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What does low WBC count indicate?

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Posted on Thu, 22 May 2014
Question: I recently had my yearly physical. I am 35 years old. My WBC was 3.3. Neutrophil absolute was 1.84 and lymphocyte absolute was 1.08. The year prior my WBC was 4.9 and year prior 7.6. My doctor wants me to see a hematologist and I'm worried. I was diagnosed with lymes in 2009. They said it might be chronic. I had a high ANA marker and apparently I tested positive for celiacs disease but never really took that seriously. The reason I was getting tested for all these things is because I had spine pain, and rib pain and leg pain. But it was more muscular..... My doctor thought I may have some sort of spondylitis. No one ever really figured anything out nor were they worried. I went to a rheumatologist and he said I have a "human condition " and gave me Loma and Mobic. Nothing worked so I just try to stay active, eat well, go to a chiropractor Ect. I feel fine otherwise. No infections, no tiredness, nothing. Just wondering why the low WBC...and what they think it can be.
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Answered by Dr. Robert Galamaga (9 hours later)
Brief Answer:
Considerations

Detailed Answer:
hello and thank you for sending the question.

This is one of the most common consultations received by hematologists. I do see that your white blood cell count is trending lower but this does not necessarily mean that there is any type of life-threatening hematological disorder going on.

many many things can contribute to lowering of white blood cell count including medications, vitamin deficiency, autoimmune phenomenon and sometimes there can be a problem with in the bone marrow which can disturb the production of active amounts of white blood cells. It does appear that you have an adequate immune system at this time. And at this time I do not see any signs of danger.

I think it is reasonable for you to review your case with a hematologist. The hematologist might request some additional laboratory testing which may include eight per referral blood smear.

The blood smear will allow a physician or pathologist to study your blood cells under the microscope to see if there is any abnormality or irregularity which might help delineate the cause of the low white blood cell count.

Sometimes we never find a major cause and we end up having to just follow the blood count over a long period of time.

on many occasions continued monitoring of the blood count will reveal a mild fluctuation up and down. Other considerations include viruses but if you are otherwise feeling well I would tend to think that this might be something which the hematologist will recommend following over a period of time.

Additional testing such as a bone marrow biopsy is not necessarily indicated unless you have a Nino or low platelet count.

Thanks again for sending your question. Please let me know if you have any additional specific concerns that you would be interested in reviewing

Dr Galamaga.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Robert Galamaga (22 minutes later)
Dr. Galamag,

Thnak you for your response its very much appreciated. I will tell you that my vitamin D was low...its was 28. My Dr put me on 8 week vitamin D suppliment. Its been a tough winter here in CT..havent been outside much. Can this attribute to the low count? Also, i do take Lorazepam for anxiety only when needed.. I did take it a few times last week. I see after looking it up that this too can cause a decrease in WBC but its rare? I will attach the last page of my blood work for you too see.
doctor
Answered by Dr. Robert Galamaga (2 days later)
Brief Answer:
Followup

Detailed Answer:
thank you for the additional information.

It is remotely possible that lorazepam could contribute to this but I have never seen it and it would be considered very rare.

I think again that it is reasonable to check the blood count again in a couple of months. Also it is important that the peripheral smear be examined for any abnormalities. The computer and machine can tell us things about the blood count but actual visualization of the blood cells is important.

I suppose it is possible that the vitamin D issue may be related but this is not likely. I think it would be reasonable for you to visit with a local hematologist for a comprehensive evaluation but this is not something that is urgent. At some point within the next few months it would be reasonable especially if the count remains slightly below average.

Thanks again for visiting with us. Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2636 Questions

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What does low WBC count indicate?

Brief Answer: Considerations Detailed Answer: hello and thank you for sending the question. This is one of the most common consultations received by hematologists. I do see that your white blood cell count is trending lower but this does not necessarily mean that there is any type of life-threatening hematological disorder going on. many many things can contribute to lowering of white blood cell count including medications, vitamin deficiency, autoimmune phenomenon and sometimes there can be a problem with in the bone marrow which can disturb the production of active amounts of white blood cells. It does appear that you have an adequate immune system at this time. And at this time I do not see any signs of danger. I think it is reasonable for you to review your case with a hematologist. The hematologist might request some additional laboratory testing which may include eight per referral blood smear. The blood smear will allow a physician or pathologist to study your blood cells under the microscope to see if there is any abnormality or irregularity which might help delineate the cause of the low white blood cell count. Sometimes we never find a major cause and we end up having to just follow the blood count over a long period of time. on many occasions continued monitoring of the blood count will reveal a mild fluctuation up and down. Other considerations include viruses but if you are otherwise feeling well I would tend to think that this might be something which the hematologist will recommend following over a period of time. Additional testing such as a bone marrow biopsy is not necessarily indicated unless you have a Nino or low platelet count. Thanks again for sending your question. Please let me know if you have any additional specific concerns that you would be interested in reviewing Dr Galamaga.