QUICK ANSWER
RDW-CV measures how much your red blood cells vary in size, as a percentage. A mildly abnormal RDW-CV is extremely common and usually does not indicate anything serious by itself. Most people with a slightly high or low RDW-CV do not require urgent treatment.
RDW-CV is always interpreted alongside MCV and haemoglobin — never in isolation.
⚠️ Is your result in fL (femtoliters) rather than %? If your lab report shows a value like 42 fL, 47 fL, or 38 fL — that is RDW-SD, not RDW-CV. RDW-SD and RDW-CV are different measurements with different units and different reference ranges. → See our dedicated RDW-SD page for fL results
MOST COMMON RESULTS AT A GLANCE
| Your RDW-CV | What it usually means |
|---|---|
| < 11.5% | Low — usually not clinically significant |
| 11.5–14.5% | Normal |
| 14.5–16% | Mildly elevated — common; correlate with haemoglobin and MCV |
| 16–20% | Moderately elevated — evaluate with iron, B12, and folate |
| > 20% | Significant variation — clinical evaluation appropriate |
Values just above or below the reference range are extremely common and often reflect normal biological variation. RDW-CV is never interpreted in isolation.
Normal reference range: approximately 11.5–14.5% (Some labs use 11.7–15.4% or 11.5–15.0% — always use the range on your specific lab report)
| Result (%) | Interpretation |
|---|---|
| < 11.5% | Low — uniformly small or large cells; usually not clinically significant |
| 11.5–14.5% | Normal |
| 14.6–16% | Mildly elevated — correlate with MCV and haemoglobin |
| 16–20% | Moderately elevated — evaluate for nutritional deficiency or chronic disease |
| > 20% | Higher elevation — medical evaluation appropriate |
Reference ranges vary by laboratory. Always compare your result to the range on your specific report.
WHAT IS RDW-CV? (AND HOW IT DIFFERS FROM RDW-SD)
RDW-CV is the most commonly reported form of RDW in the United States (used by LabCorp and Quest as the default CBC measurement). It expresses red cell size variation as a percentage of the average cell size (MCV).
The two forms of RDW:
| RDW-CV | RDW-SD | |
|---|---|---|
| Units | % (percentage) | fL (femtoliters) |
| What it measures | Size variation relative to average cell size | Actual width of the red cell size distribution curve |
| Influenced by MCV | Yes — elevated MCV can raise RDW-CV artificially | No — more independent |
| Normal range | ~11.5–14.5% | ~37–54 fL |
| More commonly reported | Yes — US labs (LabCorp, Quest) | International and hospital labs |
Simple rule: if your result shows %, it is RDW-CV. If it shows fL, it is RDW-SD.
If your report shows fL, visit our RDW-SD page for the correct reference ranges and interpretation.
WHAT DOES HIGH RDW-CV MEAN?
A high RDW-CV indicates anisocytosis — your red blood cells are varying more in size than expected. Most mildly elevated RDW-CV results are caused by common and treatable nutritional deficiencies — not serious blood disorders.
Most common causes:
- Iron deficiency (most common)
- Vitamin B12 deficiency
- Folate deficiency
- Mixed nutritional deficiency (iron + B12, or iron + folate)
- Recent blood loss or transfusion
- Recovery phase after anaemia treatment — new reticulocytes temporarily increase variation
- Chronic disease or inflammation
- Liver disease
RDW-CV often changes before anaemia develops. In early iron, B12, or folate deficiency, haemoglobin may still be completely normal while RDW-CV is already elevated — because red cell size variation develops before haemoglobin concentration drops. This makes RDW-CV one of the most sensitive early signals of nutritional deficiency. A mildly elevated RDW-CV with normal haemoglobin is very common, treatable, and not an emergency.
High RDW-CV with normal haemoglobin: Very common. Usually represents early nutritional deficiency. Doctors frequently monitor this pattern or order iron, B12, and folate testing as a next step before initiating treatment.
WHAT DOES LOW RDW-CV MEAN?
