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A low RDW (below 10.2%) means that the red blood cells vary very little in size. One reason for a low RDW level is macrocytic anemia. Another cause of a low RDW level is microcytic anemia. In these two disorders the red blood cells do not vary much in size because they are either all small or all large.
In certain forms of anemia, the RDW may be higher than normal because there are more immature or abnormal red blood cells skewing the statistical range of values. The RDW result is nonspecific. If a doctor suspects an unusual form of anemia, there are more sophisticated tests that can make the diagnosis.