguish between various causes of low haemoglobin levels, enabling targeted interventions.
The relationship between RDW and MCV creates distinct patterns that point toward specific diagnoses. Iron deficiency typically presents with elevated RDW and low or normal MCV, whilst thalassaemia trait usually shows normal RDW with low MCV.
An elevated RDW can reflect the bone marrow's attempt to compensate for blood loss or blood cell destruction by ramping up red blood cell production. This compensatory response creates size variation as the bone marrow works overtime.
Understanding RDW patterns help monitor treatment response and monitor progress. Iron deficiency anaemia typically shows gradual RDW normalisation as iron stores replenish, whilst chronic disease-related anaemia may maintain elevated RDW until underlying conditions improve.
The RDW-Anaemia Connection
RDW serves as a crucial diagnostic tool when combined with other blood parameters, particularly mean corpuscular volume (MCV), to classify different types of anaemia. This combination helps distinguish between various causes of low haemoglobin levels, enabling targeted interventions.
The relationship between RDW and MCV creates distinct patterns that point toward specific diagnoses. Iron deficiency typically presents with elevated RDW and low or normal MCV, whilst thalassaemia trait usually shows normal RDW with low MCV.
An elevated RDW can reflect the bone marrow's attempt to compensate for blood loss or blood cell destruction by ramping up red blood cell production. This compensatory response creates size variation as the bone marrow works overtime.
Understanding RDW patterns help monitor treatment response and monitor progress. Iron deficiency anaemia typically shows gradual RDW normalisation as iron stores replenish, whilst chronic disease-related anaemia may maintain elevated RDW until underlying conditions improve.
The RDW-Anaemia Connection
RDW serves as a crucial diagnostic tool when combined with other blood parameters, particularly mean corpuscular volume (MCV), to classify different types of anaemia. This combination helps distinguish between various causes of low haemoglobin levels, enabling targeted interventions.
The relationship between RDW and MCV creates distinct patterns that point toward specific diagnoses. Iron deficiency typically presents with elevated RDW and low or normal MCV, whilst thalassaemia trait usually shows normal RDW with low MCV.
An elevated RDW can reflect the bone marrow's attempt to compensate for blood loss or blood cell destruction by ramping up red blood cell production. This compensatory response creates size variation as the bone marrow works overtime.
Understanding RDW patterns help monitor treatment response and monitor progress. Iron deficiency anaemia typically shows gradual RDW normalisation as iron stores replenish, whilst chronic disease-related anaemia may maintain elevated RDW until underlying conditions improve.
The RDW-Anaemia Connection
RDW serves as a crucial diagnostic tool when combined with other blood parameters, particularly mean corpuscular volume (MCV), to classify different types of anaemia. This combination helps distinguish between various causes of low haemoglobin levels, enabling targeted interventions.
The relationship between RDW and MCV creates distinct patterns that point toward specific diagnoses. Iron deficiency typically presents with elevated RDW and low or normal MCV, whilst thalassaemia trait usually shows normal RDW with low MCV.
An elevated RDW can reflect the bone marrow's attempt to compensate for blood loss or blood cell destruction by ramping up red blood cell production. This compensatory response creates size variation as the bone marrow works overtime.
Understanding RDW patterns help monitor treatment response and monitor progress. Iron deficiency anaemia typically shows gradual RDW normalisation as iron stores replenish, whilst chronic disease-related anaemia may maintain elevated RDW until underlying conditions improve.
Understanding Your Results
RDW Reference Ranges:
Normal RDW: 11.5 -14.5%
Normal RDW values indicate your bone marrow is producing consistently sized red blood cells, suggesting adequate nutrient availability and healthy cell production mechanisms. Even within the normal range, values approaching the upper limit may warrant monitoring, particularly if you have risk factors for nutritional deficiencies.
Mildly elevated RDW often responds well to nutritional interventions, particularly iron, B12, or folate supplementation when deficiencies are identified. Significantly elevated RDW typically requires comprehensive evaluation to identify underlying causes, and compared alongside the rest of the blood count parameters.
Low RDW in an RBC blood test is often not a cause for alarm and is not specifically linked to any particular forms of anaemia, whilst persistently elevated values require ongoing investigation. If there are multiple abnormalities in your blood count combined with a raised RDW, it is important to follow up and discuss the results with your doctor.
Understanding Your Results
RDW Reference Ranges:
Normal RDW: 11.5 -14.5%
Normal RDW values indicate your bone marrow is producing consistently sized red blood cells, suggesting adequate nutrient availability and healthy cell production mechanisms. Even within the normal range, values approaching the upper limit may warrant monitoring, particularly if you have risk factors for nutritional deficiencies.
Mildly elevated RDW often responds well to nutritional interventions, particularly iron, B12, or folate supplementation when deficiencies are identified. Significantly elevated RDW typically requires comprehensive evaluation to identify underlying causes, and compared alongside the rest of the blood count parameters.
Low RDW in an RBC blood test is often not a cause for alarm and is not specifically linked to any particular forms of anaemia, whilst persistently elevated values require ongoing investigation. If there are multiple abnormalities in your blood count combined with a raised RDW, it is important to follow up and discuss the results with your doctor.
Understanding Your Results
RDW Reference Ranges:
Normal RDW: 11.5 -14.5%
Normal RDW values indicate your bone marrow is producing consistently sized red blood cells, suggesting adequate nutrient availability and healthy cell production mechanisms. Even within the normal range, values approaching the upper limit may warrant monitoring, particularly if you have risk factors for nutritional deficiencies.
