Anisocytosis – What is it, causes, symptoms and treatments!

Anisocytosis is a condition when red  blood cells are of uneven size. “Aniso” means uneven and “cytosis” refers to the movement, characteristics or number of cells. In itself it is a non-specific term as there are several different ways in which cells can be unequal.

Anisocytosis is a prominent condition in cases of iron  deficiency anemia . Iron is primarily stored in red blood cells , which help transport and store oxygen in the blood . The lack of iron  in the blood leads to a reduction in red blood cells. In this article, we will explain everything about anisocytosis , along with its causes and symptoms. We also look at how to treat and prevent this condition. 

The normal diameter of red blood cells is 7.2 µm, although it can range from 6.8 to 7.5 µm. When the size of red blood cells decreases by more than 6.2 or exceeds 8.2 µm, anisocytosis  is called anisocytosis .

What is anisocytosis?

Anisocytosis is a  condition in which red blood cells are of uneven size. It is common in people suffering from anemia , thalassemia and other types of blood cell disorders. It comes from the word “aniso” which means different or uneven and “cytosis” which means movement or characteristics of cells. Anisocytosis represents a serious underlying blood – related condition . 

It is important that red blood cells are ideal in sizes and shapes to transport oxygen smoothly to different parts of the body . If they are unequal in sizes and shapes, the oxygen transport system will not work efficiently.

If the red blood cells are abnormal in shapes, anisocytosis  is a condition that is called poikilocytosis. The normal shape of the red blood cell is flat and circular. The rim is fatter than the middle portion. If the irregularly shaped red blood cells are more than 10% of the total red blood cell population, the patient suffers from poikilocytosis.

Any abnormality in red blood cells can be easily felt by the body . If red blood cells are deficient in hemoglobin, the body  will suffer from a condition called Anemia .

If there is insufficient color or pigmentation in the erythrocytes, mild anisocytosis is possible , which is quite common in pregnant women. It is one of the reasons why pregnant women are advised to increase their intake of iron-rich foods and take iron  supplements .


This condition can be divided into three distinct types: macrocytic, normocytic and microcytic:

  1. Macrocytosis: This refers to when red blood cells are larger than usual. It affects about 3% of the American population.
  2. Normocytic: This is a blood problem  when a person has normal sized red blood cells but there is a small amount of them.
  3. Microcytosis: This is when red blood cells are smaller than normal.

Causes of anisocytosis:

There are several factors that can trigger anisocytosis , such as:

  • Vitamin B12 Deficiency: If you don’t get enough B12, your body  can produce irregular blood cells. For any vegan reading, be extremely careful – you will need to supplement with B12 as plants do not contain this vitamin.
  • Iron Deficiency: The main battle weapon of red blood cells is iron . It is what binds to oxygen molecules and makes up protein hemoglobin. Without  enough dietary iron , your hemoglobin levels will drop.

Vitamin B12 is found exclusively in foods of animal origin. Meat eaters can be vitamin deficient, which is why you should check your levels regularly. If your body  is having trouble absorbing B12 from food, your doctor may prescribe B12 injections. .

Symptoms of anisocytosis:

The first signs and symptoms of this condition begin to appear when the shape and size of red blood cells are not correct, oxygen is not being transported through the body  as efficiently as it should. This can lead to:

  1. Tiredness;
  2. Shortness of breathe;
  3. Dizziness;
  4. Headache;
  5. Cold hands and feet;
  6. Pale skin;
  7. Chest pain.

Is anisocytosis more common in pregnancy?

Yes. This condition is most common during the first half of pregnancy. During this time, the fetus requires more iron . The average amount of iron intake  is not adequate during pregnancy. This results in a loss of iron  in the woman’s body , resulting in temporary anisocytosis . 

Diagnosis of anisocytosis:

There are two ways to diagnose this condition:

  1. Blood Test: A blood sample is needed to diagnose anisocytosis . The blood smear will be checked under a microscope to reveal irregularities in cell size. To determine the degree of anisocytosis,  a red blood cell distribution width (RDW) test is done.
  2. MCV: This method provides an accurate red blood cell count. From the above mentioned tests, the degree of anisocytosis  is determined. +1 anisocytosis  is diagnosed if red blood cells are low. A +2 anisocytosis  is diagnosed if the number of irregularly sized red cells is greater.

Fortunately, nowadays, the diagnosis of various diseases can also be done at home thanks to the many medical kits available on the market. You can perform any of these tests at home to check for the condition.

  1. Anemia;
  2. Adrenal Gland Function;
  3. Thyroid Gland Function;
  4. Calcium Deficiency .

Treatments for anisocytosis:

  1. There are several types of treatments aimed at combating anisocytosis . Although there is still no universal cure for anisocytosis , there are some means of treatments that help normalize it, here they are:
  2. Blood Transfusions: This is most often reserved for extreme cases where simpler treatments are not working. With this option, irregularly shaped cells will be filtered to those with the correct size.
  3. Diet Changes: As we mentioned before, a simple change in your diet can help alleviate the various symptoms of anisocytosis . Make sure you are consuming and getting plenty of iron  and B12 (vegans should supplement with B12).
  4. Injectables: If your body  cannot properly absorb vitamin B12 , your doctor may give you injections with supplemental B12. B12 pills are usually tested first. If that doesn’t work, injections will be necessary.

Depending on the individual these treatments may be done frequently. Some people may only need them once, while others may need them for life. To prevent future episodes of Anemia , pay attention to your eating habits. Specifically, make sure you’re getting enough B12 and iron . This will keep your red blood cells working efficiently.

Precautions regarding anisocytosis:

If you have or know someone who is showing the symptoms of this condition, then you should take the necessary steps as soon as possible before the condition worsens. You must consult a healthcare professional immediately.

You also need to evaluate your diet. The modern diet lacks essential nutrients. When it comes to blood related symptoms , you have to increase your intake of foods rich in iron , vitamin A and vitamin B12 .

Useful links: 

Strictly comply with all doctor’s advice. If you cannot contact a medical professional right now, the best thing to do is to assess for the presence of this condition at home. There are now test kits to help you assess the possibility of having anisocytosis .

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