Poikilocytosis (What is, Definition, Causes, Symptoms, Treatment)

What is poikilocytosis?

When a person’s blood shows the presence of poikilocytes or abnormally shaped red blood cells (RBCs), the person suffers from a condition known as poikilocytosis.

Abnormally shaped blood cells are common in many domestic animals.(1) However, such blood cells are very rare in humans.

The plasma of human blood comprised of many white blood cells and red blood cells. While the red blood cells serve the function of transferring oxygen to the vital parts and organs in the body, white blood cells together serve a number of functions in the body.(2)

An increased number of poikilocytes can be life-threatening for the individual too. These abnormal red blood cells can interfere with blood circulation, oxygen transfer and nutrient supply.(3)

Although poikilocytes are commonly found in human blood plasma, they are limited to certain numbers. Medically proven numbers of poikilocytes in human blood are close to 10 percent of the total blood cells.(4)

When increased number of poikilocytes are detected in your blood cells, it can cause various problems. Most patients with this disorder are treated for blood deficiency and vitamin deficiency.



Blood poikilocytes are found in various shapes, sizes and numbers. Some of the common poikilocytes are burr cells, target cells, teardrop cells, spur cells and keratocytes, and the elliptocytes.(5)

The shape and size of each of these poikilocytes vary from each other. In addition to these cells, poikilocytes can be found in many other peculiar forms and shapes too.



The cause of poikilocytosis can be due to many reasons. The major cause of this disorder in humans is due to vitamin deficiency.(3)

Studies on this disorder reveal that lack of folic acid in food can lead to vitamin deficiency and poikilocytosis in human beings.


Because of the abnormally shaped cells in poikilocytosis, blood circulation becomes a major problem. The normal size of the blood cells is small and circular in shape.

Therefore, blood cells easily carry oxygen and pass through the tiniest blood vessel without having any problem. Due to the huge and deformed shape of poikilocytes, the blood plasma becomes unable to carry them to all parts of the body.

When blood cells cannot transfer oxygen to various vital organs, the person can suffer from moderate to severe anemia.(6)

In the case of a high number of sickle cell poikilocytes, the person can fall under the category of blood cancer too. Patients with leukemia can also develop severe poikilocytosis.

Depending on the consequences, the affected individual may develop cardiovascular problems, breathing disorder and other problems in a course of time.

Normal RBCs perform many of the most vital biological activities in our body. When the blood circulation and oxygen transfer is reduced due to the abnormal RBCs, the overall body growth will be affected too.

Therefore, patients are more likely to observe a drastic weight loss, severe growth retardation, and nutrition deficiency.(7)

Heart diseases are also very common in people with poikilocytosis.(8) Plus, patients may experience many other symptoms depending on the underlying cause of the associated disease.



To detect the problem, your healthcare provider will conduct a blood film test. This test would be conducted to see if the number of poikilocytes in the blood is higher.

The certain amount of blood sample will be drawn from the individual for this test. The technician will create a thin layer of blood film on the test slide and examines the shape of the blood cells under a high-resolution microscope.

After the test results, your doctor may order further blood work and even bone marrow testing if required. In a case of vitamin and nutrition deficiency, the person is given supplements immediately after the blood work results are out.

Differential blood count is another important test that is conducted to count the number of abnormal cells found in blood plasma. This is a confirmatory test after the initial blood film test.

Blood composition test also becomes necessary in order to detect the actual cause of the deficiency. In addition, medical practitioners also suggest patients undergo a hemoglobin test to find the exact range of RBCs.

This percentage analysis gives a clear picture of the severity of the poikilocytosis.



Doctors don’t prescribe any treatment plan or medication until the underlying cause of poikilocytosis has been determined.

If the condition is celiac disease or anemia, doctors will treat the condition accordingly. However, an individual with sickle cell anemia may have to undergo further tests before any treatment.

Generally, poikilocytosis patients are treated with moderate lifestyle and dietary changes. Doctors also prescribe taking supplements such as folic acid and multivitamins to treat vitamin related deficiency.

In addition, doctors will initiate other medical treatments based on the underlying cause and the problem. Chemotherapy is the treatment option for patients with cancerous poikilocytosis.(9)



Patients diagnosed with poikilocytosis are often advised to follow some dietary changes and lifestyle changes. Because the underlying cause of such a condition is nutrient and vitamin deficiency, the treatment is focused on making lifestyle and dietary changes.

However, if the underlying cause is found different, doctors take another approach to treating the condition.

The chief aim of diet and lifestyle change is to incorporate a nutrient rich and healthy eating habit. By taking appropriate medications and supplements, patients can easily manage this condition.

Nutrients get absorbed in red blood cells, and it is possible to get back the normal RBCs in blood after a few weeks. Maintaining your health, therefore, is highly dependent on how you eat and manage your food.


Nutritional Deficiency

Managing nutritional deficiency is very important in poikilocytosis health condition. To allow the red blood cells to develop, your body requires high amounts of vitamin B12 and folic acid.

If the diet you follow doesn’t contain vitamin B12 rich food, your small intestine will be unable to absorb the essential nutrients required for the nutritional deficiency treatment.(10)

After diagnosed with this condition, patients are often given a supplement rich in vitamin B12 and folic acid to facilitate essential vitamin and mineral absorption.

Foods rich in iron will also help in normal growth and development of red blood cells.

Folic acid is a major nutrient for RBCs and their normal growth and development. Nutritional deficiency in poikilocytosis is always because of iron and folic acid deficiency.(11)

These can sometimes deform the RBCs structure. This deficiency can lead to structural deformity of RBCs, which often leads to the condition of poikilocytosis.

Patients, therefore, should follow their diet chart and take the prescribed supplement to improve their condition.


Dietary Changes

To supply your body with vitamin B12 and other nutrients, you should focus on a diet rich in protein, animal protein, soy products, lentils and whole grains and folic acid rich foods, including beetroot, spinach, broccoli, and almond.

Leafy green vegetables are rich in folic acid and iron, ideal for treating the nutrition deficiency in poikilocytosis.

Some patients may need to follow a gluten-free diet if the poikilocytosis is identified as a celiac disease. To control this disease, you should follow a wheat and soy free diet.

Your nutritionist will design a diet plan for you to improve the celiac disease condition.



Seeing your healthcare provider is the first order of business if you have symptoms that worry you.

Before initiating the treatment and prescribing a diet plan for patients with poikilocytosis, it is important for the healthcare provider to let the patients know about the cause, importance of lifestyle changes and disease progression.

Poikilocytosis can be managed well if the disease is due to nutritional deficiency or by a digestive disease.

Take the lifestyle and dietary changes positively to improve your condition and manage the symptoms of poikilocytosis easily.