Mildly elevated RDW often responds well to nutritional interventions, particularly iron, B12, or folate supplementation when deficiencies are identified. Significantly elevated RDW typically requires comprehensive evaluation to identify underlying causes, and compared alongside the rest of the blood count parameters.
Low RDW in an RBC blood test is often not a cause for alarm and is not specifically linked to any particular forms of anaemia, whilst persistently elevated values require ongoing investigation. If there are multiple abnormalities in your blood count combined with a raised RDW, it is important to follow up and discuss the results with your doctor.
Understanding Your Results
RDW Reference Ranges:
Normal RDW: 11.5 -14.5%
Normal RDW values indicate your bone marrow is producing consistently sized red blood cells, suggesting adequate nutrient availability and healthy cell production mechanisms. Even within the normal range, values approaching the upper limit may warrant monitoring, particularly if you have risk factors for nutritional deficiencies.
Mildly elevated RDW often responds well to nutritional interventions, particularly iron, B12, or folate supplementation when deficiencies are identified. Significantly elevated RDW typically requires comprehensive evaluation to identify underlying causes, and compared alongside the rest of the blood count parameters.
Low RDW in an RBC blood test is often not a cause for alarm and is not specifically linked to any particular forms of anaemia, whilst persistently elevated values require ongoing investigation. If there are multiple abnormalities in your blood count combined with a raised RDW, it is important to follow up and discuss the results with your doctor.
The Takeaway
RDW provides valuable insight into your bone marrow's ability to produce consistent, healthy red blood cells, Elevated levels indicate your blood cell production needs support, but most causes respond well to targeted interventions when identified early, and your bone marrow possesses remarkable capacity to restore normal function with appropriate treatment.
A simple component of your full blood count blood test can reveal whether your bone marrow is producing uniform, healthy red blood cells or struggling with inconsistent production that may compromise your energy levels and overall health.
The Takeaway
RDW provides valuable insight into your bone marrow's ability to produce consistent, healthy red blood cells, Elevated levels indicate your blood cell production needs support, but most causes respond well to targeted interventions when identified early, and your bone marrow possesses remarkable capacity to restore normal function with appropriate treatment.
A simple component of your full blood count blood test can reveal whether your bone marrow is producing uniform, healthy red blood cells or struggling with inconsistent production that may compromise your energy levels and overall health.
The Takeaway
RDW provides valuable insight into your bone marrow's ability to produce consistent, healthy red blood cells, Elevated levels indicate your blood cell production needs support, but most causes respond well to targeted interventions when identified early, and your bone marrow possesses remarkable capacity to restore normal function with appropriate treatment.
A simple component of your full blood count blood test can reveal whether your bone marrow is producing uniform, healthy red blood cells or struggling with inconsistent production that may compromise your energy levels and overall health.
The Takeaway
RDW provides valuable insight into your bone marrow's ability to produce consistent, healthy red blood cells, Elevated levels indicate your blood cell production needs support, but most causes respond well to targeted interventions when identified early, and your bone marrow possesses remarkable capacity to restore normal function with appropriate treatment.
A simple component of your full blood count blood test can reveal whether your bone marrow is producing uniform, healthy red blood cells or struggling with inconsistent production that may compromise your energy levels and overall health.
References
Newcastle Hospitals NHS Foundation Trust. (2025). Red Cell Distribution Width (part of FBC) - Laboratory Test Directory. NHS Trust Clinical Guidelines.
National Health Service. (2024). Iron deficiency anaemia. NHS Clinical Information.
British Society for Haematology. (2021). Guideline for the laboratory diagnosis of iron deficiency in adults and children. British Journal of Haematology.
Royal College of Pathologists. (2024). Full blood count interpretation guidelines. RCPath Clinical Standards.
References
Newcastle Hospitals NHS Foundation Trust. (2025). Red Cell Distribution Width (part of FBC) - Laboratory Test Directory. NHS Trust Clinical Guidelines.
National Health Service. (2024). Iron deficiency anaemia. NHS Clinical Information.
British Society for Haematology. (2021). Guideline for the laboratory diagnosis of iron deficiency in adults and children. British Journal of Haematology.
Royal College of Pathologists. (2024). Full blood count interpretation guidelines. RCPath Clinical Standards.
References
Newcastle Hospitals NHS Foundation Trust. (2025). Red Cell Distribution Width (part of FBC) - Laboratory Test Directory. NHS Trust Clinical Guidelines.
National Health Service. (2024). Iron deficiency anaemia. NHS Clinical Information.
British Society for Haematology. (2021). Guideline for the laboratory diagnosis of iron deficiency in adults and children. British Journal of Haematology.
Royal College of Pathologists. (2024). Full blood count interpretation guidelines. RCPath Clinical Standards.
References
Newcastle Hospitals NHS Foundation Trust. (2025). Red Cell Distribution Width (part of FBC) - Laboratory Test Directory. NHS Trust Clinical Guidelines.
National Health Service. (2024). Iron deficiency anaemia. NHS Clinical Information.
British Society for Haematology. (2021). Guideline for the laboratory diagnosis of iron deficiency in adults and children. British Journal of Haematology.
Royal College of Pathologists. (2024). Full blood count interpretation guidelines. RCPath Clinical Standards.
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Research articles
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