RED BLOOD CELLS
RED BLOOD CELLS (RBC's), hematocrit and hemoglobin follow suit and what causes increases or decreases in one will have the same effect on the other two
RBC count (erythrocyte count) (measured in microliters or cubic millimeters of blood)
RBC's via hemoglobin carries oxygen from the lungs to the cells and CO2 from the cells to the lungs. RBC's are biconcave thereby increasing the surface area of oxygen to Hb. RBC's can also change shape allowing RBC's to pass into small capillaries.
About 5 liters of blood is found in the human body (3 liters of plasma and 2 liters of cells). Blood plasma is derived from the intestinal and lymphatic fluids.
THE FUNCTION, PRODUCTION, AND DISTRIBUTION
OF THE BLOOD CELLS
RED BLOOD CELLS
Red blood cells, granulocytes, and platelets are exclusively produced in the bone marrow after birth.
B-lymphocytes are produced by the marrow and lymphoid organs whereas T-cells are produced by the thymus.
From years five to twenty, your long bones produce most of the red blood cells.
After the age of 20, the majority of red blood cell production comes from membranous bones such as your vertebra, sternum, ribs, and ilia. As we age, red blood cell production becomes less productive at these sites. It is imperative for the Doctor of Chiropractic to know that he/she can stimulate red or white blood cell production by correcting spinal distortions that effect bone marrow productivity.
The genesis of a red blood cell is as follows: In the bone marrow, there are cells called pluripotential hemopoietic stem cells (PHSC) which act as the template to form all other blood cells. These PHSC differentiate into the various types of blood cells based on physiologic considerations from oxygen content in the blood to infectious diseases, which stimulate white blood cell production, as well as allergic and toxic reactions, which determines the fate of a PHSC. So, PHSC can become erythrocytes, granulocytes (neutrophils eosinophils, basophils/mast cells), monocytes, macrophages, megakaryocytes, platelets, T, and B-lymphocytes.
For example, as mentioned above tissue oxygenation is the primary factor in regulating red blood cell production.
Hemopoietic stem cells are activated by erythropoietin a glycoprotein with a molecular weight of 34,000 {80-90% of it is produced by the kidneys and 10% by the liver}.
During times of stress epinephrin/norepinephrine, and prostaglandin production {via the adrenal medulla} and platelets also stimulate erythropoietin.
Therefore, if tissue oxygenation is decreased due to anemia, low blood volume, poor circulation, heart/pulmonary disease etc. the adrenals can help produce erythropoietin as well.
RED BLOOD CELL MATURATION
The stages of red blood cell maturation are:
STAGE 1 PROERYTHROBLAST
STAGE 2 BASOPHILIC ERYTHROBLAST
STAGE 3. POLYCHROMATOPHIL ERYTHROBLAST
STAGE 4. ORTHOCHROMATIC ERYTHROBLAST
STAGE 5. RETICULOCYTE-ERYTHROCYTE.
Please note that red blood cells require B12 (cyanocobalamin) and folic acid. These vitamins regulate the synthesis of DNA (in all cells as well). If not present, the formation of thymidine triphosphate may be hindered.
When this interference occurs blood cells become large, have a flimsy membrane, irregular shape, and have a reduced life span.
As you may be aware, the parietal cells secrete a glycoprotein called intrinsic factor that attaches to B12, thus allowing it to be absorbed by the gut and stored in the liver to be released when there is a need for red blood cell production. So gastric conditions can create red blood cell maturation conditions causing irregular/abnormal cells noted in many of your blood cell dyscrasia's such as microcytic, hypochromic, megaloblastic, sickle cell, and Mediterranean anemia's. Here you have abnormal cell shapes, such as poikilocytosis and anisocytosis, which is excessive variation in size of RBC's.
RBC's are increased (erythrocytosis) in:
1. Primarily by myeloproliferative diseases such as polycythemia vera and erythremia erythrocytosis (increased bone marrow production)
2. Secondarily by the renal, pulmonary and cardiovascular disease that are secondary to tobacco/carboxyhemoglobin.
3. Alveolar hypoventilation
4. High altitude
5. Hemoglobinopathy
6. Decreased plasma volume via diarrhea/vomiting and water deprivation
7. Toxic reactions
A decrease in RBC's occurs in:
1. Anemia, which is caused via cell destruction, blood loss or a dietary vitamin B12/iron deficiency.
2. Hodgkins disease and other lymphomas
3. Myeloproliferative diseases such as multiple myeloma and leukemia
4. Hemorrhage
5. Lupus erythematosus
6. Addison.s disease
7. Rheumatoid arthritis
8. Chronic infection
9. Endocarditis
10. Hemolysis