A low RDW-CV means red blood cells are very uniform in size. Low RDW-CV by itself is rarely clinically important. In most cases, it is a normal finding and does not require treatment.
Low RDW-CV may appear when:
- Red blood cells are consistently small (microcytic) — as in thalassaemia trait or early iron deficiency
- Red blood cells are consistently large (macrocytic)
- Bone marrow production is stable and uniform
- Other CBC markers are normal
Is low RDW-CV dangerous? Usually no. Low RDW-CV without other CBC abnormalities or symptoms does not require treatment. If low RDW-CV accompanies low MCV and low haemoglobin, the combination warrants evaluation for thalassaemia trait or iron deficiency. Thalassaemia trait is a common genetic carrier state — most carriers live completely normal lives.
RDW-CV AND MCV PATTERNS
Interpreting RDW-CV alongside MCV is the standard approach to anaemia classification:
| RDW-CV | MCV | Most likely cause |
|---|---|---|
| High | Low (< 80 fL) | Iron deficiency anaemia |
| High | Normal (80–100 fL) | Early/mixed deficiency, chronic disease |
| High | High (> 100 fL) | B12 or folate deficiency |
| Normal/Low | Low | Thalassaemia minor, anaemia of chronic disease |
| Normal | Normal | Normal CBC |
WHAT LEVEL OF RDW-CV IS DANGEROUS?
No single RDW-CV percentage is inherently dangerous. Clinical significance depends on context.
RDW-CV becomes more concerning when:
- High RDW-CV accompanies low haemoglobin
- High RDW-CV accompanies abnormal MCV
- Symptoms of anaemia are present (fatigue, pallor, shortness of breath, dizziness)
- The elevation is persistent on repeat testing
Reassurance: Most mildly elevated RDW-CV results reflect common nutritional deficiencies — iron, B12, or folate — which are treatable. A single mildly elevated RDW-CV in an otherwise normal CBC with no symptoms is very common and rarely urgent.
When to see a doctor about an abnormal RDW-CV:
- RDW-CV persistently elevated above 16% on repeat testing
- Elevated RDW-CV alongside low haemoglobin or abnormal MCV
- Fatigue, weakness, shortness of breath, dizziness, or pale skin
- RDW-CV worsening over successive tests
- Any CBC abnormality alongside the elevated RDW-CV
COMMON PHRASES SEEN ON LAB REPORTS
RDW-CV / RDW CV
RDW-CV BLOOD TEST
RDW / RDW %
RDW BLOOD TEST
RED CELL DISTRIBUTION WIDTH
RED CELL DISTRIBUTION WIDTH CV
RBC DISTRIBUTION WIDTH / RBC DISTRIB WIDTH
RED DISTRIB. WIDTH
RDW COEFFICIENT OF VARIATION
ERYTHROCYTE DISTRIBUTION WIDTH
RDW LOW / RDW HIGH
RDW-CV LOW / RDW-CV HIGH
RDW BLOOD TEST LOW / RDW BLOOD TEST HIGH
LOW RDW BLOOD TEST
RDW-CV BAJO / RDW-CV ALTO (Spanish)
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What does RDW-CV mean in a blood test?
What is the normal range for RDW-CV?
What does high RDW-CV mean?
What does low RDW-CV mean?
What does low RDW blood test mean?
What level of RDW-CV is dangerous?
What is the difference between RDW-CV and RDW-SD?
What does RDW-CV low mean?
Can iron deficiency cause high RDW-CV with normal haemoglobin?
What does RDW mean on a blood test?
Can dehydration affect RDW-CV?
Can stress affect RDW-CV?
Can alcohol raise RDW-CV?
Can pregnancy affect RDW-CV?
Can RDW-CV return to normal?
All our content is backed by peer-reviewed studies, academic research, and trusted medical sources. We’re committed to accuracy and transparency — see our editorial policy for details.
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Clinical and Laboratory Standards Institute (CLSI) Reference Ranges
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Improved classification of anemias by MCV and RDW
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