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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Male, 27, bloodwork came back showing low white blood cell

Answered by
Dr.
Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 2754 Questions

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Posted on Tue, 2 Apr 2019 in Medicines and Side Effects
Question: Male, 27, bloodwork came back showing low white blood cell count, low iron, and cholesterol too low. He is tired a lot, a little light headed sometimes. He had been taking meds for depression, (Sorry I don't know what meds), had not felt good since starting the meds, doctor kept upping the doses, finally he went to a new therapist who has him on half his original dose for about a week now, with intentions of weening off. Can you please tell me what MEDICALLY might be going on with him?
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Follow up: Dr. Antoneta Zotaj 13 minutes later
Just more info - he is slender, active, does not smoke or do drugs, drinks socially, has a high pressure job with a lot of stress that has really gotten intense this past year. He eats very good, cooks for himself, chicken vegetables oatmeal apples nuts seeds, no fast food or soda or red meat.
doctor
Answered by Dr. Antoneta Zotaj 2 hours later
Brief Answer:
Thyroid check might be needed

Detailed Answer:
Hi

Because he has very low cholesterol and depression it might be good to have a TSH and FT4 test to rule out thyroid problems because thyroid may cause low cholesterol, depression, changes in CBC and also slim construct.
Low cholesterol in itself is not anything to worry unless it is associated with thyroid problems and this is why we have to do the tests to rule it out.
Sometimes patients with depression do feel unwell with the medications and in this case different classes of antidepressants can be tried till we find the ones he can tolerate and can help him to feel better. This would be the case in case the thyroid tests come out normal and thyroid is not the cause of his symptoms.


I hope this is helpful and answers your query.
Let me know if I can assist you further

Regards,

Dr. Antoneta Zotaj
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Antoneta Zotaj 51 minutes later
Thank you for the Thyroid concern confirmation, I was thinking that and was also scared about Leukemia. The low white blood cells have been going on a long time.
I don't think he has or has ever had depression, nor does he or his family. This therapist doctor was the only one that did. He has had no loss of interest in hobbies or friends, no lack of concentration, no trouble sleeping, no self loathing, no suicidal thoughts. He's never cranky or blue. He does however have anxiety - worries about deadlines, frets over his work, stresses out over the toll his job takes on his relationships, panics when his boss is in a bad mood, etc. And he has a very high stress job. I did not say he was depressed. I said a therapist put him on meds for depression, which is when he began to feel terrible, and he is seeing a better doctor now who is getting him off those meds. He lives in Poland, and travels a lot for work. In the past 6 weeks he's been to Romania, Tunisia, Iran, and is now in Korea with poor internet which is why I'm doing this for him. Thank you for your help, is there any revision to your answer?
doctor
Answered by Dr. Antoneta Zotaj 18 minutes later
Brief Answer:
Thyroid function tests still need to be done, as for leukemia it seems unlikely but uploading a CBC is advisable

Detailed Answer:
Hi,

Thank you for the reply and the extra information provided. It is great he does not have depression. On the other hand the thyroid gland may effect the way we respond to stressful situations as well so checking it and making sure it has a normal function is important in his case while he is facing stressful job and circumstances.

As for the leukemia, I do not believe he has it especially if the white blood cell count has been low for a long time and there is no continuous decline with time. Leukemia is a progressive disease and with time it is expected to get worse.

On the other hand having a CBC result and other tests that he might have had related to this might give us more information so if you have any of these tests available would be a great help if you could upload them for me to review the results.

I hope this is helpful and answers your query.
Let me know if I can assist you further

Regards,

Dr. Antoneta Zotaj
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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