How to Increase or Decrease Red Blood Cells

The primary function of red blood cell is to transport oxygen to all parts of the body. Inflammation and nutrient deficiencies can reduce red blood cell numbers or their ability to effectively deliver oxygen, which can contribute to hypoxia.

In this post, you will learn ways to increase or decrease your red blood cell count.

If you would like to know the optimal range for your lab tests, download our lab test reference guide here.

Read the post on what it means if you have high or low Red Blood Cells, and the optimal ranges if you haven’t already.



Over 99% of the particles in the blood are cells called red blood cells, or erythrocytes, due to their red color. Red blood cells look like a disc with indentations in the middle so they can bend easily to squeeze through narrow blood vessels (R,R).

Each red blood cell contains the protein hemoglobin, which transports oxygen (R)

In tiny blood vessels in the lung, the red blood cells pick up oxygen from inhaled air and transport it through the bloodstream to all parts of the body.

Our cells need oxygen to function. Oxygen is used to accept electrons at the final step of cellular respiration. At the same time, carbon dioxide is released as a waste product from the breakdown of carbohydrates and fats for energy (R). The red blood cells pick up the carbon dioxide and transport it back to the lungs. There we exhale it when we breathe out.


Aside from oxygen and carbon dioxide, red blood cells can also pick up or release hydrogen ions and nitric oxide.

By picking up or releasing hydrogen ions, they help to keep the pH level (acidity/basicity) of the blood steady.

When red blood cells release nitric oxide, the nitric oxide can cause the blood vessels expand, which leads to a drop in blood pressure (R).

Ways to Increase Red Blood Cells Levels

1) Iron


Your body needs iron to make hemoglobin. Iron can be absorbed from meats, vegetables or other foods.

Read this post to learn more about how to increase iron levels.

Note that large amounts of iron can be harmful because it increases oxidative stress in the body.

2) Copper

Copper is a necessary cofactor in the production of red blood cells (R).

3) Vitamin B12

Low levels of vitamin B12 (cobalamin) can lead to pernicious anemia. This type of anemia often is treated with vitamin B12 supplements and by increasing consumption of animal products.

4) Folic Acid

Folic acid (folate) is a form of vitamin B that’s found in foods. It is needed for making and maintaining new cells, including red blood cells.

5) Vitamin C


Vitamin C helps the body absorb iron. Good sources of vitamin C are vegetables and fruits, especially citrus fruits. Other fruits rich in vitamin C include kiwi fruit, strawberries, and cantaloupes.

Vegetables rich in vitamin C include broccoli, peppers, Brussels sprouts, tomatoes, cabbage, potatoes, and leafy green vegetables like turnip greens and spinach.

Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones.

Note: If you’re taking medicines, ask your doctor or pharmacist whether you can eat grapefruit or drink grapefruit juice. This fruit can affect the strength of a few medicines and how well they work.

6) Vitamin D

Vitamin D can help when anemia is associated with inflammation.

Vitamin D, through its down-regulatory effects on inflammatory cytokines and hepcidin may help with anemia, particularly anemia of inflammation (R).

7) Stop Drinking

Stop drinking alcohol. Alcohol consumption decreases the red blood cell count, because even the lowest consumption producing a significant decrease (R).

8) Exercise


Training increases red blood cell levels and hemoglobin by stimulating erythropoiesis. This increases the amount of oxygen that can be carried by blood (R).

However, some athletes can also develop anemia due to increased red blood cell destruction.

9) Drugs

Drugs that can treat an underlying cause of anemia, which can increase red blood cell count include:

  • Antibiotics to treat infections
  • Hormones to treat heavy menstrual bleeding in teenaged and adult women
  • Medicines to prevent the body’s immune system from destroying its own red blood cells
  • Chelation therapy in cases of heavy metal toxicity

10) Erythropoietin

Erythropoietin, also known as EPO, hematopoietin or hemopoietin, is a hormone produced in the kidneys that controls red blood cell production (erythropoiesis) (R).

Natural ways to increase EPO in the body:

EPO used as therapeutic agents are produced by recombinant DNA technology, and include Epogen/Procrit (epoetin alfa) and Aranesp (darbepoetin alfa) (R).

EPO is used as a treatment for:

11) Blood Transfusions


This is a common procedure in which blood is given to you intravenously. Transfusions require careful matching of donated blood with the recipient’s blood.

12) Blood and Marrow Stem Cell Transplant

A blood and marrow stem cell transplant replaces your faulty stem cells with healthy ones from another person (a donor). During the transplant, which is like a blood transfusion, you get donated stem cells through a tube placed in a vein in your chest. Once the stem cells are in your body, they travel to your bone marrow and begin making new blood cells.

Ways to Decrease Red Blood Cells Levels

1) Stop Smoking


Smoking increases red blood cell count (R,R,R).

2) Phlebotomy or Blood Draw

A procedure that removes some blood from the body. A needle is inserted into one of the veins and blood from the vein flows through an airtight tube into a sterile container or bag. The process is similar to the process of donating blood.

Phlebotomy reduces red blood cell count and brings the blood thickness closer to normal.

3) Drugs

Drugs that prevent the bone marrow from making too many red blood cells:

Hydroxyurea is a medicine generally used to treat cancer. It reduces the number of red blood cells and platelets in the blood. As a result, the blood flow improves and the thickness of the blood approaches normal.

Interferon-alpha is a substance that the body normally makes. It can prompt the immune system to fight overactive bone marrow cells. This helps lower red blood cell count and keeps the blood flow and blood thickness closer to normal.

Imatinib mesylate is a medicine that’s approved for treating leukemia. In clinical trials, this medicine helped reduce the need for phlebotomy. This medicine also helped reduce the size of enlarged spleens.

4) Radiation Treatment

Radiation treatment can help suppress overactive bone marrow cells. This helps lower red blood cell count and keeps the blood flow and blood thickness closer to normal.

However, radiation treatment can raise the risk of leukemia (blood cancer) and other blood diseases.


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