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Hematology

Got a blood count result? Here is how to read it

You have a result and see a row of abbreviations with numbers beside them. That is a complete blood count, sometimes called a general blood picture. It is not a single test but a panel. From one tube of blood, an analyser counts your red blood cells, your white blood cells and your platelets, and measures the amount of haemoglobin. That is why your blood count as a whole cannot be too high or too low. Individual values can. This page explains what you are looking at.

Doctor's Assessment Included

Complete Blood Count (CBC): what this test measures

The abbreviations on your result belong to three groups. Once you see the groups, the list becomes much easier to follow.

The first group is about carrying oxygen. It holds the erythrocyte count, the amount of haemoglobin, the haematocrit and the cell indices. The MCV tells you how large your red blood cells are. Small cells are called microcytic.

The second group is about immune defence. That is the total leukocyte count. In a differential, the lab splits it into the different types of white blood cells: neutrophils, lymphocytes, monocytes, eosinophils and basophils.

The third group is the platelets, which close a small wound.

GroupAbbreviations on your resultWhat it covers
Red seriesRBC, Hb, Hct, MCV, MCH, MCHC, RDWcarrying oxygen
White seriesWBC, diffimmune defence
PlateletsPLTclotting

Some of those numbers are not measured but calculated. The haematocrit follows from the cell count times the MCV. That explains why several values sometimes deviate together.

Complete Blood Count (CBC): why this value matters

The main question about a result is usually this: there is one arrow, should I worry?

Usually not, and there is a level-headed reason. A reference interval is built to cover about 95 percent of healthy people. Five percent of healthy people therefore fall outside it, purely because of where the limit was drawn. If your result lists ten values, the chance that one sits just outside without anything being wrong is real.

That is not a reason to wave everything away. It means you look at the pattern instead of the single number. Three values pointing the same way say more than one outlier. How far a value sits outside the limit counts too, as does whether you have symptoms.

The values also interpret each other. A haemoglobin without an MCV tells you there is too little, but not what kind of shortfall. An MCV without an RDW can hide a double deficiency, because small and large cells average each other out. A percentage in the differential without the total is misleading, because a share is not a number.

And the reverse matters. A normal blood count does not automatically mean nothing is going on. With iron deficiency, ferritin falls first and haemoglobin last.

So you can have a tidy result and still have a deficiency. If symptoms persist, keep reporting them.

Complete Blood Count (CBC): when is testing worthwhile?

A blood count is often ordered as a first, broad look. For instance with fatigue that will not lift, with breathlessness, with infections that keep coming back, or simply as part of a periodic check.

The moment of the draw does more to your result than you might think. A fair share of abnormal values comes not from your body but from the collection itself.

If the band stays on your arm a long time, or you have been seated a while, your blood becomes a little more concentrated and every cell count reads slightly higher. If transport to the lab takes long, red cells swell in the tube: your MCV reads higher and your MCHC lower. Platelets can clump in the tube, making the count look artificially low. And if you exercised hard shortly before, your white blood cells are clearly raised.

If there is a comment or flag on your result, the analyser saw something it could not classify on its own. A technician then looks at a smear under the microscope. That is routine.

Complete Blood Count (CBC): symptoms of a high or low value

Low Levels

Your blood count as a whole cannot be low, but individual components can. Which complaints go with it depends on which group is involved.

If the red series is low, you mostly notice fatigue, pallor, becoming short of breath sooner, and sometimes palpitations or dizziness. If your white blood cells are low, infections can return more often or last longer. If your platelets are low, you bruise more easily, sometimes see small dots in your skin, or your gums bleed sooner.

Symptoms prove nothing on their own. They do help your doctor decide which values genuinely deserve attention.

High Levels

An elevation also always sits in a component, not in the panel itself.

A high red series is often simply because you drank too little. Your blood is then more concentrated, while you have not gained any cells. Headache, dizziness or a flushed face can go with it.

High white blood cells fit an infection or inflammation, but also stress, smoking and exercising just before the draw. High platelets appear with inflammation, after blood loss and with iron deficiency.

With an elevation, context counts: how high is it, how long has it been like that, and are other values moving with it?

Complete Blood Count (CBC): lifestyle and this value

There is quite a lot you can do yourself to make your result reliable.

Drink normally on the day you are drawn. Being drawn dehydrated gives a red series that looks higher than it is. Do not exercise hard in the 24 hours before, because your white blood cells are still raised then. Sit quietly for a few minutes before your turn, rather than going straight in after arriving.

For producing blood cells you mainly need iron, vitamin B12 and folate. With varied eating, most people get enough of these.

Keep your results. A second measurement alongside a first says far more than a single value, because your doctor then sees a direction instead of a point. Get in touch with fatigue that persists, bruising without reason, or infections that keep coming back.

Complete Blood Count (CBC): frequently asked questions

What does a blood count mean?
A blood count is a panel that counts your red blood cells, white blood cells and platelets from one tube, plus the amount of haemoglobin. It gives a broad first impression of your blood. It does not make a diagnosis: your doctor reads the values alongside your symptoms and history.
There is one arrow on my result. Is that bad?
Usually not. A reference interval covers about 95 percent of healthy people, so with ten values one easily falls just outside. Look at whether several values point the same way, how far outside the limit it sits, and whether you have symptoms alongside it.
What is the difference between a small and a complete blood count?
By a small or general blood count people usually mean the basic values without a breakdown of the white blood cells. A complete blood count with a differential also shows how those white cells are divided across the different types. Which version you had is stated on your result.
Why are there abbreviations like MCV and MCHC on my result?
Those are the cell indices and they describe your red blood cells. The MCV is the average size, the MCH is the amount of haemoglobin per cell, and the MCHC is its concentration. Together they say something about the kind of shortfall, not in isolation.
Do I need to fast?
For the blood count itself you normally do not need to fast, so you can eat and drink. If you are having other tests at the same time, such as glucose or cholesterol, follow the instructions for the whole investigation you ordered.
My blood count is normal but I am still tired. What now?
A normal blood count does not rule everything out. With iron deficiency, for example, ferritin falls well before your haemoglobin drops, so your result can look fine while something is still going on. Keep reporting your symptoms to your doctor, even with a reassuring result in hand.

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Complete Blood Count (CBC)

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