Low RBC could be due to anemia, nutritional deficiencies of iron, folate, vitamin B12 & B6
With the symptoms of tired, lack of energy etc.. it appears to point toward anemic. Some of the main causes for being anemic include:
Chronic illness secondary to refractory anemia: inflammatory GI/GU diseases, malignancies (cancer), arthritis, kidney or liver failure, and acute and chronic infections
Cancer therapy: surgery, radiotherapy, chemotherapy and/or immunotherapy
Infiltration (replacement) of bone marrow with cancer
Hemolysis: Breakdown or destruction of red blood cells
Decreased red cell production due to low levels of erythropoietin (a hormone produced by the kidney {90%} and liver {10%}) which promotes red blood cell production
I don't know what type of doctors you have seen. Have you talked with a hematologist?
Here is a good site that also talks about anemia as well.
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