Hematocrit Level Test

A hematocrit (HCT) test measures how much of your blood is made up of red blood cells (RBCs). Results can help healthcare providers determine whether you have a blood or bone marrow disorder, nutritional deficiency, or another condition that can cause too many or too few RBCs.

The HCT is a simple blood test usually done along with other tests.

This article explores the purpose of the test, how it's done, and how results are interpreted.

Purpose of Test 

Red blood cells, also called erythrocytes, are important for distributing oxygen from the lungs to the rest of the body. The percentage of your blood that consists of red blood cells also indicates the thickness of blood.

A high or low result on an HCT test can:

• Be an early indicator of certain conditions
• Help diagnose certain diseases
• Indicate your response to certain treatments

An HCT test is usually ordered as part of a complete blood count (CBC) in which multiple tests are run from blood taken at one time. In addition to red blood cells, a CBC evaluates white blood cells (part of the immune system) and platelets (important to stopping bleeding and healing wounds).

Red blood cells contain an important protein called hemoglobin that carries oxygen so it can be delivered throughout your body. Often, a hemoglobin (Hgb) test is done with an HCT blood test and as part of a CBC. The pair of tests is called an H and H test.

Commonly, healthcare providers use the HCT to check for anemia, a blood disorder related to a low RBC count—which tests will show as a low hematocrit and low hemoglobin. Symptoms of anemia include:

• Fatigue
• Headaches
• Dizziness
• Feeling cold
• Shortness of breath

The hematocrit test also may be used to screen for polycythemia vera (PV), a rare blood disease that increases red blood cells and thickens blood, leading to high hematocrit. PV enlarges the spleen and also causes fatigue and headaches.

Anemia can also be a side effect of cancer treatments, such as chemotherapy and radiation. If you're undergoing cancer treatments, an HCT will be one of several routine tests used to check how you're responding to the medication. Results enable healthcare providers to manage anemia if it develops.

Procedure

As a basic blood test, the HCT doesn’t require fasting or special considerations. Blood is drawn from the elbow or the back of the hand. With infants and young children, it may involve a small puncture in the heel or fingertip to collect blood onto a test strip.

If a hematocrit test is taken as part of a complete blood count, you may need to have more than one vial of blood drawn.

In addition to the full CBC, other tests may be performed at the same time or as a follow-up to help with a diagnosis, including:

• A blood smear: A small blood sample is examined under a microscope for signs of problems
• Reticulocyte count: A blood test that determines how well your bone marrow (the spongy tissue inside bones) makes RBCs
• Iron studies: A group of blood tests interpreted together to check for iron deficiency or iron overload
• Vitamin B12 and folate levels: A test to see if you have enough of the nutrients needed to create blood cells

How Blood Is Tested

Once your blood is collected, it’s placed in a centrifuge or an automated hematology analyzer instrument.

The centrifuge separates the red blood cells from the plasma (non-cellular liquid), white blood cells, and platelets, giving a direct measure of the percentage of RBCs in the blood sample.

The automated instrument, which calculates the average RBC volume rather than a direct measurement, provides quick results but can produce false-positive results (meaning they incorrectly indicate a problem).

Depending on the purpose of the test, your healthcare provider will determine which testing method may be best.

Interpreting Results

Many factors affect hematocrit level, but general guidelines for normal levels in adults and young children are as follows:

If your levels are above or below normal, one of these serious health issues could be the reason why:

HCT test results may be affected by factors such as:

• Recent blood transfusion
• Pregnancy
• Living at a high altitude

Your healthcare provider will take these factors into account when interpreting the results.

Follow-Up

Your healthcare provider should review the results of the HCT and all other tests that were done with you. Depending on the practice, this may be done in person, over the phone, or via a secured message.

If your hematocrit results are outside the normal range, your healthcare provider may have you come in for additional blood tests to help diagnose the cause.

If test results point to a bone marrow problem, a bone marrow examination may be needed. A sample of bone marrow is taken, usually from the hip, to check for lymphoma and similar disorders.

Your healthcare provider may want to repeat the HCT test after weeks, months, or at least annually to monitor your levels.

Balancing Levels

If your results along with other tests indicate that you have iron-deficiency anemia, you can usually improve your red blood cell count by fortifying your diet with iron-rich foods.

Some examples of iron-rich foods include:

• Red meat
• Chicken
• Liver
• Eggs
• Shrimp
• Tuna
• Spinach
• Peas
• Broccoli
• Whole wheat bread
• Tofu
• Beans

Your healthcare provider may also suggest using over-the-counter iron supplements. If the iron-deficiency anemia is severe, a blood transfusion may be needed.

If anemia is the result of an infection, you may need to begin antibiotics to fight bacteria.

If you have a condition that causes overproduction of RBCs, your healthcare provider may suggest lifestyle changes such as quitting smoking or adopting a heart-healthy diet. In the rare case of PV, a healthcare provider can provide medication that will help you manage the condition, but it cannot be cured.

Summary

A hematocrit test gives your healthcare provider important information about your health. The test measures red blood cells, which have a protein that delivers oxygen throughout your body. The hematocrit level can help to diagnose or monitor blood disorders, dehydration, nutrient deficiencies, blood-related cancers, and many other conditions.

If your test results are abnormal, other tests may be performed at the same time or afterward to help identify the cause of anemia (low hematocrit) or high red blood cell counts, so you can get the right treatment.