Q. What do hypochromia and anisocytosis mean?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 27, 2017 and last reviewed on: Jul 16, 2019

Hi doctor,

I am diabetic, and my latest report showed HbA1C as 11, it says hypochromia and anisocytosis of red blood cells. What does it mean?



Welcome to

  • HbA1C of 11 is very high, and it suggests toward uncontrolled diabetes. I suggest you investigate your urine sugar, blood fasting sugar, serum urea and creatinine. The treatment for diabetes should be started with oral hypoglycemic drugs like Metformin and Gliclazide.
  • Lifestyle changes are also needed, like reducing weight and consume more fruits and green leafy vegetables.
  • Hypochromia means central RBC (red blood cell) pallor is reduced. For that, check your hemoglobin first with CBC (complete blood count). If hemoglobin is low, then further work up needs to be done with serum ferritin and TIBC (total iron binding capacity).

Take care. Hope this will help you. Consult a physician for examination and discuss your case.

For more information consult a hematologist online -->

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Frequently Asked Questions


What is Anisocytosis?

Anisocytosis is a condition where the red blood cells (RBC), which are the blood cells that carry oxygen, are unequal in size. It is usually seen in anemia and other blood disorders. The three types of anisocytosis are:
Anisocytosis with microcytosis - The red blood cells are unusually small in size.
Anisocytosis with macrocytosis - Enlarged red blood cells.
Anisocytosis with normocytosis - Normal size RBC.


What causes Anisocytosis?

Anisocytosis is commonly seen in sickle cell anemia, iron-deficiency anemia, hemolytic anemia, folic acid or vitamin B12 deficiency, myelodysplastic syndrome, chronic liver disease, aplastic anemia, protein deficiency, and thalassemia.


How is anisocytosis treated?

The treatment of anisocytosis depends on the cause. The underlying illness should be identified and treated first. As the most common cause is anemia, the treatment is mainly done with iron, vitamin, and other nutritional supplements, and consuming an iron-rich diet. Iron-rich foods include green leafy vegetables, nuts, seeds, pulses, tofu, eggs, and dry fruits. In extreme cases, blood transfusions might be needed.


What is hypochromia?

When the red blood cells are paler and have less color than usual, it is called hypochromia. This occurs due to less amount of hemoglobin in the cells. The color of the red blood cells is evaluated using mean corpuscular hemoglobin (MCH) or mean corpuscular hemoglobin concentration (MCHC). This condition is diagnosed in adults when MCH is below 27 picograms/cell, and MCHC is less than 33 g/dL.


What causes hypochromia?

The most common cause of hypochromia is iron deficiency, which when left untreated might cause iron-deficiency anemia. Other conditions where hypochromia can result are thalassemia, sideroblastic anemia, heavy menstrual bleeding, and chronic infections.


Is hypochromia dangerous?

Hypochromia is usually associated with microcytic anemias, and severe anemia can damage your heart and lungs. It can result in heart failure, cardiac arrest, and abnormally fast heartbeat, and can even result in death. So always find the underlying cause of hypochromia and get it treated.


What is microcytic hypochromic anemia?

Microcytic hypochromic anemia is a type of anemia where the red blood cells are smaller (microcytic) and paler (hypochromic) than usual. These red blood cells lack enough hemoglobin, which results in a lack of oxygen in the body. This anemia is commonly seen in thalassemia, kidney disease, cancers (Hodgkin’s lymphoma and breast cancer), inflammatory diseases (heart failure, diabetes, lupus, arthritis), excessive menstrual bleeding, and infectious diseases (HIV, tuberculosis).


What is the treatment for microcytic hypochromic anemia?

Depending on the cause, microcytic hypochromic anemia is treated by antibiotics for chronic infections, hormonal medicines for excessive menstrual bleeding, blood transfusion in severe cases, and surgery or chemotherapy for cancer. Other measures that can be taken are eating food rich in iron, vitamin, and minerals.

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