In general, hematocrit is the number of red blood cells (RBC) in circulation and is highly variable among fish species. Active fish, like the blue marlin, tend to have higher hematocrits, whereas less active fish, such as the starry flounder exhibit lower hematocrits. Hematocrit may be increased in response to both short-term (acute) or long-term (chronic) hypoxia exposure and results in an increase in the total amount of oxygen the blood can carry, also known as the oxygen carrying capacity of the blood. Acute changes in hematocrit are the result of circulating stress hormones (see - catecholamines) activating receptors on the spleen that cause the release of RBCs into circulation. During chronic hypoxia exposure, the mechanism used to increase hematocrit is independent of the spleen and results from hormonal stimulation of the kidney by erythropoetin (EPO). Increasing hematocrit in response to erythropoietin is observed after approximately one week and is therefore likely under genetic control of hypoxia inducible factor hypoxia inducible factor (HIF).
While increasing hematocrit means that the blood can carry a larger total amount of oxygen, a possible advantage during hypoxia, increasing the number of RBCs in the blood can also lead to certain disadvantages. First, A higher hematocrit results in more viscous blood (especially in cold water) increasing the amount of energy the cardiac system requires to pump the blood through the system and secondly depending on the transit time of the blood across the branchial arch and the diffusion rate of oxygen, an increased hematocrit may result in less efficient transfer of oxygen from the environment to the blood.