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Low Red Blood Cell Counts (Anemia)

Click to listen to this page using ReadPleaseRed blood cells are produced in the bone marrow which is the soft tissue in the center of most bones. Red blood cells carry oxygen to all parts of your body. When your red blood cell (or hemoglobin) count is low, parts of your body do not get enough oxygen to do their work. This condition is called anemia and can make you feel very tired.


Impact of Chemotherapy

Most cancer cells grow and divide very quickly. Chemotherapy drugs work by acting quickly on dividing cells. Unfortunately, chemotherapy drugs can’t tell the difference between cancer cells and normal cells that also divide quickly. Blood cells such as red blood cells, white blood cells (neutrophils), and platelets all divide quickly and are also killed by chemotherapy drugs. However, the decrease in your blood cell count with chemotherapy is only temporary.


Blood Test Monitoring

Blood tests are taken regularly to monitor your red blood cell (hemoglobin) levels.

  • Normal hemoglobin (Hgb) levels: Women: 115-155   Men: 130-175
  • A slight drop in your red blood cell count may not result in any symptoms
  • A large drop (severe anemia) may result in a variety of signs and symptoms which may require special medical/nursing care
  • If your hemoglobin level falls below 80 or 90 you may be given a red blood cell transfusion


Signs and Symptoms associated with Low Red Blood Cell Counts (Anemia)

  • Fatigue, No motivation, Bruising
  • No patience, Restless, Itching
  • Mood changes, Swelling, Sweating
  • Weight loss, Indigestion, Weakness
  • Lack of appetite, Nausea, Dizzy
  • Irregular menses, Diarrhea, Headache
  • Constipation, Black stools, Paleness
  • Loss of sex drive, Ringing in ears, Numbness
  • Short of breath, Fast heart rate, Pale nail beds
  • Tingling of toes, Sensation of cold

Suggestions to help you live with Anemia

Modify your lifestyle:

  • Avoid use of heating pads and hot water bottles.
  • Take extra care not to injure yourself.
  • Change positions slowly.
  • Lie flat for a few minutes if you feel dizzy or lightheaded.
  • Sit at the bedside for a minute when getting up.
  • Rest when you are tired and after activities.
  • Pace your activities. Don’t overdo it!
  • Let others help.
  • Exercise a bit each day.
  • Ask for assistance if you feel unsteady on your feet.
  • Sexual activity may be easier in the morning when you are well rested.
  • Try to maintain your usual sleep patterns.
  • If in bed for long periods, turn every hour and move your arms and legs, if only a small amount.
  • Do mouth care frequently, carefully, yet thoroughly.
  • Accept that you might have changes in mood/interests.



  • Try to eat green leafy vegetables and cooked red meat to obtain the iron, folic acid and vitamins needed to build and maintain red blood cells.
  • Eat well balanced meals. Dietitians are available to assist you in planning.
  • Drink 2-3 litres (8-12 glasses) of liquid a day unless you have a heart or kidney problem.
  • If your doctor prescribes iron supplements, try prunes, prune juice or dried fruit to prevent possible constipation.



  • Gradually resume normal activities as you recover from chemotherapy.
  • Help family and friends learn to understand how to help and support you.
  • If you have any further concerns or questions that you are unsure of, please ask your doctor or nurse for help.


Call your Doctor if:

  • Dizziness or fainting is new.
  • You are noticeably more tired.
  • You are more short of breath.



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Regional Cancer Care
Northern Cancer Fund